Part 2: Impact of Overdose Care on Frontline Peers
Over the past several months, several of PAN’s staff have been sitting down to consult with Candice Norris about her observations and experiences with the opioid overdose public health emergency. Candice is an Aboriginal woman from the Cree/Dene nation who has been in recovery from substance abuse for more than seven years. She was diagnosed as HIV+ 22 years ago when pregnant with her now 21 year-old (uninfected) daughter and she has been active in research, evaluation and advocacy projects related to people’s experiences with living with HIV for more than a decade. Candice became involved with PAN as a Peer Evaluator for the PLDI Impact Evaluation and is currently a consultant to PAN on the Opioid Overdose Crisis.
As a resident of the Downtown Eastside, Candice has experienced the loss of neighbours, friends and family members as a result of the opioid overdose public health emergency, and is a member of many advocacy and healing activities that the community has initiated in response to these losses. This two-part blog post series was inspired by discussions with Candice about her perceptions of the data she read in a report by the BC Coroner’s Service, and from our talks with her about her contributions to the incredible peer-based initiatives that have emerged in response to the overdose crisis. We hope that you will find these posts, a contextualized look at the current crisis from the perspective of an Aboriginal woman trained as an evaluator and deeply involved in a hard hit, but resilient and activist community, as insightful and thought-provoking as we do.
While the BC Coroner’s Service report provides insight into the deaths related to the opioid overdose crisis, Candice is also experienced in the impacts of reversing people from what would otherwise be fatal overdoses. While the media often focuses on reporting the impacts of overdose deaths, Candice explained that there are many traumas and challenges being experienced by those who are administering naloxone and/or performing rescue breathing to bring back their family, friends, and clients from overdose. This work is taking a severe toll on those who have found themselves on the frontlines of the opioid overdose public health emergency. She explained how her friends on the frontlines of responding to the overdose, including peer workers, are being “burnt out” and “not replaced fast enough.” Candice described an incredible need for more frontline workers, including more peer frontline workers.
Candice talked about the trauma that friends experience when pulling their friends, family members and other people they know back from the brink of death, and how there are not enough resources or forms of support for peer workers to continue stepping up in response to this crisis without suffering from burnout. In addition to the lack of support for peers, Candice has observed a lack of support and increasing rate of burnout for frontline service staff who were hired for jobs that are very different from the overdose reversals that they now find themselves providing.
Candice described one group that has been crucial to providing training and support for those living in the Downtown Eastside’s Single Room Occupancy (SRO) hotels: The TORO (Tenant Overdose Response Organizers) Program. This program is part of the DTES SRO Collaborative and they are doing really grassroots work in SROs; for example, the group provides naloxone trainings in the hallways of SROs, where they set up coffee and snacks on the floor and train residents on how to identify and reverse overdoses. The goal of the TORO Program is to have at least one ‘TORO,’ a peer resident, in each of Vancouver’s 12 privately owned SROs. Each peer TORO leads group and one-on-one naloxone trainings, and distributes TORO program-provided harm reduction supplies to the building residents. The peer TOROs are also responsible for communicating with the TORO program coordinators, who then communicate with Vancouver Coastal Health and the City of Vancouver about issues related to overdoses in their buildings.
Candice also described the number of frontline staff members participating in First Nations wellness practices, like smudging, talking circles and prayer circles. She explained how many of the frontline and peer responders who are suffering from responding to overdoses and witnessing so many deaths are seeking out spiritual wellness practices and training as coping strategies. She explained how bringing in culture promotes wellness, describing how “the soul yearns for it” when people hear drums. Candice believes that more outreach and resources to help people access wellness practices would provide people with the spiritual support to help them slow down on drug use and/or abstain at a faster pace. Candice herself co-facilitates a Friday talking circle/drum group for the residents, their families and personal supports in the Raincity Housing building where she lives. She also described how quite a few staff and community frontline workers attend the circle/drum group she co-facilitates, explaining how it has becoming a valued space that people find helpful and healing in terms of managing their grief, loss and trauma.
On the topic of recovery, Candice emphasized that people need support right when they have that moment of clarity where they want to stop using drugs. She spoke of a new detox-at-home program, the START Team, as having a lot of potential and as a program she’d like to see come to the Downtown Eastside. With regard to other detox programs, Candice sees a need for good detox and treatment beds where residents follow programs with rules and restrictions intended to help them to abstain from their use of drugs. Beyond immediate detox and treatment, there is a need for wellness resources to help people avoid relapsing. Candice named The Aboriginal Wellness Program as a place that has been really successful in helping people by offering wellness resources.
Candice is hopeful about the impacts of the new initiatives and funding for interventions related to the ongoing opioid overdose crisis. She is actively involved in her community’s response to the impacts of the public health emergency and we at PAN are fortunate to have her consulting expertise on-board as we work to respond to the needs identified by our members. Candice is especially committed to advocacy and interventions aimed at reducing the impacts of the crisis on the indigenous community, which has been hit the hardest in terms of suffering a disproportionate number of overdoses and overdose deaths. With the hope of more funding geared toward life-saving detox and treatment programs and wellness resources, Candice prays to see an end to this epidemic soon.
Learn More:
Read Part 1: The Who, What and How of Drug Use that Impact Overdose Outcomes
Vancouver Coastal Aboriginal Health Programs
Questions? Feedback? Get in touch!
Heather Holroyd, PAN’s CBR and Evaluation Coordinator at [email protected]