MESSAGE FROM TSINIKSSINI The Blood Tribe Communications department submitted a proposal to the Alberta Opioid Response Public Awareness Grants For Communities to produce a magazine dedicated to tribal concerns surrounding the ongoing Opioid crisis. We are not alone in our battle to eventually overcome these deadly and extremely harmful drugs. We acknowledge our leader, Makiinima – Chief Roy Fox, our members of council and the Mayor of Lethbridge for their encouragement. We also acknowledge the many professionals including Dr. Esther Tailfeathers and Dr. Sue Tallow Christensen for their dedicated desire to help those in need. We are proud to have you in our midst. As well, we recognize the hard work and commitment provided by our many departments and entities that care deeply for our people and their tireless work in striving for communities who may one day embrace environments free from these drugs. We know there is much more work needed to combat this influx of illegal drugs, and we also recognize the law enforcement agencies, especially the efforts of our Blood Tribe Police Services, who work around the clock to ensure safety for our people. A crisis is a situation that has reached a critical phase of which the results include family dysfunction, poor mental and physical health, child apprehension, loss of family structure, housing problems, legal battles and incarceration and much, much more. The time to stop this behavior is NOW. We hope the information contained within this magazine can help you make up your mind to providing and contributing toward a productive and healthy lifestyle for yourself, your children, family and tribe.
THAT CHOICE IS YOURS.
BLOOD TRIBE SPECIAL EDITION OPIOID MAGAZINE TABLE OF CONTENTS PAGE 3
Message from Makiinima – Chief Roy Fox
PAGE 4
Message from Lethbridge Mayor Chris Spearman
PAGE 5
Kevin Cowan, CEO – Blood Tribe Department of Health
PAGE 6
Kainai Healing Lodge Process
PAGE 7
Suboxone Clinic -- Report
PAGE 8
Blood Tribe Emergency Services
PAGE 9
Gayle Chase – Harm Reduction
PAGES 10-11
Dr. Esther Tailfeathers MD -- Reflections
PAGE 12
Dr. Sue Tallow Christensen, MD -- Report
PAGE 13
Messages From Our Children
PAGES 14-16
Kainai Wellness Centre – Summary Report
PAGE 17
ARCHES – Indigenous Recovery Coach Program
PAGE 18
Kainai Board of Education -- Report
PAGE 19
Blood Tribe Housing -- Report
PAGE 20
Young Man’’s Journey
PAGE 21
Telltale Signs of Consuming illegal/Harmful Drugs
PAGE 22
Attention Community Members
PAGE 23
Gayle Chase – Safe House Project
PAGE 24-25
Blood Tribe Police - Report
PAGE 26
Child Protection Services / Mobile Health Unit
PAGE 27
PUBLIC NOTICE / EMERGENCY NUMBERS
PAGE 28
Message
TSINIKSSINI RICK TAILFEATHERS,, LENORA MANY FINGERS, TOM RUSSELL, MYRON FOX, ZANE MEDICINE CRANE, TRACY WEASEL FAT.
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TSINIKSSINI Special Edition 2018
MESSAGE FROM
Makiinima – Chief Roy Fox Nikso ‘Kowai Kainaiwa: Our ancestral leaders and warriors protected our nation from outside forces that sought to harm us and lessen our strength as a fierce and proud member of our Confederacy. Our traditional leadership continues today and I am proud of our ancestor Stumicksoosuk who was the principal war chief of the Siksikaitsitapi during the early to mid 1800s.
are very grateful to those of you Those enemies of our people who have helped to reduce the were always defeated and so opioid crisis either individually we are now charged with that or collectively and we are traditional responsibility of fortunate to have the assistance protecting our membership from of trained people who provide an enemy that is very cunning the necessary expertise. and dangerous. This enemy, which has again been brought To those of you who are directly by outsiders to harm our people, affected by these harmful drugs, is more devious and uncaring I can only tell you that I was towards the well-being of once addicted to another drug Kainaiwa and was unfortunately that perhaps was not as initially introduced under the guise of a harmful and deadly as opioids. I have been told by some of pain-relieving medicine. you that the addictive power The opioid drug problem of opioids is much greater than affects us all and your political alcohol dependency and is much and administrative leadership harder to deal with. My heart has done much to work goes out to those of you that are collaboratively within our ranks addicted to opioids, however, in and with others to combat this the end there has to be personal ever-growing problem. Many of commitment on your part. Much you have realized the dangerous of my personal commitment effects and consequences of these found strength through our harmful drugs and you have spiritual leaders and traditional acted positively and bravely sacred ways and prayers. in battling this enemy that is harming your relatives, friends There are alternatives. We and fellow Kainaikowan. We are most fortunate to have 3
professionals and spiritual leaders within our midst who can guide you towards that process of being free from these harmful and addictive drugs. That choice is yours and it will have a profound effect on your friends and relatives, especially your spouses, children and grandchildren. Remember Kainaiwa, we have been plagued with enemies and illness before and we have overcome and defeated them. May our Creator continue to guide and protect us, as we embrace the challenges before us.
Makiinima
TSINIKSSINI Special Edition 2018
A Message from the Mayor of the City of Lethbridge
Like many other communities in Canada, the Blood Tribe and City of Lethbridge are facing an epidemic of drug abuse and drug addiction. Sadly, the crisis continues to escalate and claim the lives of sons, daughters, siblings, parents and grandparents in our respective communities. But more importantly, we share a commitment to collaborating on solutions to help those suffering from addiction and to help rid our communities of illicit drugs that are damaging and claiming lives. We all recognize that this is no easy task. We know that we can accomplish more by working together with our neighbours than we can in isolation from each other. In Lethbridge, we are in the process of developing a community-driven drug strategy built on the four pillars of Education & Prevention, Harm Reduction, Treatment & Recovery, and Enforcement. We also need the support of the provincial and federal governments if we are to be successful. From an enforcement perspective, we need to stem the flow of illicit drugs that is feeding this crisis. Politically, Lethbridge is rallying support from municipal leaders across Alberta in advocating to the federal Justice Minister for tougher penalties for drug trafficking. Similarly, we’re rallying these same voices in advocating to the province for new legislation that would permit lawful intervention and transportation to safe sobering facilities for those addicted and visibly using drugs in public. And we continue to urge the provincial government to provide badly needed detox, safe sobering and supportive housing supports to meet the acute needs in our city and region. I commend the Blood Tribe for your efforts to confront this troubling issue and ultimately bring healing to your community. Lethbridge is united with you in this effort.
Chris Spearman Lethbridge Mayor
WORDS OF ENCOURAGEMENT The Blackfoot way of life is beautiful. We are enriched with traditions and customs centuries engrained into our existence. Our ceremonies continue to bring our people together for prayers and blessings. Our leadership does their very best in seeking paths for the people to follow and our administration and entity management and employees strive to work for the best interests of the tribe. During our lifetime, colonialism encroached upon us and the government of the early Dominion of Canada was cruel. The attempt to cleanse their society of what they described as “The Indian Problem” was far-reaching and the aftereffect continues today. We have survived the residential school experiment; but at what cost? Children ripped from their parents’ care and placed into these schools where abuses of all kind were overlooked on a daily basis. The nurturing and the development of our children were replaced with a cold and stern environment controlled by starvation, hard labor, the whip and ultimately, fear. Is it any wonder why our children have no respect, and no remorse? The abuse of alcohol was rampant in the homes of many tribal members. And now, the abuse and addictions to prescription and deadly street drugs are killing our people and putting our children at risk from abuses, neglect and starvation for food and proper care. In keeping with a dire need to focus attention on harm reduction and preventative measures regarding these harmful and, at times, deadly drugs, the Blood Tribe Communications has dedicated the effort to combine the hard work from our leadership, management, technicians and internal and external professionals in response to this epidemic. In life, there is always room for hope. The dedication in compiling the information provided within this magazine is intended for those who are addicted and to know there are people who are truly concerned for your well-being. A person addicted to drugs may not be aware of being watched by family members or, if they have dependents, of how deeply affected their children have or will become when they know it may be the last time they see their mother, father, brother or sister before a fatal overdose. Just imagine that for a moment. The original people of this land are strong-willed and resourceful. We have overcome many obstacles in our fight for survival. We must never give up that desire to exist. We must celebrate life, not death. And in doing so, we must remain ever so vigilant in protecting our people at all costs. Our future depends on it. 4
TSINIKSSINI Special Edition 2018
KEVIN COWAN, CEO
BLOOD TRIBE DEPARTMENT OF HEALTH Early in 2018, agreements were signed with the Federal and Provincial Governments to help deal with the opioid crisis and the Kottakinoona Awaahkapiiyaawa “Bring the Spirit Home” program was initiated. Funds have been made available for a Mobile Clinic that will bring care and support to the community.
