Dr. Claudette Chase, who has spent her career working with isolated First Nations in northwestern Ontario, says the key to fighting opiate addiction is to provide treatment within a community instead of sending people away for help.
Chase, a family doctor, has been following the crisis in New Brunswick's Esgenoôpetitj First Nation.
Since April 10, five people have been admitted to hospital for treatment, and one woman has died, all of suspected drug overdoses. A pill seized in Esgenoôpetitj contained fentanyl, a painkiller 100 times more powerful than morphine.
Chase told Information Morning Moncton that in the past six years she has seen the use of opiates "spread like wildfire" in northern communities.
"I think in part because people had been living for years with such chronic anxiety and depression and trauma and ... the first few times people use an opiate all those anxieties go away."
For the communities she works in, on-site drug treatment centres, which offer opiate replacement therapies similar to methadone, have had positive results.
"Initially, there was very little help forthcoming from Health Canada, but I'm pleased to say that situation has changed and most of the programs are funded — although not to the full extent that the communities have requested," she said.
Treatment must be offered at home
Alvery Paul, the Esgenoôpetitj First Nation chief, has asked Health Canada for help dealing with the drug crisis in his community.
In an email statement, Health Canada spokesperson Maryse Durette said the department is working with the chief, and a "local mental wellness crisis team" is offering counselling to Esgenoôpetitj members.
"Health Canada funds a number of programs and services that are delivered in the community," Durette wrote.
"Short-term mental health counselling, as well as medical transportation services for community members accessing mental wellness team services, are available through Health Canada's Non-Insured Health Benefits program."
Chase, however, said the key to the success of programs in northwestern Ontario has been permanent addiction centres in the community.
"The retention rate has been about 90 per cent, which is much, much higher than any urban-based opiate treatment program that we've been able to find," Chase said.
"I think people are very motivated to heal from their addiction, to get some control over it, but it also helps that they don't have to leave home to get treatment."
Success, Chase said, is measured by social outcomes.
"We've seen fewer crimes, fewer children going into care, more families reunited, more people able to work, more people finishing school and going on to higher education," she said. "And when we measure those things, the program is unquestionably a success."
Opiate treatment a good investment
Chase argued that government funding to help people addicted to opiates is well worth it and has also reduced hepatitis C rates and other health problems over the past few years.
"Horrible" infections from shared needles have forced some people to undergo open heart surgery and valve replacements, she said.
"In terms of cost saving — I think if you were to add up all the money that was spent on health-care costs and then add up what's spent on a program that provides treatment and support, there's no question that it's economically viable."
Chase believes people who "self-medicate" with opiates are trying to escape "horrendous trauma, so counselling must be part of any treatment program.
"They're trying to find the courage to keep on living — that's what scares me. ... Someone like that, who maybe if they had access to treatment, if they could get into a program and get the trauma therapy that they need and deserve, then fewer deaths would happen."
At a meeting on Thursday, the Esgenoôpetitj band council will discuss banishing convicted drug traffickers from the community and denying them any community help, including housing.
Chase said she supports local control by First Nations but worried that approach wouldn't help those already struggling.
"What I hope for is that communities will receive adequate support from both provincial and federal governments to actually deal with the intergenerational trauma," Chase said.
"That we would see real movement on things as basic as clear water, adequate housing and at least ask for education, and if we move forward in those areas, then I think there would be less of the repetitive traumas that lead people to self-medicate with opiates."