The implications of substance use and addiction

The Niagara region’s substance addiction and opioid use rates are climbing higher and higher with each passing year. Despite this ever-increasing number, local agencies and authorities are working hard to help combat these issues.

According to Statistics Canada through their Canadian Tobacco, Alcohol and Drugs Survey (CTADS) conducted in 2017, the prevalence of past-year non-medical use of at least one drug excluding alcohol and tobacco was 15 per cent (4.5 million), an increase from 13 per cent (3.7 million) in 2015. This increase was due to an increase in the use of cannabis and cocaine over the two years since the last survey was conducted. Statistics Canada expects that the prevalence of particularly cannabis use will climb after analysis of their 2019 survey with the legalization of the substance having occurred recently.

In the last published Canadian Alcohol and Drug Use Monitoring Survey in 2012, it was estimated that 21.6 per cent of Canada’s population met the criteria for a substance use disorder, that is, they not only abuse substances but are also dependent on it. That means close to eight million people are currently suffering from addiction in Canada.

 

One of the most popular arguments many with an addiction have is, “I’m not hurting anyone but myself.” This, however, is far from the truth. From reckless driving, to violent behaviours such as domestic abuse, addiction in Canada affects far more than just users themselves.

 

Those closest to a drug-addicted individual are oftentimes the hardest hit. Common patterns emerge within families where at least one individual is addicted to drugs. These patterns include high levels of criticism or negativity within households; parental inconsistency or, in the case of parents coping with drug-addicted children, denial. Misdirected anger between drug-addicted and non-addicted family members is common as is self-medication as a strategy in coping with family dysfunction.

 

Codependent relationships have been seen to form between partners, where at least one partner is addicted to drugs. Codependency can result in a difficult spiral in which the codependent partner cares for and enables the loved one’s challenges, making it easier for the loved one to maintain the challenging or destructive behaviors — in this case substance abuse.

 

According to the Canadian Centre for Addictions, children with one or more parents that abuse drugs are more likely to take on the responsibility of the parental role, often functioning in denial of their parents’ addiction or behaviours relating to the addiction. These children commonly lack necessities, including shelter and have much less access to health care. Similarly, families with at least one drug-addicted parent tend to be more likely to end up homeless or in poverty and are less likely to seek and maintain adequate health care, representing a common barrier in obtaining treatment for the addiction.

 

In 2018, The Canadian Centre on Substance Use and Addiction (CCSA), in collaboration with the Canadian Institute for Substance Use Research (CISUR), released substance use costs by province and territory. It was found that the cost of substance use in Ontario is approximately $14 billion. $5 billion of which was associated with lost productivity as a result of substance use.

 

Co-workers of drug-addicted individuals often take on additional responsibilities at work to accommodate decreases in productivity. They also work longer hours “covering for” drug addicted individuals who fail to show up as scheduled. Someone working while under the influence of drugs and alcohol are at higher risk of workplace related injury, resulting in increased insurance premiums passed on to employers and co-workers.

 

A loss in productivity affects employers directly and if drug-use is rampant, can result in loss of the business. Smaller to medium-sized businesses are most at risk of failure resulting from drug related decreases in productivity.

 

Evidently, substance use and addiction is on the rise in Canada and the implications are noticeable. So how does this affect St. Catharines and the Niagara region as a whole?

 

In 2019, the city of St. Catharines topped a list of Ontario cities hardest hit by the national opioid epidemic. As such, both prescription and non-prescription opioids are among the most widely abused drugs in the city.

The list, compiled by Simcoe Muskoka District Health Unit in July, places St. Catharines as number one among Ontario municipalities with populations of more than 100,000, for the number of residents who visited emergency departments suffering from opioid overdoses in 2019.

 

According to Dr. Andrea Feller, Niagara’s associate medical officer of health in the first half of 2019, Niagara Emergency Medical Services paramedics responded to 335 suspected opioid overdoses for an average of 56 calls a month. That’s compared to 2018, where there were 496 suspected opioid overdoses to which EMS responded with about 41 per cent of them in St. Catharines and 27 per cent in Niagara Falls. That’s an average of 41 calls a month.

 

The somewhat good news is that based on the statistics, there has been a drop in the number of emergency calls for overdoses in the past year. Public Health department staff are hoping the trend continues in the months to come, as a result of interventions that have been implemented by organizations working collaboratively on addressing the crisis.

 

Much of that work is being done by Positive Living Niagara which runs an overdose prevention site in St. Catharines, while naloxone kits are distributed through harm reduction programs and organizations including Start Me Up Niagara offer outreach programs.

 

Niagara hospitals are contributing as well, offering Rapid Access Addictions Medicine clinics to patients who need assistance.

Glen Walker, executive director at Positive Living Niagara, attributes the cause of many opioid overdoses to fentanyl, a powerful opioid that is up to 100 times more potent than morphine.

 

“The problem with fentanyl is people don’t know how much is in [each] dose they are taking,” said Walker. “It is very risky and we don’t see a plateau in terms of overdoses that would give us some encouragement. We are still in the midst of the crisis and there doesn’t seem to be an end in sight.”

 

In 2016 there were over 40 opioid overdose deaths in the region which works out to just about three per month. In 2017 the number increased to 74 or about six per month. Up to the end of Fall 2018, there were 68 opioid overdose deaths for the year, an average of eight deaths a month.

