Caitlin Burritt  00:00 

Thank you for listening to the Unsilencing Stories Podcast. We are in the midst of a public health crisis. More than 32,000 people in Canada have died from fatal opioid overdoses since 2016 according to Health Canada. Previously, this podcast featured interviews with bereaved people in smaller towns and communities in BC and Alberta who have lost loved ones to fatal overdose. In this phase, we're sharing interviews with seven harm reduction workers, also known as peers, in different parts of BC.  

Caitlin Burritt  00:27 

The BC Centre for Disease Control Harm Reduction Services defines harm reduction as support services and strategies that aim to keep people safe and minimise death, disease and injury from high risk behaviour. Peers face a lot of challenges. This has been documented by many researchers including Zahra Mamdani and colleagues in BC. In their 2021 paper they outline significant challenges peers face including financial struggles, difficulty finding housing and stressors at work. We wanted to explore these themes with peers and find out more about their experiences and share this information with the public. So we conducted multiple remote interviews with harm reduction workers and invited them to talk about the stressors they face.  

Caitlin Burritt  01:06 

Please note this podcast contains information about substance use, overdose death, grief, trauma and stressors that peers face and this may be distressing to listen to. The podcast is part of a research project led by Aaron Goodman, PhD, faculty member at Kwantlen Polytechnic University in Surrey, BC, and conducted under the auspices of a grant known as the Chancellor's Chair Award. I'm Caitlin Burritt, a researcher with the project. A number of researchers including Giorgia Ricciardi and Chloe Burritt, who happens to be my sister, and a number of students have played key roles in the study and you'll hear many of their voices in this podcast.  

Caitlin Burritt  01:40 

In this episode, you'll hear Lucas Akai and Esther Cheung interview Ben about how often he personally faces death and trauma in his work. Ben explains that it is a constant presence in his work due to the toxic drug crisis and shares some specific incidents and emphasises the importance of safe supply and accessible resources.  

Lucas Akai  01:58 

Okay, so as I mentioned, we're going to just kind of jump straight in, we're gonna go off the list of questions. I don't know if you have it up in front of you. But um, maybe just to set some foundation? How often do you personally face the aspects of death and trauma? 

Ben  02:14 

Well, it's kind of currently, you know, more so than ever before. It's, it's always looming in terms of anybody that I know, in the, who's an active drug user is, you know, might be on any given day. So particularly if somebody's making changes in their lifestyle or trying to reduce their use or just... There's always changes to the illicit supply. So unless the person is pretty stable on, on safe supply, safer supplier, medicalized safer supply, or ORG it's always a question of, you know, is that person going to be alive again today or? 

Ben  03:20 

So? I think that's the way that it impacts me most, currently, because the people that I know are, the people that I interact with most directly most of the time are people like myself, are kind of stable enough to sort of prioritise concerning themselves with helping other people and aren't just trying to score or whatever on a daily basis. So I don't, it's not like those people are typically passing away. All that often, but just sort of one or two circles out from me, it's more common that people are dying or overdosing.  

Ben  04:11 

Well, I guess this week, a friend of mine overdosed, and they survived but was more or less just lucky that someone was there because they were having a bit of a tiff with their partner and these are people that are pretty close to me as far as people that I interact with on a daily or weekly basis anyway, and so the, the partner was out of the room, but there was another friend present, so if that friend hadn't been there, presumably it might have taken longer for the partner to check in with the other half, so to speak and it, it was, it took them three, three doses of naloxone to revive the person. So, you know, that, I don't probably hear about it every time that happens. 

Ben  05:17 

And I certainly don't hear about it as far as the clientele that I'm serving sort of. I think it's not uncommon for people to, people that are just getting by day to day on the illicit supply, I think quite often might overdose multiple times, sometimes in in a day or a week or whatever. Depending on the supply. So,  I've heard recently, it took a, there's been a bunch of carfentanyl in the local supply. And so that's making people much more inebriated and presumably more at risk for for overdose, generally, but, and in this case, like, we were pretty much stable on safer supply ourselves, and were careful careful about accessing relatively clean drugs. 

