Pubdate: Fri, 02 Jan 2015
Source: Sudbury Star (CN ON)
Copyright: 2015 Osprey Media
Contact: http://www.thesudburystar.com/letters
Website: http://www.thesudburystar.com
Details: http://www.mapinc.org/media/608
Author: Carol Mulligan
Page: A1

TAKING IT TO THE STREETS

Not everyone basks in the afterglow of a merry Christmas and a happy 
new year. As many as 10 people died of drug overdoses last year in 
Sudbury during the Christmas season.

In a 12-month period in Sudbury, 86 people died from overdosing. That 
number doesn't take into account the physical, mental and emotional 
consequences suffered by people who survived.

Lisa Toner, Kaela Pelland, and other staff and volunteers with Reseau 
ACCESS Network were determined to change those statistics this Christmas.

Toner is the injecting drug use support services outreach worker with 
ACCESS and Pelland works with her.

Last year, "an outstanding, over-the-top percentage and number of 
individuals overdosed and died over the holiday season," says Toner, 
partly because people who work with the drug-addicted aren't on call 
during the holidays.

ACCESS offers several programs -- on the street and in its office at 
111 Elm St. -- for people infected with HIV (human immunodeficiency 
virus) and/or hepatitis C, a liver disease caused by the hepatitis C virus.

To respond to the high number of overdoses last year, ACCESS 
developed an overdose prevention program, and its staff and 
volunteers went into the community to educate people on how to 
respond if needed.

Their message was delivered to professionals and partner agencies, 
but also to "peers" who use the drugs that often kill people.

"Part of fatal overdoses is that the right process isn't taken to 
respond effectively to the overdose so the person does survive it," 
said Toner before Christmas.

She and others who work with a high-risk population got vital 
information about how to respond "into the hands of people who live 
it every day and can make a difference."

That's how you keep moving forward in work that can be difficult emotionally.

"You see the negative happen, then how do we respond to do to try to 
prevent that from happening in the future?" asks Toner.

There is a large population of people in Sudbury who are 
drug-dependent and have serious addiction issues, says Toner.

That population is largely comprised of street people who come from a 
variety of socioeconomic, ethnic and other backgrounds.

ACCESS works with those people to provide them support where they 
live -- either on the street or elsewhere -- and refer them to 
services available in the community.

Most Sudburians have heard of the Red Coats, outreach volunteers with 
l'Association des jeunes de la rue who patrol the streets at night 
offering warm blankets, clothing, hot coffee, a ride to a shelter and 
other necessities.

Fewer have heard of the White Coats, people such as Toner and Pelland 
from ACCESS who take to the streets most nights to offer harm 
reduction tools to users, as well as information and referrals to 
people who need them.

Like chronic and acute illnesses, the rates of drug dependence and 
addiction are higher in Northern Ontario than in other parts of the 
province, says Toner, who has been working in addictions and mental 
health for almost 10 years, eight with ACCESS.

It's no surprise HIV and hepatitis C are spread by sharing needles 
and unprotected sex. It may be less well known that borrowing 
someone's hygiene tools such as nail clippers poses a small risk. So 
does tattooing if you're not going to a legitimate business being 
monitored by public health officials.

It's difficult to get accurate numbers of people living with HIV and 
hepatitis C because as many as 25% of those who are infected don't know it.

ACCESS's White Coats work closely with the Red Coats, and staff and 
volunteers from the Sudbury Action Centre for Youth, known as the Blue coats.

Referrals are often made from one agency to another.

By day, Toner works providing case management, support and 
educational services out of the offices. At night, she, Pelland and 
other White Coats provide prevention and street services to a 
marginalized population who may not make it into ACCESS's office downtown.

A Tuesday afternoon clinic is also offered in a building across from 
the Elgin Street Mission, that used to house the Corner Clinic.

Ninety-five per cent of ACCESS's clients recognize White Coats on the 
street and approach them. Toner, Pelland and others go out with 
supplies to reduce the spread of HIV and hepatitis C, biohazard bins 
to dispose of used needles and tongs to pick them up, and condoms.

"Our job is extremely safe," says Toner of the two-person teams who 
work out of ACCESS. "We're received very well. We're a positive 
support for individuals in the community and, for the most part, 
people know our name and are interested in connecting with us.