The Blood Tribe Department of Health is approaching the opioid crisis in the community on a number of fronts. This past year has seen a number of initiatives to respond to this issue. Our Emergency Services Department under the leadership of Jacen Abrey was able to secure a three (3) year agreement with AHS to fund EMS services for the Blood Tribe. With this funding, staffing has increased from 16 to 24 employees and an additional ambulance was put in service. This ambulance was funded by FNIHB and arrived in January. With these additional resources, on March 12, 2018 an ambulance and crew were stationed in the Moccasin Flats Plaza in Moses Lake. We are currently looking for a more permanent home for Emergency Services in Moses Lake. Although the Emergency Medical Services has responded to an average of 25 overdoses per month on the reserve, there have been no deaths directly related to overdose on the reserve during this fiscal year. Although most overdoses continue to happen in Standoff, the ambulance situated in Moses Lake has decreased response time to the south end of the reserve.
In June 2018 the Mobile Clinic was delivered to the Department of Health. During the summer, staff were hired and trained, the unit was equipped and tested. The mobile clinic will initially focus on two areas: I) Prenatal and postnatal families who are considered to be high risk; II) Clients who require Direct Observed Therapy. There are estimated to be over 300 individuals receiving or attempting to receive Suboxone treatment. There are approximately 80 individuals that get to their Suboxone appointments utilizing our Non-Insured Health Benefits Program on the reserve and many that live in close proximity to the access points in Cardston, Standoff and Lavern. We also know that many patients do not receive Suboxone for a variety of reasons. The mobile clinic will take the Suboxone to the client. It should be noted that the mobile clinic will also allow staff to do health assessments, basic treatments and assess the home environment. The mobile clinic will be a connection for Wellness Programs, including traditional healing and support, prevention of family violence, crisis intervention and response, drug recovery supports and numerous Community Health Programs. Staff will provide harm
The Community Health Team, under the leadership of Lori Healy, is very involved in a Harm Reduction, Sexually Transmitted Blood Borne Infections Program. Lori and her team provide harm reduction services (clean needles, inhalation kits, biohazard kits, etc.) Communicable disease treatment and follow-up, and education. The staff provides naloxone training on an ongoing basis. 5
reduction education, naloxone kits, safe sex supply kits and needle bags. On Friday March 2, 2018 negotiations commenced with the province to have an Overdose Prevention Site (OPS) established in Stand Off at the Health Centre. The OPS was established and fully functional by Friday March 9. The OPS trailer was staffed by ARCHES from Lethbridge, with the support of local staff. On May 8, after seeing 92 unique clients the OPS was decommissioned. Changes are occurring throughout the Blood Tribe Department of Health in order to be more responsive to the key health priorities identified in the community – addictions, health promotion and chronic disease management. The changes include strengthening the Healthcare Team at the Department – ensuring that the right individuals and services are available to the community. The Kainai Wellness Centre under the leadership of Terri-Lynn Fox is strengthening the Mental Health and Addictions programs. Terri-Lynn is working to provide a balance of traditional healing and contemporary therapies to those in need. She and her staff are moving into a new facility where a plan to provide wrap around services will be in place. Kevin Cowan, CEO Blood Tribe Department of Health Telephone: 403-737-3888 Cell Phone: 403-593-0040 Email: kevin.c@btdh.ca
TSINIKSSINI Special Edition 2018
KAINAI HEALING LODGE CENTRE -- PROCESS TO ENTER TREATMENT -Kainai Healing Lodge is a six-week residential treatment program focused on delivering culturally sensitive programming addressing the needs of clients who are impacted by addictions, trauma and various related issues. In using our traditional values, clients will reveal the potential for further healing and wellness, which in turn, extends to their family and community. To enter Kainai Healing Lodge Treatment Centre, an individual needs to go to a National Native Alcohol & Drug Abuse Program (NNADAP) outreach Wellness Center on their reserve or Detox to fill an intake package that includes: Application for admittance, Referral information and Medical form; all have to be filled or it will be considered incomplete. Once this NNADAP application is filled, the referral agent will fax it to the center where the intake worker and counselors will look over application. If there are no problems with the application, the intake
worker will phone the referral to see which intake this individual wants to attend. A bed confirmation is then sent to referral who in turn faxes bed confirmation and authorization request form to NNADAP referral unit who will send bed authorization to center to reserve a bed for the client.
• Substance abuse education (prescription drugs, cocaine, opioids, marijuana, wellbriety, etc.). • Strengthening their knowledge (family roles, life skills, community resource, etc.). • Post treatment (after care, relapse prevention, etc.).
When a client enters the Kainai Healing Lodge, the client will be processed by a counselor and shown to their rooms. They are then given a tour of the building. Clients are to start on their STEPS while incoming clientele are processed. Counselors then do the file intake with the client assigned to them. During their stay the client will go through:
Before the clientele leaves treatment, they can see their counselor or our case manager if they require help obtaining housing in Calgary, Edmonton or Lethbridge. They are assisted with getting into the halfway houses like Oxford homes, SAMS, Blood Tribe Women’s Shelter, Blackfoot Lodge or other related housing or shelter. We also assist in getting applications in for schooling or call their referrals to get them started for school, housing, AA/NA on their reserves or whatever they require.
• Culture week (pipe ceremony, sweat, face painting and spending time with elder). • Sessions on focusing on themselves (AA, ACOA, profiles of an addict, circle of life). • Exploring client issues and needs (anger management, co-dependence & boundaries, domestic violence, grief and loss, etc.).
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TSINIKSSINI Special Edition 2018
SUBOXONE CLINIC REPORT The Opioid Dependency Treatment (ODT) Clinic was established in May 2016 in the Cardston Hospital. Since then, we have been providing services to those who suffer with opioid use disorder. Our clinic, which is an Alberta Health Services facility, currently has 128 active patients and many of them are stable as far as opioid use disorder is concerned. The majority of our clinic’s patients are Indigenous and we accommodate patients from a large demographic area. Our clinic was placed strategically near the Blood reserve due to the Opioid crisis affecting this area so heavily. We have dedicated and passionate staff who are always there to help our clinic clients. We are open from Monday to Friday with a nurse in clinic Tuesday to Friday and our prescribing physician, Dr. Afridi, who provides services via Telehealth from Edmonton, works with this clinic on Tuesday, Wednesday and Friday. Dr. Afridi is a humble individual and is always ready to accommodate her patients. Even though we prefer client’s visit through pre booked
appointments, we try our very best to assist those who present by walk-in as long as we have the capacity to do so. It is easy to get into our treatment program. On day one of treatment, our patients typically spend 3-4 hours in the clinic. During this time, following the intake, an opioid withdrawal assessment will be completed by the nurse. The physician will then prescribe a low dose of Suboxone for the client to take right away. The client is then requested to do baseline blood tests and come back for the second dose of the day, which will be increased depending on the client’s needs and tolerance of the first dose. On Day two, the physician determines whether the Suboxone dose needs to be further adjusted (each person’s needs will vary); the prescription is then sent to the pharmacy of his or her choice where the client will need to present daily for witnessed dosing. Random urine tests will also be conducted at the clinic to ensure Suboxone is in the client’s system and to ensure no unsafe substances are being used.
At our clinic, we provide multiple services which include but are not limited to: • Medical management for Opioid use disorder • Addiction counselling services for client’s education & support • Harm reduction services by a dedicated Indigenous harm reduction nurse This clinic has not only been providing services to those who need Suboxone treatment & Addiction counselling, but also has been involved in various community awareness programs and educational services when requested. Looking at the gravity of opioid crisis, we are eager to help and look forward to working closely with Kainai Wellness center and other facilities in the vicinity. Collaborative work is key to success! For more information or to book an appointment with us, please phone (403) 653-5283.
