Pubdate: Sun, 12 Mar 2017
Source: Edmonton Sun (CN AB)
Copyright: 2017 Canoe Limited Partnership.
Author: Meghan Potkins
Page: 20


Suboxone offers hope for fentanyl addicts as reserve marks period of

Nearly every day, Darcy Medicine Crane catches a ride in a medical
transport truck to a pharmacy in Stand Off, a community on the Blood
reserve in southern Alberta, to take his daily dose of Suboxone.

He's earned enough trust to be given "carries" - a small amount of the
drug that he can administer himself at home - but said he prefers to
make the 20-minute drive to the pharmacy each day.

"I like coming to the pharmacy and getting my pill every day so that I
know that I'm doing it right still. It kind of motivates me to keep
going, staying on it," says Medicine Crane.

The 34-year-old has been on Suboxone - an opioid replacement drug
similar to methadone that alleviates the pain of withdrawal for
addicts but doesn't provide a high - since last May when he made the
decision to kick fentanyl after years of using.

Medicine Crane is among hundreds of band members taking Suboxone - the
latest weapon in the arsenal of health and social workers in the
battle against the deadly opioid crisis that has gripped southern
Alberta - and its usage is spreading.

At the height of the crisis on the Blood reserve, Medicine Crane
administered a lifesaving injection of Naloxone - a drug that reverses
the effects of overdose from some opioids, including fentanyl - to
three different people. He's haunted by memories of the grey,
purple-ish colour of the skin of an overdose victim, and the
recollection of his own breath being expelled back at him from the
lungs of a man he was performing CPR on, moments before the victim was
carried away in an ambulance.

But it took the death of a close family member and the realization
that he needed to protect his four-year-old son from harm to find his

"I was always getting high at home. I figured, what if we OD'd? What
if we did the wrong pill and we OD'd and my son can't do anything? He
can't help us. So, I figured we gotta quit. I don't want that around
my son anymore. I don't want him to think it's OK to do pills or drugs."

Overwhelming demand

Around 70 patients each day will pass through the doors of the Blood
Tribe pharmacy to receive a dose of Suboxone. It's estimated more than
300 patients are being treated with the drug at clinics in Stand Off,
Leverne and Cardston.

Some pharmacies in the area have begun capping the number of new
Suboxone patients they'll take as they struggle to meet the demand.

"(Suboxone) gets me through the day, every day. It just made me normal
again. That's how I feel, normal again. I don't feel sick. I can
sleep. I got bigger," Medicine Crane laughs, gesturing to his waist.

There have been dozens of deaths reported on the reserve since the
onset of the fentanyl crisis in 2014, part of a larger epidemic that
has resulted in the deaths of more than 700 Albertans.

While specific numbers have not been confirmed by the band or provided
by the province, Blood Tribe health workers and police say the rate of
fatal overdoses has been decreasing on the reserve.

There is a cautious optimism apparent in the voices of band members
when they talk about the progress they've made in disseminating
Naloxone antidote kits.

And the south zone, which includes the Blood reserve, was the only
health jurisdiction in the province that didn't see an increase in
fentanyl deaths in the last six months of 2016.

Naloxone has been key to saving lives, officials say, and Suboxone
continues to be a critical part of the recovery for many opioid addicts.

"Overall, we're accomplishing one goal and that is to reduce the death
rate, which we have. The second is to reduce the stress on the addict
and help them find support and treatment," says Dr. Esther
Tailfeathers, who has played a critical role in the band's response to
the crisis.

"The next thing we have to do is work on the upstream area of this,
and that's avoiding or preventing new starts."

Each patient must be supervised as they place the Suboxone tablet
under their tongue, and for several minutes after as the tablet
dissolves and is absorbed into the blood.

The monitoring is necessary to ensure the drug is being taken properly
and the patient doesn't try to pocket it - this happens occasionally,
since the pills can be sold on the street for around $20 each.

On any given weekday, medical transport trucks and vans criss-cross
the reserve, ferrying recovering addicts to medical appointments and
pharmacies from early in the morning until late in the evening.

Getting these patients to care centres on the Blood reserve - Canada's
largest reserve by geographic area - is a significant task.

Lifeline on wheels

The Blood Tribe has added at least two more vehicles dedicated solely
to Suboxone patients to their federally funded medical fleet.

One driver, who asked not to be identified, said he transports around
54 band members each day from different parts of the reserve to Cardston.

"My phone rings off the hook. Especially when they go on their
followups. Wednesdays are the busiest. They finally hired two more
drivers, which is great for me, because before I was always doing
overtime, 12-hour days."

It's Wednesday and the waiting room at the Levern Health Clinic is
starting to fill.

Patti Eagle Child has brought her teenage daughter to see the doctor
and to get a dose of Suboxone.

Eagle Child, herself a recovering addict, is there to support her
daughter to quit fentanyl.

"It really took a toll on me," she says of the fentanyl pills she used
to take. "Then my kids were doing them, too. I didn't care, I was
doing them with my kids, because that was the addiction. To this day,
I think, why would I do something like that? If I could turn back time
I would change it, but it's not possible," says Eagle Child.

When Eagle Child finally decided to get help, she went to see Dr.
Susan Christenson.

Christenson was the first doctor in the area to begin prescribing
Suboxone at the onset of the crisis, and she's been working flat-out
since, sometimes more than 100 hours a week at her clinic in Levern.

"I'm here from 8:30 a.m. until the end of time," jokes

She says the opening of a new opioid treatment clinic in Cardston last
spring has allowed her to focus on patients and families from the
band, like Eagle Child's.

"I think family-centred care is very, very powerful. If you have
several family members that are on Suboxone or have addictions, they
can kind of support one another, so I'll usually tell them, if anybody
in your family wants to come forward and try this, I'm here for them,"
Christenson says.

Blood Tribe Police also see some encouraging progress when it comes to
stemming the tide of illicit fentanyl pouring into the reserve.

A big drug bust by the Alberta Law Enforcement Response Team last
October led to the arrest of someone police believe was one of the
reserve's main fentanyl suppliers.

Jerry Bull and associates Ali Zalfo and alleged Mad Cowz gang member
Corey Amyotte were arrested in Lethbridge and charged with 32 drug and
firearm offences.

"Once they kind of cut the head off the snake, now we're just dealing
with the leftovers," says Sgt. Rayan Najjar of the Blood Tribe Police.

"We were hitting the outside dealers a lot, the people bringing it,
because we know it's not being manufactured here," Najjar says.

Modern-day drug war

"But now our focus has shifted to our local dealers and the people
that are housing the people coming in that are selling."

Najjar says crack and other illicit drugs are still problems on the
reserve. And, recently, marijuana laced with fentanyl has been seized.

And the dealers on the reserve are getting smarter.

"They're going into Lethbridge or Calgary to get it and coming back,
as opposed to (the suppliers) coming on reserve and distributing it
here. They're switching up their strategies."
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