An overdose call to action: treatment, recovery seen as keys to Catholic opioid crisis response

Every day, on every shift, Solomon Atta worries about the opioid overdose epidemic that has ravaged British Columbia for the past six years. As manager of the Catholic Charities Men’s Shelter in Vancouver, Atta works closely with many male drug addicts – a demographic group that figures all-too-prominently in the province’s overdose-death statistics.

“For the last one month or so, we’ve had an overdose crisis almost every day,” Atta said. “It’s something that’s always in our mind. It makes our job quite stressful, knowing that any time, any day, we may be called to respond to a crisis. There can be some very stressful moments.”

Just how bad the overdose scourge has become in this province was made evident Feb. 9 when the province’s chief coroner, Lisa LaPointe, said a record 2,234 people died last year due to suspected illicit-drug overdoses. That’s a 26-per cent increase over 2020 and works out to more than six persons a day who lost their lives due to a drug overdose. 

In comparison, about there were about 1,500 reported deaths due to COVID in 2021.

Overdose fatalities were at their worst in November and December, when about seven persons a day died. The coroners service reported that 78 per cent of those who died were men and 71 per cent of the victims were aged 30 to 59.

“This public health emergency has impacted families and communities across the province and shows no sign of abating,” LaPointe said. She reiterated her suggestion that lawmakers respond to the crisis by decriminalizing drugs, thus ensuring that drug users can access a “safe, reliable, regulated drug supply.”

Last November, the B.C. government took a small step in that direction by applying to the federal government to remove criminal penalties for people who possess small amounts of illicit drugs for personal use. 

But public support for full legalization appears weak. Pollster Mario Canseco wrote last year, “There is little appetite for a blanket legalization of all substances that are currently controlled or prohibited.” Polling he conducted last April showed, for example, that only 14 per cent of Canadians supported legalizing fentanyl.

Tackling the drug abuse problem through legalization troubles the Catholic Church as well. Pope Francis said in 2013, “The problem of drug use is not solved with drugs.” The Canadian Conference of Catholic Bishops said in a Special Statement in 2017 that while harm-reduction measures such as needle-exchange programs and “safe” injection sites “may reduce the immediate harm done to sufferers by limiting overdose fatalities and the spread of certain communicable diseases, they alone do not address the deeper problem of addiction, nor do they bode well for public safety.

“For this reason, [harm-reduction] measures should not be made the centrepiece of a drug strategy that aims to be truly effective and comprehensive.”

The CCCB quoted from a 2017 pastoral letter from Vancouver Archbishop J. Michael Miller, who said Catholics should respond to the crisis by reaching out to society’s suffering men, women, and young people. The archbishop called on Catholics to urge elected officials to focus more attention on the crisis and the need for more treatment facilities, to promote more education on safe-prescribing practices, and to support 12-step-programs.

At least three such 12-step recovery homes – Sancta Maria House in Vancouver, Talitha Koum Society in Coquitlam, and Luke 15 House in Surrey – have received financial support from the archdiocese’s Project Advance in recent years.

Nationally, complete overdose-death figures were not available for last year, but the Globe and Mail reported that the country was on track for more than 7,000 overdose fatalities in 2021 – up 12 per cent from 2020.

Data collected by the federal government show a substantial increase in opioid-related harms and deaths since the beginning of the COVID-19 pandemic. A simulated model of opioid-related fatalities suggests the number will remain high and could even double by June. The death rate is being attributed to several factors, including higher stress levels as people deal with COVID-19.

A misperception is that the opioid crisis most severely affects the street-entrenched populations in Canada’s major cities, but in fact it’s people using in their own homes who are the demographic most impacted, health officials observe.

British Columbia’s most rural health authority, Northern Health, looks after the needs of about 300,000 people throughout the province’s north. Overdose fatality rates there are as high as in Vancouver, said Kevin Hollett, associate director of communications at the B.C. Centre on Substance Use, an academic centre housed within Providence Health Care.

The problem is fuelled by a lack of access to services, said Hollett. “The most impacted are young men. Most of them are working labour and are using alone in their homes.”

Public messages used at supervised injection sites – “Don’t use alone” and “Carry Naloxone” (the overdose-reversal drug), are not reaching this population,” said Hollett.

