Just a few years ago Chilliwack did not have piles of discarded needles, and overdoses occurring in its streets.
Now the opioid crisis has its claws in Chilliwack with overdose numbers higher per capita than elsewhere in B.C.
The community conversation in 2017 about what to do about the crisis got underway in the ‘Wack against a backdrop of exploding homelessness, overdose deaths, and rampant petty crime.
Chilliwack was projected to be on track this fall for 29 deaths in total, due to overdose, up from just 12 in 2016. Abbotsford saw 42, while Maple Ridge saw 28.
Fentanyl is considered the prime suspect in the majority of fatalities.
Statistically, Chilliwack came in sixth of seven communities in the Fraser Health region and was 11th of 14 across B.C., with the highest number of deaths due to illicit drug overdoses, according to the June 2017 data from BC Coroners Service.
READ MORE: OD in B.C.
One of the first stories The Progress covered in 2017, was the idea floated by some medical professionals, and supported by one city councillor, about establishing a safe consumption site in Chilliwack.
READ MORE: Consider safe injection
It was only an idea, and has not in any way become reality in terms of funding or planning.
But, along with so many other Canadian communities, Chilliwack is looking for answers and fresh ideas to handle the one-two punch of opioid substance disorder, and the affordable housing crunch, so the topic has been discussed.
Coun. Ken Popove, co-chair of the Chilliwack Healthier Community, stated he could see the advantage of supervised injection services for Chilliwack as long as there was counselling and wraparound services also available as well.
Emergency room physician Dr. Marc Greidanus said he had first-hand experience with the impacts of the crisis, and overdoses.
“I see it in Emergency,” he told The Progress. “It’s obstructing everyone’s care when staff are busy dealing with overdoses.”
Mitigating with the health effects of homelessness, addictions, crime and mental health issues can eat up a good portion of a doctor’s workday in the ER.
A safely monitored site for Chilliwack’s addicts would reduce the chaos significantly, he suggested.
The concept is moving forward elsewhere in the region but not here.
Fraser Health announced two “safe consumption” sites being proposed for Surrey, since that’s where most of the region’s overdose fatalities occurred.
When Fraser Health officials came before council at city hall to answer to criticism, it was to outline its multi-layered response to the crisis for Chilliwack.
Deaths due to opioid overdose were on the rise in Chilliwack, Coquitlam and New Westminster, according to stats presented by Fraser Health in Chilliwack in November.
“We are actively working to establish an ICM team here,” Fraser Health CEO Michael Marchbank told Chilliwack council, adding that the conversation had begun on the setting up a team, with BC Housing and community stakeholders.
READ MORE: Help promised by Fraser Health
They’ve been “gradually” adding to the outreach efforts in Chilliwack as well.
An ICM team would see a multi-disciplinary approach, with clinical support workers, a peer support worker, administrative support, after-hours on-call support, a psychiatrist, a specialized addictions specialist and a physician.
Maple Ridge and Langley have ICM teams set up, but Chilliwack is not quite there yet.
Also planned was an “opiate agonist treatment clinic” with two doctors out of Chilliwack General Hospital to provide opioid replacement treatment.
It was supposed to open by December 2017, but staffing problems have put it on hold temporarily.
But that is where they are headed, with providing first-line treatment for opioid substance with medications like methadone and Suboxone.
Another thing that was made clear by Fraser Health is that the facile cry for more “detox treatment beds” is not the answer.
Critics always frame the problem as a need for more “detox” resources.
However, the medical science says detox on its own is not effective.
“It is absolutely important to emphasize that for opioid use disorder (OUD) the first-line treatments, meaning the most highly recommended, are Suboxone or methadone.”
In fact, the science shows that detoxing without these medications “increases a patient’s risk of death, or elevated rates of relapse” and other health conditions like HIV infection.
It may seem counterintuitive to some, since most people think of treatment beds and detoxing specifically as the ultimate solution to people getting their lives back on track.
But according research by the B.C. Centre for Substance Use, most addicts should be offered community-based, out-patient treatment as opposed to “rapid in-patient treatment.”