As the effects of the toxic drug crisis become an intrinsic part of health care, nurses on Vancouver Island are having to adapt to what that means for keeping patients healthy.<\/p>\n
On Dec. 2, Vancouver Island University fourth-year nursing students hosted a harm reduction education panel along with the VIU Harm Reduction Alliance, intending to raise awareness about the toxic drug crisis, challenge stigma and foster a safer community.<\/p>\n
Nursing professor Sarah Lovegrove told the News Bulletin that harm reduction is becoming more relevant in the nursing field as the crisis goes on.<\/p>\n
\u201cEven just six years ago when I was practising in the ER, very few nurses practised harm reduction or understood what harm reduction was,\u201d she said. \u201cNow we\u2019re seeing a new wave of nurses who understand it and are practising from that perspective, and that includes these students who are coming into practice this spring. So they are going to be nurses in your hospital this coming summer and they are going to have all this knowledge about harm reduction and be able to treat people.\u201d<\/p>\n
Some third-year nursing students also took part, offering naloxone training so that attendees can understand how to counteract the effects of an overdose, one aspect of harm reduction in the field.<\/p>\n
Those presenting on the panel included Corey Ranger, Harm Reduction Nurses Association president; Dr. Jessica Wilder, Doctors for Safer Drug Policy co-founder; Edward Joe, First Nations Health Authority Indigenous harm reduction educator; and Lenae Silva, Open Heart Collaborative co-founder and an opiod user.<\/p>\n
Wilder noted that while the concept of harm reduction is most associated with reducing the harm done by illicit substances, the philosophy is used elsewhere in activities deemed inherently harmful to reduce risk, such as using sunscreen to combat UV exposure or wearing seatbelts in a motor vehicle.<\/p>\n
\u201cAs a doctor I am not a judge, it isn\u2019t my place to decide whether or not my patients engage in behaviours that are harmful or maybe I don\u2019t agree with,\u201d Wilder said, \u201cmy job is to help them stay healthy and my patient is the one who defines what healthy means to them.\u201d<\/p>\n
She warned the local street supply has become increasingly dangerous, moving from containing heroin to fentanyl to fentanyl analogues, such as para-fluorofentanyl which can cause an overdose at just two milligrams. While para-fluorofentanyl can be detected with a drug testing strip, another potenant type of opioid, nitazenes, can be found in the street supply and isn\u2019t detectable.<\/p>\n
Other drugs that are mixed in include benzodiazepines, used clinically as a medication to treat anxiety, but also highly addictive.<\/p>\n
\u201cWe\u2019ve had in our community at times upwards of more than 80 per cent of our opioid supply that has benzos in it. When people are getting it on a daily basis, their body becomes accustomed to it. Sudden discontinuation of benzos when your body has become dependent on it causes severe withdrawal from discomfort to tremors to seizures and sometimes death.\u201d<\/p>\n
Wilder said one of her Nanaimo patients is \u201cincredibly diligent\u201d about getting his drugs tested, and she shared the results from a one-month period earlier this fall.<\/p>\n
The first week, his opioids contained 30 per cent fentanyl, 23 per cent para-fluorofentanyl, six per cent medetomidine, as well as caffeine and erythritol, a sweetener. Medetomidine is a veterinary sedative, which Wilder cautioned does not respond to naloxone. The second week\u2019s drugs contained 11 per cent fentanyl, eight per cent para-fluorofentanyl, two per cent medetomidine, as well as caffeine and erythritol. During weeks three and four, there was no fentanyl, with the drug replaced by various amounts of para-fluorofentanyl. Week three read 38 per cent para-fluorofentanyl and four per cent medetomidine, while week four had 15 per cent para-fluorofentanyl and two per cent medetomidine. Both weeks also had caffeine and erythritol.<\/p>\n
\u201cSo when someone asks me, \u2018why don\u2019t people just stop using drugs if they know the supply is so lethal?\u2019 There are a lot of answers that come to my mind, but an easy answer from a medical perspective is they physiologically cannot abruptly stop these drugs because they could die\u2026\u201d she said. \u201cOur current system does not have the capacity to support people who want treatment when they want it. This results in my patients dying while waiting for the resources and supports they need to try to enter into recovery.\u201d<\/p>\n
Joe said one of the ways the First Nations Health Authority has addressed harm reduction is by funding community care cabinets with naloxone and plant-based medicine. He said Indigenous-based harm reduction also includes providing traditional foods and sharing culture, such as music, traditional art and teachings, to populations living on the street, as often community ceremonies require sobriety as a prerequisite for attending. Joe said the \u201copposite of addiction is connection,\u201d with the drugs often tied to poverty, homelessness and trauma.<\/p>\n
\u201cIn some communities across the Island, harm reduction brings culture to where our unhoused community members are\u2026\u201d he said. \u201cOne thing we\u2019re seeing is elders are starting to go out into the communities.\u201d<\/p>\n
Ranger stated there has been fear, misinformation and moral panic surrounding harm-reduction strategies, turning people into opponents, rather than partners. He recalled hearing someone comment that \u201conce you get started on fentanyl, you\u2019re done,\u201d but stated this couldn\u2019t be further from the truth. He shared a story about one individual he personally treated for multiple overdoses during the pandemic, and since then, the individual has quit using unregulated substances, has housing, access to care providers and is in an opioid use disorder program. After 10 years of being ostracized, the individual was finally welcomed back to his family\u2019s dinner table.<\/p>\n
\u201cSince 2016 there has actually been 18,000 people in British Columbia who have died due to the unregulated drug supply,\u201d Ranger said. \u201cThese deaths were and continue to be preventable \u2026 they are driven not by individual failure, but political and policy choices that have allowed a highly toxic, unpredictable, illegal supply to flourish.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"As the effects of the toxic drug crisis become an intrinsic part of health care, nurses on Vancouver…\n","protected":false},"author":2,"featured_media":343148,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[49,48,84,392],"class_list":{"0":"post-343147","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-ca","9":"tag-canada","10":"tag-health","11":"tag-healthcare"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/343147","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/comments?post=343147"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/343147\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media\/343148"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media?parent=343147"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/categories?post=343147"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/tags?post=343147"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}