It’s been about five years since Arlene Last-Kolb’s son died of a fentanyl overdose and she began lobbying for improvements to addiction services.
She laments how it often feels like a solo fight.
"We pay taxes. My son paid taxes. Our government works for us. Our premier works for us," Last-Kolb said. "So why do I feel like I’m working for him? Why do I feel like I’m doing somebody else’s job?"
Last week marked the one-year anniversary of the release of the Virgo report, which is a blueprint to improve and intertwine Manitoba’s mental health and addictions systems. The 279-page report, delivered by a Toronto consulting team co-led by Dr. Brian Rush, was distributed on May 14, 2018.
'How many times do we have to say "immediate help" over and over and over again' – Arlene Last–Kolb
Last-Kolb was one of about 350 stakeholders who were consulted.
She — and other critics — are frustrated by the pace of progress.
"How many times do we have to say ‘immediate help’ over and over and over again?" Last-Kolb said.
In an email, the province said that so far, it has acted on 26 of the report’s 125 recommendations.
The Virgo report doesn’t include timelines for when each of the recommendations should be followed. Rush’s team described 15 short-term priorities, including enhanced capacity for services outside Winnipeg and supports tailored for new immigrants and refugees.
The Winnipeg mother said that during consultations for the report, meth consumption wasn’t the all-hands-on-deck issue it is now. Much of the report’s contents relate to opioids, which dominated discussions about addiction almost exclusively a few years ago.
Manitoba’s Advocate for Children and Youth, Daphne Penrose, has repeatedly called for more mental health and addiction services for young people, many of whom are addicted to meth.
The Virgo report recommended "giving immediate funding priority to the expansion of services for children and youth... for people with (substance use addictions), eating disorders, and those who have experienced severe trauma."
'I know (Virgo) is a big report. I understand that. But we need a plan for kids and we need to get moving on that plan' – Manitoba's Advocate for Children and Youth, Daphne Penrose
Last September, Penrose put out a three-page statement of concern about the province’s slow response.
"I could republish this statement today," she said Friday.
The advocate’s office has also published four special reports in the last year, three of which focused on the deaths of children: Circling Star, Angel and Tina Fontaine.
All three children struggled with substance use during their young lives, as do many more youth who visit the advocate’s office every day, she said.
Penrose expects to publish her first audit of the October report on Circling Star by the end of the month. One of her recommendations therein was for the government to fully implement Virgo.
The advocate said she is optimistic about the province’s response; it has set up a committee of deputy ministers to deal directly with her recommendations.
"We have gotten the first set of recommendations back and the response plans to the recommendations. And some really thoughtful and meaningful work has gone into some of those responses," Penrose said. "Where I continue to have questions is around the addictions piece and the mental health piece."
"I know (Virgo) is a big report. I understand that," she added. "But we need a plan for kids and we need to get moving on that plan. Because every day that passes, there are kids out using and struggling with their addictions and they need help."
Health Minister Cameron Friesen was not made available for an interview to discuss progress on the report. He answered two questions about it on Wednesday.
"The challenge that that report pointed out was that we had very good practitioners and clinicians and people working in mental health and addictions in this province, but working in sub-optimal areas because the system was not well-aligned," Friesen said.
"Manitobans recognize that solving that and responding to over 100 recommendations is going to take time. Nevertheless this government continues to show progress (with) meaningful investments that have been made in just the last year that respond directly to that report."
The investments include opening five Rapid Access to Addictions Medicine clinics; doubling the number of treatment beds for women at the Addictions Foundation of Manitoba, to 24; adding six in-patient mental health beds at Health Sciences Centre; and enhancing access to medications such as naltrexone, which helps manage alcohol or opioid dependency.
Last-Kolb said local access to medically assisted detox facilities is urgently needed. She helped create a petition, which was circulated by Overdose Awareness Manitoba, that will be presented at the legislature by the NDP this week. About 5,000 Manitobans have signed it so far.
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"The huge, urgent issue we have to confront is meth use. Most of what the government’s pointing to in that (Virgo) document has to do with opioids. So they’re missing the mark," NDP Leader Wab Kinew said. "It’s not that opioids aren’t important, of course they are. We have to address those. But there’s this huge vacuum in terms of responding in a real way to the meth crisis."
It was the first time Last-Kolb had put together a petition, and it was the first time in a very long while that she felt hopeful, she said.
"Nobody’s listening to sad stories anymore. I am not telling my sad story anymore," she said.
"I’m talking about moving forward. I’m talking about change."
Meth pipes suggested as harm-reduction tool
As the province continues to pay for millions of clean needles that are distributed to intravenous drug users, the government has been advised to consider supplying meth pipes as harm-reduction tools.
Briefing documents for the health minister, which were obtained by the Free Press through freedom of information law, point out that widespread meth use hurts harm-reduction efforts.
“Historic volumes of harm-reduction supplies (mostly needles) have been distributed. Consideration needs to be given to other sorts of harm-reduction supplies (i.e. meth pipes, condoms),” an official wrote in an advisory note in July 2018, which was mostly redacted.
Regional health authorities distributed more than 4.6 million needles in Manitoba in the last two fiscal years. The Winnipeg Regional Health Authority gave out about 2.1 million needles during 2018-19.
Health Minister Cameron Friesen wasn’t made available for an interview, but responded to some questions by email, including whether the province should consider paying for meth pipes.
“Harm-reduction efforts take several forms and many different strategies are considered. Various supplies, including take-home naloxone kits, and opiate-replacement therapies are just some examples,” Friesen wrote.
“Like other jurisdictions facing this challenge, we continue to consider a variety of harm-reduction options to help Manitobans.”
Liberal Leader Dougald Lamont said providing pipes to people with addictions makes sense, especially as public health officials raise red flags over the spread of blood-borne illnesses such as syphilis, which have been tied to a rise in intravenous drug use in Manitoba.
“That’s what people need to realize – that harm reduction is about death and disease reduction,” Lamont said.
“Part of it is trying to make sure people with addictions live to see another day and holding up the possibility that they can actually get clean.”
— Jessica Botelho-Urbanski, with files from Dylan Robertson