Healthy Living in the North

Overdose Prevention: Northern BC’s Naloxone Champions

Thursday, August 31 marks International Overdose Awareness Day (IOAD), a day that aims to raise awareness of overdose and reduce the stigma of drug-related death. Since the recent rise in overdose deaths, Northern Health staff and physicians, as well as community partners, have responded quickly in providing take home naloxone training and naloxone kits to people at risk of overdose as well as their friends and family members.

In 2017 alone, records show 105 naloxone kits refilled in northern B.C. – that’s 105 kits used and 105 lives saved thanks to training and dispensing taking place in our region!

Over the course of the last year, staff at the 41 take home naloxone sites across northern B.C. have had diverse experiences and developed unique strategies to get naloxone kits into the hands of those who need them. We want to share one of these experiences now, from the Intensive Case Management Team in the northwest.

team van, naloxone

Part of the NW Intensive Case Management Team

In what ways do you work with community members?
First and foremost, our team is non-judgmental and comes from a place of caring and support for individuals experiencing difficulties with substance use, regardless of their history. We work at street level with many clients, building rapport over time, providing wellness checks, harm reduction supplies, and supporting clients with access to various services. Our team also attends shelters, clients’ homes, and conducts meetings within the office as well, based on what the community member is comfortable with. For some community members, it takes time for trust to form to ask for services, including take home naloxone or harm reduction supplies.

What’s the message to your audience?
We try to convey that our intentions come from a place of caring and that we hope to help keep them healthy and safe, not to judge or push for a change that they may not want or be ready for. We’re humble and recognize the immense value of lived experience in the work we do.

Our team tries to be flexible and take the direction from the individual we’re working with and support them in their journey, whatever journey that may be. We help empower them to access resources based on their own choices to reduce harms, and our team truly believes in the work they’re doing and the people they engage with.

How do you train people to use naloxone and/or when dispensing kits?
It really depends on the audience, but we maintain that we’re adaptable and that the client can take the lead. This means to be effective, sometimes our strategies toward naloxone training have to be pretty fluid.

Recreating life-like scenarios dealing with overdose, similar to if you were learning CPR training, has been an effective way of teaching individuals the steps to how to handle an overdose scenario. Diving into the realities of what people may see if they witness or come across someone who has overdosed can be unsettling, so we make sure to create a safe space for individuals to ask questions and practice drawing up and injecting the medication. Take home naloxone is comparable to having a first aid kit, and our team respects a person’s privacy around their use of it or the use of it on someone close to them.

Our most important training assets, of course, are our amazing peers who champion take home naloxone. They hand out their cards, nurture relationships with the at-risk population, and let them know where they can get naloxone, training, and other resources. They work within the community and seize any opportunity to offer naloxone training and kits!

naloxone kit overdose

Naloxone kits are easy to carry, and include application instructions.

Can you tell us about the experience you’ve had when developing community partnerships to dispense naloxone?
The support we’ve received from community partnerships has been awesome. We started building relationships within the community by going out and introducing our team, and then created a space for collaborative dialogue amongst Northern Health partners and other community agencies. Our team provides support to community agencies if they are wanting assistance navigating naloxone information and access to take home naloxone kits. In turn, the community service providers are able to alert us when a person is ready and willing to receive services.

We’re very thankful our partners have been open to welcoming us into their space to work alongside them in service provision, as this is where the clients are and feel most comfortable. Partnering with various agencies and various emergency responders has helped us better connect with individuals that may be at risk of overdose, which has proved to be invaluable when it comes to helping people in a timely manner.

Where can naloxone and other resources be found?
Naloxone kits are available to be dispensed for free to community members at risk for overdose and their friends and family members. The more naloxone kits we can get out into the community, the better equipped our community members are to respond to an overdose and save a life!

Harm Reduction Sites supply naloxone and other health and wellness resources – get to know the one in your community! Northern Health also has an Overdose Prevention page on their website that has lots of great overdose information, including how to recognize overdose and the SAVEME steps to help in an overdose situation.

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Learning to stop an overdose: can you?

Take home naloxone kit includes safety equipment and everything needed to administer naloxone

After completing a training program, you can receive a take-home naloxone kit to stop overdoses

When we think of the problem of overdose, we are often picturing the strong drugs such as narcotics and opioids that people use on the street, but what about the opioids that are prescribed drugs like morphine, heroin, methadone, Percocet, or OxyContin? These drugs are used every day by people, maybe even you, with chronic pain, cancer, addiction, or recovering from surgery or trauma. When you consider that all opioids can cause an overdose, leading to problems breathing or even death, it is not so difficult to see why stopping overdose may be for you.

Naloxone stops overdoses by reversing the effects of an opioid drug and it is saving lives every day. How does it work? Naloxone is an antidote to opioid overdose that can be given by injection. It binds to the same sites in the brain as opioids and works by pushing out and replacing the opioids. It acts quickly to restore breathing. Naloxone decreases the effect of an opioid drug for about 15 minutes, but has no effect on other types of medication. It starts to wear off in about 30 minutes, so if you use your naloxone, you need to go to the emergency room, too, because the overdose can come back. You may be asking yourself: doesn’t it take a medical degree to recognize an overdose? Not necessarily. Research has shown that with some basic training, anyone can save a person from overdosing just as well as a medical professional.

So what can you do to stop or prevent an overdose? With the help of the BC Centre for Disease Control, Take Home Naloxone programs are being developed in northern communities supported by partnerships between public health, mental health, and doctors trained in the naloxone program. In Smithers, public health and mental health nurses are working together to provide this basic education to the public. Once you have completed the Take Home Naloxone training, a doctor will prescribe the naloxone, you then bring your prescription to the public health office to receive a kit to take home. The kits are portable and should be kept in a visible and accessible location to be readily available if needed. Having naloxone with you to prevent an overdose is like carrying epinephrine or an EpiPen when you have severe allergies. You never know when you will need it.

