At a time when overdose deaths reach a record high in the province, the third and final part of this series explores how adverse childhood experiences can lead to substance use, and what can be done to prevent it.

Part 1:

Part 2:

The question of whether the emotional stress caused by COVID-19 will have a long-term psychological effect on British Columbians isn91裸聊视频檛 a matter of if 91裸聊视频� it91裸聊视频檚 a matter of just how widespread it will be, says a leading physician in the province.

South Surrey91裸聊视频檚 Dr. Tahmeena Ali, who this year was named the , and White Rock psychologist Jennifer Mervyn, who was among 1 in mental health, have both signed an open letter urging government to prepare for the potential short- and long-term harm from the ongoing COVID-19 pandemic.

Mervyn and Ali are joined by more than 200 child advocates, physicians, researchers and health care professionals in the province who91裸聊视频檝e signed the letter.

91裸聊视频淐hildren91裸聊视频檚 social environments have shrunk during the isolation measures, diminishing critical opportunities for co-regulation of emotion and stress through social connection and the support of broader families, communities, and culture,91裸聊视频� the letter reads.

The letter asks that a B.C. task force be created to support an evidence-based strategy for children91裸聊视频檚 wellness during pandemic recovery.

91裸聊视频淭his is potentially creating trauma for people, this COVID situation,91裸聊视频� Mervyn said. 91裸聊视频淲e don91裸聊视频檛 have as many people to bounce things off of, to regulate, to get away from the stress, to talk through things with. That91裸聊视频檚 so critical, to us as human beings, it actually changes how our brains work.91裸聊视频�

A comprehensive study by U.S. organization Kaiser Permanente published in 1998 examined the link between adverse childhood experiences (ACEs) and challenges in adulthood. The study found the more adverse experiences a child has endured in their life, the more likely they are to have health complications, including diabetes, high blood pressure, and substance abuse.

Ali said trauma doesn91裸聊视频檛 need to be overt. It can be the result of something as simple as a workaholic parent, who loved and provided for their child, but never developed an emotional connection with them.

91裸聊视频淭hat leads them down a road that isn91裸聊视频檛 as healthy in terms of self-coping mechanisms,91裸聊视频� Ali said.

In June, B.C. recorded 175 overdose deaths, the highest monthly total for the second consecutive month. The drug overdose crisis, experts have said, has been exacerbated by COVID-19.

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91裸聊视频淐OVID just illustrates the vulnerabilities in society that when any of us are under stress, our coping mechanisms are where we go to. So whether that91裸聊视频檚 getting violent, or losing our temper, or overeating, or using drugs. It91裸聊视频檚 not a surprise, to any of us, that the overdose deaths are up. It91裸聊视频檚 a sad reality that when we have dysfunctional coping mechanisms, that91裸聊视频檚 what we fall on in periods of stress,91裸聊视频� Ali said.

Preventing drug overdoses through harm reduction practices, such as safe injection sites and distribution of naloxone, has resulted in fewer overdose deaths. But some experts describe harm reduction as a Band-Aid solution to a bigger objective, which is providing citizens with the tools they need to not rely on drugs as a self-soothing mechanism in the first place.

Both Ali and Mervyn agree that the most important thing people need, whether or not they experienced ACEs, is to have connected relationships. Mervyn described relationships as a way to co-regulate stressful environments, and Ali said it91裸聊视频檚 critical for a young child to have at least one connected relationship with an adult.

91裸聊视频淲hen you91裸聊视频檙e wrapped around love and support and care and connected relationships that help you co-regulate, and bring your stress levels down and know that you91裸聊视频檙e safe and protected,91裸聊视频� Mervyn said. 91裸聊视频淭oxic stress is when we91裸聊视频檙e experiencing these stressful environments in our day-to-day environment in the absence of that support.91裸聊视频�

Both women said the medical field is in the early phases of applying ACEs research and working from a trauma-informed approach. However, there is a long way to go.

91裸聊视频淚t91裸聊视频檚 also a cultural of medicine all around us that has to start shifting to that trauma-informed approach of recognizing that our tone of voice, and how we question patients, and how we approach them universally needs to shift. So that people don91裸聊视频檛 feel ostracized when they come into emergency intoxicated with alcohol yet again, but they feel supported and understood that this is a disease that comes from other things,91裸聊视频� Ali said.

