Chilliwack could soon be getting the Intensive Case Management (ICM) team it has been asking for to tackle its addiction and overdose crisis.
For the past few years, Chilliwack council has taken the brunt of community anger over the impacts of increased homelessness, substance use, overdoses and needles in the streets.
Last summer city officials appealed to Fraser Health to publicly address what it was doing because the community’s frustration had reached a fever pitch.
Michael Marchbank, CEO, Fraser Health Authority appeared before council on Tuesday afternoon with colleagues, to offer city council an update on new and expanded health initiatives.
He mentioned several projects already underway, and some that hadn’t started yet, like the new opiate replacement clinic at CGH and a new way to tackle it at the ER level, with first-line treatment.
“So if someone were to present in the middle of the night, it means we could do something in that regard,” said the Fraser Health rep.
He underlined the importance of teamwork and “working together” since single agency could solve the problem on its own.
He sounded positive on the new team idea.
“We are actively working to establish an ICM team here,” said Marchbank, adding that the conversation had begun on the topic, with BC Housing and community stakeholders.
They’ve been “gradually” adding to the outreach efforts in Chilliwack as well.
An ICM team would see a multi-disciplinary approach to tackling addiction and housing issues, 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.
“Hopefully you will be hearing soon about the establishment of that (ICM) team,” Marchbank told council.
Coun. Jason Lum thanked the FHA official for that news, as he had been the one to champion that cause months ago.
One of the concerns noted by Mayor Sharon Gaetz was that Chilliwack should be receiving services on an equitable basis compared to other communities trying to deal with the crisis.
She also added that the medically supervised detox beds inside CGH that shut down years ago in Chilliwack left the community with a “big ache” despite the existence of Riverstone Home and Mobile Detox and Treatment Centre locally.
Council received a report last summer on the housing and addictions support services in Chilliwack, compared with other Lower Mainland communities experiencing similar levels of homelessness, substance use, and overdoses, such as Maple Ridge, Abbotsford and Langley. The report highlighted the severity of the growing overdose crisis in Chilliwack, and listed concerns like the disposal of needles in public places by harm reduction clients and challenges in accessing substance use treatment services.
Chilliwack is projected to have 29 deaths from drug overdoses in 2017, up from 12 in 2016. The death rates from overdose are on the rise in Chilliwack, Coquitlam and New Westminster, according to stats presented by Fraser Health.
Another key initiative for Chilliwack coming by the end of November is an “opiate agonist treatment clinic” with two doctors out of Chilliwack General Hospital to provide opioid replacement treatment.
“There is first-line treatment for opioid substance use and that is ‘opioid agonist treatment,’ and that includes medications like methadone and Suboxone,” said Dr. Victoria Lee, chief medical health officer for Fraser Health.
Clear clinical evidence for the treatment means they are expanding it right across the region.
“We’re fortunate to have two physicians in our community that are able to support that,” Dr. Lee said.
Many think “detox” is the answer for all addicts. But not with these kinds of drugs.
“Often we hear about ‘beds’ and ‘access to beds,’ and ‘detox,’ and that is actually required in some substance-use conditions, but for opioid use specifically, detox can put you at higher risk of death, so that’s why it’s important to start people with first-line treatment,” said Dr. Lee.
The FHA website defines “agonist” treatment:
“Opioid agonist treatment is an evidence-based treatment delivered in a supervised clinical setting that uses medications such as suboxone or methadone to stabilize a person who is addicted to substances and significantly reduce harms associated with opioid use.”
Additional efforts brought up for council were: a mobile housing initiative, a healthy school initiative, and expanded collection of used needles with sharps collection containers.
“We are making some investments, and we have to make more, but if we work together, we can get there,” said Marchbank.
The new video released by FHA this week was aimed at starting the conversation about addictions to remove the stubborn stigma.
— Jennifer Feinberg (@CHWKjourno) November 7, 2017
Coun. Sue Attrill called it “compelling” and said it might go a long way to dispelling some myths. One myth disproven is the idea that overdoses only happen to homeless addicts outdoors.
“Unfortunately I don’t think this crisis is going away anytime soon,” Marchbank continued. “We have recently started to respond in different ways.”