"Our clients are really great. We have built a great rapport and 
trust with them over the years."

Understanding and awareness about the programs ACCESS offers has 
increased in recent years, but "unfortunately, the population of 
individuals who face the struggles and have addictions issues and 
drug dependency issues in our community is not decreasing, it's only 
increasing," says Toner. "That's an uphill battle for sure."

She points out addiction doesn't discriminate in terms of 
socioeconomic status, ethnicity or other factors.

"We're dealing with a population of individuals who have been active 
in their addiction for a period of time, and have lost a lot of 
supports in terms of family members and friends, financial support.

"We're definitely dealing with a really marginalized, 
street-entrenched population that don't access a lot of other 
services in the community. Sometimes we may be their only point of 
access for community resources for a lot of our folks."

The chronically homeless and "unstably housed" -- people who may be 
couch surfing or in and out of the shelter system -- are their main clientele.

Toner and Pelland say they don't judge the people they help because 
they don't feel that far removed from them.

"I think part of it is, if you can understand that if your life would 
have gone a little differently, you could easily be on the other side 
of the intervention or the conversation," says Toner.

"Then it helps to understand how people are in the place they are and 
why you want to do everything you possibly can to brighten their day."

If things had worked out differently in her life, "I could have 
easily been in a situation where I'm not the addictions worker, but 
the person who's in need of help."

Many of their clients suffer from mental health issues as well as addiction.

"Are people self-medicating with substances to try to deal with some 
of the mental health issues or are the mental health issues a symptom 
of chemical dependence? Often you're dealing with mental health and 
addictions hand in hand."

Pelland has worked with ACCESS for a year after 18 months with 
l'Association des jeunes de la rue.

Working with the Red Coats, she made contact with many of the same 
people she now assists in a new capacity. In her former job, working 
with people one on one, "on their turf, not in an office, just where 
they are," taught her a great deal.

"Just talking with them, as a human being, not as though I'm this 
profound professional and they're just these clients, these people.

"It was so great to be able to just hang out and get to know them and 
hear their stories."

Pelland learned it was often traumatic events that caused people to 
spiral downward.

"Life happens and sometimes people just end up where they end up. 
They need agencies and people to understand and not to judge them or 
look down on them because of what happened in their life."

Like Toner, Pelland believes "one thing in our past could have 
changed that could lead anybody" to the life her clients live.

Most of the time, Toner admits, the outcome "is not positive" for 
those clients.

"We see a lot of individuals who are still in marginalized 
populations who are progressing to AIDS in our community. That is 
still happening.

"We do see a lot of overdoses, we do see a lot of adverse medical 
outcomes and, you know what? Every once in a while, you do get that 
individual who, through assistance with our programming and with our 
organization, are in a place where they have the capability and the 
ability to turn their situation around."

When that happens, and those instances are few and far between, "it's 
a pretty wonderful moment. You've kind of got to ride it out for 
awhile because there's a lot more negative outcomes unfortunately 
than positive ones."

Not surprisingly, it makes the work Toner, Pelland and others do in 
the field difficult.

"It's definitely tough to see people you've been working with and 
built a relationship with going downhill," says Toner. "Another part 
of it is to respond to those trends effectively."

Pelland says trying to explain to people "what we do and why it's a 
good thing is probably the hardest part of this job."

There are several ways Sudburians can get involved to help the 
population ACCESS assists.

People can volunteer with ACCESS or one of its partner agencies. They 
can take part in the Red Scarf campaign in which ACCESS staff and 
volunteers distributed 300 hand-knit scarves last year. Members of 
knitting circles may wish to help with future campaigns. The scarves 
are as much to promote awareness of World AIDS Day on Dec. 1 as for warmth.

Two other ways to help don't cost a cent and won't take a moment's time.

"What people can do to help is (exercise) tolerance," says Pelland. 
"Just being tolerant, challenging their views on how they may 
perceive this population."

Toner agrees.

Changing attitudes toward the population she works with and being 
more accepting of community members, "of all community members," is 
as good a place as any to start.
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MAP posted-by: Jay Bergstrom