Marcie

Additional information related to Marcie Pruden’s September 6, 2018 presentation at Health Canada’s Opioid Symposium in the workshop on: Increasing Access to Substance Use Disorder Treatment and Prevention Services in Indigenous Communities

 

At Impact, rather than focusing on inevitable risk factors that we will all be significantly challenged by, we focus on building three reliable and evidence-based resiliency factors that are protective no matter the level of risk. These three factors form the core of all Impact’s work. They are:

  • Caring, connected relationships
  • Opportunities to participate and contribute
  • Developing high self-expectations

Our Vision: A community that recognizes and responds to substance use needs as a complex issue best addressed through conditions that allow for resiliency.

From this vision and the three resiliency factors comes Impact’s mission:

Our Mission: Collaborating with the community, families and young people to cultivate caring, connected opportunities for sharing the personal gifts that help us and others confidently navigate a society where substance use is common.

Watch a video describing our mission and vision below:

You can also see Impact’s webinar with the University of British Columbia’s Indigenous Learning Circle from 2016, where three youth (including Marcie) share about how this approach was built and strengthened within the program VYPER (Valley Youth Partnership for Engagement and Respect), which was funded by Health Canada and managed by Impact from 2014 to 2016.

April 14, 2016: “Naloxone Ninja” community naloxone training. This was coincidentally already planned to occur on the day that the public health emergency was called. Press coverage of the event included a piece in Burnaby Now and a number of appearances of Impact’s Executive Director, Brian Gross, on CKNW radio.


CORNELIA NAYLOR / BURNABY NOW

A surge in drug overdose deaths that led the province to declare a public health emergency in April has motivated organizations working in Burnaby to try to get the life-saving antidote naloxone into the hands of more young people.

Drug overdose deaths in Burnaby have nearly doubled over the last nine years, jumping from nine in 2007 to 16 last year, according to new data released by the B.C. Coroners Service last month.

The increase mirrors a similar surge provincewide – with fentanyl, a synthetic painkiller 100 times more potent than morphine, accounting for or contributing to a growing percentage of the deaths.

In 2012, fentanyl was detected – alone or in combination with other drugs – in five per cent of overdose deaths in the province. In 2015, that figure shot up to 32 per cent.

And people under the age of 30, have accounted for an increasing percentage of drug deaths: 29 per cent for the first quarter of 2016, compared to 19 per cent in 2007.

Even before the province declared the health emergency, Brian Gross, project director for Valley Youth Partnership for Engagement and Respect (VYPER) said youth in his program had talked about coming up with ways to keep kids safer.

“A lot of these youth are dealing with friends who are using fentanyl on a daily basis and feel like, ‘What can I do?’” Gross said.

Many didn’t know what naloxone was, he said, and only after they first learned about it, did they start sharing personal stories about times they really could have used it.

“Stories started coming out about having been at parties where there was an overdose and sometimes sitting next to someone who was overdosing, and that was a really horrific experience for them that probably was unspeakable until that moment because it’s so stigmatizing too,” Gross said.

VYPER, a Health Canada-funded program that works with youth throughout the Fraser Health region, decided to approach Fraser Health and the B.C. Centre for Disease Control to partner on a youth-centred naloxone training session.

Odyssey I Substance Abuse Services for Youth and Families, a program that runs out of the Boys and Girls Club in Burnaby, stepped up to provide the venue.

“In recent years, opioid use has become much more mainstream and common amongst Burnaby youth aged 13 to 24,” program coordinator Bridgette Ebing told the NOW in an email. “Youth are dying from accidental overdoses and that trend is continuing. Hosting the naloxone training was an opportunity to support our youth and their families to know about and access a tool that could help save a life.”

Youth working with VYPER designed posters for the event challenging their peers to become “naloxone ninjas.”

The session attracted a total of about 60 participants – about 20 under the age of 25 – and organizers handed out 30 take-home naloxone kits.

To those who might argue providing naloxone to young people could encourage drug abuse, Gross said the issue is complex.

“It would be wonderful if people just didn’t do this and this didn’t happen, but it’s happening,” he said. “The fact is that we have a public health crisis on our hands, and there have been a lot of lives saved as a result of naloxone in the Fraser Health region.”

Gross went on to say events like the naloxone session also do more than distribute the drug; the non-judgmental setting also gives drug-involved youth a chance to make connections with stable, reliable adults.

For more information on naloxone or how to prevent, recognize and respond to a drug overdose, visit towardtheheart.com.

Summer 2017: Developed and delivered the PIPS (Prevention Is Power Sharing) program at Impact. Three youth from Impact were also trained to train other youth in naloxone use and to distribute naloxone with Impact staff. Press coverage included an appearance of one of the youth developers, Andrew Millage (15), on CBC’s On The Coast.


Design Principles of PIPS (Prevention Is Power Sharing):

Viewing drug use as a way to meet unmet human needs: PIPS starts with the assumption that “you can’t educate away a human need.” So rather than approach the opioid crisis through an educational lens, PIPS explores the deep-rooted feelings surrounding each individual’s role in the opioid crisis. Topics include concepts of vulnerability, fear, shame, anger, loss, belonging, acceptance, & family dynamics. Through sharing we explore how all of these aspects of “feeling” can create a “push” toward drug use and also, away from drug use.

