Pubdate: Tue, 02 May 2017
Source: Lethbridge Herald (CN AB)
Copyright: 2017 The Lethbridge Herald
Author: Melissa Villeneuve
Page: A1


Coalition on opioid use informs council about local issue and efforts
to combat problem

The rising use of illicit opioids, such as fentanyl, in Canada has
become an "epidemic" and Lethbridge isn't immune. On Monday, a local
coalition on opioid abuse informed members of city council about the
scope of the issue and how, through collaborative efforts, it plans to
combat the multi-faceted problem.

The coalition was formed last November in response to the rising
number of addictions and overdoses related to the dangerous and
highly-addictive drug, as well as the resulting consequences such as
increased property crime, drug trafficking, public consumption and
needle disposal.

It includes representatives from the health, police, justice,
emergency medical, post-secondary, municipal, education and social
service sectors.

Dr. Karin Goodison, Medical Officer of Health for Alberta Health
Services South Zone, led the presentation, which included: Tom
Mountain, Director of Addictions and Mental Health; Lethbridge Police
Insp. Tom Ascroft; Lethbridge Fire/EMS Deputy Chief Dana Terry; and
Stacey Bourke (executive director) and Jill Manning (managing
director) of ARCHES, which provides outreach, education and
harm-reduction services for people who use drugs.

"This is truly an epidemic," said Goodison. "What we're seeing is an
increasing number of deaths year on year from 2011 to 2016." According
to AHS statistics, fentanyl overdose deaths across Alberta increased
from six in 2011 to 349 in 2016. In just the first six weeks of 2017,
the province saw 51 deaths attributed to fentanyl overdose.

Province-wide, the rate of fentanyl deaths per 100,000 population
doubled from 2.9 in 2014 to 6.1 in 2015 and then rose to 8.1 in 2016.

"In South Zone we're also seeing that impact and it's a big problem,"
said Goodison.

When the Calgary area added up the number of deaths due to motor
vehicle collisions and homicides, they found the number of
fentanyl-related deaths was higher.

In addition, life-saving naloxone kits, which help to temporarily
reverse the effects of opioid overdose so an individual can seek
medical treatment, now contain three vials instead of two. This is
because the drug potency has increased so much that two vials are no
longer sufficient. Sometimes three isn't enough either.

"We've gone from seeing fentanyl to seeing carfentanil, to seeing
other types of products. These are made in labs and you don't know
what's in it," said Goodison.

"What we're getting is people who sometimes need six vials of naloxone
to reverse an overdose. And that's really scary."

Lethbridge Fire/EMS are responding to an increasing number of
narcotics overdose calls, which has created additional stress on the

The need to administer naloxone used to be rare, but is now necessary
almost on a daily basis, Deputy Chief Dana Terry told council members.
Fire/EMS responders administered naloxone 88 times in 2015 and 83
times in 2016, compared to just 11 times in 2013.

They are also called upon often to pick up needles disposed in the
community, which also was once quite rare. When it comes to the
manufacturing of the drugs, Terry says their staff is at risk of being
exposed to dangerous products and situations.

"We have had different labs in the city we've had to deal with, with
our Hazmat team, so they would be the ones called in to deal with
those issues. But if you have somebody responding to those calls (for
an overdose), they may not know there's a lab in the house."

Lethbridge Police Insp. Tom Ascroft said they've seen an increase in
property crime, drug-related violent crime and drug trafficking as a

"We see the property crime that's fuelled by the drug addictions. We
see the public order issues, the people consuming drugs in public, the
overdoses in public, the needle debris, the drug dealsÂ…"

"It's just not the kind of thing people want to see in this

It's not something the police can "arrest their way out of," Ascroft
explained. Although an individual may get sent to jail, it still
doesn't take care of the root of the problem.

"These people are addicted, so the threat of a criminal charge doesn't
hold the same weight as for you or I," he said. "The police certainly
have a role to play in this, but arresting the users is not an
effective strategy."

Only 18 months ago, ARCHES was distributing 3,000-4,000 needles per
month. In April, ARCHES distributed 16,000.

"We've seen about a four-fold increase in a period of about a year and
a half," said Jill Manning, managing director of ARCHES.

ARCHES is conducting a needs assessment study to determine whether a
supervised consumption site could be beneficial to southern Alberta.
The site would provide comprehensive in-house support with medical
supervision for drug users.

They are surveying up to 200 drug users to see what services they

"It really needs to come from users to identify where the gaps
currently are, what they would benefit from, what would encourage them
to use a facility like that if it were to exist," said Manning.

There are only two supervised consumption sites in Canada, both in
Vancouver. Similar sites have been in use in numerous cities
throughout Europe for the past 30 years, with the first one in
Switzerland in the 1980s. ARCHES had the opportunity to visit that
site, and a few others, a couple months ago.

The immediate goal of such a site is to save lives, Manning explained,
but there are other benefits as well. It would reduce community health
issues such as public consumption and intoxication, reduce needle
debris in public areas and reduce stress on police and emergency
responder resources.

"If all of that is happening within one site and one location, it's
much easier to manage and it's a smaller drain on community resources."

They hope to have data completed by the end of May, with
recommendations by the summer. The provincial government has earmarked
funding for potential supervised consumption sites. If they do go
ahead with an application, it would go to the federal government as it
would require exemption from federal drug laws for the use of the facility.

Although it would likely be somewhat controversial, Ascroft agreed a
safe consumption site would make sense.

"It would get it off the streets, get it out of the library, get it
out of the malls, get the needle debris out of the bathrooms, and I
think to address this in a more controlled fashion makes a lot of sense."

Mayor Chris Spearman said he gets a lot of complaints that the city
isn't doing enough to combat crime and drug use. He said "it's a more
complex issue" than people think, and it's important to have community
organizations working together as a team to get the best advice and
response going forward.

He noted drug users and addicts are often looking for help, but unsure
how to get it without prejudice or stigma attached. The city needs to
ensure there are no barriers to accessing help, he said.

"Let's realize that it's not any one demographic, that it's across the
spectrum - people of different incomes, different abilities - they're
all being affected," said Spearman. "We need to make sure that they
can get the help that they need so we can solve a significant problem
within our community."

As a community, Dr. Goodison said we need to look at things we can do
to address people experiencing trauma, to address social determinants
of health and what leads people to addiction.

"Our awareness, our education, and looking at how we can all work
together on this, because it's not a problem that's going to be solved
all within health or policing... It's going to take the entire
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