 

Although pharmaceutical opioids are responsible for some of the deaths, a large portion of deaths as a result of opioid overdose are due to non-pharmaceutical drugs.

 

“The frustrating part is we have no control over the supply,” said Walker. “A lot of us are working on what to do after overdoses have occurred — and when someone is motivated — how we can get them into treatment.”

 

More and more businesses in the region have started to report feeling threatened and unsafe during their operations due to run-ins with violent, drug-addicted individuals. As a result, calls for more police presence have been made throughout 2019.

 

For 2020, the Niagara Regional Police (NRP) will be increasing their number of constables by 40 — one of the largest cohorts in recent years. This increase comes as a result of often complex calls, which when coupled with drug addiction issues, do not allow for a particularly quick or easy solution.

 

“The number of recruits is based on the number of calls for service, as well as the operational need determined by the chief,” said Ken Gansel, chair of the NRP board.

 

It is expected that with the increase of police presence in the region, there will be a greater handle on the volume of calls and police-reported issues related to substance abuse and drug addiction.

 

A holistic approach is needed, however, to address the underlying factors that lead people to drug use. Currently, the municipality of St. Catharines is working with other local organizations and the provincial government in order to properly address each of the factors that lead to drug use and is expected to have a plan completed by 2021.

Drug addiction is a complex illness with far-reaching consequences for those who know, work with and support the drug-addicted individual. Even if individuals don’t know someone who is abusing drugs directly, they are likely impacted in other ways both directly and indirectly. As such, it can be beneficial to know the resources available to help individuals who are faced with addiction and help create a safer environment for both substance users and non-substance users alike.

 

The City of St. Catharines is currently the location of the Niagara Region’s first and so-far only supervised injection site known as StreetWorks. The site, which is operated through Positive Living Niagara focuses on helping to prevent overdoses and deal with the regional opioid crisis. Streetworks, funded by The Ministry of Health, provides personnel who can supervise people injecting drugs who may otherwise be doing it alone, provide naloxone for those who overdose and supply harm-reduction services and supports.

 

According to Walker, as of March 2019, the clinic, which is located on Queenston Street in downtown St. Catharines, has saved just over 55 clients from drug overdoses since it opened. The site has only transferred two patients to the hospital as a result of overdoses.

 

According to Talia Storm, manager of StreetWorks, there are over 200 unique people who access the space regularly and in May of 2019, the site had just shy of 1,000 visits.

 

“We tend to average about 30 overdoses successfully reversed every month,” said Storm. “We have been receiving positive feedback about fewer syringes being found in public spaces. In addition, a lot of people using the site are connecting with other service providers in the space.”

 

The overdose prevention site is open seven days a week, from 9:30 a.m. to 3:50 p.m. Individuals go in, provide their name, date of birth, what they intend to use and any past usage so paramedics can respond should they need assistance. They are then given 30 minutes to inject or ingest their substance of choice at a designated station with clean materials, before being invited to stay an additional half-hour for monitoring.

 

Harm-reduction programs, like StreetWorks, are slowly being adopted across the province in hopes that they can provide a gateway to addiction treatment.

 

For individuals who may require help with addiction or know someone who might benefit from the services that help overcome addiction, Community Addiction Services of Niagara (CASON) offers a variety of professional and confidential recovery programs. Funding for CASON has been provided by the Hamilton Niagara Haldimand Brant (HNHB) Local Health Integration Network (LHIN) and as such is free of cost. Individual counselling is available by visiting CASON at 60 James St., St. Catharines or via telephone at 905-684-1183.

 

The Niagara Region Withdrawal Management Service also provides assistance to individuals faced with substance-use disorders and is open 24/7. The centre provides crisis intervention, withdrawal management, rest, nutrition and hygiene restarts, assessments, supportive counselling and self-help groups, consultation, treatment referrals and discharge planning in a supportive, supervised setting where no referral is necessary. Inpatient and outpatient support is available at 264 Welland Ave., St. Catharines or via telephone at 905-682-7211.

 

Naloxone kits are free in Ontario. Naloxone is an emergency medication that blocks the effects of  opioids such as fentanyl, heroin, methadone and morphine. Whether for personal use or for use with a loved one at risk for an overdose, individuals can get naloxone kits and training on how to use them from Positive Living Niagara by calling or texting 905-328-6715.

 

For those who have lost loved ones due to substance use, Niagara Area Moms Ending Stigma (NAMES) is a group of parents, family members and community members from the Niagara Region and beyond who have lost their loved ones too or are coping with substance use disorder. To join and receive support from the group, interested individuals can engage with their Facebook group at www.facebook.com/NAMESNiagara.

 

If any individual requires assistance, but does not feel comfortable going to a rehabilitation program at the moment, some useful phone lines in the region that offer support are:

 

Distress Centres:

 

St. Catharines / Niagara Falls: 905-688-3711

Welland / Port Colborne: 905-734-1212

Grimsby / Beamsville: 905-563-6674

Fort Erie: 905-382-0689

 

Other related services:

 

Narcotics Anonymous: 1-888-811-3887

Drug and Alcohol Help Line: 1-800-565-8603

Mental Health and Addictions Access Line: 1-866-550-5205

Positive Living Niagara: 905-984-8684

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