“These individuals maybe had an injury in the workplace and so on the weekend are using opioids to manage the pain. They’re using it alone, not socially,” he said. 

Because of the stigma surrounding substance abuse, “they don’t think they should be going to a supervised consumption site or an overdose-prevention site, which is usually directed towards the more street-entrenched population.”

St. Paul’s Hospital in Vancouver has been working with care practitioners and clinicians to be more cautious when prescribing opioids for non-acute or non-cancer pain. During the pandemic, the hospital launched the Opioid Stewardship Program to ensure opioids are prescribed in a way that minimizes future addiction.

The St. Paul’s program provides support for prescribers so they can more confidently prescribe opioids for those who need it for pain and “in a way where that person is not going to be vulnerable to developing an addiction,” said Hollett.

When the alarm was first raised around over-prescribing, there was an inverse response that led to not adequately managing people’s pain,” Hollet said. Today, a drug like OxyContin that might have been prescribed for minor dental surgery would no longer be recommended, Hollett said.

The problem has worsened over the past five to 10 years with a change in the illicit-drug supply. Drugs like heroin are increasingly contaminated with the much more addictive opioid fentanyl. Due to the impact of COVID-19 on restricting the transnational organized crime drug-supply chain, fentanyl – cheaper and easier to obtain – has become even more concentrated in the drug supply.

The B.C. Coroners Service says people are dying of overdoses with higher concentrations of fentanyl in their system, particularly in Vancouver. Users who already knew that fentanyl was in the drug supply – and were adjusting how they were consuming substances – are suddenly dying because there’s even more fentanyl than they expected. Ontario has experienced the same changes over the past year.

Making the situation worse, opioid drug supplies are increasingly being cut with benzodiazepines, which are highly addictive and affect the brain differently than opioids, complicating the overdose response. Naloxone doesn’t work on benzodiazepines, causing people to overdose – fatally and non-fatally – at higher rates.

In Kitchener, Ont., St. Mary’s Parish has been feeding those who go without basic needs as a result of their addictions. Since 2020 the parish has provided tiny homes as an alternative to the tent cities that have sprung up, a common sight in cities nationwide.

St. Mary’s pastor, Father Toby Collins, said COVID-19 has revealed and exacerbated brokenness that has always been present. People who are battling illness as a result of COVID or who are risking their lives on the frontlines, those grieving the loss of loved ones or suffering from financial challenges, stresses around parenting, or relationship challenges that would otherwise be manageable – all have intensified.

Parishioners have stepped up with donations, prayers, and letters of support, Father Collins said. For people of faith looking to help, opioid addiction must be a call to action.

“I think it’s more than anything a call for everybody to walk with those directly affected or those helping with this crisis,” he said. “We may not have the capability of working on the front lines for whatever reason … but it does mean for us to support through prayer, through resources, through affirmation and listening to those who are directly working with people suffering from all these addictions and the mental illness often associated with it. That’s a big help.”

The number of individuals and families seeking help has been overwhelming throughout the pandemic, said Silvana Tibollo, program manager and policy and outreach coordinator at Toronto-based Caritas School of Life founded by Father Gianni Carparelli. The organization takes a multidimensional holistic approach to supporting those suffering from addiction, which includes residential treatment programs.

At one point during the pandemic, 70 people were on a waiting list and more than 20 were waiting for a subsidized bed. With many services having gone virtual due to the pandemic, some people no longer have access and are self-medicating at home, Tibollo said.

In Vancouver, Atta said one resident of the Catholic Charities Men’s Shelter’s died of an overdose last year, even after staff were able to administer Naloxone and paramedics arrived on the scene. The workers were understandably distressed, he said, and counselling was made available to them.

Last week, all staff members attended a semi-annual crisis-management training session provided by medical experts from St. Paul’s Hospital, which is adjacent to the shelter. The session is aimed at making staff aware of all the latest practices for responding to an overdose.

Atta said that although dealing with overdoses is stressful, he and his staff are sustained by their commitment to helping people in need. “And so, if you are religious man like myself, the work is very rewarding.”

With files from Wendy-Ann Clarke, The Catholic Register