Submitted by Hassan Naqvi - Counsellor 7
TSINIKSSINI Special Edition 2018
BLOOD TRIBE EMERGENCY SERVICES -- Report
The Blood Tribes Emergency Services operates 24 hours per day, 365 days per year using a schedule of two (2) ten (10) hour day, two (2) fourteen (14) hour nights, followed by four (4) days off. The fulltime staff is augmented with a core of community firefighters to assist when fire emergencies arise, as well as day-to-day duties. All staff members are trained and qualified to respond to both fires and ambulance calls. Over the past 5 years our call volume has increased considerably as evident with the stats below: 2013-14 2014-15 2015-16 2016-17 2017-18
The Blood Tribe Emergency Services (BTES) is a combination fire department that provides fire, emergency medical services, vehicle extrication, fire inspections, fire investigations and fire prevention and education services to a population of approximately 13,500 in an area of 1,413 square km residing in approximately 1250 dwellings. These services are provided from one main station in Stand Off and a substation in Moses Lake. The department of 25 career firefighter/emergency medical services staff consists of one (1) Director, two (2) assistant chiefs, four (4) captains, four (4) lieutenants, eight (8) firefighter/ paramedics as well as nineteen (19) casual firefighter/paramedics.
1896 calls 1968 calls 1982 calls 2430 calls 2653 calls
This is an increase of 40 per cent over the past five years with zero to no relief in sight to our growing call volumes. During this time we have seen our opioid issue consistently increase with a response over the past year entailing 324 calls, averaging of 24-30 calls each month
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TSINIKSSINI Special Edition 2018
GAYLE CHASE – REPORT on HARM REDUCTION I would like the community house highlighted, as it’s something that is actually for the community members in the community, and was driven from the community. The request came from the community. Our biggest challenge for the project is funding to keep working with the most vulnerable in the community and we meet the community members where they are. It’s hard when the project has to compete with core-funded programs to work with the most vulnerable and those who are more comfortable in their own environment. Personally, I believe it’s assisting and being supportive to community members to grow and develop in their own environment. The community members are the ones that actually bring about change. As professionals, we are here to provide support and assist with resources required. It doesn’t matter who does what; it’s what is actually done that matters. The other huge issues are preventive factors; too many young people are on the streets. So why is this happening? And long-term factors of reducing poverty increases long term employment after many go through the employment programs, but relapse when the programs end and they go back to being idle. Lastly, addressing the stigma around addiction -- no one is immune from the reality of addiction either directly or indirectly.
Among the other areas the Harm Reduction program is involved with include: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
Continue naloxone training and addictions workshops Continue distribution of ‘safe use’ supplies Support and encourage peer support groups Link motivated clients with traditional supports and life skills programs Continue and enhance education through PR: * Build Internet presence * Distribute information through newspapers, fliers, posters, radio. Continue to provide emergency transportation and Help-line access. Develop ‘support team’ to focus on ‘high risk individuals and families.’ Continue to develop programs to help with non-pharmacologic management of stress and pain: yoga, counseling, drum circles, non- addictive medication. Community projects: environmental cleanup and gardens. Nurture and develop partnerships with community organizations.
The Harm Reduction participated in other areas as well including: Naloxone training (105 kits dispensed in 2017), 24 intranasal kits provided (& trained) for security at Indian Days, supplies distribution, circulation of mobile unit (transportation to NA and emergencies), educational materials drafted and distributed, community information sessions and surveys, Support Groups – NA, women’s group, family group, partnerships with Job Readiness and Moses Lake Shelter, training sessions and Community Directory completed.
The Harm Reduction Mandate is: “To keep our community safe and minimize death, disease and injuries from high risk behaviors associated with substance use.” This includes Strengthening the Harm Reduction Program through community development, education and awareness by utilizing traditional teachings and values.
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TSINIKSSINI Special Edition 2018
DOCTOR TAILFEATHERS SHARES EMOTION AND FEELINGS LOOKING INTO OUR FUTURE WITH HOPE AND RESILIENCY necessity that we work together to address this crisis once more. I felt a grounding in the voices, the ideas from the broad number of individuals from every walk of life. We are not alone, this burden is not to be carried by a few people this time and it has spread to the outside non-Indigenous people. We are all not alone and it is a comfort to see the numbers of people rising to help.
On day two of our Niistitapi Reziliency Conference, my friend Tom asked me earlier today: “What are your feelings on what is happening here today”. Talking about feelings on what has happened and is happening to our Niistitapi people, I, being part of this, is a lot harder than I thought. It’s easier to talk about my thoughts than my feelings. Thoughts are based on learning from the western teachings on addictions and strategies for addressing addictions, evidence-based practice that says that harm reduction saves lives. Reducing the biggest barrier, stigma and people’s beliefs becomes the greatest challenge of our predicament. My feelings, last week were of total horror that we were being struck again by an incredible wave of chaos during a blizzard. My reactions to the reports from my colleagues in the ER, the paramedics and EMTs in the field, the police who responded to the weekend of overdoses to a more lethal drug than the fentanyl that we were prepared for, was utter and instant fear. In the days that followed, there were meeting after meeting and lots of voices and lots of discussions on what to do. I listened to familiar community voices, to voices from Alberta Health Services and Health Canada and to those voices of friends in the addictions fields. They reflected the urgency, the disbelief and the immediate
I feel pride after attending the first meeting that Chief & Council called to listen to all entities. I feel that our leadership is taking an active part of this and that they will support the movement forward in an organized and timely manner, showing their support in the announcement of the state of emergency and then committing $750,000.00 from tribal sources to start this action. I feel hope after watching and listening to the creative and authentic voice of our youth, who worked diligently over the first two days to create and give their voice to the adults in Music, Dance, Film, Podcasts, and Art performances. These voices of our youth were strong and meaningful and gave us direction. Their work made my chest rise followed by tears and laughter. I felt extreme pride in Cowboy Smithx and the whole group of young facilitators who did a magnificent job in two days. The work of Gabor Mate in listening and answering to what our youth were bringing to us to support and assist with was grounding. To hear about the centuries of colonial policy and the incessant trauma, war, starvation, smallpox, residential school, prison and justice systems, child welfare -- all forms of assault on our communities, and yet, here we are, alive and growing, being resilient in the face of utter despair. We understand this but when a trauma expert explains and we understand, it is pure relief, it’s like searching for how does the word trauma come to do the damage it does to each of us and as a collective. It gives me hope that we can turn the force toward self-destruction and we can do this with our own ways of healing, in our own way, is a very engaging and loving way. 10
I was brought to tears by the surprise visit of Clara Hughes, one of Canada’s most decorated Olympic champions who came to participate and was brought in by Tyler White from Siksika. First so honored to meet this amazing woman. Even more touched by her story of trying to be ‘enough’ for her father with an addiction. She pushed herself through a vigorous training schedule, almost impossible first in speed skating then in cycling. She pushed herself through major injuries such as three fractured vertebrae and did races through pain like that, because she was so driven to win, to bring the win to her father who she dreamed would acknowledge her Olympic Medals and be proud. It wasn’t to happen, and even with those medals in her hands she felt empty when alone. That brought tears, because believe it or not, I suffer the same. Whatever I do is not enough and if I am not working towards solutions or working, then I am not enough. I suddenly got it and I had tears. Truly, the most wonderful day of sharing between tribes within our confederacy was touching. Our songs are healing; I felt that today. Three songs filled the room of people who witnessed the power of song, as if hearing the voice of our ancestors, telling us to keep going and honor our past and the strength of ancestors. The shared tears, laughs, hugs, space and recognition that we have all these ‘feelings’ and being human beings and allowed to be imperfect human beings with addictions, that those that suffer are taken into the arms and given warmth and hope in the arms of our people. This was truly the strength we have as a collective.
What started out as a feeling of doom and great impending disaster had become a memory replaced by a true sense of hope and resiliency, by just being amongst the strength of my people, the Niitstitapi. My chest if full of hope and pride with the knowledge that we will find a way and it will be a shared burden.
