Ontario has implemented federal funding for Safer Supply programs in response to the overdose epidemic. There are many approaches to reducing harm from substance abuse.
Overdoses are up between 35 and 40 percent this year, compared to a year ago. This September, Minister of Health Patty Hajdu announced $9.5 million for safer supply programs. The funding will go to four programs in Ontario. The London InterCommunity Health Centre (LIHC) has received $6.5 million.
Safer Supply programs are government-funded clinics. Here, the most at-risk population of substance users can receive pharmaceutical-grade injectables. In a media release provided to LondonFuse by Safer Supply, the eligibility criteria are high.
Requirements for entry include “Regular opioid use over the last year; Long term intravenous drug use; Complications related to injection drug use (e.g. infections, abscess, HIV); High risk of death without substitution therapy; The capacity to consent; Poor social functioning (e.g. disengaged from health care and social services, involvement in crime, sex work).”
Safer Supply programs use harm-reduction strategies. Harm-reduction strategies assume people will use substances and focus on lowering harm to the individual, their loved ones and their communities. The practice values people’s lived experiences and relies on their involvement. Clients have a direct role in planning their intervention.
In light of an increase in overdoses during COVID-19, Public Health Ontario initiated a rapid review study. While the full effects of the pandemic are unknown, there were key findings. The report highlighted reduced access to support during COVID, including decreased access and price increases for drugs. It also highlighted the increased toxicity of street drugs due to the reduced access in supply with border closures and travel restrictions. Additionally, the report highlighted the reduction in service supports.
Ignoring the overdose epidemic is not going to make it go away. Unfortunately, one of the critical aspects that help prevent the spread of COVID also increases the likelihood of overdoses or use. As we isolate, we can become disconnected from healthy outlets and people who love us. The effect is worse for those of us with a predisposition to addiction.
My Lived Experience
My name is Elizabeth McDonald, and I haven’t consumed alcohol since February 24th, 2018. I make no pretensions to assume that blacking out is the same as the opioid epidemic, but I do believe we both fit on a spectrum called addiction. Let me further clarify — I do not think that the use of a substance is bad. It’s a normal, human biological response to want to feel good and avoid feeling bad. If you haven’t noticed, things are pretty bad right now.
The one thing I do know is that I did not get better from hiding my problem, ignoring its existence, or being shamed for it. I needed to admit or believe that an issue existed before I could even tackle it. We need a coordinated and targeted effort grounded in public health research to help those with a substance use disorder.
My attack plan for solving my blackouts may seem harsh to some, and I don’t believe it’s a one-size-fits-all solution. I went cold-turkey before going to a support group that uses a 12-step abstinence approach. My strategy for solving this problem wasn’t fully-fledged at this point. All I knew was that I was sick of poisoning myself and getting in the way of my well-being. Something had to give. I can slice it whatever way I want, but my talent for drinking wasn’t a talent that was good for me.
I began the process of putting one foot in front of the other. I did this for long enough that I managed to string some days together, then months, and now, years. I try not to prophesize my future and fail all the time at that goal. I have dreams and hopes like everyone else, but I can’t predict if I will ever drink again. I can only base my actions today on the information I have available to me. There is no good without the bad, and to get to the top of a mountain, you have to be willing to climb it first.
I study at Western University and am an alumnus of Fanshawe College. My GPA at Western plummeted when my drinking accelerated. After giving up alcohol, I finished last year on the honour roll. My relationships are both functional and meaningful. My mental health has improved with individual therapy. Therapy allowed me to understand why I drank and learn healthier coping methods. In sum, it’s okay if you have some wine at dinner, but I am liable to blackout and never be welcome to your house again.
How Can You Help Those You Love?
From this perspective, I turn to a person with more experience than I have in treatment. Dean Anderson is a certified addictions counsellor. I spoke to Dean to ask him about his experience as a counsellor during the pandemic. I also wanted to gather insight into how to talk to the people we love about substance use.
Dean explained to me the process by which someone can begin treatment with a counsellor. “Most people that come to me are less severe cases of substance use, binge drinking or people that are in early recovery, that are looking to improve their quality… I help them to understand the process of recovery and how to use community services and how to navigate [through that].”
Dean has noticed a shift when asked about how the pandemic has affected people’s need to seek counselling for addictions.
“People that were on the brink of increasing their substance use as soon as the pandemic and the isolation came in, they went from somebody who might be using my services to somebody that’s outside of the realm and became daily users… now they would only fit in the realm of withdrawal management or going somewhere else. So, I think there’s just been a huge dynamic shift.”
As a person in recovery, Dean has lived and professional experience. Life experience gives him a unique perspective on advice-giving.
“What I encourage people to try not to do is to tell people what to do because that is always the first way to shut somebody down. You’ve got a problem you need to do this… you need abstinence, you need this, or whatever it is… The family members can see it very clearly, and it’s really easy to say, oh, there’s a problem here.”
So, how do you approach someone?
“I encourage them to talk to somebody else about how to have that conversation properly… talk to somebody in recovery, find somebody else that understands addiction to do that intervention piece for you. The bigger problem is the people that don’t have experience with substance use tend to have an underlying dialogue that’s shame-based.”
Dean goes on to explain that shame-based dialogue isn’t practical. “Dialogue that[‘s] shame-based ends up pushing people away further and causing more disruption, pain, with those people… it usually sends them deeper into their addiction… you think that this information is giving them something better, but really is causing [a] disconnect.”
Approaching people based on feelings instead of facts is another way to connect. After that, give the person options. Ask them questions and determine the direction they feel comfortable going in. By doing this, individuals can work to reduce harm. You give agency to the person experiencing addiction. This approach is more effective than insisting they have to change everything about the way they use.
If you or someone you love is struggling with substance use during the pandemic, you are not alone.
If you are seeking help, please see the following information for community support: