Healthy Living in the North

Saving lives takes a village: International Overdose Awareness Day is August 31

Two women sit at a table.

Charlene Burmeister (right), President of the Coalition of Substance-abuse Users of the North (CSUN), and Northern Health’s Reanne Sanford (left). CSUN was the first drug-user group to form in the North. Charlene is a local and provincial pioneer in harm reduction advocacy. She’s also one of the familiar faces from the Stop Stigma campaign.

Three years have passed since a Provincial Public Health Emergency was declared because of the overdose rates in BC. When it was first announced in 2016, I had just begun my current role as regional nursing lead for Harm Reduction. In this job, I’m responsible for supporting harm reduction services for the North, and my first piece of work was the expansion of naloxone.

Before my Harm Reduction role, I worked as a generalist public health nurse for 13 years. I also worked as the local street nurse in Quesnel, supporting marginalized individuals to access health care. I had 12 or so regular clients on my case load who I met up with or supported for several years. Today, all of these individuals are now gone.

People who use drugs are community members

Most of my clients called Quesnel their hometown — they did not come from an outside community. They weren’t transported by bus to make space for the Olympics in Vancouver, as some rumors claimed. They had families, loved ones, and children they left behind — and they loved their community. Despite this, very few of them felt included or had a sense of belonging. Many of these individuals relied on public space to exist and connect with services in the downtown core.

Reflecting on progress and loss

As Overdose Awareness Day comes around again (on Saturday, August 31), I’m reminded of those we lost, but also how far we have come:

  • Naloxone is now a regular part of the work we do.
  • Northern Health has partners in the provincial response: pharmacists, community paramedics, housing, First Nations communities, and local non-profits.
  • We’ve increased our capacity to treat opioid-use disorder.
  • Staff helped create opportunities for people with lived experiences to participate in local discussions, including a campaign called Stop Stigma Save Lives (stigma is one of the main causes of accidental illicit drug overdose deaths).

All of these strategies save lives every day.

Bravery in the face of crisis

What humbles me most about the work in the past three years is the bravery that people who use drugs have had throughout this crisis — the level to which they’ve taken grief and built networks of safety for each other. When other systems have failed, peers have stepped into lifesaving roles, offering community education and peer advocacy. On Overdose Awareness Day, I want to take time to honour and acknowledge their work.

It’s time for a new conversation

Despite the advances, I still feel the daily challenge of defending and advocating for harm reduction. I want to use my voice to start a new conversation – one that begins with agreeing that people do not choose to die or deserve to die because they use drugs.

Communities have a vital role to play and can be a part of the solution. Here’s how:

  • Get trained on naloxone and carry a kit: drug use is common in many populations in our community. Make a naloxone kit part of caring for one another.
  • Choose compassion: instead of thinking “what’s wrong with that person?” think, “what has happened in that person’s life?” Become curious instead of judgemental.
  • See the value of programs that save lives: trust that services and harm-reduction strategies, like syringe distribution, are rooted in research and backed by evidence. People use drugs for a variety of reasons, including poverty, mental illness, a history of abuse, neglect, and childhood trauma – not because of the services they are offered and access.
  • Uncomfortable with public drug consumption? Support and advocate for a safe place where people can use drugs, where they can dispose of their paraphernalia safely with trained staff available to help them.
  • Support and donate to organizations in your community that offer access to housing, food, low-barrier employment opportunities, and support services.
  • Challenge statements that minimize or ostracize members of your community: forcing people to exist in the corners of our community, out of sight, increases drug use and people dying alone.
  • Advocate for changes in drug policy.
  • Offer creative solutions.

As a community member, you have the ability to support the health and well-being of our entire community. It’s a shared responsibility, and it’s time we all made it a priority.

About Reanne Sanford

Reanne is the Regional Nursing Lead for Harm Reduction, and is based in Quesnel.