TSINIKSSINI Special Edition 2018
Dr Esther Tailfeathers
--MY REFLECTIONS ON THE BLOOD TRIBE FENTANYL EXPERIENCE
Oki: In August 2014, I was witness to the first ever Fentanyl overdose in a Walmart parking lot. Since that day, the Blood Tribe was tumultuously thrown into an epidemic of deaths due to opioid overdose and related suicides and deaths. From August 2014 to March 2015, the Blood Tribe experienced at least 20 deaths due to Fentanyl overdose. Our community united and strategized, many late evening meetings by people of all walks and professions met and worked hard to address our community in crisis. We talked and planned and came up with an early strategy. We chose to use evidencebased medicine and strategy. Harm Reduction -- we were the first, First Nation community in Canada, and the second community in Alberta to adopt the education and use of Naloxone. We held community-wide education and distribution. Our people became warriors of Harm Reduction and, as a result, from March 30 to June 30, 2015, there were no deaths. The second step was to adopt Opioid Replacement Therapy. Alberta Health Services was first to step up and opened the Cardston Suboxone Clinic which has helped many of our people; Dr. Christensen also began to use Suboxone in her practice, followed by myself. This has been a very helpful strategy as we have seen many people who have gone from desperate and in agonizing withdrawal to stable and getting their lives back together. I have patients now who are either working or in school and one university student who will graduate this year. Many Suboxone patients, who are in college, or programs, are bettering their lives. Thanks to many of our entities who collaborate to get people into training and education: Red Crow College, Family & Community Support Services, Social Development, Transition Program. In February of this last year we experienced the Perfect Storm -- there was a payday for tribal employees, AISH, Social Development, Child Tax and an actual spring storm. That weekend we suffered 14 overdoses and lost two members to Opioid overdose. Lethbridge saw almost 50 overdoses that same weekend. Carfentanyl
had been the cause of many of those overdoses. Alberta Health Services, South Zone and Blood Tribe Department of Health collaborated to bring on a Safe Consumption Site that was brought on scene and temporarily housed at the Health Centre. This site was, sadly, not used. Only 2 to 3 people used this site in the eight-weeks it was here. In my opinion, it was because of fear of shame and stigma. There were some awful comments made in our community and ill-informed people who added to the stigma. Safe Consumption Sites save lives! If you were to ask any parent who has lost a child to overdose, any one of them will tell you that they would have wished there was a safe place where they could take their child to be watched and helped. Today, at the Lethbridge Safe Consumption site, there have been roughly 70,000 uses, meaning that those uses are times when someone has used a booth for safe consumption. 70% of those uses are Indigenous people but, without direct identification, we deduct that most of that 70 % are our people. Our people who left our reserve to move to Lethbridge for two main reasons: we have stigmatized our own people and evicted many of them, where they went to Lethbridge; many of them are now homeless and are subject to victimization, racism, cold, hunger and shame. The second reason, the services they are seeking such as safe consumption is in Lethbridge. These are our people, our children, brothers, sisters, daughters, mothers, fathers -- these are our people. The future needs to be about developing our Treatment and Support services to help our people with Opioid Addiction. We need to adopt kinder ways of helping our people. Our treatment options need to expand to adequate space and time for clients to begin to heal. Our treatment, both inpatient and outpatient, needs to use Trauma 11
Informed Care as a base for working with those who suffer with addiction. We need adequate time for treatment -- 41 days is not adequate. We need at least 3 months to 6 months of treatment and support. Along with Harm Reduction, Opioid Replacement Therapy and Treatment, we must think ahead. We must develop a Prevention Strategy that would reach out to our youth and children to help them learn about what opiates are and how they are so quickly addictive. We need to be very aware that our new culture includes many people who believe that opiates are the quick and easy way to relieve pain. We need to understand that the pain our people have is inherited from the Trauma of Childhood Adverse Events, Residential School and the pain we in turn inflict on our own people because of intergenerational trauma. We need to recognize we do not need opioids for everything and that we, as a community, need to be very aware of this. Physicians and pharmaceuticals and NIHB formulary have a large part to play in where we are today. The prescribing practices are being addressed by the College of Physicians and Surgeons and Primary Care, as well as by the pain experts in the province. There will be new practices and strategies announced this year as these bodies recognize the role that is played in this whole opioid crisis. The Blood Tribe Department of Health has seconded a planner from Alberta Health Services with the help of South Zone to help bring all of our past work together and talk to many individuals who have been involved in this work on reserve. An Opioid Response Plan is being developed and a draft will be presented to the Blood Tribe Department of Health Board and then in mid-November to Chief and Council.
TSINIKSSINI Special Edition 2018
OPIOID CRISIS: BLOOD RESERVE 2018 By Susan Tallow Christenson, MD Levern Clinic / Blood Tribe Department of Health The opioid epidemic has 3 main causes: 1. Our community’s vulnerability due to socio-economic (poverty) and psychological/ / stress factors.
2. Our brain’s natural tendency to become addicted to opioids (genetics.1) 3. Over prescribing of man-made opioids by physicians and pharmaceutical companies.
What are opioids?
They are substances that are naturally found in our brain and are required for survival. Opioids are released from our brain, to reinforce healthy behaviours. An opioid is released when you ‘do a good job,’ pass a class or win a race. You get a ‘healthy high’ that is the result of doing something that makes you better and improves your survival. Besides naturally occurring opioids, the pharmaceutical industry has created numerous ‘man-made’ opioids (e.g. Tylenol 1s-4s, fentanyl, morphine, Percocet, oxycodone, Dilaudid) to treat pain. These are highly addictive in the right circumstances. It is well established that our brains are wired to change and crave more opioids with repeated use of ‘man-made’ opioids. It really doesn’t take much exposure to ‘man-made’ opioids to start the biologic change in our brains. Well meaning physicians prescribe man-made opioids to relieve pain and suffering, but often do not realize how vulnerable some people can be to opioid addiction. Our brains will adapt to the ‘extra’ opioids and require higher doses for relief
of pain and ‘to just feel normal.’ In the right circumstances, it doesn’t take much to create a physical dependence on opioids which involves brain changes, which is a medical condition, ‘a disease.’ This phenomenon is not a ‘character flaw’ or ‘weakness,’ but a medical disease that is associated with changes in the brain resulting in a ‘long-lasting,’ ‘life-threatening’ condition and which can cause major community health , social and economic problems. No one should ever take more opioids than they need to achieve ‘tolerable pain,’ and they should, when possible, avoid daily use. By March of 2015 we had lost around 30 individuals to fentanyl overdoses in the preceding 15 months. The loss of ‘Tim and Roxanne’ was a breaking point and our community stepped up and embraced medically effective tools to save the lives of those with opioid addiction. In early March 2015, we began training and distributing naloxone (an antidote for an opioid overdose) to community members and by April provided Suboxone therapy, a medication to help those with opioid addiction begin their path to recovery. Our community started working together and provided education campaigns, stress reduction tools, counselling supports, ceremonies and prayer-work and improved access to Treatment Programs, non-addictive pain therapies, and education. Eventually, the local medical community became more actively involved, as well as our social development programs, housing, police, community health and children’s services. The overdose death rate dropped from 2/month to 1-3/year – on the reserve. To date (these statistics are ‘loose estimates’), we (Levern Clinic, Cardston Opioid Treatment Centre and Cardston Clinic, Standoff) have
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started around 450-600 individuals on opioid replacement therapy (largely Suboxone, but some are on methadone). With the support of Community Health, we have trained and dispensed at least 1500 naloxone kits to our community members. We still experience 1530 overdoses/month, but these are rarely fatal. Since our community ‘stepped up’ and became prepared and educated, this resulted in a profoundly positive impact on overdose deaths on our reserve. We have shown that community education and involvement can have a huge positive impact on outcome. Most of us have been personally affected by this tragic opioid epidemic and we should understand how to get help for active drug users who may want to begin a path to recovery; and, if they are not yet ready, however, we need to accept their decision and keep them as safe as possible. This is where ‘harm reduction’ (naloxone use, safe use counselling, Suboxone, etc.) becomes critical and important. We want to keep our loved ones with us and hope they will reach a point where they want to start their path to recovery. “Dead Addicts Do Not Recover.” Our hope is that when they decide to begin their recovery, they have easy and non-judgemental access to tools that are proven to help. Opioid addiction is an unfortunate and tragic medical condition, but we, thankfully, have medical tools and supports that really work. If a patient can not stop on their own -- (only 5 out of 98 succeed) -- there is a path for the motivated individual. As a physician, I feel quite blessed to have the tools of opioid replacement therapy/Suboxone and all the additional supports within our community, to help my patients. I have been a part of some inspiring and successful stories and it is an honour. It is important for us to remain ‘prepared and ready’ to help those in need. Our community is incredible and strong in the way it embraced this tragedy. We must keep trying and working to address this crisis which is with us, and will likely stay.
