In all her years living on the streets of Kelowna, Mama has never seen anything terrorize her community more than the current toxic drug crisis.
Kjaer Mama – or just Mama to those who know her – seeks refuge at a well-known encampment off the Kelowna Rail Trail. The ‘tent city’ is adorned with mementos of those lost to the increasingly toxic drug supply. Mama said that in addition to losing loved ones, most people have suffered from drug poisoning themselves, in the form of an overdose.
This week, the B.C. Coroners Service released the latest update on the ongoing overdose pandemic, reporting that at least 1,095 people in B.C. have died between January and June.
Despite the risks, illicit drug use is the “only option” for many people, Mama told Capital News in a sit-down in the core of tent city.
Like her name suggests, Mama is a caregiver and leader in the community. Her mom and grandmother were nurses so caregiving comes naturally to her.
Mama is articulate and knowledgeable, with 30 years of experience living with substance-use disorder.
She said that everyone has their own reasons, but most people start using drugs to cope with trauma.
B.C. declared its first-ever public health emergency in 2016, but addiction and substance use disorder is an issue that began long before then.
Mama explained that in her lifetime, she witnessed physicians over-prescribing the pain-numbing opioids, followed by an immediate restriction of drugs in 2016, which forced people to seek their fix in other ways.
In 2003, the FDA issued a warning letter to the manufacturer of OxyContin, Purdue Pharma, for the misinformation they were spreading in advertisements and medical journals.
The government of B.C. alleges that opioid manufacturers, distributors and their consultants engaged in deceptive marketing practices with a view to increase sales, resulting in increased rates of addiction and overdose.
Opioids became a popular pain reliever in the early 2000s, when doctors – persuaded by drug companies – regularly prescribed large amounts of opioids.
Following the 2016 declaration of the B.C. opioid crisis, the Canadian Guideline for Opioid Therapy and Chronic Non-cancer Pain was released. The guideline initially ordered doctors who treat people with chronic pain to restrict the prescribing of opioid drugs. In 2017, the guidelines for prescription opioids were amended, urging doctors to not limit opioids to those who require them.
Mama said that an overabundance, followed by the harsh restriction of drugs, forced people to seek their fix in other ways. Even with the restrictions changed, the impact lives on.
She said that these days, using street drugs without a safe supply is like “putting a lethal weapon in desperate people’s hands.”
Her doctor was afraid to increase her prescription “to match what (she) needs,” forcing her to turn to illicit sources to avoid withdrawal. She explained that methadone, buprenorphine and suboxone are not a suitable options for many people due to the side effects and the fact it is not strong enough.
“Doctors should be giving healthy doses,” said Mama, meaning an amount that prevents withdrawal or the need to seek additional, potentially unsafe drugs.
She is in the belief that drugs should be managed like alcohol.
Beginning in January 2023, the B.C. government will be removing criminal penalties for possessing small amounts of illicit drugs including heroin, cocaine and methamphetamine – but that doesn’t solve the problem of a deadly supply, often unknown to the user.
A growing number of advocates and medical researchers have called for legal drug accessibility, beyond suboxone and methadone – particular prescription heroin.
Legal access to a safe supply of drugs is not a new concept, said Sana Shahram, Ph.D., assistant professor at the College of Nursing at UBCO.
When people buy a bottle of liquor they know its concentration, the ingredients, and the risk associated with its consumption.
Drug-users don’t have that luxury.
Shahram said a bag of cocaine can be stronger than usual or have harmful additives, like fentanyl, unbeknownst to the consumer.
Locations in other areas of B.C. offer drug distribution programs, but Kelowna currently has no safe supply initiatives.
In Kelowna, Interior Health is in the early stages of developing a fentanyl patch program, in line with the B.C. government’s prescribed safer supply policy.
Mama has a testing kit and regularly tests other people’s drugs, along with her own. Often, she finds that the results are not what was expected, exposing lethal combinations, concentrations and ingredients that were not advertised by the dealer.
It’s an integral way for her to combat the otherwise unpredictable nature of substance use disorder, and continue to be the community’s Mama.
“I want to live. I don’t want to die.”