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Written by Elaine O'Connor

Deadly decisions

17/10/2016 9:05:19 AM | 0 comments |
A parent’s guide to the new generation of deadly drugs killing teens in BC.

Jack Bodie was an average teenager who played hockey and went to Burnaby high school. The 17-year-old had a good family and a bright future. But like many teens he sometimes liked to party and experiment with drugs on the weekend. A year ago, on a summer Saturday night in August, he sat down on an East Vancouver park bench next to a friend to get high for fun. Before that night, he had only been using drugs recreationally for about six months. He and his friend popped some counterfeit OxyContin pills called ’fake 80s.’ They were laced with fentanyl – a powerful synthetic painkiller 50 to 100 times more toxic than morphine that has contaminated the illicit drug supply in BC.

Bodie overdosed. As he sat in the park, the fentanyl in his drugs began slowing his breathing, depriving his brain of oxygen. His 16-year-old friend called 911 after realizing they were both in trouble. The friend barely escaped with his own life. Bodie never recovered.

In the days that followed Bodie’s death, the teen’s distraught parents and younger sister made a public plea to other youth not to make the same mistake. Jack, his father told the media, was “not what we could consider, in our mind’s eye, the typical overdose. He’s a young man who took a pill and fell asleep on a park bench.” His mother warned that teenagers were using these drugs just “like drinking, a casual thing for a fun time.” 

But, she told Global News: “If it’s a street drug, you don’t know what’s in them. You have no idea. Someone is just trying to make money, and they’ll put anything in it to make it cheaper or get your business.” 

Fentanyl can be fatal

A year after Bodie’s death, fentanyl overdoses have become so prevalent that they have prompted a public health emergency. Illicit drug overdose deaths in BC are up nearly 75 per cent over last year, according to the BC Coroners Service report covering the first seven months of 2016. There were 433 illicit drug overdose deaths from January to July, the report revealed. Fentanyl was detected in 62 per cent of these deaths, a dramatic increase from 2012 when just five per cent of deaths were associated with fentanyl. Fentanyl overdoses are occurring in occasional users as well as habitual users, in urban, suburban and rural communities.

Fentanyl overdoses and deaths have been reported in communities across BC, including Vancouver, Surrey, Maple Ridge, Langley, Nanaimo, Prince George, Fort St. John and others.
           
These shocking numbers are the reason BC’s Provincial Health Officer Dr. Perry Kendall called a public health emergency in April. Since then, Fraser Health and other BC health authorities have been ramping up efforts to educate the public about the overdose crisis, increase public access to naloxone, and increase awareness of the issue.
 
“It is important to note that the individuals we have seen for overdoses include not only people who use drugs regularly but also those who use drugs on a recreational basis,” said Dr. Victoria Lee, Chief Medical Health Officer for Fraser Health. “People report taking a variety of drugs including, but not limited to, heroin, crack cocaine, cocaine, amphetamines, ecstasy and GHB. At this time, we are warning anyone using drugs that all drugs may be contaminated with other substances, leading to increased risk of overdose and death.”

What you need to know about fentanyl

Fentanyl is a synthetic narcotic that is 50 to 100 times more toxic than morphine. Pharmaceutical grade fentanyl is used in medical treatments as a pain killer or anesthetic. When used on patients in a clinical setting by trained health professionals, it can be administered safely. However, outside hospitals, using fentanyl can lead to fatal errors. That’s because very small amounts of fentanyl – equal to a few grains of salt – are enough to cause overdose or death. That risk can increase when people use more than one substance – alcohol or other drugs– at once, as combining substances can reduce the amount of fentanyl required to overdose.

Fentanyl has a strong sedative effect and can severely depress the respiratory system.  At first, a fentanyl overdose can look and sound as if someone is going to sleep, but as the drug takes deeper effect, it can stop the user from breathing, causing brain damage and eventually death. Fentanyl overdoses can be temporarily reversed with an injection of naloxone medication, but only if they get help on time.

The spike of fentanyl in the illegal drug supply is primarily because it is cheap and concentrated. Drug manufacturers can produce fentanyl more cheaply than other drugs, and cut it into other drugs to save costs and enhance the drug’s effects. Its concentrated strength means it can also be trafficked more easily: a tiny vial of fentanyl can be smuggled across a border more easily than a brick of heroin. And fentanyl is highly addictive, hooking users who are often unaware that their regular dose of drugs is much more toxic, due to added fentanyl. 
 
One of the challenges with fentanyl is that it is virtually undetectable: you can’t smell or taste it. It has been found in a wide variety of drugs. To date, fentanyl has been reported in heroin, cocaine and crack, ecstasy and MDMA, methamphetamine, and fake OxyContin and Percocet pills, but it’s likely sold in many other forms. Over-the-counter drug testing kits – the kind you can buy online or the drug-testing services you can often access at music festivals – cannot detect fentanyl compounds. Detecting fentanyl in illicit drugs requires a specially-equipped laboratory.  

Drugs don’t discriminate

It’s a myth that only seasoned drug users are overdosing – and dying – from illicit drug use. Overdoses are affecting people from all walks of life, of all ages and in many communities.
 