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Healthy relationships through harm reduction

reanne and her son riding horses.I grew up in the North, and I feel blessed to be able to live and practice in my hometown of Quesnel. Guiding my work, I have two strong influences from my childhood: medicine and ranching. On my mother’s side I come from several generations of nurses and doctors; my father’s family were pioneers and moved to this community 100 years ago.

Growing up as a ranch kid helped me to develop a strong belief that all living things have value and worth. This has helped me to recognize that our own advancement and success is based on how we honour relationships in our lives, and for me growing up, these were family and cattle.

When I was asked to write an article about my work in harm reduction and how it relates to healthy relationships, I had to sit with it for several days. Before my current role, I worked as a generalist public health nurse for 13 years, and part of my role was as the local street nurse, but for some reason, in my mind, I couldn’t get the two to connect. The more I thought about it though, the more I began to realize the reason for my difficulty was that these two concepts are inseparable. From my experience, it would be extremely difficult to apply the principles of harm reduction within health care without considering the importance of healthy, trusting relationships.

Harm reduction involving drugs and people who use drugs is a social justice movement that strives to uphold basic human rights. It means believing in, respecting, and supporting people who use drugs, whether abstinence is their goal or not. This kind of harm reduction is supported by evidence based research, and proven to be effective in reducing risks and ultimately reducing the burden on the health care system.

A good example of this method of harm reduction is the distribution of harm reduction supplies to people who use drugs. Providing clean, sterile equipment has also shown to reduce new infections of HIV and Hepatitis C within our communities.

Healthy Relationships

Another benefit of distributing harm reduction supplies to clients, is the opportunity for service providers to develop meaningful relationships with the client; these relationships can ultimately lead to greater access to health care. We know that when people engage in services where they feel supported and accepted by staff, they are more likely to make positive changes and further access supports.

Relationship building is at the core of harm reduction work. When you show up for people and allow them to be seen and heard, they feel valued and worthy. This is so important within a demographic of individuals who often feel marginalized and ostracized in our communities.

This is a mutually beneficial relationship, as we, the service provider, can ask clients questions in order to gain a greater understanding of the barriers and challenges they face, and better understand the world they live in. This connection allows staff to hear real, lived experiences that can ultimately help them implement change.

The caring bonds and healthy connections created through harm reduction is lifesaving for clients. Over the past few years, the landscape of working with people who use drugs has changed drastically. In the past, we worried about keeping people safe, preventing HIV transmission, and other harms related to drug use; now, we’re worrying about keeping people alive.

In order for clients to engage in our services, receive education on how to safely use drugs, take harm reduction steps towards wellness, and to enter into treatment (if that is what they choose), they must be with us. It is well known that the number of people dying across the province due to unintentional illicit drug overdoses has continued to rise in 2017, despite exceptional work on the frontlines.

Reducing Stigma and Judgment

In today’s society, it’s important to use a thoughtful approach and be compassionate with our messaging. Stigma and judgment towards people who use drugs creates a climate where people do not feel safe to share experiences, and in turn, forces them to isolate themselves. Working closely with harm reduction has shown me how vast and diverse this population is in our communities.

Reducing stigma and judgment in our communities takes a collaborative approach. Northern Health has championed anti-stigma work in B.C. as a part of our overdose prevention strategy. You can make a difference by changing the conversation:

  • Describe peers as individuals (i.e. “person with a substance use disorder” vs “drug user”).
  • Decide not to share or engage in fear-based messaging about overdoses and drug use on social media.
  • Be mindful of how you talk about people who use drugs; choose not to use discriminating language like “user,” “junkie,” or “addict.”

These small steps can work to help eliminate the feelings of isolation and judgment.

Harm reduction in the context of substance use is about advocacy and caring. It is understanding that people use drugs for a variety of reasons, and many will never become dependent or deal with an addiction. Above all, harm reduction services exist to support everyone in staying as safe and healthy as possible – and that’s what we’re all after: staying safe, healthy, and happy. Together.

About Reanne Sanford

Reanne is the Regional Nursing Lead for Harm Reduction, and is based in Quesnel.

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