Ikakimaat
TSINIKSSINI Special Edition 2018
Messages From Our Children
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TSINIKSSINI Special Edition 2018
Submitted by Terri Lynn Fox Kainai Wellness Center
Opioid Statistics
Oki, this summary report includes what I have learned thus far regarding Opioid use and statistics relating to Blood Tribe members. My tenure started in June 2018, thus, this summary is what I have gathered from my team reports; it includes our future program vision. The following statistics were reported in our Annual Report April 2017 – March 2018.
1. The Addictions Counselling Program:
National Native Alcohol/Drug Abuse Program (NNADAP)
Summary of Graphs A & B: * Alcohol prevalent for the majority of the clients. * Fentanyl is the second drug followed by Crack Cocaine, Crystal Meth, solvents and prescription drugs. * A high number of clients are referred either to treatment or Detox. * Thirty clients of the 314 referred to treatment completed their treatment. * Alcohol addiction continues to be the primary focus of NNADAP. Thirty clients completed their treatment programs which is status quo from last year’s statistics.
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TSINIKSSINI Special Edition 2018
2. Mental Health Program
Good mental health and wellbeing is known to be vital to overall good health and is the foundation of strong and resilient individuals, families and communities. This is not a new concept to Blood Tribe peoples who have always had a holistic perspective on health with the understanding that wellness comes from seeking balance within ones mental, physical, emotional and spiritual being. In response to the Opioid emergency, Mental Health staff collaborated with a number of social agencies in the community to address the crisis. In addition to offering oneon-one counselling sessions, Mental Health offers alternative ways on how to effectively cope with various social issues/ problems.
Summary for Graph C: Anger Management issues were the number one reason why clients sought counselling. Grief and loss was second with family conflict, anxiety and depression. Bullying and Postpartum were other reasons clients seek counseling. 3. Crisis Intervention Team:
As a health and wellness partner to community agencies, the Crisis Unit priorizes being responsive to community needs and direction when an emergency/ crisis strikes in order to best support and coordinate crisis response activities within community.
A strong partnership has been developed with emergency services, Blood Tribe Police Services, Emergency Services and local hospitals in Cardston, Fort Macleod and Lethbridge. The job of a first responder is of critical importance, keeping situations calm and providing much needed medical and emotional care. On-site supports include counselling, assist in stabilizing situation and provide follow-up services to Mental Health and NNADAP and other available resources. In addition, transportation services are provided for clients seeking detox services at Foothills/Renfrew and family violence shelters such as Safe Place and other shelters. 15
4. Future goals to target the Opioid strain on Blood Tribe members: • Re-vamping and re-evaluating program content and delivery to ensure we are honing in on the root causes of the prevalent use of Opioids, pharmaceuticals, alcohol, and other drugs; • An integrated service-delivery approach that would cater to the ease and confidentiality of clients who self-refer or are mandated referral—a “one-stop shop” if you will; • Continued training for KWC staff to increase employee understanding of the root causes of addictive behaviours, and increased traditional healing mechanisms in all program areas to ensure a uniform approach to understanding these explicit behaviours and re-learning traditional teachings to decrease opioid use; • Utilization of an Elder-in-Residence to assist with increasing an overall health and wellbeing pathway – mind, body, and spirit; • Introduction of new training opportunities to target trauma, such as trauma-informed care and delivery, brain-certification, which may include invitation to worldrenowned researchers and authors that address trauma, intergenerational trauma, and incorporation of how to deliver different and innovative approaches and methods to our clients; • New initiatives, such as monthly community Speaker Series and presentations; • Continued partnerships, creation of new relationships, and innovative techniques to create and secure research dollars to collect data, track outcomes, and project future statistics and programs. This data will tell a story— what is working, what isn’t, what is needed, what cohort is most affected, who are we missing, what are we doing “right”, and • Incorporating Blackfoot language into KWC programs, logos, presentations, and more.
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TSINIKSSINI Special Edition 2018
ARCHES INDIGENOUS RECOVERY COACH PROGRAM
PROVIDES RESOURCES TO SUPPORTS AND RECOVERY What is ARCHES?
The ARCHES Indigenous Recovery Coach Program is a peer-to-peer community-based and culturally informed recovery coach program, supporting adults undergoing opioid agonist therapy (OAT) for opioid addiction in Lethbridge. The program combines one-on-one community-based case management practices with culturally-focused healing and behavior relapse prevention. The program offers: • Recovery plans designed around the participants needs • A strength-based harm reduction approach to support • A focus on developing resources that support the participants recovery • Opportunities to create or recreate links to traditional Indigenous wellness activities • Connection to Indigenous Elders • Transition navigator services to connect participants to resources • Community wellness supports to participants (emotional, motivational, instrumental and community referral support). What do Indigenous Recovery Coaches offer? The Recovery Coaches focus on helping participants apply their newly acquired recovery skills in their living environment and help them resolve any issues or problems that can impact their recovery. Recovery Coaches also help participants stay engaged through their continuum of recovery, using techniques such as Motivational Interviewing and behavioral intervention practices. An Indigenous Recovery Coach functions the same as any other Recovery Coach, however, they approach this process from an Indigenous cultural lens.
Referral Process: Indigenous adults who are starting/re-starting OAT for opioid addiction at Prairie Treatment Clinic will be automatically referred to the Indigenous Recovery Coach Program. If a client has not yet started OAT but has a desire to, they can enter into the Indigenous Recovery Coach Program and then be referred to the clinic.
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TSINIKSSINI Special Edition 2018
KAINAI BOARD OF EDUCATION -- REPORT
How do you strengthen a community affected by intergenerational trauma? How do you raise the children of these communities to become healthy and resilient adults? These were some the questions and responses published by the Kainai Board of Education during their Nitsitapii Reziliency Conference. The main outcomes of these discussions and the Call to Action are to: 1. Increase awareness and understanding of trauma and resiliency across professional sectors; 2. Provide children and youth with safe, loving and positive relationships with adults; 3. Offer parents and caregivers the additional support they need to help provide healthy relationships for the children in their care; 4. Provide children and youth with greater access to extra-curricular programs; 5. Increase volunteerism amongst the adults in the community in order to support and participate in these prevention programs; 6. Provide opportunities for people to reconnect with their cultural identity in order to increase their sense of belonging, strengthen intergenerational relationships and promote healing, and; 7. Increase education on and response to addiction and the opioid crisis. PROVIDE CHILDREN AND YOUTH WITH SAFE, LOVING AND POSITIVE RELATIONSHIPS WITH ADULTS. • Connect every child with a healthy, supportive adult, e.g., parent, parental figure, relative, teacher, community member, Elder, etc., to provide positive serve-and-return interactions, contribute to healthy brain development, and build resilience. When necessary, these relationships will help children manage adversity so that stress becomes tolerable rather than toxic.
• Provide children with safe and supportive spaces, especially if their own homes do not provide such stability. For example, schools can fill this role for children. To meet this goal: • Schools should have an open-door policy for all students, and teachers and other school staff should listen to students’ concerns, refer them to appropriate resources, offer emotional support, validate students’ feelings, and be non-judgmental. • Teachers and other school staff can show that they respect, value and care for each individual student by, for example, greeting each student by their name. • Provide children and youth with additional supports through resources such as one-on-one counselling, access to healing circles, and access to a toll-free helpline. IMPROVE EDUCATION ON AND RESPONSE TO ADDICTION AND THE OPIOID CRISIS. • Increase awareness on the brain science underlying addiction in order to change the popular mindset about people struggling with addictions. For example, taking a healing rather than a punitive approach to people who are involved in drug dealing and/or misuse. • Provide treatment and after-care programs that take a holistic approach, for example: • Provide whole-family treatment centres and programs to encourage families to stay together; • Create ongoing support groups where people can develop healthy relationships, such as cultural camps for healing that could include women’s circles, men’s circles, and youth groups, and; • Provide after-care programs that aren’t limited to access to a counsellor, but could also include access to a “sober house” that incorporates Blackfoot cultures 18
and focuses on healing and re-entry into the community. • Integrate the involvement of Elders, cultural teachings, and ceremony into all addiction-related programs and resources, for example: • Conduct ceremonies at each entrance to the reserve, and; • Replace the fentanyl signs at the entrances to the reserve with a more positive message. Underlying the Call to Action is the central concept of “walking in two worlds,” of joining contemporary life to traditional Blackfoot knowledge, cultural practices, and language. A stronger connection or reconnection to traditional culture will be key to building a thriving web of relationships, an ongoing sense of identity and belonging, and a healthy and resilient community. Every community member has a role to play in building the foundations of resilience in children, from parents, grandparents, and Elders to educators, policy makers, and frontline professionals. When all members of a community have the resources they need to care for themselves and others, intergenerational cycles of trauma can, with time, become intergenerational cycles of healing.
