By Tim Kalinowski on June 15, 2021.
The Southern Alberta Council on Public Affairs welcomed Dr. Esther Tailfeathers, Â Senior Medical Director, Provincial Indigenous Wellness Core, at Alberta Health Services, to a special session of its YouTube livestream speaker series on Monday.
Tailfeathers spoke about the importance of a comprehensive strategy to address the opioid and addiction crisis on the Blood Tribe reserve, and elsewhere, which includes harm reduction and safe supply.
Tailfeathers called abstinence based treatment ideals the “golden place” where all recovering addicts eventually want to get to, but felt it just doesn’t work for every person who is addicted to drugs to get there all at once and right away.
“The golden place is to be completely abstinent, but through our experience we know that many people cannot go from A to D, and walk out and be completely healthy,” she explained. “We know from experience, especially with detox, is people may try two or three times before you really actually begin to heal. And they do need lots of support: family support or a partner who is very supportive. We know abstinence based treatment has very high expectations of people. And one of the things that is very human is a feeling of failure when you cannot achieve what other people expect of you.”
Tailfeathers said alternatives like opioid agonist therapy have had a better success rate for individuals on the Blood Tribe reserve.
“Most of the treatment centres we sent our people to (originally) were abstinence based treatment, and they were not withdrawn enough, they were still sick, when they arrived at the abstinence based treatment centres,” she explained. “And as a result, many of them did not finish the course of the abstinence based treatment. Many returned to reserve and used at the dose they were using, or the amount they thought they were using, when they left. As a result, we had more deaths and more overdoses; so we recognized abstinence based treatment did not work for people. We had to start working on more humane ways of helping people to withdraw and also to be treated so they don’t feel like failures.”
Tailfeathers credited the establishment of Bringing the Spirit Home Detox Centre in Standoff as an important step toward helping prevent even more overdose deaths on the Blood Tribe, and getting individuals through their first stages of withdrawal before getting them on to an opioid replacement therapy regime, and then on into further treatment when they were ready to make that leap.
“I think the harm reduction treatment model is the most effective way of dealing with people,” Tailfeathers told SACPA attendees. “I think wrap around supports are very important, including housing alternatives. And for people to recognize addictions, like I said, are not from A to D. I think we need to have more trauma-informed care in the work we do with all people with addictions, not just Indigenous people with addictions.”
Tailfeathers also responded to questions about her thoughts on safe supply. She confirmed she supported both alcohol treatment therapy and safe supply in principle.
“I think a very supervised and safe drug supply would help decriminalize drugs,” she responded. “(That) would help because we would see less harm to the individual.”
Tailfeathers said she would like to see something like the Portugal approach potentially adopted in Canada when it comes to safe supply.
“Portugal has done a very good job of safe supply,” she explained, “and I really think in order to decrease the criminal element, and safely bring people to the possibility of going to detox, the possibility of getting into treatment, is to make it safer for them, and easier for them, to get the help they need.”
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