Overdose Crisis Response, as Seen Through The Lens of an Emergency Psychiatric Nursing Student

Who are you? What is your education, and volunteer/work experience to date?
Hi! My name is Emily and I’ve just completed my final practicum of a 4-year registered nursing program! I feel honoured to have been placed in emergency addictions and mental health, which is an extension of the emergency department (ED) in which we must be dynamic and think on our toes based on the presentations we see. I’ve got one more course to complete before I graduate (and I’m counting down the days)! I work as an undergraduate nurse employee on an overflow medical/surgical unit, and a lifeguard/swim instructor at my university. I also volunteer as one of the co-presidents of the Nursing Undergraduate Association of my program, in order to advocate for the academic needs, health, and wellness of nursing students.

Where in Canada are you located?
Edmonton, Alberta.

Does Alberta have a drug-poisoning crisis?
Unfortunately, Alberta does have a drug poisoning crisis. At the peak of the drug poisoning crisis, we regularly saw “four to five opioid-related deaths a day, and drug poisoning remains the number one cause of fully preventable unnatural deaths” (Alberta Medical Association, 2021).

From what you’ve seen in your work, why do you think people use drugs?
I think there are several reasons people use drugs, and in my practice a common theme relates back to coping with adverse childhood experiences (ACEs). ACEs include “experiencing violence, abuse or neglect, witnessing violence in the home or community, and having a family member attempt or die by suicide” (CDC, 2022). Additionally, drugs can be a coping mechanism for chronic or situational stressors and are used recreationally in many cases. Many individuals who I have the pleasure of working with through my nursing practice explain that they use drugs to simply “feel better”, which can mean reducing either emotional, or physical pain.

Describe the stigma that surrounds people who use substances, and how you think it may affect your patients?
I think that often individuals who use substances are surrounded by the harmful stigma that they exclusively make poor personal choices, or that using substances reflects personality traits; defects in one’s character. In my emergency department experience I’ve had multiple patients refuse to endorse their history of substance use/current substance use for fear that they will be seen as less than or be given “worse” care than others. For this reason, it can be difficult for those who use substances to feel trust in healthcare professionals, and the healthcare system in general.

In your eyes, what do you see as a strategy for the everyday person to help do their share to combat the drug poisoning crisis?
In my personal experience, the easiest strategy to implement for the everyday person in the face of the drug poisoning crisis is to read the news (stay updated on the state of the opioid epidemic) and carry a naloxone kit. The ability to empathize with victims of the drug poisoning crisis is a tool that Albertans, and Canadians alike should have in their back pocket.

What is one key message you’d like to relay to youth, in regards to substance use and harm reduction?
If you suspect that someone might be having an overdose, administering naloxone will not cause further harm. It has no effect on people who do not have opioids in their system. Carrying a naloxone kit can save lives!