TSINIKSSINI Special Edition 2018
BLOOD TRIBE HOUSING REPORT ON THE OPIOID CRISIS SUBMITTED BY CALVERT MANY FINGERS, TENANT RELATION OFFICER FOR ZONES 5 AND 6 OPIOID OVERDOSES ARE AN INCREASING PROBLEM FOR ALL SERVICE PROVIDERS ON THE BLOOD RESERVE AND THE PROBLEM IS GETTING WORSE. FOR BLOOD TRIBE HOUSING WE ARE SEEING AN INCREASE IN THE FOLLOWING: • • • • • • • • • • • • • • • • • • • • • • • • • •
The ambulance and police are responding to more overdose calls. Drug dealers are moving into housing units to distribute drugs. Increased calls to Child Protection to intervene with children at high risk, Increased vandalism to housing units and costs for renovation repairs. More housing units are boarded due to no money for repairs or renovations. Increase traffic causing wear and tear in housing units. Family breakdown is causing tenants to abandon their homes leaving the housing unit open for vandalism. Abandoned housing units have been burned down. All homes are insured for $130.000, the deductible is $25,000.00. To rebuild a house will cost $260.000. Homes should be insured for $260.000, Blood Tribe Housing can not afford to insure homes for $260,000. Renovations are costing $40,000-80,000 per unit Contractors cleaning housing units are putting themselves at risk. Drug busts most likely lead to evictions and child apprehensions. Drug dealers and tenants deal with break-ins by people looking for drugs or to find valuables including food and clothing to sell for drugs. Tenants are harbouring drug dealers in the housing units to support their addiction. Abandon drug paraphernalia in the community. Increase violence and gang activity. Increase drug activity and drug use when community receives a payment. Tenants are feeling unsafe in their housing units and some are afraid to report drug activity because of retaliation. All types of drugs: marijuana, alcohol, street drugs, prescription drugs are being sold in the communities. Overdose and violence related deaths. Blood Tribe Housing not able to evict until tenant is legally charged and convicted for drug related activities. Security for new housing units is needed. Limited funding for Blood Tribe Housing due to non payment of rent. Community does not understand the costs related to the Opioid crisis.
BLOOD TRIBE HOUSING CONCERNS • •
Has to deal with Opioid crisis and we need to update policy and procedures to best deal with this crisis for example, evictions; We also need to hear reports from community agencies on the impacts of the Opioid crisis and to help develop policies to address this crisis. Presently, housing is updating these policies.
HOW HAS BLOOD TRIBE HOUSING ADDRESSED THE OPIOID CRISIS IN THE COMMUNITY
Developed COMMUNITY PARTNERS COMMITTEE to work with agencies such as The Blood Tribe Police, Blood Tribe Child Protection, Kainai Wellness and Blood Tribe Social Development to help families deal with the Opioid crisis, instead of just evicting them. If a tenant is charged with any illegal activity they are given a 30-day eviction notice. This gives the social agencies time to work with these families. Children are placed with relatives or childcare is provided if these agencies recommend counselling, treatment or other services to help them. They will be monitored by these agencies to ensure these families are working on helping themselves. The police will also inform the committee if drug activities continue. If families comply with all recommendations, the eviction is rescinded. If they don’t comply, the eviction will be enforced.
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TSINIKSSINI Special Edition 2018
A YOUNG MAN’S DOWNWARD JOURNEY ON A PATH THAT WAS SLOWLY LEADING HIM UNDERGROUND
Keegan Shouting
Growing up on tribal grounds among family and friends is, on occasion, filled with adventure and excitement, however, it can also be monotonous and idle as in the case of many other people growing up in communities surrounding this area. Those who have employment develop their own personal routines while others, unemployed, seek other forms of refuge to break the humdrum of inactivity. For one young man seeking his place in society, it was in a moment of trust that would change his life for the worse. Keegan Shouting, a young man who grew up in the Levern community, recalled that time in his life when his family moved from the friendly and idyllic neighborhood he was accustomed with and into another where borders and boundaries were seemingly nonexistent. It was here, at the tender age of eight, where he encountered a trauma that continues today. “I was asked by a man if we needed a ride,” he began; his voice unsteady. “We dropped off my cousin at his house and when he stopped again, my brother jumped off. But I was too late. He brought me to the rodeo grounds and that’s when it happened.” To counter the teasing that came after by his peers, he began to hang out with an older, more street-wise group of boys. It was then when he first experimented with marijuana and drinking. In his teens, and being in a community where certain people exhibited behaviors he wasn’t quite accustomed to, he felt a need to fit in – and that led to experimenting with drugs that were addictivebased rather than just the recreational drugs he was using to cope. “When I lived in Levern, I didn’t know what pills were,” he said. “But, when I moved to Stand Off, I experienced pills. I started hanging out with a guy in his 30s and he showed me what kind of pills to take. The first time I took these pills, I became really hyper. It was like a rush and I had a lot of energy.” The older friend taught him how to mix and match the drugs to get high and this lead Shouting to delve deeper into his growing addictions. On his sixteenth birthday, his parents sent him to the Adolescent Treatment Centre on the reserve. But, his attempt to stop his addictions was short-lived. He began drinking and smoking weed and then switched to taking pills again. “I had a trust fund when I turned 18, and people would always call me to see if I would buy pills from them,” he recalled. “During that time, I met a woman from Brocket who
would tell me ‘I have some Percocets. Do you know who wants to buy them?’ I bought some, crushed them and snorted them. They made me feel like I was bionic, like I could do anything.” He began introducing others to his contact and it was then he was introduced to Oxy 10s. He was told by his dealer that the Oxy 10s were like Percocet’s, only a little stronger. He then began to take Oxy 40s, then eventually graduated to Oxy 80s. He said the Oxy 80s were the real thing.
“These were the real Oxy 80s. They were plastic, you had to cut them up and mix it with another pill like acetaminophen. It creates a powder and when you snort it, it gets sticky in your nose and you have to continually snort water and eventually it will go away. But, the feeling lasts longer, usually all day.” Shouting said his supplier would come to the reserve with large zip-lock baggies filled with a huge assortment of prescription and illegal street drugs. His drug consumption intensified. “She called Percocets ‘Cets’ and called Oxy 80s ‘Apples’,” he said. “I was working by then and I was really bad into Oxy 80s and it wasn’t into finding that initial feeling anymore, it was fixing myself up because I was dope-sick. It’s worse than a hangover because you feel like you’re getting worse as the day goes on. I was pacing in my house and throwing up. I never threw up before. It wasn’t fun anymore.” His dealer, by now, had streamlined her operation where she unloaded all her drugs with one main supplier in the townsite. It was here when Shouting had his first encounter with Fentanyl. It was a time when he came dangerously close to overdosing. “I went to this new dealer and he sold me a pill,” he said. “’They’re not plastic anymore’ he told me, they’re powder.’ I went home and broke it up after work and mixed it with acetaminophen and made four lines. I snorted two lines and when I breathed in, I couldn’t let the air come back out of my lungs. I think it was my tolerance level that saved me because when I fell on my bed, I slid off and banged my head on the floor. I think it was the shock that made me snap out of it.” That encounter with Fentanyl scared him. He stopped using it for at least a year until a death in his family affected him even more. He then moved away from home, hurting deeply from his loss, and began taking pills even more heavily than before. “I was using Fentanyl at least three times a day, buying pill after pill,” he said. “My withdrawals became ten-times worse and I did this for a least two years. I’d always try to help myself, but I was sick. I would always relapse.” Shouting credits Dr. Sue Christensen, and a
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dream from one of his friends, for helping him begin on his path to healing. “In my friend’s dream, she said she dreamt of Shouting’s late brother,” he said. “She said his late brother was waiting for him. I told my grandparents about the dream and they told me I needed to take care of myself. I love my brother, but I’m scared to leave my parents. It hurts too much. I then went to Dr. Christensen and she said she could help me.” Shouting was put on Suboxone and now, in his third year, he is beginning to see and feel a light in his life once again. “I’m starting my process, after three years, of getting off Suboxone now, because I feel like I’m strong enough to do it,” he said. “Ever since I began working at my new place of employment, I feel stronger. I’m learning how to deal with things and situations in my life – I’m learning how to cope and that’s all anyone can ever expect to do. I’m not perfect, I’m getting better one day at a time because I’m able to wake up and feel good about getting better. I began to smudge and pray for everyone and for those going through what I went through. Now, I try to help other people by just being with them and supporting them.” There is always hope and, with it, forgiveness. In his few short years, Shouting has experienced a lifetime of hurts and pains. But, the desire to live, and to live his life onward on a path he has yet to define, will be on one where he will one day find refuge, and where his will be one of many whose life experiences may help others find their own paths to freedom.
