Vital Perspectives
Introduction
Vital Perspectives is a four-part story series about some of the broadest public health issues of our time and how they impact individual and population health in Oxford County, Elgin County and the City of St. Thomas. They amplify the vital perspectives of those with lived experience, public health professionals, and community partners. We hope this series helps you learn more about public health work and the issues that require our shared time, energy and investment.
Part One
There are few crises that have beset so many communities so quickly as the opioid crisis has. Across Canada there are approximately 20 opioid toxicity deaths per day - more than 7000 each year. There are countless physical, psychological and social harms beyond death for the individuals who consume opioids, and for those who love and care for them. The reasons behind this crisis are complex and multi-faceted. The resolution to this crisis must be complex and multi-faceted as well. Prevention, harm reduction, treatment and enforcement are all equal and important parts of the solution - as are the associated factors of belonging and connectedness, housing, employment, mental health, poverty, and discrimination and violence.
It is our sincere hope that you will watch our videos, read our stories, review our data, and share what you have learned with your friends, your family, and your colleagues.
Partner Spotlight: Central Community Health Centre Team is Helping People Move Toward Better Health
“It’s important to recognize that people use opioids to deal with their past and present traumas as well as a coping mechanism for when they’re stressed. But despite the fact that each person has a different relationship with opioids, each can be helped.”
CENTRAL COMMUNITY HEALTH CENTRE IS TREATING OPIOID ADDICTION IN ST. THOMAS. READ THEIR STORY. |
For the past two years, Dr. Joseph Mai and Registered Practical Nurse (RPN) Shelley West have provided treatment for opioid addiction to vulnerable and homeless patients in St. Thomas through the Central Community Health Centre’s (CCHC) Primary Care Outreach Clinic. Each week at INN Out of the Cold, they help people suffering from addiction to break the cycle while providing a safe space that embodies acceptance, understanding, and freedom from judgment. Dr. Mai and Shelley agree that the historical responses to the opioid crisis have been ineffective and it’s time to focus on an individual’s needs rather than their failings. Furthermore, they stress that barriers to wellness, such as housing and mental health, must be addressed as part of the treatment for addiction. “It’s hard to treat patients unless they have a place to stay, and we see that treatment is most successful when patients have security and they are also receiving mental health care,” they say. Addiction is complex and there needs to be a strong foundation supporting each person wanting to move forward with their health. Recent research has shown that Buprenorphine, available as an ingestible medication known as Suboxone or an injectable known as Sublocade, is an effective treatment for Opioid Use Disorder (OUD). Sublocade works by eliminating cravings and withdrawal effects and each dose is effective for 30 days. It allows patients to participate in their daily lives without having the interruption of a doctor’s appointment or pharmacy visit daily or weekly. As with other OUDs, “eliminating withdrawal and cravings helps with improved mental health and family relations,” Dr. Mai says, “The problem isn’t that we don’t have a treatment, it’s that some treatments like this aren’t well accepted.” The program offered through CCHC doesn’t require complete abstinence from substance use. That’s because the team understands there is often a psychological dependency on substances to mitigate previous traumas. There is a lot of misinformation circulating that leads to many forgoing the treatment available to them. That is something both Dr. Mai and Shelley are hoping to disband. “A lot of patients come to us through word of mouth, and we first talk to them about how Sublocade works. We chat through their worries and anxieties and the negative stories they’ve heard,” says West. The program does not turn anyone away and they put an emphasis on completing the injection quickly as there is a risk of the patient not returning if there’s a delay in administration. “These are people who may have been put on pain killers twenty years ago for chronic injuries, who come back a week after their first injection and tell us they went from rock bottom to being able to do things like walk their dog and maintain relationships with their friends and family.” This is the result of the Sublocade which remains constant in their systems throughout the month and helps to reduce cravings. The lack of awareness about treatment options like Sublocade, and the perpetuation of stigmas surrounding substance use will continue to hold people back from better health unless we have new conversations from a different lens. Dr. Mai and Shelley are only at INN Out of the Cold one afternoon a week, but they make themselves available by phone or in person throughout the week to both current and potential patients…”If they wake up at 2 p.m. in the afternoon and can’t find someone available to administer Sublocade, that’s an issue in their treatment journey, so, they can send us a message and plan for when they can come see us. We are very diligent about seeing them and building trust [that the care will be there for them],” says West. Dr. Mai and Shelley have not lost a patient of this program in the two years they’ve been offering it. The message they both want to convey is that people experiencing addictions have a chance at reentering society and getting their lives back. “We have had patients who had businesses years ago who have restarted them,” says Dr. Mai, “We need to understand that we all play a part in how our society functions, and if we want a better society, we need to take the steps to help those around us.” There is hope, there is help, and there is space for understanding and empathy. However, there needs to be a more multifaceted approach that focuses not only on addiction but also mental health care and housing as these issues are all so intricately weaved together. |
Community Story: Brennon's Overdose Was Preventable
“As soon as we got to the hospital, we knew, but we had to wait forty-five agonizing minutes in a back room for them to tell us our son had passed away.”
