BEPPLE – Access to primary healthcare key to fighting drug addictions

YESTERDAY, AUGUST 31, International Overdose Awareness Day, was a time to pause and reflect on this other pandemic that has swept our city and our province.  There were 1,011 fatal overdoses in B.C. between January and June of 2021.

The BC Centre for Disease Control reported that, here in Kamloops, one or more are dying of suspected drug overdoses every week.  Sixty people died last year in Kamloops.  Another 32 have died so far this year.

Since the beginning of the overdose pandemic, I have seen friends, colleagues and children of friends die of drug overdoses. We all have. In Kamloops, the illicit drug overdose pandemic goes on and on, and is getting worse.

Yesterday was International Overdose Awareness Day. Today, we move on. But what should we do?

The drug overdose pandemic has affected us unequally.  BC Centre for Disease Control reports that in 2020, 40 percent of paramedic attended overdoses were men from 19-39 years old, and 25 per cent were males 40-59 years old.  Overall, males are dying at five times the rate of females. Illicit drug overdoses are especially a male health pandemic.

In The Netherlands, many health care services have adopted a triad approach to mental health issues.  In the triad is the individual, the healthcare providers, and the family. The individual is supported by expertise of the health care providers. The family act as advocates for the individual.

Here in B.C., it sometimes feels like a one-leg stool, with the individual expected to self-advocate, and to deal with drug dependencies while having limited access to primary health care services.

Access to primary health care is difficult for many in B.C., especially for men.

In Kamloops and in B.C., obtaining a family doctor or other primary health care provider is difficult.  Across B.C., more than 760,000 people do not have a family doctor or other primary health care provider.  For men, it is far worse.  Statistics Canada reports overall men are almost 50 per cent more likely to not have a primary health care provider.

It is worst for males from 18-34 years old, where 30 per cent do not have a regular health care provider compared to 20 per cent for women in the same age range.  In all age ranges from 18 to 64, males are less likely than females to have a primary health provider.

One of the solutions to the opioid crisis that some propose is access to a safe drug supply.  One option is physician prescribed opioid replacement, such as methadone.  Drug users cannot access Opioid Agonist Treatment (OAT) without access to a primary care provider.  Almost 1,700 individuals in B.C. access this service.  Having access to a physician is key to accessing OAT.

Health care providers cannot be part of supporting an individual with a substance use problem through programs like OAT if that individual does not have access to primary health care.

Key to the Dutch approach is three legs: the individual, the health care providers, and the family.

Reading through the BC Centre for Disease Control “Overdose Response Indicator Report” and supporting “Overdose Emergency Response Report,” there is direction for creating Community Action Teams of people and families with lived experience, First Nations communities, municipalities, first responders, front-line community agencies, businesses, local government agencies and local recovery communities.

It is good to see that families are part of the Community Action Teams, but increasing their voice is important. The Dutch have identified families as the most important advocates, and they need to be supported in this role as well.  As much as individuals with drug dependencies need access to health care, their families need support in being stronger advocates.

As the number of deaths by opioids mount, we need to remember that men especially have been hard hit by this health care pandemic.  The average age of those dying of drug overdoses is 44 years of age. Four out of five who die are men.

The International Overdose Awareness Day is past, but for many, memories of loved ones linger on. Increasing access to primary health care for men should be a priority.  Supporting their families to better support them needs to be just as important.

Nancy Bepple is a former City councillor of Kamloops with a strong interest in community building projects.