TSINIKSSINI Special Edition 2018
TELLTALE SIGNS OF CONSUMING ILLEGAL AND HARMFUL DRUGS In the early days, when alcohol was prevalent in our society, it wasn’t very hard to distinguish who was intoxicated and who was sober. There were those who were obviously intoxicated and there were those who were closet alcoholics who did their best to hide their addictions from others. Today, in the ever-evolving introductions of illegal and harmful drugs, the telltale signs of those consuming illegal and harmful drugs differs somewhat from the loud and boisterous alcoholic. For those users who have become hard-core, the behaviors exhibited in everyday interactions with non-users can be extreme or subtle. When a person is struggling with an addiction, they might try to deny that anything is wrong. Instead of admitting that they need help with their addiction, they may make excuses in order to cover up the addiction-related problems in their life. Additionally, friends and family may also try to hide the addiction with excuses. But ignoring addiction and making excuses do nothing to help the person struggling with addiction to regain control of their life. Instead, they can make the person’s life extremely difficult, and can put both the person and those around them in danger. Denial and excuse-making come into play for many people with an addiction because they think they are in control of the problem and can stop whenever they want. Furthermore, since some people associate addiction with weakness and failure, a person might feel ashamed about their addiction and want to hide it from people who might judge them. For those living with someone with an addiction, they may encounter certain behaviors and common addiction excuses. A person who denies that they have a substance use problem will often make excuses to avoid taking responsibility for their harmful and potentially dangerous behavior. Some common excuses that people make when they are dealing with addiction may include: • “It’s not a big deal. I can quit whenever I want” – The person
may think that they are in control of the addiction, but the reality is that the addiction is controlling much of their life and influencing many of the decisions they make every day. • “I’m not hurting anyone” – They might argue that the addiction only affects them, but everyone around is also negatively impacted by the addiction, physically, socially or emotionally. • “I’ll get help at a later date, just not right now” – Many people claim that they will get help after using the substance one more time, but procrastination both increases the person’s risk of harming themself and others and gives the addiction further power in their life. • “No one can help me with this problem” – The person might believe that there addiction is too difficult to treat, or may have gone through rehabilitation and experienced relapse. Every addiction is treatable, though, and relapse doesn’t have to equal failure in the recovery process. As a professional, there is concern of getting rid of the stigma of drug abuse and addiction. When a person thinks that they will be judged negatively for their struggle with substance use, they are often much less likely to seek out help. They suggest that one way to get rid of the stigma associated with substance use is to change the language used to talk about drug abuse and addiction. Specifically, it recommends avoiding words like “addict,” which suggest that the person is nothing more than their addiction, and “substance abuser,” which ignore the fact that substance use problems are actually disorders that affect the way the brain functions. What Does Recovery Look Like? Changing the stigma associated with drug abuse and addiction is an important step to take towards helping people struggling with these conditions to get the help they need. Another way to encourage recovery is to understand exactly what recovery looks like. Recovery is a long-term process that often involves several rounds of treatment. Most doctors 21
recommend that rehabilitation last at least three months or longer in order to help the person reduce or stop drug use. Additionally, many people experience at least one relapse in recovery, but that these relapses can be addressed and successfully overcome when the person is willing to return to treatment. Once a person successfully completes drug abuse rehabilitation, they will need to know what to expect in longterm recovery and that recovery involves a person making changes in their life in order to: Develop their health and wellness; Live an independent and self-controlled life and Seek to reach their full potential. It also lists the following four components of successful recovery: Health: the person makes knowledgeable and positive choices in their life that support their physical, psychological and emotional wellbeing; Home: they have a safe and stable place to live; Purpose: they engage in meaningful activities every day, and works to acquire independence, income and resources with which to actively participate in society; Community: they create and develop relationships and social networks that offer support. Life in recovery has many difficulties, but, ultimately, it is much better than the alternative of continuing a lifestyle of drug abuse. Although the stigma attached to drug abuse and addiction makes it difficult to seek out help with drug abuse, getting help is often the only way for a person to begin recovery. Without recovery, a person struggling with drug abuse will continue to miss out on the full potential of their life, as well as put themself at risk for the many negative physical and psychological effects of drug abuse.
TSINIKSSINI Special Edition 2018
ATTENTION COMMUNITY MEMBERS WHAT IS OXY 80?
• ALL Oxy 80 are fake. It is not from a doctor. • The criminals making it using a pill press and food coloring to make it look like a prescription pill. • It is not a prescription. This drug is made by criminals. • Most fake Oxy 80 pills contains fentanyl.
WHAT IS FENTANYL?
• Fentanyl is a very strong drug that slows your body down. • Fentanyl is toxic. Very small amounts of fentanyl can stop your breathing. • If you use drugs with fentanyl, like fake Oxy 80s, you will become addicted very quickly. • Once you are addicted the cravings are extreme. It will be very hard to get off the drug. • It is very easy to overdose on fentanyl. • Fake Oxy 80s have different amounts of fentanyl in every pill. Some could have a very deadly dose. • One fake Oxy 80 pill can have a deadly dose and can kill you. Don’t be the next victim.
WHAT IS CARTFENTANYL?
• The drug carfentanil (4-carbomethoxyfentanyl) is an analogue of the synthetic opioid fentanyl. It was first synthesized in 1974 by Janssen Pharmaceutical, and was sold under the trade name of Wildnil®. Carfentanil has no distinguishable odor and comes in many forms, including powder, tablets, patches, blotted paper, liquid, and sprays. Carfentanil can be administered orally, nasally, or intravenously. Although known to resemble powdered cocaine or heroin, this drug has also been seized as a pale yellow, pink, or brown powder. Common street names of carfentanil include “drop dead”, “C.50”, “serial killer”, and when mixed in combination with other opioid/ opioid- like drugs, “grey death”. • Carfentanil acts as an agonist on the mu-opioid receptors in the central nervous system. This causes effects similar to other opioids, such as analgesia and extreme sedation. It also suppresses the respiratory system, depresses the cough reflex, and constricts pupils.
• Carfentanil is one of the most toxic opioids currently known, with studies showing it to be 10,000 times more potent than morphine, 4,000 times more potent than heroin, and 100 times more potent than fentanyl. In humans, a dose as small as 1 microgram is enough to elicit a response to the drug and about 20 micrograms, which is less than a grain of salt, is enough to be fatal. Like fentanyl, carfentanil can be absorbed through accidental inhalation of airborne powder, which makes its exposure and handling dangerous. • There are reports of drug dealers adding carfentanil to traditional drugs because it is cheaper, more potent, and easier to obtain than heroin or cocaine. It is unlikely that drug users are aware that they are receiving drugs laced with carfentanil, 22
and may be more likely to overdose when taking their usual dose.
WHAT IS CAUSING SO MANY OVERDOSES IN OUR COMMUNITY?
• Fentanyl in fake Oxy 80s is what is causing the deaths in our community. All Oxy 80s are fake, don’t be the next victim; using fake Oxy 80s is like playing Russian roulette; mixing Oxy80’s with other drugs or alcohol increases your chances of an overdose and you can die.
CALL 911 – EARLY OVERDOSE SIGNS
• Severe sleepiness; slow heartbeat; trouble breathing; slow, shallow breathing or snoring; cold, clammy skin and trouble walking or talking.
TSINIKSSINI Special Edition 2018
HARM REDUCTION PROJECT SAFE HOUSE REPORT related areas of concern.