However, a change towards a trauma-informed society doesn91裸聊视频檛 start or end with the medical community.

Mervyn suggested that prenatal classes could be re-tooled to teach young parents how to establish meaningful connections with a newborn, ACEs, early brain development, stress management, and a way to break generational trauma.

Sources manager of substance use services George Passmore said a prenatal program of that nature would be the 91裸聊视频渦ltimate dream.91裸聊视频�

Decriminalization

Over the course of this series, Peace Arch News has interviewed health and addictions experts, an active substance user, people who are in recovery and a man who lost a child due to overdose. Everyone that PAN spoke to agreed that decimalization of drugs would be an effective tool to save lives.

Recently, the Canadian Association of Chiefs of Police president, Vancouver police Chief Adam Palmer, called for the decriminalization of simple possession of illicit drugs. B.C. Premier John Horgan put his support behind the call, as did provincial health officer Dr. Bonnie Henry, adding 91裸聊视频渢here91裸聊视频檚 no more important time for us to do this than now.91裸聊视频�

91裸聊视频淲e need to put as much time and effort and kindness and compassion into caring for people who use drugs as we have been successful in doing in responding to the COVID-19 crisis,91裸聊视频� Henry said at one of her near-daily July COVID-19 briefings.

The is often touted for its success for decriminalizing drugs and turning substance misuse into a health issue, not a criminal one. In the 1990s, Portugal was averaging 360 drug overdoses per year (in comparison, B.C. has half the population of Portugal and recorded 728 overdose deaths so far in 2020).

After Portugal decriminalized drugs, the overdose deaths dropped to 26 in 2016. The number of heroin users in that country dropped from more than 100,000 when they created the policy in 2001 to less than 25,000 in 2017, according to the country91裸聊视频檚 health ministry.

Portugal paired decriminalization with a rehabilitation program and safe drug supply. People caught with a personal-supply of drugs in the country are not put in the criminal justice system, but instead are encouraged into treatment programs that are immediately available and fully subsidized.

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91裸聊视频淭his is a very difficult conversation to have, and it91裸聊视频檚 understandable,91裸聊视频� Passmore said. 91裸聊视频淚 struggle with some of the implications of the ideas around fixed drug supply. I struggle with it, and yet, when I look at what91裸聊视频檚 happening, I think, let91裸聊视频檚 stop empowering the organized crime.91裸聊视频�

White Rock91裸聊视频檚 Ryan Nielsen, 26, who91裸聊视频檚 recovered from a six-year heroin addiction, said the most effective way to save lives is to provide a safe drug supply.

91裸聊视频淥f course that91裸聊视频檚 a very tricky slope. We can do the whole counselling or whatever there is, but there are addicts that maybe won91裸聊视频檛 want to do those steps. If you actually add a safe drug supply that would save a lot of lives,91裸聊视频� he said. 91裸聊视频淚 know a lot of people don91裸聊视频檛 like that idea. It would immediately save lives.91裸聊视频�

White Rock Mayor Darryl Walker agreed in that drug use is a health-related issue, not one of criminality. However, Walker said people who sell illicit drugs need to be held accountable.

91裸聊视频淒ecriminalization speaks to a level of control where people can get it and they don91裸聊视频檛 have to worry about getting it through somebody who91裸聊视频檚 a pusher, trafficker, or whatever. Where they can actually get it safely. We need to talk about it as a health-related issue. We91裸聊视频檝e gotten partway there with marijuana,91裸聊视频� Walker said.

It91裸聊视频檚 discussion, he added, that needs to involve the whole community.

91裸聊视频淎nd we have to do it under a guise of health-care as far as I91裸聊视频檓 concerned, because that91裸聊视频檚 what it is,91裸聊视频� Walker said.

Ali said the issue with policing personal drug use is that it doesn91裸聊视频檛 resolve the root cause of why people to pick up substances.

91裸聊视频淪o putting them in jail or fining them isn91裸聊视频檛 going to fix the hurt inside that they91裸聊视频檙e trying to heal,91裸聊视频� Ali said.

aaron.hinks@peacearchnews.com
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