The Drug Poisoning Crisis in Waterloo Region

​What we know; What is missing;
Envisioning a way forward.
​June 2023

Kathy Moreland
​RN, MScN, MOM

​Kathy Moreland is a recently retired registered nurse and professor of nursing. While her background is in cancer care, her passion for harm reduction and the current drug crisis is personal. Kathy lost her 18 year old son Austin to fentanyl poisoning in June of 2020 here in Waterloo Region. She is an active member of Moms Stop the Harm (MSTH), a group of family members fighting for changes in drug policy and an active advocate for harm reduction and education of politicians and healthcare workers with the Registered Nurses Association of Ontario (RNAO). 
Preview (full video below)

Presentation & Slides

​Presentation slides above provided by Kathy Moreland
​On June 1st, 2023 host Regional Councillor Rob Deutschmann held this virtual conversation focused on Waterloo Region's  drug-related crisis.

Expert guest speakers, including Kathy Moreland, outlined key aspects of the drug poisoning crisis we face in Waterloo Region, opportunities to improve our local prevention and response measures, and their visions for a safer and healthier community. 

​“This community needs an integrated strategy to address the toxic drug crisis to prevent more unnecessary deaths. People from all walks of life are dying. Stigma is making a health crisis into a political minefield.” 
- Kathy Moreland, RN, MScN, MOM

​​In her comments, Kathy discusses the importance of an integrated strategy for harm reduction, using the analogy of an umbrella with different panels, each representing a distinct aspect of harm reduction.

She begins by acknowledging the previous speaker Michael, for giving the macro context of the problem. She then delves into the "micro" perspective, speaking about the need for "upstream thinking", or focusing on the root causes of substance misuse, and what an integrated strategy would look like in practice.

One panel of the umbrella, she says, represents prevention efforts. Kathy stresses the urgency of this panel, pointing to the rapidly changing and increasingly dangerous drug supply as a critical issue. She talks about the proliferation of drugs such as fentanyl and their potentially lethal mixtures, posing significant risks to users who may not even be aware of what they're consuming.

In the same vein, she brings attention to the urgent need for a safer supply of drugs, another panel of the umbrella. A safer supply would protect users from unknown and lethal substances, helping to reduce the alarming rate of deaths linked to the current unpredictable drug supply.

A further panel in the umbrella metaphor, “support for people using substances and their carers”. This support should extend beyond just users to include frontline workers and carers who are often overlooked but are crucial in providing the necessary support and care for users. In addition to potential burnout, these workers face a risk of PTSD due to their high-stress roles.

Moreover, Kathy highlights the importance of decriminalization of simple possession, as has been initiated in British Columbia. This is another panel of her umbrella, a move she believes is crucial in shifting the conversation around substance use from a criminal issue to a health issue.

Kathy spoke to consumption & treatment services, an additional panel on her umbrella. She argues that these services offer more than just a place for drug users to safely inject drugs. They also link users with social services and establish supportive relationships, providing them with a sense of care and community.

Importantly, Kathy includes treatment as part of her harm reduction umbrella. Despite some debate around its place in harm reduction, she believes that it plays a crucial role. She notes that a large proportion of individuals undergoing residential treatment for opioid struggles will relapse within the first year, emphasizing the need for safe, accessible, and effective treatment programs.

Kathy further discusses how to approach substance misuse from a broader societal perspective. She emphasizes the need for addressing the social determinants of health and providing timely access to mental health services for children, youth, and adults.

She calls for confronting the stigmatization around drug use. This requires a collective rethink of society's ingrained beliefs and media portrayals of individuals who use substances. She uses her son's story to illustrate the heartbreaking reality of substance use, stressing that individuals who use substances are not always stereotypical "drug addicts", but could be everyday people struggling with underlying issues.

In conclusion, Kathy appeals for compassion and a humanistic approach towards substance use. She urges listeners to understand that this is a complex health issue, deeply intertwined with societal factors. It requires not just treatment, but a comprehensive, empathetic, and integrated approach to harm reduction that includes prevention, safe supply, support, decriminalization, and a societal shift in attitudes towards substance use.

Takeaways
  • Successful strategies in facing the drug poisoning crisis through an integrated harm reduction approach are necessarily multi-faceted and wide-reaching.
  • The importance of addressing the broader social determinants of health, such as providing timely access to mental health services for children, youth, and adults, along with preventing and managing conditions like Fetal Alcohol Spectrum Disorder (FASD).
  • We must advocate for a shift in how we perceive and treat substance users, challenging and changing ingrained stigmas, and replacing them with empathy and understanding. Substance use is a complex health issue that should be viewed as such.