BRENNON'S YOUNGER BROTHERS AIM TO SERVE THEIR OWN COMMUNITIES WITH EMPATHY AND UNDERSTANDING. READ THEIR STORY. |
In October, it will be two years since the passing of Brennon Verhegghe, a funny, polite, and sometimes overly honest son and brother. Brennon loved to fish on the lake. It was the last thing he did with his family before his death, and indeed that is where they chose to spread some of his ashes. His family hopes that sharing his story and his struggle will help others and raise awareness about the gaps in services that must be bridged if we are to change the course of the opioid crisis. Brennon’s parents, Angie and Mike, and younger siblings, Donovan, and Reese, are the Godelies from Norwich, Ontario. For 11 years, they battled Brennon’s addiction alongside him and didn’t give up hope that he’d overcome it with the help of rehabilitation and healthcare services. They remained hopeful even as his addiction worsened. The Godelie’s eldest son passed away of an opioid overdoes at 27. He’d injected a ‘speedball’ (combination of fentanyl and meth), after a significant stretch of being “clean.” When Brennon was a teen, he had to change high schools when the one in Norwich closed, compelling students to choose between alternatives in Woodstock or Delhi. Brennon chose Woodstock because of its many opportunities in the trades. At 16, he became close with a crowd who smoked cigarettes and marijuana. His family believes this was his steppingstone to riskier behaviour and harder substances. During those same teen years his mental health began to suffer but he was waitlisted for the mental health services he needed. When he was 16, neither his parents nor the police had the authority to keep him home or return him home when he was engaging in risky behaviour in the community. Essentially, he could just come and go as he wanted. In 2018, Ontario’s Youth Welfare System raised the age of protection from 16 to 18 years old, a change that came more than a decade too late for Brennon. “We couldn’t force him to stay home but we were responsible for him until he was eighteen,” Angie and Mike say. “When he first started to stay out in Woodstock or Ingersoll for two to three days at a time, I’d go out and find him and tell him we were going home. One day we were a few minutes into the drive when the police pulled me over because Brennon had called, and they told me I had to let him go because it was unlawful confinement.” Brennon began to have more significant run-ins with the law, which started a cycle of him asking his parents to bail him out, typically under the condition to stay at the family home, and then being released back out on his own only to repeat the cycle. Each time Brennon was released from jail, his addiction became progressively worse. He became thin and had scabs on his face. The Godelies felt something like relief when he was in jail because they knew where he was, and they knew he was sober and had food. “When Brennon was using, he was paranoid and thought we were out to get him, but when he was in jail, he got his personality back and we’d talk on the phone,” shares Donovan. “When he got out, we always made sure he had clothes, we packed him care packages, we told him we loved him. He never missed a birthday celebration unless he was in jail,” Angie adds, “We told him there was always time to turn it around.” Throughout his addiction, Brennon left home to use substances out of sight from his family, but that in turn caused ongoing concern for his whereabouts and wellbeing. Brennon would detox from substances in jail but would often be released on a Friday without a prescription for sublocade or methadone. By Monday he had relapsed again- waiting to fill a script. By his early 20’s, Brennon was both HIV and Hep C positive. “If there’s something to take away from Brennon’s story, it’s to have open communication because you never want your kids to be afraid to talk to you about anything, even if it’s an uncomfortable topic like using clean needles.” Brennon and his mom had very direct conversations about his substance use and he would reflect on what he learned by saying things like, “it’s a mistake to try anything new because you’ll chase that first high forever.” More importantly, Brennon didn’t want to die and said, “If [ODing] happens, Mom, I want you to know I didn’t mean it and I’m sorry.” While the conversation was difficult, knowing his wishes for arrangements following his death by overdose brought the Godelies some peace. Brennon overdosed six times before he passed away. Around Thanksgiving 2021, Angie and Mike could tell he was using again, despite having been sober for an extended time. Brennon was with his friends when he injected the speedball, and although he was administered naloxone, his parents received the phone call of their worst nightmares. “After forty-five minutes of waiting in a quiet room at the hospital and asking for a yes or no, so I could be the one to tell people if he’d passed away, detectives came in and said he didn’t make it,” says Angie. His parents weren’t shocked, but his death stood in stark contrast to their belief that recovery was possible. Brennon’s story is like too many others in this community and beyond. Extensive rehabilitation programs, service coordination following release from jail, counselling and mental health services, and more understanding about the nature of addiction are all things the Godelies believe could have saved Brennon. And could save others too. They want their community to remember that people who suffer from addictions deserve love and support- even if from a distance – and that it is not too late to “turn things around.” Brennon’s experience with addiction has been the main motivator for his younger brothers to work toward careers in policing and paramedicine. Ultimately, they want to serve their communities with empathy and understanding for those dealing with addiction. |
Infographics: Telling the Story of the Opioid Crisis in Oxford County, Elgin County and the City of St. Thomas
The health harms related to taking opioids (heroin, oxycodone, hydrocodone, morphine, methadone) have increased and continue to increase, across our region. These harms include deaths, infections, and overdoses requiring emergency services and hospitalization. The average number of monthly deaths from opioid overdoses have increased from 1.42 per month in 2019 to 3.83 per month in 2021.
Download full size infographics as PDFs.