Near-fatal overdose recounted
Stephanie McNeely didn't know she had ingested fentanyl; addictions programs in the city adapt to deadly drug | Killer on the streets Part III of IV:
Yellowknifer is investigating fentanyl's toll. |
Shane Magee
Northern News Services
Friday, April 22, 2016
SOMBA K'E/YELLOWKNIFE
Stephanie McNeely moved home to Fort Resolution from Yellowknife last year hoping to curb her drug use. In October, the 30-year-old mother of four was using again.
When the cocaine and crack ran out one day, McNeely and another person turned to what they believed was liquid codeine.
She doesn't remember much beyond the room going black as the liquid was injected into her body. Suffering seizures, she was taken to the community's health centre and medevaced to Yellowknife. Her heart stopped for more than a minute during the flight, she was told.
"I just remember that it happened so fast," McNeely said about the overdose that nearly killed her. "It was awful. I wish I could change it but I can't."
McNeely spent 17 days at Stanton Territorial Hospital and was told high levels of fentanyl were found in her system. She had no idea that's what she had taken and said she wouldn't want to use the opioid first developed as a painkiller that's about 100 times more powerful than morphine.
Since the overdose, McNeely said she's been good about avoiding drugs. She's seen a counsellor, gone through two treatment programs and is using prescribed methadone to deal with opioid cravings.
"It just made me think that I had to change my life around," she said.
Fentanyl has been linked to hundreds of deaths in Western Canada and at least five since 2009 in the territory. As more people become addicted, or end up using it accidentally like McNeely, there has been a growth in those seeking treatment.
The number of patients using a methadone program in Yellowknife for opioid addiction more than doubled as illicit fentanyl hit city streets about two years ago, according to Dr. Jennifer Harris.
"It really increased our numbers of people looking for help and it increased the severity of addictions," said the family doctor who has been able to prescribe methadone or suboxone as opiod addiction treatment for about five years.
Methadone, a synthetic opioid, alleviates withdrawal symptoms and diminishes the euphoric effect of opioids which can decrease the user's need to feed the addiction.
For three years, the number of patients in Yellowknife was around 10. Now that number has doubled or tripled because of fentanyl, said Harris.
In January, the methadone treatment program was reworked, adding crisis counselling, mental-health nurses, a counsellor from the Tree of Peace Friendship Centre, creating a more cohesive program to deal with the increased number of people addicted to fentanyl.
Patients can be directed to the program, can access it directly, or can call the clinic. After a screening by a nurse that also provides information about the program, patients see one of four doctors prescribing methadone and suboxone for opioid addiction treatment.
Users start with a small dose given at one of three pharmacies where they are witnessed taking the methadone. The doctor would typically see the patient weekly, and the dose would increase depending how the patient is doing.
Once the person is showing signs of stability, they can take the dose home.
"It can last forever, it just depends on the person," she said about how long that second stage of treatment may continue.
Compared to other opioids such as heroin or prescription painkillers, fentanyl is harder to treat because of how addictive it is, Harris said.
"It's very challenging for people who have a fentanyl addiction to manage the withdrawal they're getting versus if they're addicted to another opioid. They're not able to tolerate the methadone doses being too low," she said.
People still struggle with using fentanyl intermittently when getting treatment, she said. Those in treatment are screened for drug use with urine tests on most visits.
"We don't throw people out of the program if they end up using, we just figure out how to find a safer way for them, recognizing that the street fentanyl is very dangerous," she said.
The "social costs" of a person left untreated who is dependent on opioids was estimated to be $44,000 per year, according to a 2000 study in Toronto. Studies have also shown methadone programs are cheaper to administer than policing and health care required for drug users. Yellowknifer couldn't determine the cost of the methadone program by press time.
During a news conference earlier this month announcing the results of a year-long investigation into an alleged network trafficking fentanyl and other drugs, the Yellowknife RCMP detachment commander specifically pointed to the need to deal with addictions.
"We're very pleased with the result," Insp. Matt Peggs said about the bust. "However, seeing the scope first-hand of the demand for the illicit drugs in the community should be a sobering moment for everybody. Drug trafficking cannot exist where there is no demand."
Peggs said the use of drugs is not limited to one group in the community and affects all parts of it. Harris said she's seeing people in their 20s coming into fentanyl use through parties as well as those who have long struggled with addictions and have gone in and out of treatment programs.
Mayor Mark Heyck, asked recently about the drug issue in Yellowknife, said higher-than-average incomes contribute to the market.
"I think Yellowknife, like any community that has high disposable incomes, provides a market for those things," he said, adding the key is to reduce demand.
Various officials have said fentanyl, while a growing concern, still pales compared to the impacts alcohol and other drugs have on the community.
"Compared to other provinces and territories, our opioid addiction numbers are much smaller, thankfully. But there was still a doubling or tripling when fentanyl arrived," Harris said.
Data provided by the GNWT indicates that of the 290 people who have gone south for addictions treatment at one of four centres since 2013, only 21 have gone to a facility that is focused more on prescription drug abuse.
Those figures reflect only those who enter treatment programs in the south, not the larger number of those referred to treatment who are accepted into programs but don't attend.
"By far the most common is alcohol," said Andy Langford with the Department of Health and Social Services.
The Salvation Army operates a six-bed, two-week long program funded by the GNWT to prepare people headed south for treatment. There's three other extended-care beds as well.
Lt. Dusty Sauder, the Salvation Army's executive director of the NWT Resource Centre, said people using the beds are asked to self-disclose what they use. The organization doesn't have any records recently of people self-disclosing about fentanyl use, he said.
"I don't think we've seen a wave of it," he said at the beginning of April.
The vast majority, he said, are alcohol, marijuana and to a lesser extent other drugs such as cocaine and crystal methamphetamine.
McNeely said in the five years she lived in Yellowknife, she witnessed drug-related issues get worse as heroin, fentanyl and methamphetamine moved in.
"It's dangerous. I'm glad I got out of there or I would have come back in a casket," she said.
She still has friends in the city who she says use fentanyl. Asked what advice she has for users, she kept it simple.
"I know it numbs the pain, but it only lasts a few hours. Face reality.
"Sooner or later you're going to have to. Either you clean up your life or you're going to die," McNeely said.
Next week, Yellowknifer examines what happened to a program officials say could help reduce prescription
drug abuse.