The majority of fentanyl victims – 54 per cent – have been between the ages of 20 and 39. But teenagers are being struck down too – 11 youths aged 10 to 19 died of illicit drug overdoses in the first seven months of 2016, according to the BC Coroners Service. Boys and men made up 80 per cent of the overdose victims in the seven months of 2016. But women and girls are also being affected.
 
Just this August, about a year after Bodie’s death, a 16-year-old girl died in the bathroom of a Port Moody Starbucks coffee shop. Gwynevere Staddon was a Coquitlam teenager and gymnastics instructor who struggled with substance use. Her mother said her daughter knew dealers were selling fentanyl, but that she didn’t believe an overdose would ever happen to her. Her mother told the media she suspected her daughter died from a fentanyl overdose. The official BC Coroners Service review of her death is pending. 
 
Clearly, the message isn’t getting through to teens. That’s what prompted Coquitlam mother Michelle Jansen to start a foundation to raise awareness of fentanyl and the overdose crisis in B.C., particularly among teens. Jansen lost her own son, Brandon, to a fentanyl overdose in March. The 20-year-old was being treated in a detox and recovery centre on the Sunshine Coast when someone smuggled in some drugs that contained fentanyl. He took a gamble on them and lost his life. His mother launched the Brandon Jansen Foundation in his memory and has made it her mission to save other families the same pain. Youth, Jansen told the Vancouver Sun, “go to a party, and think they are taking… ecstasy. They don’t realize the dealers are lacing it with fentanyl.”

Given the fact that overdoses don’t discriminate, it’s important that parents and family members arm themselves with the facts. 

Keeping your kids safe

Surrey RCMP Inspector Shawna Baher can never forget the day she had to tell a family their teenager had overdosed on drugs. It’s one of the reasons the veteran drug enforcement officer has made it a priority to talk openly and honestly with her own stepchildren about drugs from a young age. She believes parents need to start a conversation about drugs with their teenagers now before it’s too late.
 
“If you don’t educate your children properly on this, someone else will, and they won’t give them the right message,” she explained. “Youth are given false information from a lot of people, their friends, their dealer, if they are using. You have to ensure they are educated properly because fentanyl is such a danger. These are not the drugs you grew up with. There is nothing worse as a police officer than to tell a parent that their child has died. I have given that awful message and it broke my heart.”

Starting when her stepdaughter and son were teenagers, she and her partner regularly started conversations with their kids about drugs at the dinner table. She’d mention issues in the news or cases she was aware of as talking points, and simply ask them what they thought. When she became aware of fentanyl creeping into the drug supply about a year and a half ago, she made sure she shared what she was learning with her kids and answered their questions.

“We talked a lot about what fentanyl was,” she said. “They know it’s 100 times more toxic than morphine. They know the difference between stimulants and opiates. When they see it on the news they say they have the ability to explain to their friends what it means.”

Most important, she said, was the way her message was delivered: without judgment or threats. 

“Now, with fentanyl and the increase in opiate use, I think it’s extremely important to have that conversation, and in my opinion it can’t be seen as lecturing,” Insp. Baher said. “Sometimes I see my friends with their children and they want to tell them what to do. I don’t think we can. We need to have open communication, we have to get their buy-in and be willing to listen to what they tell us in order to get our message across.”

How to talk to your kids about fentanyl

In June, the Surrey RCMP released a letter to parents specifically warning them about the risks fentanyl poses to their teenagers. “Despite our best efforts as parents, our children can easily be at-risk of drug use. They are young and influenced by people and factors outside of our control,” Surrey RCMP Assistant Commissioner Bill Fordy warned.
 
Police cautioned parents not to take a “it-would-never-happen-to-my-child” approach, stressing that children’s susceptibility to drug use isn’t determined by their family’s education, socio-economic status, or neighbourhood. 
 
“It is important to not assume your child hasn’t already or isn’t thinking about experimenting with drugs – it’s not always as obvious as we think,” Fordy, the Lower Mainland District Commander, warned. “And whether your child experiments with drugs for the first time or uses drugs regularly to ‘escape’ or fit in, serious harm or death is a very real possibility. Overdoses do not discriminate between the first time and the 50th time one takes drugs.”

Bob Rich, Chief Constable of the Abbotsford RCMP publicly warned parents not to fall into the mistaken belief that it could never happen in their family. “We have often heard parents say, ‘not my son, not my daughter,’” he said in a letter to parents, “and fortunately in many cases that is true, but we also have heard many youth say “My parents have no idea that I am using drugs.” This includes teens from all social-economic, cultural and religious backgrounds.”

Both police departments provided guidelines for parents to discuss drug use with their families in general and the opioid overdose crisis specifically. Among their recommendations: think through your conversation before you start it, get in the habit of regular talks with your kids, stick to the facts, stay focused and be clear, and be supportive and inclusive of their thoughts and feelings.  They suggest using a recent news article as a jumping off point for an open conversation on drug use in general. 

