By: Victoria Lopatka

It is no secret that some university and college students use drugs. A study conducted at UBC found that one in 30 university students have experimented with study drugs while enrolled. When asked about their own study drug use in a previous Peak feature, students at SFU recounted that Adderall and similar prescription medications are “very popular” among them and their peers. A larger study examining rates of drug use by Canadian undergraduates found that 47.5% of the 7800 candidates had used drugs, study and illicit alike, during their lifetime.

A city-wide issue

In July of 2016, BC saw 482 overdose deaths, 60% of which involved fentanyl, according to the BC Coroners Service. In the first seven months of 2017 alone, the number increased to 876 suspected drug overdoses, with 81% linked to fentanyl.

Lisa Lapointe, B.C.’s chief coroner, describes a pattern in drug use during an interview with The Globe and Mail last September: “We saw an increase in the spring, and then August, September, the numbers looked not too bad, October started to increase, November and December were the worst months we had ever seen,” she said. “It’s being ingested knowingly by some individuals who prefer fentanyl. But it’s also contained in substances that the user has no idea fentanyl is in.”

In an op-ed for The Globe And Mail written in April this year, Dorothy Bakker, an associated clinical professor at McMaster University and a mother who lost her son, Stephen, to a fentanyl overdose, expressed her belief that many users like her son “trust” their dealers. The reality is, though, that fentanyl is often cut into street drugs.

Misconceptions surrounding fentanyl lead the public to believe it is only found in drugs like heroin and methamphetamine, but prosecutors warn that cocaine users are at risk, too. This is especially problematic for post-secondary students who use cocaine, as they may not think they need to be concerned about or prepared for a fentanyl overdose.

The problem is becoming more and more common: in a five-month long study in Vancouver’s Downtown Eastside, UBC researchers followed and tested the drugs of a large group of residents. At the beginning, 45% of the opioid users within their group tested positive for fentanyl. At the end of the five-month study period, 100% of users had trace amounts of fentanyl in their systems.

A 2017 report by the Vancouver Police Department notes that fentanyl has been found in every type of illicit drug, excluding marijuana. The deaths of unsuspecting users cross a variety of demographics, social classes, and backgrounds: this problem isn’t only a Downtown Eastside issue. As Darrell Reid, Vancouver Fire and Rescue Services chief, explained to The Georgia Straight in a January article on the exacerbated drug-overdose problem in Vancouver, “We want to make sure that everyone understands, this has become a city-wide problem.”

Harm-reduction initiatives in the city, including making drug-testing equipment and take-home naloxone kits available, and the establishment of overdose-prevention sites with trained staff members have been implemented and are making progress. A new study reported by The Vancouver Sun documented the effect of increased naloxone availability in B.C. on the number of fentanyl-related overdose deaths in 2016: “The study estimates that the Take Home Naloxone program prevented 226 deaths in 2016 and that one in 10 uses of naloxone kits prevented an overdose death.”

Surgeon General Jerome Adams likens naloxone kits to other live-saving interventions, like the use of CPR and EpiPens. “It’s easy to use, it’s lifesaving, and it’s available throughout the country fairly easily,” Adams told Stat News, encouraging the families of those at risk of overdose to carry kits with them.

A campus problem

Study after study consistently reflects that youths use drugs and alcohol more than any other demographic. But why? University and college students may turn to drinking and doing drugs for a multitude of reasons, including social stress, academic stress, a heavy course load, to self-medicate, and curiosity. The Peak reached out to multiple employees of SFU Health and Counselling about unhealthy substance use in students, where it begins, and how one can open conversation around it in healthy, constructive manner.

Britt Phillip and Ruth Vandenberg, mental health nurses at SFU, added that academic pressures, a family history of substance use, isolation, peer pressure, and a lack of information can make students more susceptible to risky substance use.

“We have approached substance use by way of focusing on social connectedness, which is a known preventative factor,” says Rosie Dhaliwal, health promotion specialist. “Many of [our outreach programs] focus on ‘bring a friend, make a friend’. Our projects within the Healthy Campus Community Initiative also link to social connectedness.” 

SFU itself does not offer specific resources for substance abuse or naloxone kits on campus. However, nurses Phillip and Vandenberg mention a multitude of online resources students can find with Fraser Health and Vancouver Coastal Health. Martin Mroz, director of health services, says, “We are very supportive of students evaluating their situations and deciding to get a [naloxone] kit from the many pharmacies and public health locations that offer them.” Mroz also recommends the site TowardTheHeart.com, where students can find the closest naloxone-distributor to them.

