Healthy Living in the North

“Don’t judge us. None of us want to die.” A success story of a woman struggling with addiction

Selfie of Teri-Lynn.

“If it wasn’t for naloxone or Narcan, I’d be dead,” she says.

Teri-Lynn was put up for adoption by her biological parents, both of whom struggled with substances. She remembers from a young age thinking she’d done something wrong to not be loved or wanted. This message became deep-rooted as she was moved from foster home to foster home due to abusive environments. Fortunately, Teri-Lynn eventually moved into a great, safe foster home, with people who she still has a close relationship with.

Growing up, she still unconsciously, yet desperately, sought acceptance. She found that despite being kicked out of school, providing THC (the mind-altering ingredient found in cannabis) to her friends was worth it to her. At 14 years old, she became hooked on crack cocaine, a habit she supported by engaging in criminal activity. After three years of experiencing repeated episodes of paranoia and drug-induced psychosis, she hitchhiked with a friend to the downtown East side of Vancouver and soon began using heroin and fentanyl.

This cycle of stealing and other criminal activity continued until her 18th birthday, when she became pregnant. She did her best to cut back on her use, to “do right by her baby,” but after a year, this lifestyle was too much and after one hit, she was hooked again.

She became re-entrenched in a life of stealing and other criminal activity to support her substance use habit. During that time, nurses, shelter staff, strangers, and mental health workers revived her 22 times.

“If it wasn’t for naloxone, I’d be dead,” says Teri-Lynn. “I was tired of having seizures, going to jail, being on the psychiatric unit for being suicidal, seeing cops outside my window, hiding in the closet because I was so paranoid, going to detox three times and treatment three times.”

After being on the methadone program for three years, fearing she’d overdose due to ongoing polysubstance use, she made the move back to Fort St. John with only a 4-week prescription.

After connecting with the Fort St. John Northern Health mental health office, she was immediately accepted into the Opiate Substitution Treatment Program (OSTP) and began working with the staff and Dr. Ohiaeri (now the Northern Health Medical Lead for Addiction in the Northeast).

Opiate Substitution Treatment provides clients with methadone or Suboxone to provide stable, long-acting relief from withdrawal and cravings. These medications replace the heroin or fentanyl that’s causing the problem with a regular dose of medication, which allows for a stable life.

During the intake process for the program, she was diagnosed with Hepatitis C and knew that changes needed to be made.

“Dr. Ohiaeri understood how hard it was for me, but still called me out when I told him I wasn’t clean. At first I didn’t like him, but looking back that’s what I needed,” says Teri-Lynn.

She recalls how the Women’s Resource Society and the mental health office helped her navigate the medical system, which had previously looked down on her and judged her. She found the staff to be open-minded and caring.

She was placed on medical disability due to a seizure disorder and things started to look up. She had stable housing and a regular income and was ready to make some big changes. She joined Narcotics Anonymous, working the 12-step program and going to church. These agencies provided some much needed support and acceptance.

It was at this time she requested to be transitioned into Opiate Agonist Treatment (OAT), with the intention of coming off medication altogether. This program supports clients with opioid use disorder by using a harm reduction approach and providing overdose survival training, take home naloxone kits, and opioid agonist therapy (buprenorphine/naloxone or methadone). Opioid agonist therapy works to prevent withdrawal and reduce cravings for opioid drugs. People who are addicted to opioid drugs can take OAT to help stabilize their lives and reduce the harms related to their drug use.

Teri-Lynn characterizes this decision as “the best thing ever. It helped me stay clean. Everyone should be offered it. I started on 32mg and within three months was down to 2mg. I’ve been off for 30 days and I don’t have any cravings. These past several months have been the first time in my life I’ve been motivated, happy and healthy. I’m even working part-time as a cashier at a local fast food establishment.”

She has reconnected with her 13-year-old daughter, who lives full-time with her father, and has recently been granted custody of her 5-year-old daughter, four days a week. She is slated to go to court in the near future, with the support of the foster mom, to ask for full custody. Teri-Lynn was also referred for Hep C treatment and is now cured.

Her advice: Have naloxone at shelters, Women’s Resource Centre, Mental Health Centres, hospitals, and Narcotics Anonymous meetings. Make access to naloxone easy. Have peer volunteers providing clean needles, naloxone kits, and candy for people on the streets.

“Don’t judge us. None of us want to die,” says Teri-Lynn.

Teri-Lynn has naloxone kits in her car, her house, and her purse.

“If it wasn’t for naloxone or Narcan, I’d be dead,” she says.

She currently holds a General Service Resource position with Narcotics Anonymous, chairs meetings, and advocates opiate substitution treatment to her peer groups.

If you or someone you know needs help, go to the Northern Health Mental Health and Substance Use webpage, the overdose prevention webpage, or call the crisis line at 1-800-784-2433 (1-800-SUICIDE).

Bailee Denicola

About Bailee Denicola

Bailee is a communications advisor in the Primary Care Department and was born and raised in Prince George. She graduated from UNBC with an anthropology degree and loves exploring cultures and learning about people. When not at work, Bailee can be found hanging out with her dogs, building her house with her husband, or travelling the world.

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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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