Fraser Health’s Mark Goheen, a clinical specialist in mental health and substance use, encourages parents not to place unrealistic expectations on themselves to cover all the bases and convince their child not to use drugs in one talk. Just as with all aspects of life, supporting your child in making healthy decisions is an unfolding process that develops across the journey to adulthood.        

“Parents often put a lot of pressure on themselves to ‘get it right,’ which can turn conversations into lectures,” Goheen said. “How young people respond to conversations has little to do with the content of what you’re saying and everything to do with the existing and developing quality of your relationship with your child.” No matter how right a parent or caregiver may be, the message will not be heard if the youth feels there is little room in the conversation for their ideas and feelings.
 
He encourages parents and caregivers to focus more on listening and understanding rather than “talking at” children, especially youth.  Parents can start by asking their children to teach them more about fentanyl and other drugs by inviting them to share what they’re hearing from peers or seeing on social media. Parents can also ask their children about the kinds of concerns their peers are sharing with each other about drugs and about what steps they have been taking to keep each other safe.
 
Saving lives amid the fentanyl overdose crisis means both preventing people from using drugs, and helping them reduce the risk if they still choose to use. Parents can stress to their children that now – during an epidemic of deadly tainted drugs – is the wrong time to start experimenting with drugs. 

In cases where parents know their child is consuming drugs, it is vital to have a heart-to-heart talk about safety. Since every situation is different, there is no simple formula, yet there are some key areas that are crucial to explore. First, emphasize that there is confidential help available for anyone whose life has got caught-up in drugs and that you are open to supporting your child if they ever feel open to meeting with a professional. Second, explain no one should be alone when using and that having a naloxone kit nearby can save a life.  If someone does end up using alone, ask them how they stay safe. Find out if they do things like leave the door unlocked so people can check on them and help can reach them if needed; if they arrange for a trusted person to check on them (in person or via phone/text); and if they let people know in advance where they are and what drugs they are doing. Finally, it never hurts to remind your child that you love them, that your main concern is that they are safe, and that if they ever need help they can reach out and you will reach back.

Over her years in law enforcement, Insp. Baher has learned that as much as parents may have forbidden it or don’t want to admit it, in reality, many teens are experimenting with drugs. So for their own protection, especially during the current fentanyl overdose crisis, Insp. Baher stresses that teens need to know if they mess up, their parents will be there for them. 


Step-by-step guide to The Conversation

  • Look for opportunities to talk about drug use with your teenager, when discussing school, social media or current events.
  • Plan the main points you want to discuss, rather than speaking on impulse. Avoid saying everything you think all at once. Instead, target your main points about drugs.
  • Listen to them and respect their opinion. If they see you as a good listener, they may be more inclined to trust your input. Give them room to participate and ask questions.
  • Focus on facts rather than emotions. If your teenager is using drugs, you may feel anger, sadness, fear or confusion. Those are natural reactions. But talking about the issue is more productive than talking about your feelings.
  • Avoid being judgmental.
  • Respect their independence. Tell them you are trying to help them make good decisions, by giving them information they may not know.
  • Be clear about why you are worried. Whatever your teenager may think, communicate that your main concern is for their well-being.
  • You are your teenager’s most important role model and their best defense against drug use. Start early and answer the questions about drugs before they are asked.

Signs your teen may be using drugs

  • Increased secrecy about possessions, friends and activities
  • Use of incense, room deodorant, or perfume to hide smoke or chemical odours
  • New interest in clothes that reference drug use
  • Increased need for money
  • Missing prescription drugs, especially narcotics and sedatives
Source: Surrey RCMP


Resources

Fraserhealth.ca/overdose: Visit our content hub for all the facts you need to know before you talk to your kids about fentanyl. Learn about signs of an overdose, how to respond to and prevent them, and how to access resources in your community. You can email your questions to overdose@fraserhealth.ca.
 
Parent Helpline: Parents concerned their children are getting involved with drugs or illegal activities can call the Surrey RCMP’s parent helpline at 604-599-7800 to connect with youth officers, information and resources. The service is available in English, Punjabi, and French. 
 
Police guides to help you talk about fentanyl: Read Surrey RCMP’s letter to parents. Read the Abbotsford Police Department’s parent advisory.
 
Harm reduction principles for effective parenting: Learn how to guide your child who may be using substances to make safer choices by asking them about their reasons for substance use, meeting them where they are at, and helping them make small, positive steps. Read more tips in this article by a psychologist and public health advocate.
 
Naloxone training in your community: Learn how to save a life, just in case. Fraser Health offers free naloxone training sessions across our health region, some training is delivered via pre-scheduled sessions, others via drop-in, and others by appointment. Find a session
 
Mindcheck: This website is designed to help youth and young adults in British Columbia check out how they’re feeling and quickly connect to mental health resources and support. Support includes education, self-care tools, website links, and assistance in connecting to local professional resources.
 
Drug treatment resources: For treatment options and resources throughout B.C., call the Alcohol and Drug Information Referral Service at 604-660-9382 or toll-free at 1-800-663-1441.


This article was originally published in the Healthier You Fall 2016 magazine. Check out the issue here (best viewed in a Google Chrome or Firefox browser) or download the PDF magazine

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