Even before the fentanyl crisis was declared and recognized as a crisis in April 2016, UBC’s Student Health Services (SHS) was distributing naloxone kits for free. In theory, this was a fantastic idea, but they faced a big problem: students didn’t want the kits. After 18 months of naloxone kits being readily available on campus, only 63 kits were actually taken. Since kits are for those at risk of a drug overdose or of witnessing an overdose, owning one comes with a huge, and unwanted, stigma.

A problem that hits close to home

Coming to terms with and addressing the unhealthy drug use of a loved one can be confusing, difficult, and emotional for families and friend groups.   

SFU Health and Counselling shares a few physical and behavioural signs that somebody is struggling with substance use issues, which include lateness or absenteeism, borrowing money, uncharacteristic moods or mood swings, puncture marks on the body, constricted pupils, red or bloodshot eyes, and being in the possession of drug-related paraphernalia. With regards to having a conversation about drug use, the staff at Health and Counselling stress the importance of being compassionate and recommend listening rather than trying to jump into advice-giving right away: that way, you avoid sounding preachy or superior. They share the importance of being non-judgemental, of encouraging action and following-up instead of corralling, and of making sure you don’t rush the conversation.

Dhaliwal shares some resources with me that outline key things to remember when discussing someone’s drug use with them, including reminding the person of their inclusion in supportive communities and groups, acknowledging the trauma or pain that may be leading them to drugs, and doing your best to reduce the stigma they may be facing.

Richard Saitz, addiction expert and professor of community health sciences at Boston University, states in an interview with Addiction.com the best way to reduce and eradicate stigma around addiction is to change the language we use to describe it. “Changing our language is a fundamental and inexpensive way to decrease stigma. In turn, this may lead to more people seeking help, achieving remission, and ultimately reducing disability, mortality, and economic burden.”

Some of the words and phrases we use often to describe these issues are actually very stigmatizing and negative. Keeping in mind that the stigma around drug use is only worsening an already horrific crisis by preventing people from seeking treatment and making people not want to get naloxone kits, here are some word replacements to integrate into your vocabulary:

• Drug abuse — Unhealthy use
• Drug misuse — Harmful and risky substance use
• Addict — Individual with a substance use disorder
• Staying clean — Maintaining recovery
• Bingeing — Heavy use

How to stay safe when clean drugs are sparse

Whether you’re using drugs or someone close to you is, it’s important to know how to be safe. Youths who use drugs may feel invincible to the constant threat of overdose and death, thinking “I’m safe, that would never happen to me.” Unfortunately, a lack of clean drugs in Vancouver means the threat is very real. It’s one of those situations where the only safe way to do drugs is not to do them at all. If you are going to use drugs, though, especially those that could be contaminated, it’s important to try your best to be safe – or as safe as you can be.

Here are some useful tips, from both online resources and an interview with SFU Health & Counselling:

• Educate yourself on drug use, effects, and risk.
• Never use alone
• Go slowly, with low doses
• Don’t mix different drugs, or mix drugs with alcohol
• Carry a naloxone kit and know how to use it in case of an emergency
• Know the signs of an overdose (see below), and what to do in case one happens
• Stay hydrated
• Let someone know where you are and when you should be home/finished
• If you’re worried about yourself or someone else, seek help immediately
• Consider using drugs at a safe-injection site, where your drugs can be tested for fentanyl
• Trust your instinct: if something doesn’t feel right, take a step back to consider the situation. Ask questions about what you’re being offered. Don’t accept drugs from someone who you don’t know or don’t trust

Here are some signs of an overdose:

• Severe sleepiness, struggling to stay awake, or “nodding off”
• Inability to walk or talk
• Slowing breathing
• A pale or blue complexion
• Skin cold to the touch
• Unresponsiveness to physical or verbal stimulation
• Limp body

Keep in mind Canada’s new Good Samaritan Law, enforced since 2017, which protects individuals seeking emergency help (like calling 911) during an overdose crisis from charges of possessing illegal substances or breaching any conditions regarding to drug use (i.e. parole).

Vancouver is being described as a “nightmare,” a “war zone,” and an “overdose bloodbath,” facing an overdose crisis that competes with some of the most-affected U.S. cities, the worst we’ve seen in decades. It is an incredibly dangerous time to be a youth experimenting with drugs, and an incredibly crucial time to be looking out for yourself, your friends, and your family.