Ben  06:20 

 And so these friends are also using drugs that don't have benzos in them and are not, don't have, they don't change, like, it's a reliable source that it's pretty much, we can be confident about quality of this stuff. So it was just, you know, a little bit of variation or different source, one day can can really impact person, pretty extremely.  

Ben  06:57 

And that's always in the background, as I say, just you never know, like, if somebody can't, somebody can't access their safer supply on a given day because they didn't get to the pharmacy or something, then that person is much more vulnerable to whatever variations in the illicit marketplace, if they're trying to just get, get well on that day when they can't get their, their pharmaceutical drugs. And that's something that worries me. And, yeah, I guess, I don't know the as far as the current situation, we don't have a safer inhalation site on our overdose prevention site is very limited and its capacity to serve our clientele.  

Ben  07:52 

So it's pretty frustrating, as far as that goes, that is just, like, accessing resources, there's really not much available currently, other than the medicalized safer supply, if people are open to that, or, or whatever. And it really doesn't meet the needs of greater portion of, of people who are just sort of coping day to day by using the illicit drugs. That's still not, not strong enough, not enough options as far as how you can ingest the drugs, like the fentanyl patches that work for me are not really, they're not fun or easy, or you need to be pretty stable to make that work for you. 

Ben  08:53 

 And even people that are using those, as I've said before, typically if they're in the lifestyle, if they're not, they're not sort of somewhat isolated from the hall scene, and they're still going to be susceptible to using the illicit supply pretty frequently, because it's so much stronger. So you have to be really determined and sort of separated from the daily street drug scene to make that work. So that generally answers your question.  

Lucas Akai  09:28 

So in these instances where you either hear about or perhaps or witness an overdose or someone passing as a result of the toxic drug crisis, how do you personally respond in the moment or after it's happened, kind of in the aftermath?  

Ben  09:45 

Well, I just tried to check in with the people if they survive, obviously. And yeah, it's it's not too common for someone I know to pass away. As I, I recently lost a friend or two, it wasn't drug related death, but I just mainly respond by carrying on doing what I'm doing and trying to increase the options for people to be safe and and have their needs met one way or the other. So yeah, I guess I'm just increasingly aware of the sort of multifaceted nature of the problem and the way the system doesn't really address it in a, in a coherent way. Because,you know, it's, it's not, it's not adequate to just try to medicalize people and their, essentially, their housing needs. I mean, housing is just such a huge factor.  

Ben  10:54 

And right now, as I mentioned last week, they're just trying to sort of mask or hide the problem of inadequate housing by pushing the homeless population further out of the, sort of, residential area in the main largest town here, and it's not going to make the problem go away, it's just going to make it a little less visible on a daily basis, temporarily anyway, or that sort of thing. Actually, today, there's a city council or town council meeting where there's going to be a presentation by us, several people from the homeless encampment or one person who has been nominated by the many majority of other people that are trying to have their voices heard. And I'm not at that, because I'm doing this, but find out about it afterwards.  

Ben  12:02 

So I'm happy that the CAT team and OPS are taking that on to the degree that they've helped organise this presentation to town council, because it's, as I say, just, it's all facets of the same problem and would really be much more effective to try to address them simultaneously and recognise that they're not, can't possibly solve one problem separately from the other issues, ultimately.  

Lucas Akai  12:38 

This may be speaking to the multifaceted aspects of this issue at hand. Have you found that the ways you handle these problems in general or you structure your work or workshops has changed since the start of the toxic drug crisis? Or has it been fairly stable between the beginning and then, but the before aspects? 

Ben  13:02 

Well, in terms of the respect I received for my work, or whatever there was the, prior to the extremity of the crisis, sort of hitting home at the in the midst of COVID, so to speak, like, because we've been doing this work, more or less on a volunteer basis for a couple of decades in this community, we were approached by the Health Authority when they received funding locally to hire some peer workers. And we were the people that were most obvious to take, take those roles on. And then because the bureaucracy has such a hard time incorporating people who use drugs into their, into that context, it only took a couple of years before they had justification to let us go, which happened to coincide with the beginning of COVID.  

