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First steps to take to combat drug addiction

When The Citizen speaks to the homeless people on the streets of Prince George the most requested thing is a home. One of the biggest barriers to that is having an active addiction so being free of that addiction becomes the priority.
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Many homeless people want to find a way to get off the streets of Prince George. The first step for many is to overcome their addiction.

When The Citizen speaks to the homeless people on the streets of Prince George the most requested thing is a home.

One of the biggest barriers to that is having an active addiction so being free of that addiction becomes the priority.

But what are the first steps toward achieving that?

“It’s made challenging by multiple things,” Dr. Lawrence Fredeen, said, who is a general practitioner in the Northern Health Authority and started the Nechako Treatment Centre 18 years ago.

“We are truly needing to understand the extent of trauma that plays into addiction. I think what we’re seeing here is the result of long-standing trauma and there is trauma in many forms that people are exposed to. I truly believe that no one sets out to be addicted or homeless so it’s not something that anyone chooses but as a result of life’s events it occurs and they are powerless over it. Finding supports for not only addiction but for things such as trauma-informed counseling is really critical to help people move forward, housing is important, good health care and of course food and water.”

It’s a complex issue and something that’s been present in the world for centuries, Fredeen added.

Alcohol is still the number one addiction in terms of use, mortality rate, illness, time lost from work and injury.

“We can’t forget that as opioids take over there’s a huge push to treat and to have access to risk mitigation strategies and so-called safe opioids but the biggest risk in our society is still alcohol,” Fredeen said. “In terms of access the first step is simply to call detox so when people make that decision we can usually get people in within 24 to 48 hours.”

The only detox centre in the Northern Health Authority is the Nechako Treatment Centre where there is 21 beds available.

“It’s not adequate, by no means,” Fredeen said. “But there are beds available in every individual hospital in all communities but people don’t access them because they are unaware of them and it also comes down to staff feeling uncomfortable dealing with acute withdrawal. So our unit frequently sees people come from as far away as Fort Nelson and Prince Rupert. That’s a long drive when you’re detoxing. So what we need is more dedicated units across the North with staff comfortable with addictions.”

Detox, in terms of treatment, is not the only step that needs to be taken but it is a good entry point.

Detox includes helping people by supporting their withdrawal by using for example an opioid agonist like methadone.

There are also support group meetings and people will be offered workbooks - like one for cocaine and one for trauma - there is also assistance for people to get connected to a physician and a treatment program.

“There are a lot of programs across the province but it’s not ideal because there is no standardization of the treatment programs that are offered,” Fredeen said. “There are different requirements and different admission forms for each program so it’s not ideal.”

Limited beds is an issue but there are now more First Nations programs available but wait times are still between two to four months long.

“Which again is far from ideal,” Fredeen said.

Some programs don’t accept a person who is on a particular medication, and the time it takes to get funding and go through the application process can make the whole process quite daunting, Fredeen added.

“If you’re recovering from addiction and suddenly decide “I want to make this change’ and then being told you’ve got to wait potentially months to get into a program - that could be devastating,” Fredeen said.

He does believe that we are moving in the right direction.

“There is more effort from the government and our addiction leaders to move things forward but there are things that are not optimal for sure,” Fredeen said.

Take heart, detox is a good first step that connects people with a physician, social worker, clinician, nursing staff.

“Detox is a good first step,” Fredeen said. “People can call the number or present to the emergency department, we can get them transferred from emerg to detox or into the hospital. I think having a family physician is critical for follow up because we want to make sure there is ongoing medical treatment provided because many people come in with multiple illnesses like infections, that need to be managed.”

When Fredeen started working in addictions 18 years ago he never dreamt where addictions were heading, he said.

“Who knew that fentanyl would come in?” Fredeen asked. “We came through the opioid crisis in the 90s and now we’re right back into it.”

He believes there needs to be adequate funding for residential treatment programs.

In the meantime, there is the Nechako OAT (Opioid Agonist Treatment) Clinic.

“We accept patients off the street, we accept referrals from physicians - if a person has an addiction to opioids they just have to show up at the clinic and we can help them,” Fredeen said.

“This is a huge issue but it’s not just about addiction, it’s about society in general in terms of what we view as important and how we help each other as a community as we move forward - and not just in Prince George but in the world as a community as a whole. I think it’s been ignored for far too long and I think drugs should be decriminalized - and I’ve said that right from the start 18 years ago - not a popular idea back then. Those would be good initial first steps - and take away stigma, the use of language around it - stop using negative language and use more empowering language. But I think what we really need is accessibility to treatment programs with good trauma counseling to help people move forward in life. I never thought it would grow to this extent when I first started the program. Addiction, as I tell my clients, takes away everything in your life before it kills you and it’s a sad death. It’s a life that’s been unfulfilled to its potential and it’s very sad.”