Organized by the Canadian Centre on Substance Use and Addiction with the support of Canada, and the Canadian Drug Policy Coalition, the Centre on Drug Policy Evaluation, the Community Addictions Peer Support Association (CAPSA), the HIV Legal Network and the Thunderbird Partnership Foundation
How has the COVID-19 pandemic worsened existing inequities and negatively affected priority populations? How can we lessen these effects in the future? Join our panelists to discuss research and experiences with a Canadian focus.
Moderator: REBECCA JESSEMAN Director, Policy, Canadian Centre on Substance Use and Addiction
Overdose crisis in Canada – increasing overdose rates in BC. Significant trends of increased overdose risk in Ontario. Each panel member brings different discussions to this side event.
MICHAEL NURSE Harm Reduction Outreach Worker, Black Coalition for AIDS Prevention, and Canadian Association of People who Use Drugs
As a person of African descent, I feel that sometimes we look back and often see a strong focus on punishment including imprisonment. Mostly European descent populations have health-based responses. Lack of trust of people of African descent in accessing services – there are no specific services or culturally based services. If they are they, there is lack of funding. In terms of supervised consumption sites: most people of African descent use stimulants, but there is an absence of spaces for people using stimulants. Thinking about safe supply – people who use stimulants need to be considered. Service utilisation has been disrupted by COVID – and our communities are facing huge challenges and don’t have strong leadership to look up to and don’t receive support.
MAE KATT Nurse Practitioner and Addiction Specialist, Thunderbird Partnership Foundation
Indigenous community has strong leadership across Canada – our community leads strong measures. We have a lot of remote communities that are in fly in areas – so in COVID, people lost their drug supply. Innate and traditional language needed in our communities. It’s never just one substance. We created guidelines for remote communities to reduce effects of withdrawal and used traditional knowledge. Unsafe drug supply related to fentanyl – young men and young girls were dying of opioid ODs. Usual dealers didn’t have supply which caused a lot of concern – it was hard to find support. Opportunities – one of innovations we coordinated was virtual care – virtually connected to traditional counsellors. We recognise how unkind community has been to our community. Had to take our traditional knowledge through land and cultural based healing and use it very effectively in our community. Safer supply can provide a lot of support – BC has put in an application for decriminalising possession for personal use. Amounts of drugs that should be provided differs between people – people cant be expected to travel to pharmacy every day in a pandemic. Our northern communities don’t necessarily have health services or hospitals – so we must prevent COVID in these communities. Need to create a safe pathway for healing. Young people most at risk. We are doing may things that we want to continue following the pandemic. Haven’t been able to use our ceremonies or culture to deal with the deaths in our communities to deal with deaths from overdoses and suicides. It will take many years to recover from this.
LISHA DI GIOACCHINO Systems Stigma Navigator, Community Addictions Peer Support Association
Limited access to peer support programs has been noted in pandemic. Pre-pandemic it was easier to manage many substance use disorder (SUD) conditions. Rapid change in practice in pandemic – there has been challenges in receiving trauma-based care. People are stigmatised highly and this effects access to care and coping mechanisms. Many intersections of stigma – Women who become pregnant will experience more stigma when trying to access SUD treatment.
Employment – I have very understanding employers and I encourage others to look at these Opportunities.CAPSA provides peer support services to secure life. Foundational concept honours people’s journeys. Provide a safe environment free of stigma and discrimination. We also provide SU stigma education and promote person first language in workplaces. Multiply treatment episodes are necessary in SU care. Recurrence of my symptoms is a is a part of SUD – just like diabetes – it’s not my fault if I experience recurrence in my condition, women experience stress trauma and violence and use drugs to address this. We need to address adverse childhood experiences. Need to address stigma, especially among women. We support equity-oriented approaches for people who have used substances. Predicting that there has been an increase in stigma during COVID we need to make it safer for individuals to access services. Gender informed approaches are necessary.
We’ve had success in systems of community engagement between scientists and PWUD – seen great progress in implementing these programs. Resources cannot be diverted from SU care during COVID.
JENNIFER SAXE, Director General, Controlled Substances Directorate, Health Canada
Want to recognize that starting point is one where we have inequity. Tragically COVDI is exacerbating the overdose crisis in Canada – in come cases to record breaking levels. PWUD are experiencing and increase in risk during COVID – incl those who must use on their own in quarantine. There are various factors including marginalisation that is exacerbating these challenges – including in black and indigenous communities. Canadian Government trying to take action to better our health system for PWUD associated with toxic supply. Issuing exemptions for pharmacists to increase access to medications. [A few sentences in French]
Providing new measures and funding means people will get the support they need. We’d like to reiterate – Canadian Government is very committed to working with Indigenous, Black and other civil society partners.
