September 9, 2021—Ha-Shilth-Sa—Page 3
Communities await effects of prescribed alternatives An elevated overdose tally continues during the COVID-19 pandemic, with First Nations at five times the risk By Eric Plummer Ha-Shilth-Sa Editor As the death toll from B.C.’s overdose crisis continues, those who work closely with First Nations are urging people to look beyond the disturbing numbers and into the complexities of treating drug addiction. On Aug. 31 the B.C. Coroners Service reported 1,011 deaths due to illicit drug use over the first six months of the year, making overdose the leading cause of death for adults under 40, with eighty per cent of these fatalities affecting males. Fentanyl was detected in 85 per cent of the cases, with cocaine methamphetamine and etizolam present in a significant number of deaths. First Nations people have been affected by the crisis on a scale several times that of the general population. For last year, the First Nations Health Authority reported a fatality rate 5.3 times greater than others in B.C., a 119 per cent increase in overdose deaths over 2019, pointing to the hazards of the COVID-19 pandemic on those who use illicit drugs. “Poisoned drugs are circulating,” warned Sheila Malcolmson, B.C.’s minister of Mental Health and Addictions. “More people are dying from inhaling illicit drugs than injecting, so please be careful.” When the numbers were announced for the fist half of 2021, Chief Coroner Lisa Lapointe stressed the need for a “wide scale response.” “This includes removing barriers to safe supply, ensuring timely access to evidence-based affordable treatment and providing those experiencing problematic substance use with compassionate and viable options to reduce risks and save lives.” The recognition of substance use as a disorder requiring treatment rather than criminal activity in need of enforcement has guided a shift in government policy. B.C. is working on decriminalizing possession of illicit drugs with an applica-
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On Aug. 31 Chief Coroner Lisa Lapointe announced that 1,011 people died from illicit drug use over the first six months of 2021. tion to Ottawa for an exemption from Section 56 of the Controlled Drugs and Substances Act. Meanwhile the Solicitor General sent a letter to police chiefs asking authorities to “focus on more serious crimes and align with more harm reduction principles,” according to the Ministry of Mental Health and Addictions. A new emphasis has also been placed on prescribing less harmful alternatives to replace street drugs, something that registered nurses and registered psychiatric nurses can now offer with the appropriate training. By June the number of doctors in B.C. who offer opioid agonist treatment increased to 1,671, with a 475 per cent increase in hydromorphone prescriptions over a year. But this is not necessarily reaching those who need the help most, cautions Mariah Charleson, vice-president of the Nuuchah-nulth Tribal Council. “We know it’s very difficult for margin-
alized people to even have a physician, to even see a physician,” she commented. “There’s one individual in Port Alberni, they’re banned from drug dealers. So they give their money to other people to go get the drugs and it leads to all sorts of things.” “For people who use substances, accessing opioid agonist therapy, or prescribed opioid alternatives (“safer supply”) – this is particularly a challenge in rural/remote/ isolated communities where getting to a prescriber and then being able to access prescriptions in a timely, regular manner can be challenging,” noted Dr. Nel Wieman, the FNHA’s senior medical officer, in an email to Ha-Shilth-Sa. While the First Nations Health Authority is working to get more nurses trained to prescribe safer opioid alternatives, a historic distrust of the health care system among many Aboriginal people remains a concern. In November the long-standing
affects of negative experiences in hospitals and with doctors was highlighted by In Plain Sight, a report from an independent investigation commissioned by the Ministry of Health. “We can’t ignore the role that racism and a lack of cultural safety in health/ medical services plays,” said Wieman. “[T]here is also significant stigma in play for people who use substances – so all of these create an unsafe, unwelcoming environment that people are reluctant to access in the first place out of fear for how they will be treated.” As B.C.’s health authorities grapple with a rate of five overdose fatalities a day, Wieman stressed that the affects of trauma on First Nations people cannot be understated. Causes range from residential schools and the Sixties Scoop to evacuations due to wildfires and intimate partner violence. “When people are living with trauma/ intergenerational trauma, they are distressed – and sometimes people make choices to reduce that distress that involve using substances – substances change how we feel,” explained Wieman. “Unfortunately, with the increased toxicity of the illicit/ ‘street’ drug supply, the contamination of the current drug supply makes it increasingly lethal.” The province has reported that measures imposed during the COVID-19 pandemic have disrupted the normal pathways of illicit drugs, causing dealers to increase the toxicity of what can be bought on the street. This dynamic has brought fatalities to communities across the province, despite their remoteness. Charleson spoke of two overdose deaths in Hot Springs Cove over the pandemic. “Hot Springs Cove is a community of less than 60 people,” she said. “Everybody knows each other, everybody plays an integral role in that community.” “We’ve lost people who aren’t homeless, who aren’t visually addicts, who are simply members of the community,” added Charleson.
Multi-year project retains its UNESCO connection Continued from page 1. “Our chiefs, our council and our community agree: it was carved here, and it should stay here,” said Watts. “For the valley here, this isn’t just about raising a First Nations piece of art; it actually tells a story. Like many other poles, it has a name and it has a life of its own.” Modern technology is also playing a role in telling the story of n̓aasn̓aasʔaqsa. QR codes, which open up information on smartphones and tablets, will be in place on plaques by the pole for people to learn about the project’s development and importance, explained Jeary. “They’ll get all that information from the pole laying in the forest to its final resting place there,” he said. “It’s an opportunity to show our culture at a high traffic area,” added Watts. “Tourists and others will be able to visit and read - not just about languages - but about women and other things that Tim wants to honour on the pole.” Although it’s being raised two years after it was originally planned, Jeary stressed that the project has retained a vital connection to the United Nations. “That’s where it all started, we wanted
to get patronage from [Canadian Commission for] UNESCO,” he said, noting the importance of the project to First Nation’s culture and language revitalization. “We’ll continue to use that vehicle to promote globally.” Nuu-chah-nulth songs have been composed to mark the pole’s raising on Sept. 18, a date when Watts expects that many in attendance will think of Willard Gallic, a fluent Tseshaht speaker who recently passed. “I think for Tseshaht Willard Gallic is going to be on our minds for a long time,” said Watts. “He was one of our last remaining speakers. This is really, from our perspective, connected to what Photo by Eric Plummer Tim originally started out n̓aasn̓aasʔaqsa was carved with a combination of hand tools and motorized equipment. this project as.”