Ben  14:12 

Pretty pretty much precisely so the prior to that, we were working 10 hours a week, kind of on a paid basis plus receiving gas money and stuff like that, and the equipment and that sort of thing to distribute to our clients. And after that, we were just sort of dealing with our own situation at the beginning of COVID. And then we had the opportunity to apply for this funding that we're currently using. So the way we work has certainly changed considerably, since we've been responsible for structuring it ourselves in the last couple of years or year and a bit, and since we were hadn't previously had our own funding, we've just had a year of doing that ourselves and our initial conception of how we were going to approach it has changed as we've dealt with the reality of trying to reach people in the context of the pandemic, or multiple pandemics, or however you want to look at it.  

Ben  15:38 

And so we're just currently having a review of our project for funding renewal is coming up, pretty much now. We've had an extension of our funding, and we still have probably about half of the money left from our initial grant, which is being rolled over into the next funding year. So we have to sort of look at how, how the ideas that we had about what we're going to do at the beginning, and what, how it's actually come, come have uh, are are different and how we're going to proceed into the next funding year, so. I guess this is what I'm thinking about currently is just how to be more coherent about really dealing with the multifaceted nature of the situation and try to help people more effectively by recognising that there's not just, not just the toxic drugs that they're coping with, but lack of support in general lack of housing and, and lack of income and all of that.  

Lucas Akai  16:54 

And so do you find that the kind of, I mean, maybe you might describe as the uphill battle, so to speak, do you find that that affects your ability, or willingness to come to work everyday as a peer worker? 

Ben  17:10 

Oh, for sure. It's, it's also as a caregiver for a paraplegic person who's got a progressive condition and also, we're both getting older, but my partner's just turning 60 this year, so there's, you know, that, that reduces the stamina or degree of energy that he has to focus on this. And I have to sort of focus more on making sure that he's looked after. And so it's just because of, because of the lack of housing options in terms of accessible housing, for a wheelchair user, really don't have a lot of choices as far as places to live and the lack of stable income from this work is is a factor.  

Ben  18:14 

But as far as that goes, without, without better housing options, more, making it more possible for my partner to be more independent, I can't really go off and take a job working at the gas station or something like that, because I have to be around most of the time. So it's, I guess there's other work at home options. But for now, anyway, I can structure my own work time and do most of what I need to do at home. And so I guess for now, this is what I'm still focusing on. But it's definitely frustrating to have to confront the system as it is and try to work within that effectively as a peer working on a on a grant type situation.  

Lucas Akai  19:14 

And so maybe more focused in with the, with the beginning of the toxic drug crisis, of course, overdose has gone up significantly. So does that looming sense of, you know, negativity and the deaths surrounding this crisis, does that affect your ability to go into work or your willingness to go to work? Or do you find that that motivates you to continue what you're doing?  

Ben  19:41 

Well, initially because it was impacting us directly quite a bit in the previous few months, that was definitely motivation to to stick with it and it's still like, relatively early days in terms of having effective, safer supply options that are working for us, so I'm much more, I feel much more confident about that whole situation, in some ways, but it's still, like, if there was any significant change in my housing or that sort of thing, that would be a lot harder, like we, we have our medications delivered three times a week, and so being, we have to be here to get them. 

Lucas Akai  20:36 

 And so not necessarily as a result of experiences regarding death and trauma, but maybe critical stress in general, have you ever had to take time off from work? Because of critical stress? Or someone passing or?  

Ben  20:36 

 And if we couldn't be here, then I don't know. Anyway, it's, I guess, it's still a pretty major motivating factor in terms of just trying to represent those issues in an ongoing way. And try to have the response from the powers that be to make things more hospitable for people in general to live their lives and, and survive and preferably, be happy or thrive, or at least be content enough to not just take refuge in very risky drug drug use. But if, if there were, I would certainly prefer it if there were more options to do other things. But I don't I don't know if I would stop doing the work altogether. I think I probably carry on in some capacity, but maybe not, as my main source of of income or focus all the time. It's, it's pretty draining in some ways, for sure. 

Ben  22:01 

Yeah, I just, I only really log a few hours a week as far as my paid work goes. So I would say that, you know, the ideas that we had about organising meetings on a, on a more frequent basis, because we had to focus more on advocating for the safer supply options to be increased in our area. That was the main impact that has had on me recently, and even when we were working for sure, it was on a very part time basis. So and I guess, you know, the overlap between my lifestyle and my work is pretty significant. So I don't, I don't really have the option of taking time off as far as that goes.  It's just kind of kind of the context that I exist in for the most part. So I have to deal with it one way or the other, pretty much.  

