Alcohol, marijuana, cocaine and opioids.
Of the four most commonly abused substances in northern Manitoba, the first three have been on the public radar for decades.
But opioids, a class of powerful painkillers that includes fentanyl and oxycodone, are a relatively new – and growing – public health worry.
“People can overdose on many substances. We are particularly concerned with overdosing from opioids,” says Tara Dutcawich, a Flin Flon-based public health nurse whose focus includes drug use and harm reduction.
Government data shows at least 2,458 Canadians died from opioid-related overdoses in 2016. Statistics suggest thousands of other Canadians endured non-fatal overdoses.
In some cases, these people were prescribed an opioid medication to relieve pain and then became addicted; in other cases, they sought out the drug recreationally.
It’s unclear how many opioid overdoses occur in northern Manitoba. Dutcawich says there is no opioid surveillance program in the province, and she cannot speak anecdotally on the subject.
What is clear is that the national opioid epidemic is not, as small communities may mistakenly believe, limited to big cities.
“Overdose from opioids can happen to any person who is using the medication, whether they are prescribed it by a physician or they are misusing the medication and buying it from a person illegally,” says Dutcawich. “Overdose doesn’t discriminate.
“Addiction to alcohol and drugs can happen to anyone. It doesn’t matter your race, socioeconomic status, age, gender, the size of your community, etcetera.
“Addiction is very complex and it is affected by our social determinants of health, life experiences, trauma, etcetera. All of us have opioid receptors in our brains, so anyone can become addicted to these medications.”
Flin Flon has responded to the opioid crisis with a combination of resources and public-awareness initiatives.
Dutcawich and colleague Leah Lemauviel, another public health nurse whose focus includes drug use and harm reduction, work closely with the Addictions Foundation of Manitoba to help clients reach their recovery goals.
Last week, the women set up a display at the Flin Flon General Hospital to educate hospital staff and the general public on overdoses, and to reduce the stigma of drug-related death.
Their display also showcased the community’s latest weapon in the fight against overdoses – a take-home kit used to treat individuals suspected of overdosing on opioids.
The kits contain a mask to be used as a barrier so an individual can safely perform rescue breathing on the overdose victim. Also included are three doses of naloxone, a drug that blocks the effects of opioids and can reverse an overdose.
Since January, the Primary Health Care Centre has been offering free take-home naloxone kits to people who use opioid drugs, whether prescribed by a physician or not. Training is provided.
There is no data on whether the naloxone kits have saved lives in Flin Flon. Dutcawich notes 21 kits have been distributed through the centre so far.
People who do not themselves use opioids may purchase a naloxone kit from Pharmasave on Main Street. Pharmasave will provide training on how to use the kits.
Dutcawich stresses the importance of immediately calling 911 if someone suspects an overdose, regardless of whether a naloxone kit is on hand.
Several options are available to residents seeking to overcome problematic substance use. Dutcawich points to the Primary Health Care Centre, Addictions Foundation of Manitoba, the Play It Safer Network at the Flin Flon Aboriginal Friendship Centre, mental health clinicians, family physicians and public health nurses.
“The tragedy of overdose death is preventable,” she says.