Back Ground:
In July of 2017 the Drug Harm Reduction Project completed a “Standoff Community House Questionnaire” survey: #1: What Services would you like to be able to access out of the community house? #2: What Programs would you like to see run out of the community house? #3: How do you think we can make it a safe space for community members to access? #4: What times of the day should the house be accessible? And, do you think the community will benefit from a community house? The results of the survey were provided to Chief and Council at the February 2018 final reporting period. The unit 729 Community House for the community of Standoff was requested to the Core Group by an elder who is a long time resident of town site in May, 2017. The elder explained the community does not have access to a safe inviting location in the community where community members can gather, visit and provide support for one another. He explained many of the community members do come to his home to visit, to receive advice and support due to the ongoing opioid crisis. This community, as we all know, has been the most saturated community on the Blood reserve with the opioid/fentanyl crisis. The first State of Emergency declared to address the opioid crisis the many families in this community experienced through losses, death, child apprehensions, ongoing overdoses, violence, abuse and criminal activity at an all-time high. The February 26, 2018 and forward, overdoses in this community again reached an all-time high within a brief period of time. Community members reached out for help in restoring and rebuilding a safe community-centered approach in recovering from the devastation and destructive environment the drugs, alcohol, gang, drug dealers and death fostered in the community in recent years.
Concept: The conceptual thought is to provide the Standoff community residents with an
opportunity to regain community strength by providing a safe, accessible dwelling for a number of services and programs that are currently limited to many of the residents in the community, primarily the children over the age of 6, youth, the elder population and adults who are at risk; also, the unemployed and those in recovery. It is hoped that the community house would, for the most part, operate with community involvement through opportunities of volunteers, peer support, community services and programs donations and partnerships of the department and entities. The end result is that the community takes full ownership and operations of the Community House.
Currently: There are no safe play areas for children, children and youth at risk who are experiencing adversities i.e. violence, drug use in the home, women at risk, elders at risk. As well, for adults in recovery, there is no positive environment in the community. There are no safe places for community members to access as the need may arise. In addition, it will allow a number of services to be provided to community members who have challenges with mobility, or other challenges accessing services located within the community. It will also allow the community members to utilize this space for community support groups, for example: Narcotics Anonymous, spiritual and traditional healing events and other 23
June 2017 – Blood Tribe Drug Harm Reduction Project approached the Blood Tribe Housing Department in respect to the elder’s request to the Core Group, and followed up with a formal letter of request to the Blood Tribe Housing committee. Blood Tribe Housing responded favorable with stipulations of responsibility for renovations, secured rent and ongoing up keep of the house via email. The initial house provided by Blood Tribe Housing was, unfortunately, vandalized beyond repair. In November 2017, the current location, unit 729, was identified by the Housing department as another possible location with the stipulation to discuss partnerships with Blood Tribe Social Development. The discussions began with favorable results for this undertaking to be supported as a partnership and will continue to partnership to provide the best possible outcomes for this community’s Vision of Hope. The Drug Harm Reduction Project has received assistance from the Job Ready Program in cleaning and preparing the house for renovations and we received favorable information that the BTEST woodworking program will assist with some of the labor. . Sincerely.
Gayle Chase – Blood Tribe Drug Reduction Coordinator
Harm
TSINIKSSINI Special Edition 2018
BLOOD TRIBE POLICE SERVICES -- REPORT The primary community issue that the Blood Tribe Police Services received this year continues to be trafficking of Crack Cocaine and Fentanyl on the Blood reserve. The involvement and recruitment of drug addicted community m e m b e r s , including minors to take part in Drug Trafficking to support their habits was also being reported. As a result, the Blood Tribe Police Services made it one of its priorities to target drug traffickers. Drug addiction has affected all families of the community, including families of addicted persons becoming victims of
crime, such as property theft and violence. Over the years, there have been many families who were affected by the death of loved ones as a result of Opioid overdose. The Crime Reduction Unit (CRU) was created to work closely with community p a r t n e r s , including Blood Tribe Housing, Child Family Services, Child Protection and the CORE Group to help identify problems within the community and follow up with solutions by way of enforcement and disruption initiatives. The CRU has been effective in promoting community health by removing
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the drug traffickers from the community, thereby limiting the availability of illicit drugs. This has allowed for those who are addicted to seek treatment. The CRU partnered with Blood Tribe Housing to provide assistance as they attempted to enforce Lease agreements with tenants in the communities who were failing to abide by those agreements. This would often be the case in situations where tenants themselves were involved in drug trafficking or were providing a safe-haven for drug traffickers to deal out of those homes. Many of these homes were family homes where children were in contact with the drug subculture and increasingly vulnerable to harm. Child Protection and Child Family Services were involved in many of these types of investigations. Partnerships continued with the Harm Reduction Project where information was shared on harm reduction initiatives and CRU participated in many activities.
TSINIKSSINI Special Edition 2018
Below is a summary of CRU activity for the 2017 year:
The Crime Reduction Unit helped gather, organize and disseminate intelligence regarding drug related crime. Ongoing relationships were created and maintained with ALERT by providing information about crime on the Blood reserve. This led to many search warrants being executed in jurisdictions outside of the Blood reserve. The Blood Tribe Police Service continues to focus on drug traffickers and disruption of the illicit drug trade on the Blood reserve. In all, 42 search warrants have been executed during 2017 in an effort to gather evidence to bring those responsible for trafficking illicit drugs in the community before the courts. Anyone with information into illicit drug activity can call 403-737-8808. Your confidentiality will be maintained.
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TSINIKSSINI Special Edition 2018
BLOOD TRIBE CHILD PROTECTION SERVICES -- REPORT
Blood Tribe Child Protection Services (BTCPS) is a Delegated First Nations Authority that carries out duties that are set out in the “Child, Youth Family Enhancement Act” legislation. BTCPS is guided by the constitution of our Elder’s Declaration, “Kainaiysinni”. For this year, approximately 60 Intake/Screenings were completed, while 10% closed, 30 % percent of the files were referred to Prevention and Supports, 58% percent of the files where a child came into care was due to caregivers dealing with substance abuse, 2% of the files were due to domestic disharmony set off as a result of addictions. It should be noted that in the last year BTCPS has supported at least 12 medically fragile
children that did require extra supports such as tube feeding apparatus, special chairs, medical care in hospital and around the clock care until the infant stabilized. 100 per cent of these medical fragile children are a direct result of prescription drug abuse, fentanyl abuse and babies being born with harm reduction substances such as methadone and Suboxone. Blood Tribe Child Protection Services does support the harm reduction programs, however, it is noted that some infants did struggle with the harm reduction medications. The children do continue to have parents, and connections to parents is a practice we support. While the caseloads trend increased, it has Blood Tribe Child
Protection Services seek family placement of the children that come into care with families, while working with community support services to assist the guardians to seek help with their addictions. The Blood Tribe Child Protection Services has been pleased with the wrap around support services offered in the community such as: housing, addictions program, medical staff, KCSC Prevention and Support Services. These noted agencies are just the few mentioned as there are many more services working together to address the opioid crisis in the community. The Blood Tribe Police have also been instrumental in the supports for our community.
TRIBE’S MOBILE MEDICAL UNIT PREPARES COMMUNITY OUTREACH FOR OPIOID CRISIS The Mobile Medical Unit began operations on Monday September 24, 2018. It will be expanding its role to include community outreach in various areas on the Blood reserve every week. This unit was funded by Alberta Health Services and is designed to respond to the Opioid Crisis on the Blood reserve. The unit will be providing harm reduction services, and education. These services will also include Suboxone therapy, referrals for counselling, STBBI assessment and treatment, and pre- and post-natal care. The Mobile Medical Unit will have close working ties with community health, mental health and primary care. For any questions call 403-737-8427. An Open House for the unit is planned for the Annual General Meeting in November
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TSINIKSSINI Special Edition 2018
EMERGENCY/ HELP NUMBERS Call 911
Blood Tribe Police 403-737-3800 Blood Tribe Department of Health Wellness 403-737-3883 Blood Tribe Department of Health Crisis On-call 403-331-1591 Blood Tribe Child Protection 403-737-3437 Kainai Transition Support Program (Aftercare) 403-737-2666 Lavern Clinic 403-737-8610 Standoff Clinic 403-737-3888 Suboxone Clinic 403-653-5283 Adolescent Treatment Centre 403-653-1678 Blood Tribe Youth Ranch 403-737-2257 Kainai Healing Lodge 403-737-3757 Kainai Children’s Services 403-737-2900
Mobile Medical Unit 403-737-8427 Community House #729 Townsite 403-737-8737 or 403-382-0902 27