Lucas Akai  22:58 

And are there certain ways or methods or ways that you deal with that critical stress and knowing that you have to keep going every day or ways that you manage the critical stress within the workplace?  

Ben  23:11 

Well, just communicating with friends and family and reaching out for support to the wider community to, to some extent to try to meet my needs and feel like I've got what I, what I need to carry on, like I, I've done quite a bit to improve my living situation in the last few months. But it was really just in the last couple of years under COVID that things got pretty uncomfortable at home and just hadn't really been dealing with it so well prior to that. So we were pretty much desperately seeking additional assistance to improve things for ourselves at the at the beginning of the hole, not the beginning of the drug crisis so much but just when COVID hit and things just got more extreme in that context. So. 

Ben  24:21 

We've formed some new relationships with people in the community that are motivated to help other people to get by and feel good about themselves. And so I have ongoing counselling as I've said before I get weekly or bi-weekly counselling sessions on a paid basis. And then I have another friend who is a counsellor who has been working with me on a voluntary, voluntary basis, more or less initially to help improve my home situation on a physical level, clearing clutter and stuff like that. And but in that context, we were, you know, formed a relationship where he's providing more support on an emotional or mental level, to deal with other issues and usually check in with him or have an hour or two, a couple hours of time spent either working on cleaning up or improving the situation in my living environments, or talking about whatever it is that's coming up for me, emotionally or mentally. 

Ben  25:42 

 So that's, you know, that was pretty critical in terms of being able to make, make use of my grant and, and apply myself to the, to the work for the larger community in the last several months. 

Lucas Akai  26:02 

And so noting these different areas of support that you have, do you find that it meets your needs in terms of receiving support, or are there other kinds of support that you don't have access to, you would like to have access to? 

Ben  26:15 

Well, being in a rural situation, and a lot of the people that I'm closer to are also dealing with ill health or other kinds of instability, I, I would prefer to have more direct access to my family. Like I do, as I mentioned before, communicate with my mother pretty much every day and my father is providing more financial support in terms of upkeep for my, my home building and just more expensive home maintenance and stuff like that, and but the emotional, the direct emotional support, or just being able to understand more completely, what I'm kind of coping with on a day to day basis would be a lot easier to get across if we were physically closer to each other. So unfortunately, my family's far away in Ontario, so.  

Ben  27:27 

Getting relocated to Ontario is a huge challenge and being dependent on the safer supply options that are only available in quite a limited number of communities in British Columbia and even fewer places in wider Canada, it's remains to be seen whether or not there's any way to translate that to living in another province. But ultimately, like, because our our home is so is, is ageing poorly. It's either basically needs to be rebuilt completely and even then, as just the main able bodied person living here, the place is really too big for me to maintain on my own. I would need to have we need to be sharing the place, I think with other people that were also motivated to help maintain the building, or improve the physical environment and upkeep the physical environment on a regular basis, or it's just going to be more, more overwhelming for me as I'm dealing with my own health issues going forward.  

Ben  28:54 

And it would be preferable if I didn't have to spend so much of my time and attention just coping with that all the time and attending to my partner's needs. And if I had more support, like I guess there's home care is something that is funded. But it's not. It's kind of, I don't know, it's kind of haven't gone down that road so far and I'm not sure how it would impact us entirely, but I guess it's an option that we will need to probably explore at some point. Either that or we need to transition to supportive housing and not be living so independently. But I prefer to do that really with my family as opposed to depending on the system because the options are quite limited.  

Ben  29:58 

I think just relocating to a less rural situation is probably most likely necessary unless there are better housing options available in, in my local area, or we happen to somehow luck out and find an accessible residence that we can rent affordably because living on a, mainly on disability benefits, the rent prices around here are really pretty out of out of line with our income, but my family would cover the difference, essentially. But I just don't know. Like, realistically the disparity is quite extreme. And I don't know how long it could be sustainable unless we just actually purchase another property or something like that. So anyway, that's all stuff I have to think about and try to come to terms with pretty much every day. 

