MUSKOKA - On Sept. 25 some Muskoka residents saw behind the curtain of the raging opioid crisis and its stigma affecting not just our community but communities across Canada.
United Way Simcoe Muskoka presented a 40 minute documentary in Huntsville at the Grandview Golf Club titled; Painkiller - Inside the Opioid Crisis.
In addition to the film the night featured three impactful speakers who shared their stories and experiences with opioids. Muskoka Post will be featuring these speakers and their stories in parts 2 and 3 of this 4 part opioid series.
United Way Simcoe Muskoka is the second largest funder after government for services which address commnity and social need.
United Way chief executive officer Dale Biddell, said the organization routinely hears that housing has been the most predominant issue “whenever we go into any community and while we know that continues to be a significant factor that is impacting far too many people; opioids has done the leap over that.“
The film is an eye opener for the average individual not struggling with substance abuse.
The director of the documentary, Mathew Embry, asks experts including frontline responders, border services and addiction specialists to provide their perspective of the underlying problem to this ongoing crisis.
The documentary’s intent is to raise awareness and reduce stigma by educating and informing communities on what opioid are and how this crisis is affecting our country. No socio-economic group is spared in this crisis – it affects us all.
Painkiller begins in Vancouver at an injection site; Inside is North America's first legal supervised injection site. The site contains 13 booths in an injection room.
Tim Gauthier is the clinical co-ordinator for Inside, he talks about binders containing overdose records which at the beginning of 2016 could hold a few months worth of records and then toward the end of that same year a new binder was needed for every month as they began filling at an alarming rate.
"The volume of overdoses had just picked up so hard, so fast that then we were going through binders a lot faster,” he said.
“People are dying of drug overdoses in unprecedented numbers and most of those deaths are caused by what we call an opioid drug; heroine, morphine, most of the deaths are occuring now because we have a contamination of the illegal drug supply with a drug called fentanyl,” said chief medical health officer of Vancouver Coastal Health Dr. Patricia Daly
Dr. Dan Morhaim, Maryland State Legislator and Emergency Medicine Physician, concludes in the documentary that after 50 years the war on drugs "has been a war on people" and a colossal policy failure.
Morhaim goes on to educate the audience about the introuction of the war on drugs by the Nixon administration in 1970.
"The war on drugs was created as a particular political policy to deal with the hippies and blacks, Nixons political enemies and that was their strategy and it worked ... everything is worse more violence, more drugs use ... there is not one data point thats better,” he said.
Morhaim explains that trafficking of drugs is a giant enterprise based on money laundering into billions of dollars not counting criminal system, enforcement and health care.
"We've had a policy that has not been working and destroying our culture and society from the inside, it's a matter of life and death ... it‘s a global issue,” he said.
The documentary interviews parents who have lost children to opioid overdoses.
Danny's mother Petra Schulz described her son as a gifted culinary student who worked in some of the best restaurants in Edmonton. Her son was addicted to Heroine.
"Eventually he did reach recovery for about a year and a half, but like so many people in recovery he had a relapse and he died four years ago today from an accidental fentanyl poisoning,” Schulz said.
Mohrain explains that due to the large profit margin on opioids they seem too readily available.
"Opioids are avaialble both legally and illegally as they are also used for pain management."
Richard Rego, clinical director at the Beacon Pharmacy, said he would not take an opioid drug himself.
"I've seen too much in my own practise as a pharmacist to know better,“ he said.
Rego explains that the quick addiction to opioids is because the drugs hit receptors in the brain which stimulate euphoria. However, with prolonged usage the body can develop Hyperalgesia- increased sensitivity to pain or enhanced intensity of pain sensation which means doses of the drug intake have to increase.
Opioid withdrawal and the effects of opioid withdrawals said Rego are very hard on people and described as the worst type of flu and "multiply that by 10."
Statistically 1 in 5 people prescribed an opioid will become a long term user within 10 days.
Heroine is said to be two to five times stronger than morphine while Fentanyl is 50 to 100 times stronger than morphine.
"Because we are dealing with a much, much more powerful drug is where the problem arises,“ Daly said.
Jackie Tse with the Canada Border Services Agency, said the majority of fentanyl is coming from China.
In June 2016 border services intercepted a package at the Vancouver international mail centre which was declared as ink cartridges. That package contained 1000 grams of carfentanyl with a potential yield of 50 million lethal dosages.
The black market opioids don't have quality control and there is a very small margin of safety.
At the Insite injection centre in Vancouver, Gauthier readies his crash kit before the site opens.
