Immediate provincial action needed to combat fentanyl

DECEMBER 2, 2015           

By the end of this year, there will be more deaths associated with fentanyl overdoses than motor vehicle accidents.

“Fentanyl is one of the biggest issues we are facing right now,” said Tyler White, CEO of Siksika Health Services and the only non-elected member on the province’s Mental Health Review Committee. “It’s a critical issue and it requires brave leadership.”

The Blood First Nation knows about critical, says White. There have been 20 or more deaths there linked to fentanyl overdoses and earlier this year the Blood Tribe declared a state of emergency.

“Compounded by the jurisdictional complexity of healthcare provision, including those for First Nation and Aboriginal communities, access to treatment and services for fentanyl and opioid abuse is made difficult for those seeking services and those trying to support people in need,” said Mental Health Review Committee co-chairs Dr. David Swann and Service Alberta Minister Danielle Larivee, in a letter to Health Minister Sarah Hoffman on Nov. 23. Hoffman had requested interim findings from the committee.

The letter outlined immediate actions that needed to be taken to address fentanyl and opioid abuse. Among those recommendations was to “develop a targeted and comprehensive First Nations and Aboriginal opiate addictions action plan that includes improved access to opioid dependency treatment services, and change abstinence-only admission to care policy.” Outlined as intermediate action was “collaborat(ing) with federal counterparts and Alberta Health Services to deliver detox and rehabilitation to the First Nations, Inuit, Métis and Aboriginal population through a chronic disease management model.”

This week, Hoffman responded by announcing Alberta will make available an extra 2,000 kits containing the antidote naloxone. She said new rules would be put in place before the end of the year to allow first responders to administer the potentially life-saving treatment.

White says it is important on First Nations that first responders, such as EMTs or nurse practitioners, are able to deliver the antidote.

“This government sort of inherited two decades of issues of abuse, opiate of course being the main one, but we’ve had some other community champions out there. It’s not all bleak,” said White.

White points to his own First Nation, which he says hasn’t seen fentanyl on the reserve because of early intervention steps taken by Siksika combined with a unique approach to physician care. In order to foster relationships between physicians and their patients, to bring about continuity and “good quality primary care,” Siksika became the first First Nation in Alberta to move from fee-for-service to an alternative relationship plan with its physicians. With physicians salaried, says White, doctors can afford to spend more time with each patient. There are now seven physicians and four specialists, who provide services on Siksika First Nation.

It also helped, says White, who has provided continuity in his position for 17 years, that leadership supported the unique approach to health care and that staff is dedicated.

“There was a whole positive domino effect from some of those early humble and difficult years. So it resulted in something positive. I think we are an example of positive things going on and there are other First Nations that are also doing some positive work,” said White.