“If you severed your femoral artery, they wouldn’t put you on a bus with a tourniquet and send you to Prince George for vascular surgery.”––James Cordeiro
Last week, Premier David Eby lobbed a lifeline to northern residents, committing his government’s support to a First Nations-led, local government-backed detox proposal for Terrace, in what would be an unprecdented first for the northwest region.
“There’s a very concrete proposal on detox in the Terrace area,” Eby told media on the last day of the Union of BC Municipalities’ annual conference. “It’s being advanced by Indigenous leadership and local leadership in the Terrace area, recognizing a gap in services there that is hugely needed. And we’re engaged directly with them around supporting that proposal.”
The original project concept envisioned by the Northern First Nations Alliance proposed relying heavily on existing infrastructure to serve hundreds of people a year via medically assisted detox beds, a mobile withdrawal unit, a residential treatment and recovery centre, and a sober-living house. The project is supported by the alliance’s member nations – Haisla, Kitkatla, Kitselas, Kisumkalum and Nisga’a – and local municipal and regional district governments in the northwest, including the host city of Terrace.
According to Haisla chief councillor Crystal Smith, the alliance is a collaboration between the nations to share resources and mutual vision to improve the lives of their community members. The group tried for more than a year to draw provincial government atention to the proposal, including when they presented the idea during 2022 Budget consultations last June. Until Eby’s announcement last Friday, they didn’t appear to be making much progress.
While the “detox” proposal mentioned by the premier falls short of the original land-based residential detox, treatment and recovery program proposed by the alliance, elected local representatives embraced it as a vitally important first measure in the region.
As Terrace mayor Sean Bujtas pointed out, all services start with detox. “You can’t get to treatment if you don’t detox.”
City councillor James Cordeiro concurred, saying detox is what the community needs right now.
“From the perspective of the doctors that we have in our group, if they could just get people stabilized then they’ll worry about getting them to treatment once they’ve been stable,” Cordeiro said. “But if they’re not stable, to send them out of town to get stable, it’s just not worth the risk.”
Terrace, a hub for the unhoused
“A detox centre is a first step. Then they need a place to heal themselves,” said Arthur Renwick, former Haisla deputy chief and chair of the Alliance’s health and wellness committee, in an earlier interview.
And while nearly every community in B.C. needs more mental health and addictions services, people in the northwest are in dire straits, Renwick said at the time.
“Terrace is in the beginning stages of becoming the Main and Hastings of the North,” he said.
A hub city, Terrace attracts traffic from surrounding communities for its healthcare, shopping, entertainment and transportation services. Beyond its 12,000 residents, the city serves a larger regional district population of nearly 20,000 people.
In conversations with people living unhoused in Terrace last year, many told Northern Beat they were from other communities across the northwest.
Terrace offers a range of harm reduction and temporary housing options, from emergency shelters to over-subscribed supportive housing.
“It seems to be a place that people go to live in the streets. There’s really no safety net for them. So they go to where they’re accepted onto the streets, where people are living and doing drugs,” Renwick said.
Detox is a treacherous bus ride away
Currently, if a person without personal transportation decides to move towards addictions recovery, they have to travel more than six hours by bus to Prince George to access the closest detox/withdrawal bed. The distance is even further from Renwick’s home village of Kitimaat or for those living in Prince Rupert or Haida Gwaii.
Mayors from the communities of Smithers and Houston have also voiced the urgent need for expanded mental health and addictions services in the northwest. And communities in the northeast face similar shortcomings in access to services.
On top of the long distances residents face to get to detox, and despite assurances from Northern Health that the queue for a bed is no more than a few days, residents in both the northeast and northwest report waitlists weeks to months-long.
“If you want treatment, you need something that’s immediate,” said Renwick. “You don’t want to get on a waiting list.”
Even if someone is lucky enough to get into detox for a few days, it’s unlikely they’ll have anywhere to go for treatment on their release. Non-profit support workers for Kermode Friendship Centre in Terrace said there are no formal supports available to help people travel to Prince George or transition to additional care after detox.
Police in Prince George report people released from detox lacking community or familial supports often find themselves cycling back onto the street. Many don’t make it past the dangerous downtown Prince George drug scene (the hub city for B.C.’s entire north.).
Less risky to continue using drugs than to travel to detox
“The problem right now is, you’re transporting unstable patients to a place that’s supposed to be stabilizing them,” said Terrace’s Cordeiro. “If you severed your femoral artery, they wouldn’t put you on a bus with a tourniquet and send you to Prince George for vascular surgery.”
Never mind that many of those who get on the bus to Prince George don’t arrive.
“The likelihood of them not being able to make that trip without giving into their addiction results in them getting off the bus before they get to Prince George, needing to find whatever there it is that they’re using to satisfy that need, in an unfamiliar area, from unfamiliar people,” said Cordeiro. “And the risks of them having a fatal overdose is significantly greater than if they were just continuing to use in Terrace.”
So there’s a hesitation among people serving the Terrace community to even refer them to detox, Cordeiro said. Because the likely outcome is that they won’t get there and that they’ll be in a worse place than they are now.
“And that to me creates a really unacceptable disparity between economic haves and economic have-nots And it seems very counter to what the government’s philosophy is [on] how the province should be governed.”
Quantifying the cost of provincial inaction
Regionally, the crushing need for addictions services has unified nation and municipal government officials towards a common cause.
The Kitimat-Stikine Regional District board supports the alliance’s proposal and has commissioned a feasibility study to determine not just the cost of having the facility, but also, the costs of not having it.
“The personal cost, the human cost, is self-evident. But there hasn’t been a quantified dollar value of say, this is the cost of the province’s inaction,” said Cordeiro, who is also a regional district director.
The report will calculate costs of first responders, the BC ambulance service and other costs to the health care system, which will provide a rationale for paying upfront cost to offset the hidden costs of not acting.
“It feels bad,” he conceded, “because it feels like you’re really putting a dollar figure on people. But that’s the position we’ve been put in by not really having [gotten] any commitment to provide equitable and sustainable service.”
Case in point, most of the Northern First Nation Alliance’s early research and analysis into the detox/recovery proposal was supported and paid for by the First Nations Health Authority and the nations themselves, while the regional district’s feasibility study is being carried by Terrace, the district and Cedar LNG, the country’s first Indigenous majority-owned LNG facility, owned by Haisla Nation and Pembina Pipeline. Cedar LNG is kicking in $25,000 for the study.
“It’s not a path municipalities tread lightly or carefree,” said Cordeiro. “The last thing you want to do is get into the position of accepting, downloading or even just taking on [a new responsibility] without even having been asked, at least up here. But desperate times call for desperate measures.”
Once the project gets provincial approval, the biggest challenge will likely be finding the staff to run it.
Eby said the province is looking at what skills people need to have, how to train them up to get them, and how to stretch existing human resources like addictions doctors, psychiatric nurses and social workers with others of lower qualifications who are able to help. The goal, he said is to “help expand the number of beds we’re able to open and the support we’re able to get.”
A ray of hope
Following the premier’s announcement and a final meeting between the regional district representatives and Mental Health and Addictions Minister Jennifer Whiteside last week at UBCM, Cordeiro said he’s finally feeling some optimism.
In the meeting, Cordeiro said council members shared how they have been personally impacted by the mental health and addictions crisis in Terrace, while he emphasized the district’s feasibility study is intended to support the First Nations’ proposal and any other project that brings crucially needed services to the northwest.
If the business case isn’t there, then tell us the shortcomings so we can address them, he said. “So we can get something in Terrace.”