Addictions soldier opens new front in opioid fight

Dr. Peter Enwistle is on the frontlines of a fight to save the drug addicted in the South Okanagan.

Reduce the risk of using street drugs:

  • Don’t mix different drugs (including pharmaceutical medications, street drugs, and alcohol).
  • Don’t take drugs when you are alone. Leave door unlocked. Tell someone to check on you.
  • Use less and pace yourself. Do testers to check strength – a small sample of a drug before taking your usual dosage.
  • Keep an eye out for your friends – stay together and look out for each other.
  • Carry a Naloxone kit and know how to use it. A list of locations to get a kit can be found on the Interior Health website or on the Toward the Heart website.
  • Recognize the signs of an OD: slow or no breathing, gurgling or gasping, lips/fingertips turning blue, difficult to rouse (awaken), non-responsive.
  • If someone thinks they may be having an overdose or is witnessing an overdose, follow the SAVE ME steps and call 9-1-1 immediately, do not delay.

By Andrew Stuckey

It’s an almost overwhelming burden — one that would send most people packing.

But South Okanagan physician Peter Entwistle — who practices addictions medicine in tandem with his general medical practice in Oliver — isn’t giving up.

Rather, he’s doubling-down.

Amid news of nine drug overdose deaths over five days in the Interior Health Region, Dr. Entwistle is expanding services to those addicted.

“At the moment, I’m still the sole (addictions medicine) provider despite the fact we’re two years into the epidemic,” he said. “I’m covering Oliver and Osoyoos and I’m starting a clinic in Grand Forks as well next month.”

His addictions practice involves patients, many self-referred, who are drug dependent. The biggest part of his work is ensuring they have a safe supply of narcotics.

“About 80% benefit as far as they aren’t overdosing and dying, they’re working, they have better social relationships and their overall health is better,” he says of his practice. “It has proven the most effective thing that doctors can do.”

If all that sounds a bit counter-intuitive — giving drugs to those addicted to drugs — you’re not alone thinking that way.

“It’s not widely supported,” Dr. Entwistle admits. “But in terms of bang for the dollar, doing this is the most effective thing we can do.

“Every dollar spent on methadone or replacement therapy, we’re saving the health care system a lot of money, we’re increasing tax revenue — because people can go back to work — and we’re stopping people from dying.”

His work doesn’t end there, however. He’s involved in chronic pain clinics and seminars, providing information and support for those who would rather find other ways to deal with their pain and get off the drugs.

“I’ve had a lot of self-referrals from patients who are addicted who are getting increasingly scared,” said Dr. Entwistle. “We are trying to solve a problem, not just give people drugs.

“These people are not just street addicts,” he added. “People are getting addicted to opioids because they have chronic pain. A lot of people, through no fault of their own, become addicted and now are having to do street drugs to reduce pain and stop themselves withdrawing.”

The risk of turning to street drugs is well-documented. There were 126 overdose deaths in the Okanagan in 2017, compared to 77 in 2016 and just 13 in 2007.

Over the weekend, Interior Health (IH) urged residents using or considering using street drugs to reconsider or take steps to prevent overdose in the wake of yet another increase in suspected drug overdose deaths.

According to preliminary data provided by the BC Coroners Service, there were nine suspected overdose deaths in the region between January 23 and 27.

The Health Region won’t say specifically where those deaths occurred, stating only they occurred in “larger urban centres, as well as in smaller rural communities.”

“We do not release the details of specific communities because, in very small communities, there is the risk of unintentionally identifying individuals,” said Dr. Karin Goodison, Interior Health Medical Health Officer.

Dr. Silvina Mema, also with the Health Region, earlier this month told the board of the Regional District of Okanagan-Similkmeen that physicians and other health care providers distributed 3,800 naloxone kits last year in the region and recorded 12,000 client visits at mobile supervised consumption sites.

Dr. Mema said the two largest barriers the health authority faces in its battle are societal stigma against drug users and capacity for facilities and resources.

A third barrier is also having an impact: the introduction of carfentanil — described as 100 times as potent as the same amount of fentanyl — into the street drugs mix.

“It’s super strong,” said Dr. Entwistle. “We’re having to use much larger amounts of naloxone to combat it.”

Despite what seems to be an uphill battle — perhaps at this point even a fight that cannot be won — both Interior Health and its independent-minded Addictions Medicine soldier continue the good fight.

“This is not work the health authority alone can do,” Dr. Mema told the RDOS board, urging continued work by service agencies and other community groups to address concerns that surround addictions, such as mental health and homelessness.

“Yes, I’m doing this in addition to all the other work I do,” said Dr. Entwistle. “But I’m happy to cover Grand Forks because no one else is available to cover Grand Forks.”

There’s several seconds of silence when it’s suggested “that’s an awful lot of work.”

And finally a quiet, almost weary one-word reply.


— with files from Dale Boyd, Penticton Herald


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