Eight Canadians are dying every day from prescription painkillers and illegal fentanyl, chief public health officer, Theresa Tam, announced this fall. Public health agencies are scrambling to better understand and to respond effectively to the growing epidemic of opioid-related overdoses.
“No area of Canada is necessarily safe from this crisis,” Dr. Tam said. “Everybody needs to be prepared.”
As Rudy Eikelboom stated in CC recently, the dangers of fentanyl and of the even more powerful carfentanil are great. Naloxone, also known by its trade name Narcan, is a temporary antidote and “miracle drug,” bringing an overdose victim back from the dead.
“For a Christian doctor,” Dr. Lindsay Stokes writes, “Narcan looks like grace in a syringe.” “A spray up the nose, a shot in the thigh or a push through an IV and within seconds: a miracle. The dead live. A sin is forgiven. The hopeless receive hope” (Christianity Today, August 2017). Naloxone works quickly, within minutes, and its life-giving effects last about 45 minutes with minimal side effects. The World Health Organization (WHO) now considers it an essential medicine, among the core medications needed for basic health care.
Canada’s opioid crisis raises questions surrounding prevention, harm reduction and, for Christians, what the church’s role and response should be. The Ministry of Education states that “each local school board is responsible for decisions regarding the distribution of substances like naloxone,” which results in some disparity across the country. Ottawa Region School Boards committed to having naloxone nasal spray kits available in their high schools. Waterloo Region has yet to make a decision. Both the Toronto Public and Catholic and Dufferin-Peel Catholic School Boards do not currently plan on providing naloxone, “preferring to leave emergency medical care in the hands of the professionals.”
In Canada’s western provinces and territories, where the opioid crisis is more severe, school curriculum and programming is already being updated to include information about harm reduction and overdose recognition. In B.C., drug awareness education begins in Grade 6. In the Yukon, all school administrators are trained in how to use naloxone.
Justin Cook, Ontario Alliance of Christian Schools (OACS) Director of Learning, told CC that while “no formal conversation” has been had about carrying naloxone in OACS schools, “we want to engage in any educational issue [in a timely manner for our students].” Matt Johnson is the Outreach Coordinator of Toronto Harm Reduction Alliance (THRA), the organization responsible for the pop-up safe injection site that opened in Toronto’s Moss Park August 2017. He told CC, “I think all schools where people are using opiates should be stocking naloxone kits. . . . I would also like to see harm reduction implemented into curriculum when drugs and drug use are discussed.”
“‘Good Samaritan’ policies [should also be extended, meaning] people who report an overdose do not risk getting in trouble in case they were also using. More programs created for children and youth who have or are experiencing trauma [also need to be addressed].” Sean O’Leary, an Ottawa-area member of We the Parents, told CBC, “Schools have EpiPens for kids that may have an allergic reaction; they have CPR training, yet if a kid overdoses they’re essentially waiting for first responders to get there.”
Are teens at a higher risk than adults for opioid addiction? Andrew Hendriks, a manager with Ottawa Public Health, doesn’t think so; he suggests that marginalization, not age, is a more likely predictor, with one exception – teens who are struggling with mental illness.
“Students that self-report fair or poor mental health are three times more likely to use opioids for non-medical purposes,” he said. Not naïve to drug use in Christian schools, Cook states that the OACS does not see current evidence of a crisis in opioid use amongst OACS students; however, Cook observes increased levels of anxiety and other mental health issues. In response to these increased mental health concerns, Cook told CC that students have access to guidance counsellors and to referrals with Christian mental health professionals. Cook also notes the fundamental value in schools providing a place for students to be honest about their joys and struggles: “it is a place where students have a voice and place of belonging.”
The Centre for Addiction and Mental Health (CAMH) surveyed students in 2015 and found that 10 percent reported the non-medical use of prescription opioid pain relievers. In his interview with CC, Cook discussed how Christian schools must engage in, not retreat from, culture. “The gospel is clear; the Christian response is to reach out. Christ compels us to love our neighbour; we must get intimate with the issues instead of judging from a distance.” OACS is continually “open to becoming connected” with community organizations already at work in reaching out in various ways. From the frontlines of Moss Park, Matt Johnson of THRA told CC that “Not everyone needs to or should try handing out needles or taking on harm reduction work. Each organization can play a part in supporting people who use drugs with some part of their life. With food, clothing, shelter, whatever [can be offered].”
“Chaplain! Someone is overdosing in the bathroom upstairs!”
It’s an increasingly common refrain at The Salvation Army Vancouver Harbour Light, according to Chaplain Jordan Shaw (“The Sobering Truth,” The Salvationist, Sept. 21, 2017). Support staff will administer the antidote while Shaw stands “ready to pray, offer spiritual counsel or . . . be a calm presence at a chaotic scene.”
“We used to see one or two in-house overdoses a year. Last year there were 12, and as many as 10 in a single day in the alley behind our shelters.”
Is this the new “compassion ministry” for churches? Cpt. Mark Stanley, Salvation Army’s Alberta & Northern Territories Divisional Secretary, told CC, “Harm reduction approaches are an important and life-saving first step. Each intervention is an opportunity to provide critical, direct support and can be a point of initial connection to help and support individuals to begin a journey to healthier living.”
“As Christians it is our responsibility to preserve life and to assist people to address their challenges and the root causes of their addiction. . . .We believe in working holistically [supporting a person’s] physical, mental, emotional and spiritual needs.” Looking at the root causes of drug use provides perspective and direction in response to the opioid crisis. Zoe Dodd, part of the THRA team, says that “the use of drugs is a symptom of broader social ills, like homelessness, abuse, the effect of residential schools on Indigenous communities, unemployment and poverty.” Toronto-based Johnson echoes this perspective to CC, “For the people that use chronically and chaotically, the main reason is pain and trauma.” Public opinion of people who struggle with drug use does not always support this view. Dodd comments, “We have people who sometimes come to the park and say, ‘you’re just prolonging another day of life for someone’. . . I try to explain . . . why we as a society need to take care of each other. . . . We’re talking about people.” Johnson told CC that the THRA team “cares deeply about human beings and wants to see a better world where people can have some peace.” Dodd states, “We need to end the war on drugs. We need to work towards that. We cannot see people as disposable; we cannot just lock people up and put them away for what they put in their bodies. We cannot do that anymore. This is not working. We do have to see it as a health crisis right now, but it’s also a social and political crisis.”
Serious, but not hopeless
In Vancouver, Chaplain Shaw states that “although the situation is serious, it’s not hopeless.” In addition to supporting outreaches like Harbour Light and THRA, churches need to ensure they are “welcoming places to the outsider, the hurting and the forgotten,” for “isolation kills, but community can save lives.” Johnson told CC he wishes there was more overall church support in harm reduction efforts but also shared hopeful examples of ways churches and religious organizations were reaching out. He “applauds” churches that participate in Out of the Cold programs or hand out kits they’ve received from Harm Reduction programs, and appreciates receiving donations from congregants.
When CC asked what else the church and general public can do, Johnson said that “having greater church leadership support of harm reduction philosophy and using the power they have to advocate for a kinder, more social justice approach to the drug war” would be helpful. Additionally, monetary donations, socks, food, grocery gift cards and clothes to harm reduction grassroots organizations like THRA were all listed as needed.
“Whatever you did for one of the least of these brothers and sisters of mine, you did for me” (Matt. 25:40). Acting justly and loving with mercy those on the fringes of society, in both proactive measures and reactionary frontlines, is grace and hope incarnate.