"We want to make sure we are ready with the right amount of Narcan because we can get overdoses right away ... these crash kits are very well utilized, we use them multiple times a day. It's not uncommon for us to have multiple at one time. The average use to be two overdoses a day and we are now at seven per day as an average,” he said.
Injection sites are beneficial for users in that help is on the spot and there have been zero overdose deaths inside these sites.
"If our goal is to save lives, they clearly do," said Mohrain.
Dr. Gabor Mate is an author and addiction expert, he said that to him harm reduction is not controversial.
”What is controversial, is that it is controversial,“ he said.
The film underlines that additiction to opioids affects people from every socio-economic class, in every community, across gender, and across race.
In B.C. an average of 100 people per month die from opioid overdoses sometimes as high as 150.
It’s been described as the worst public health emergency.
"Every parent needs to talk to their kid about this because one experiment with this drug can lead to a childs death,” said a police officer on the front lines.
Ben Cory was a gifted athlete, his mom describes him as charming and loving.
Ben's addiction began at 13, his parents thought that perhaps their son was going through an experimental stage. He told his parents that "he wanted to experience all of high school."
His parents aren't sure exactly when Ben began using oxycodone but say that was a game changer. Their son would continue to struggle with drug use and addiction throughout his teen years.
Ben's parents say that at first his teachers and school councillors were helpful but as time went on and their son's addiction spiralled people began distancing themselves.
Dr. Daly notes that people don't know much about addiction which adds to the problem.
"They don't understand that this is a chronic health condition,” she said.
Ben graduated from a rehab program but the last year before he died his parents had to resuscitate him half a dozen times and he experienced nine fentanyl overdoses.
“The challenging thing with opioid addiction is that its a relapsing condition. There is no cure for it. You'll have it for your whole life. Similar to other chronic conditions,“ said Daly.
The documentary describes what occurs during an overdose.
When a person suffers an overdose they cease to breathe, very often due to the lack of oxygen they turn blue. The oxygen dropping in the blood and the heart stopping both affect brain function.
"Their brain is still trying to breathe so it looks like they are gasping, but clinically they look dead," said a paramedic.
First responders will administer Naloxone to counter the overdose, as Naloxone competes with the substance at the breathing centre.
Following an overdose brain cells have been affected and brain injuries are common.
The film also shines a light on the over prescribing of narcotics and the profits pharmaceutical companies make on pain killers.
There was a push on health professionals between 1998 to 2002 to treat pain as the fifth vital sign. Doctors were told they were under treating pain. Medical students were given textbooks repared by pharma companies outlining how to treat pain.
The promotion of drugs like oxycodone as safe and not addictive, and paying physicians to be on speaker bureaus promoting pain as the fifth vital sign was a catalyst for the widespread opioid addiction.
“The opioid crisis is not just an accident ... it‘s also a result of poor medical practise and unscrupulous pharmaceutical practice; for which no one has gone to jail by the way,“ said Mate.
In 2016 there were 2861 opioid related deaths in Canada.
In 2017 there were over 4000. A more than 40 per cent increase in just one year.
The war on drugs it seems has been a failure.
"The system needs a major overhaul, the system is not even broken, it‘s so dysfunctional and so counter poductive that we have the opposite result to what we actually want,” Dr. Mate said.
A website out of Calgary - Moms Stop The Harm - is run by parents who have lost children in the opioid crisis. It‘s an advocacy group aimed at changing policy and legislation away from the focus on criminal justice and seeing it as a health issue.
The group is working toward decriminalization of possession of drugs to take away the stigma around substance abuse.
Similar to the way Portugal has dealt with their drug problem. The country decriminalized drugs and shifted focus to addiction treatment. Portugal now has the lowest drug use problem in Europe, they use to be one of the worst.
“You never lose votes by being tough on crime, you might lose votes if you decide
to be compassionate to those who experienced the greatest traumas in our society ... it requires courage on the part of political leaders,” said Mate.
Sixty per cent of the North American prison population has substance abuse disorders.
Arresting our way out of this crisis is not working, prohibition is not working.
“We are in a crisis and people are dying every day. This shouldn't be about ideology, but about what the data shows us and the data shows us is that if we were to decriminalize possession of all illegal drugs we could reduce the risk that people might die of an overdose,” Daly said.
It has been studied and documented that every dollar invested into substance abuse treatment saves $7 to $10 in societal expenses.
Part 2 of the Muskoka Post Opioid series will bring you an interview with local resident Yvonne Heath and will feature her perspective on the crisis as a nurse and a mother with a son in recovery.