What about safety? The needles in the kit retreat back into the syringe so no one else can get poked with a used needle. Naloxone does not make you high; in fact, it only causes withdrawal if you have taken an opioid. Everyone on an opioid should think about preventing an overdose, it could save a life: yours.

For more information, visit Toward The Heart: A Project of the Provincial Harm Reduction Program or the Canadian Centre on Substance Abuse.

Kathy Davidson

About Kathy Davidson

Kathy Davidson works in Smithers at the Smithers Community Health Unit as the northwest public health nursing practice development lead. Sharing new ideas and best practices with public health nurses enhances the services and programs provided to the public. Kathy enjoys the freedom of walking fields and trails in her rural neighbourhood as well as quilting. This year, Kathy’s three garden beds grew a delightful green buffet for the deer and a few potatoes for the fall!

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Wellness Warriors

Sign on the outside of the Wellness House

The Wellness Warriors gather weekly at the Wellness House in Masset to nurture wellness.

It’s 5:00 p.m. on a Tuesday and so the space at the Wellness House (across the road from the Masset library) opens up. It always does, like breathing, and when it does, people gather here with intention. Tonight, there is the usual bustle in the kitchen: people joking and laughing. Someone is looking for a can opener – turns out we left it at camp this summer. Someone else runs off to get cream for the coffee; we should have told them to get a can opener, too! Venison stew simmers on the stove (Haw’aa to the cook); someone else made rice. I brought homemade fermented pickles (again!) and we all know who brought the salad. The energy in the room is comfortable, welcoming, safe, and fun. We are the Wellness Warriors.

After dinner, and the kinds of discussions that dinners seem to inspire, we form a circle in the living room. Passing the feather around, we all speak and bring ourselves into the room together. This circle is the heart of us warriors: pumping vitality through the community of wellness we are creating. There is much courage and much kindness that happens in this circle. It transforms us.

Colorful four-canvas art image of multi-coloured yin-yang symbol with feathers and other shapes

An image of a yin-yang (balance) with four coloured feathers (wholeness and diversity) hanging down. This image is broken down into separate canvases that we pass to our left every 10 minutes or so. As they go around, we each contribute shapes and colours in dialogue with the other shapes and colours on the canvas. The art reflects our group intention: everyone is contributing to the process of creating something beautiful – something that is more than the sum of its parts. You could call that something wellness and we, its warriors.

Then, fed, connected, and present, we delve into the activity of the week. The group determines what it does: picking berries, making candles, talking about colonialism, searching for crabs, discussing shame, playing charades, or any number of other things. This evening, we have decided to work on an art project that we will exhibit at the annual All Island Art Show. Someone plugs their iPod into the speakers and the energy in the room shifts again as we delve into creativity.

The Wellness Warriors is a weekly gathering of people focused on nurturing wellness. The group, originally modelled after the Adult Addictions Day Treatment Program, evolved over the past three years to dynamically fit the context of our community’s particular needs and resources. The group is facilitated through a strong partnership between the Haida Health Centre and Northern Health as well as through the support of other community partners like the Haida Gwaii Society for Community Peace and the various guests and contributors who have come and shared with the group over the years. Most notably, however, the group functions through the participation of the people who come to the group, who champion the group’s wellness orientation, and who support the values of nonjudgmental acceptance, connectedness, confidentiality, and respect. The Wellness Warriors is a truly community-based, non-hierarchal, client-focused, client-driven, open group that is both nourishing and transformational.

Want to learn more about the Wellness Warriors? Check out this presentation I gave as part of a webinar series last year.

Four members of the group pose outside of the community building

Members of the Wellness Warriors team gather outside of the Wellness House.

Who are some of the Northern Health team members involved with the Wellness Warriors? My bio is in the author section of this post but two other team members are:

Sandra Dan (far left in the photo) is a mental health and addiction counsellor with the Old Massett Haida Health Centre. She is originally from Sto:lo Nation in the Lower Mainland of B.C. Sandra has lived in Old Massett, Haida Gwaii since 1985. She is married to a Nisgaa/Haida from Old Massett and is mother/stepmother of four, grandmother of 15, and great-grandmother of one. Sandra worked in the field of social services and child welfare in downtown Vancouver for 10 years, social development in Old Massett for six and a half years, and as social work team leader for Khowutzun Tribes for one year before starting with mental health and addictions for Old Massett Haida Health in 1984. Sandra’s interests include walking the beach, gathering food, beading and leatherwork, coffee with her buds, reading, and watching good movies.

Darlene M. Stoddard (far right in photo) is a life skills worker with Northern Health mental health and addictions. Darlene comes from the east coast of Canada. She graduated from New Brunswick Community College in 2010 as a patient care aide in acute care. Since graduating – and even before college – Darlene has supported clients with mental illnesses, some who suffered with dual diagnoses. She is also extremely skilled at working with adolescents who suffer from the autism spectrum disorder or fetal alcohol spectrum disorder. Darlene feels privileged and honoured to have recently been able to accept the position of Life Skills Worker II with Northern Health.

Dan Binnema

About Dan Binnema

Dan is a father of two young children, living happily on Haida Gwaii. Seven years ago, he quit a great job with the mobile crisis response team in Calgary, spent a summer canoeing across northern Canada with his pregnant wife, became a father, and moved with his family to Haida Gwaii, the islands of his dreams. He has been working in Masset as a mental health and addictions clinician with Northern Health for just over six years, with no plans of leaving. In his time in Masset, he has become increasingly connected to the land, the food it offers, and the community it nourishes. This connectedness spills over into his work as a clinician, most notably within the community of the Wellness Warriors group.

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