Our resolution: Canada recognises the importance of ensure access to services for marginalised solutions. We plan on continuing Canadian priorities in human rights. We believe we have support from like minded countries in the resolution.
Q: What’s being done to reduce inequities for YPWUD?
Mae: Communities have really embraced young people – speaks to how they don’t judge PWUD. Opportunity for healing has been really evident. Delivering support work for young people to connect youth. Unable to provide education in high schools, but we know young people are using virtual means to educate each other. Whole community effort has provided community support – where they have struggled, we have been able to provide other options. We offer ceremony and listening – hearing what our young people are challenged with is important. Seeing success in our communities.
Michael: inspired by Mae’s description of services for Indigenous youth. Not the case for people of African descent – ability to focus support on youth is within same range to focus support in general. The resources that are necessary to provide culturally specific response is not there. Resistance to harm reduction concept keeps focus on need to move abstinence focused approach forward – not the right approach. Experiences that youth are having can lead to increase SU that are not being addressed. Increased number of youth on the streets and seeking shelter – you can see the issue. In terms of being optimistic. Leadership is needed from the services and within communities. Youth know what they need, and have excellent leadership skills. When they can take ownership of there lives they will be able to lead responses to their needs.
Lisha: SU care is available – Wellness Together Canada – focused on post-secondary students. You might have access to rapid addiction management in your city.
Q: Are you seeing a rise in harms from stimulant inhalants? Great change in market and impacted some more that others:
Michael: Yes – the shock that this is happening for people of African descent has an idea that they don’t use opiates so think it doesn’t concern them – and go into crisis – then naloxone is used and you realise your situation was out of your control. Then the fear – will this happen next time? Supply of stimulants is there anymore so people try new substances. Death and loss of life is happening – among people of African descent because of the shame and stigma, when someone dies, we hear it was a sudden death – sometimes you don’t even know that the people in your support networks are gone. Is causing a change in thinking and how we identify – it is new and it is real. Among people of African descent, using drugs during COVID is very distressing, and there aren’t many answers.
Q: Canada has proposed decriminalisation in some provinces: opportunities to ‘build back better’ could address inequities – please share closing thoughts or comments:
Michael: Signs in Canada that gov is willing to listen and move forward with changes that impact the lives of PWUD – challenges for people of African descent – there isn’t a specific way to have our voices brought forward – this is concerning. I’m hoping that in the absence of our voices put forward -to simply address that historically we were wrong is not enough 0 we need to move forward and look as current challenges. Look at new legalised cannabis industry. People need to be able to make an income – people previously criminalised are still be excluded from this new industry.
Mae: clinical perspective: support application for decriminalisation – where our communities differ – some have abstinence-based perspectives – need to work with this. Need to let the healing begin, let people stay alive for that healing, let people heal in their own time. Poverty has remained constant in our community – this needs to change. This is our spiritual scared land that gives us life and medicines – were looking for other ways to reduce poverty on our land and have equal access to healing centres and appropriate nursing services.
Q: Prenatal care
Lisha: very important to recognise foetal and maternal health as one. Need to make sure women can access care – speaks to all people all pathways – different ways to address people’s person centred goals for wellness. I was born with opioid withdrawal syndrome. Mum’s need skin to skin interaction with their babies – their needs to be increased.
Closing remarks: CAROL HOPKINS Executive Director, Thunderbird Partnership Foundation
Good day – I’m located in southwestern Ontario. Want to thank all panellists and speakers today – thank health Canada for this event. It’s the right time for change, and change is critical. Our learning is evolving. I want to thank our speakers for their voices – you’ve put forward meaningful solutions to our overdose crisis and suicides resulting from lack of access to services, including in remote and rural communities. Especially grateful and thankful for your highlight for the need for governance and leadership across background ds and gender for people who’ve experience trauma and who have internalised these beliefs. Youth Indigenous and Black cultural practices are meaningful. We’re thankful for resolution put forward by Canada – those services must include the voices of PWUD and those with lived experience and gender specific fouls. Can’t leave out – solutions must be meaningful. Effective mechanisms for harm reduction. Focus on decriminalisation – of all drugs with no sanctions is critically important to make critical change. If cannot address access to cleaning drinking water and housing and health care – how can we determine the right to life and health. Ensuring safer supply of drugs is critical.
To address and support people no matter where they are is important, and to be through inclusive. Have to sustain meaningful change and access to SDGs.