Lucas Akai  31:22 

Absolutely and do you find that these incidents of critical stress or the support that you've received, change how you perceive your work, or conduct yourself at work in any way? 

Ben  31:32 

Well, it does. 

Ben  31:33 

Just being sort of publicly involved in the whole drug situation makes the chances of relocating or finding the kind of support that I need to be more comfortable, more challenging, I think, and it would be much preferable if there was more appreciation of the kind of work that I do and the, like, the illusion of separation between the people that are living in more vulnerable situations. Just, you know, a lot of people, it doesn't, it's, it doesn't take much for people that are, you know, making making do with income from, say, manual labour or that sort of thing, which, you know, a lot of people get, get hooked on opiate drugs, because they're coping with pain related to manual labour, and not just not because they're partying or whatever. And so if you're, if your work situation is impacted by that, and then you can't reliably be earning the kind of money that you're used to, to pay the rent, and that sort of thing, it doesn't take long before you might lose your housing and that sort of thing. 

Ben  33:15 

 So I think that, you know, it's kind of increasingly hard to avoid the knowledge that, you know, we need, we need people to pack our groceries and, and fix our homes and all that sort of thing. And when the rents are so high, there's no place for these people to live. And so the people that are more well off are going to be impacted ultimately, by the fact that they can't find people to to work for them in those roles, if there's no place for people to live. Including, like, health care providers, like we're, our whole healthcare system is under a lot of stress. And it's hard to get people to come to work when there's when they can't find a place to live. And so increasing the number of people working in the healthcare system, in, in a rural situation where rents are so high is difficult and it's huge mess, really, in a lot of ways. 

Lucas Akai  34:21 

Well, maybe providing a little levity to this heavy topic, do you find that you have major strengths that allow you to meet these challenges of critical stress? And if so, maybe elaborate on some of those?  

Ben  34:33 

Well, I was fortunate in my younger days to have the support of my family to explore, like, holistic health care and meditation and stuff like that. So I spent a lot of time going to meditation retreats and training in various holistic health modalities and that sort of thing. And ultimately, that made it possible for me to live quiet more alternative lifestyle, I suppose and still be quite healthy and energised until COVID came along. And, and I was ageing, of course at the same time and having not spent so much time and attention doing that sort of thing, I would say like the, my involvement in meditation and spiritual practices, and I guess music and dancing and that, was really a big focus for me previously, as well, was very helpful in terms of dealing with stress. 

Ben  35:35 

And I guess, you know, I got a lot of enjoyment out of drug use in my younger days, too, and I can't really do that anymore. So these are things that I'm, I, I've benefited as sort of back to lot of mental wellness, and mental and emotional wellness by having applied myself to these things in a very focused way. For years when I was younger, and then having chosen to be married to somebody with a progressive paraplegic condition, it shifted my focus to caregiving and made it more difficult for me to carry on with those kinds of pursuits in many ways. Although, before the progressive condition became more of a dominant factor, those were all things that we did together as well. But also just being, having chosen to live in a rural community makes it all much harder to access those kinds of things.  

Ben  36:43 

And paraplegia being something that kind of undermines the ability to go dancing. We can't really do that anymore, much. So. I don't know, currently, we play music together in a ukulele group. And that's a big source of stress relief, I guess. And the group that we're in is pretty large, and the people involved are all very warm and supportive. We don't see them all the time, but they certainly are, are aware of us and try to give us emotional and other kinds of support as as they can. But mainly just getting together and playing music is good thing in our lives that we, we to do on a regular basis. 

Esther Cheung  37:42 

That's great to hear that you have these outlet. Maybe that's a good time to wrap up, maybe on a happier note. It has been a heavy topic. Yeah. 

Esther Cheung  37:52 

How do you feel about this?  

Ben  37:53 

Sounds good to me. 

Lucas Akai  37:56 

Perfect.  

Caitlin Burritt  37:57 

That brings us to the end of this episode of the Unsilencing Stories Podcast. To listen to more interviews in the series, please go to www.unsilencingstories.com and if you'd like to share your thoughts on the episode message us at unsilencingstories@gmail.com Thank you for listening.