Power imbalances can frustrate meeting the human need for connection:  Though PIPS always had adult clinical staff on-hand, they were just there for support, not as the expert in the room. Sharing power in the room between members with lived experience on all levels brings a shared knowledge about how the emotional experiences within each individual can act as a change agent, both in prevention and problematic use, depending on the individual.

Youth-led, open to anyone: PIPS recognizes that no person, and no group is immune to the opioid crisis. PIPS is an open group that does not target one group (age or ethnicity). Having youth as the developers and deliverers of the program helps to set a tone of inclusion and curiosity. When it comes to brain development, one could say that “Youth aren’t allied with anything but their own curiosity.” While this can pose some risks, it also can serve as a unique gift that they have to contribute to their community.

Trauma-Informed: PIPS provide a safe place with an abundance of choices for participants to experience a sense of belonging. There are options to share as much, or as little, that one needs to be able to learn from others in the group and unload “baggage” people may have been carrying for a long time by normalizing the complex feelings and reactions that we all have around substance use.

Fun: PIPS purposely works to engages group members in a fun and interactive environment through the use of games, art projects, sharing a meal in a judgement-free gathering place where we strive to meet human needs and build a sense of community.

Size matters: The human needs that research shows underlie substance use behaviours aren’t easily met in a one-time “spray and pray” auditorium presentation or video. PIPS is run once-a-week, in-person in two-hour sessions. The projected group size would be 12 to 15 maximum per session, with the optimal size of 6 to 8. This provides opportunities for time consciousness, emotional & mental comfort, consistency, flow, and strength of cohesion between group members.

Program participants are potential future facilitators: PIPS is strength-based. It is not meant to be delivered “to” people who “need it.” Its power sharing model places everyone on the same playing field. Each person has unique and valuable gifts, experiences and perspectives to contribute. “We are all a lot smarter than I am!” While the model and content requires clinical staff to be present to help people navigate what might come up for them (but what, without an opportunity like PIPS, might otherwise stay hidden and potentially toxic), the model allows anyone with a passion for convening people to reduce harm and support wellness to take on the role of facilitator.

Winter 2018: Developed and delivered the Passing the Torch program at Cheam First Nation (with participation of youth form other local First Nations). Included two Impact masters-level counsellors, two youth co-facilitators (age 15 & 17), and two practicum students from the University of the Fraser Valley Criminology Department.


The goal of the 16-session, 8-week “Passing the Torch” program that Impact ran at Cheam First Nation from January to March 2018 was not to teach young people what to think about substance use, but to give them a chance to explore, question and revise what they might already think about this complex subject.

One of our first activities was watching and discussing a video that questions whether addiction is caused by taking drugs, or if becoming addicted is affected by the conditions in a person’s life. Should we be trying to eliminate a person’s addiction, or trying to change other conditions in that person’s life to lessen their chances of becoming or staying addicted?

Over a dozen youth age 8 to 14 participated in the program. We developed the program with them, adapting it to their specific interests and gifts. Right from the beginning, they showed an interest in the oral tradition—performing skits together. This ended up being a great way to explore the way friends, family and other supports, like counsellors, might approach addiction and then to reflect on how helpful, or even harmful different approaches might be.

We recorded audio of the youth role playing and made animated videos from the recordings. We watched the videos and interviewed the youth (or they interviewed each other), asking questions like:

  • “What might have been helpful or harmful about how this scenario played out?”
  • “What suggestions would you make improve the outcome?”

The youth were full of insights and enthusiasm and, we hope, now have many ways to think about addiction, what causes it, and how best to address it. In all, we produced 36 videos!

FLOH (Foster system, Life promotion, Opioid dialogue, Harm reduction) is a program currently under development by over 20 Impact youth (age 14 to 24) across 4 communities in BC’s Fraser-Salish/Fraser Health region. While not limited to youth with experience in the foster system, more than half of the youth involved have had  direct involvement with the system, and the rest have been strongly affected by the system through family and friends.

Though FLOH focuses on a number of topics, it puts youth with experience in government care front-and-centre, as, statistically, their health outcomes are perhaps the most concerning of any demographic in our communities… including outcomes related to suicide (Life promotion), opioid and opioid contaminated street drug use (Opioid dialogue), and being supported and met where they are (Harm reduction). If conditions improve for youth in and from the foster system, we’re confident they will also improve for the rest of the individuals in our communities.

So far, the youth and adults involved with the project have created and begun to deliver various topic-based surveys that are designed not only to collect data about views and understandings of FLOH issues, but to also support dialogue. Two examples of these surveys are:

Addressing Substance Use Survey: Developed by over 100 youth and adults with various experiences with substance use.

Foster System Survivor Survey: Developed by over 30 youth and adults with experience with the foster system.

They have also lobbied provincial politicians in Victoria, BC and are working on repeating these lobbying efforts this year.

View press coverage 

This summer they also conducted a focus group bringing together teenagers and members of the BC/Yukon Association of Drug War Survivors in an attempt to bring light to the difficult conditions that homeless people who use drugs (often to cope with being homeless, and other issues, such as chronic pain) face in Abbotsford… despite the landmark BC Supreme Court ruling in their favour. (NOTE: Impact also has a contract from the Fraser Health Authority to support the Drug War Survivors)

This video is still being edited, but we will post it here as soon as it is ready. In the meantime, you can view recent press coverage related to the Drug War Survivors and youth involvement with the group through Impact’s programs.