Episode 5 - Avenue B

Today we are talking with Julie Dingwell from Avenue B, Harm Reduction.

Julie gives us a realistic view of addictions, resources offered to those struggling, and how we can come together as a community to best support our vulnerable populations.

Trigger Warning: This episode may be difficult to listen to as the content includes uncensored discussion around addiction, related infectious diseases, and naloxone treatment for suspected overdose treatment. 

You can contact Julie or one of her colleagues at Avenue B through the following:

Website: www.avenueb.ca

E-mail: avenueb@avenueb.ca

Phone: (506) 652-2437

Transcript

0:02

You are listening to Hills and valleys the podcast, your local wellness navigation station. Welcome to today's episode. In today's episode, I will be talking with Julie dingwell, the executive director of avenue B harm reduction, we will be exploring what avenue B offers along with gaining a better understanding of what harm reduction means and all of the things that it entails. Julie offers a deeper understanding of a very real challenge in our area when it comes to addiction and substance use, while also sharing initiatives and services avenue B has provided to those struggling with high-risk addictions today's episode includes a topic and language that may be difficult for some to listen to. Substance names related infections are also briefly discussed throughout the conversation. And so if this is something that you may find a trigger or difficult to listen to, that is okay. I encourage all who are interested in learning more about addictions and harm reduction to listen in as avenue B is a hidden gem in our city that has helped countless people. Today. I want to welcome Julie from avenue B harm reduction agency here in St. John. So welcome to Julie, and I'm going to give her the chance to introduce yourself and explain what avenue B is and what they do. So welcome, Julie. Thank you. So yes, avenue B and me. Well I'm Julie I began with the organization 21 years ago when it was aids St. John and, at the time that's when, really. We were still losing a lot of people to HIV and aids, but the new drugs had come along. So the results also a lot of brightness happening at that time. So fast forward and because we've always had a needle exchange. And so I going to say that the, when I was hired, I don't even think anybody mentioned the needle exchange. It wasn't very big. And I remember that first year in 1999 that we exchange, 750 needles. And I remember thinking, oh my God, so many needles. This year we're going to, we've exchanged more than 406,000. So that'll tell you how that's all going. So what really happened was that as HIV, became more manageable because it has not been cured. Our harm reduction services. So our services that we looked at to prevent HIV in the community, largely for us became a harm reduction. So we started really, beefing up the needle distribution program, taking needles, back, finding out what people need it, hiring peer health navigators. Today we're a very busy, vibrant agency that, we served between 700 and a thousand unique clients at any given time. I think that our greatest strength is that we're community builders. And I've always believed that, because none of the work that we do could ever be done by one person or done in isolation, So we're community partners with more than, oh, I'm going to say 25 30 agencies on a regular basis. So that's, I think the best thing about us is that we, when we refer people because we offer a great referral service, generally we know where to send people. And I think that that's an important. Thing endeavor that you're taking on. There are a lot of people in the city that are very socially motivated and want to do more and want to help people. we're recognizing. And have recognized that addiction, for example, it's an illness. It's not a choice. Like, I mean, who on earth would wake up one morning and say, oh, I think I'll be a junkie and throw my life away. Nobody wakes up and says that. So, you know, to imply that somebody makes a choice to become addicted and live what is really a very hurtful and brutal life, it's just not true. One of my favorite people that I often refer to is gab or Mateo, Dr. Gabor Matteo from east and Vancouver, who wrote a brilliant book called in the realm of the hungry ghost. And, he talked about health, for example, the women that he worked with, around HIV and addictions that, more than 80% of them were coming with trauma. We know now about trauma, the implications for your future, especially if one checked. And when I see the people that we were. Not everybody, but certainly by far the biggest majority come to us with already, on treated or undiagnosed mental illness, very big past traumas. so they're bringing a lot to the table, without any resources. So that's what we try to fill and fit in is how can we help people stay healthy? Because we're not about, making people get an estimate, right. You know, like, oh, if you don't quit that don't come here. we work with people it's actually where they're at. Try to keep them safe and as free from harm as possible. And sometimes. That can do wonders because in many cases, we're the first people that have really cared about people in a long, long time that we said like, where are you sleeping tonight? How are you getting food? what's going on that we can help you with. So I think that trauma is huge for our organization. We do not have, A therapist or, somebody onsite every day. Although we are now working with fresh start and they've moved into our office and, they do have a social worker on staff, but I'm going to tell you with all those people, karma is huge. That sounds, pretty accurate. And it's a really great introduction and information that you provided about what you guys do. And for some people out there listening, who might not understand what exactly harm reduction means. Can you explain a little bit more about. What the goal of harm reduction is and what it means. Well, I didn't don't have our written definition here, but you know, it's really about the lease term. So somebody comes to us. How can we keep them as safe as possible? So we want to prevent HIV, hepatitis C endocarditis suicide. So. In an effort to prevent those things. We have to be a supportive agency and really harm reduction is about. So in the case of substance, people who use substances, we have a needle distribution center. We've expanded that to include a meth pipe because crystal meth is now a huge. Issue in the city. And, it's about providing supplies, providing support and, referrals doing whatever we can do. Our job is to keep people alive until, they've made whatever decisions they're gonna make about their futures, but we want to keep them alive and as free from diseases POS. That's a perfect definition, actually. And it's hard to have that written definition because it's so broad and it can include a lot of things. It can if you think about, I always tell people, think about seatbelts that's higher reduction floss. Harm reduction. So it's just an extension further on down of what it means to reduce harm. Yeah, absolutely. How would people access your services? And what does, what did the referrals look like for, in terms of what process people with, I don't need any process at all. We're open Monday to Friday, they can walk in and that's all they need to do is walk in, meet at the front desk, tell people what their needs are and we'll go from there. So if it's a. Housing will make sure that they get, the full Heifetz report done up so that we can really move them along and housing. If it's food, we'll try to find ways to give them some food security. so they can walk-ins are the most common ways that people just come and see us at 62 Waterloo. You can call us at six five two two four three seven, or you can go on our website, www dot avenue, b.ca. And, you can get some information that way and connect with us. We're, happy to connect with whatever way, people find it easier. And, we can do things. However that person would like to do things. That's lovely. So you meet people where they're at and you're an open door policy. It sounds like. Absolutely. Absolutely. And that's particularly important for our community, for people to feel like they do have those resources to access and they can go back at any time. That's right. And, and we don't generally have any kind of limit on supplies or anything like that. We currently have three, peers that have been hired, employed with our agency for well, one for more than 10 years and the other two, for four years. So we really believe in empowering people. Giving people a hand up and employment's always good. How many people would you say on average a week or a month that would come through your doors? Just, ballpark. I can actually tell you that maybe Now you want it to know about how many people were coming through the door? Yeah. Approximately how many people would you see come through your door on any given day or week or month? Well, for instance, in March we had 702 people come through. Wow. That's quite a good number that is, and our numbers are down by actually, maybe a couple of hundred during COVID, but our supplies going out have increased. So we're attributing. Some of that to, people are picking up for other people. And some of our partners, we have partners that also, provide services for instance, guardian drugs. When we're not open down at prince Edward square mall provides all of the things that we provide. That's lovely that you have those partners. Do you have, trainings and things for people Naloxone training. And if you've been trained with us, you also, we give you a kit, but we can train large groups. We can train individual people. And again, it's just for that. They would call the office at six five two two four three seven and set up a time for training, or they can send an email, into, Diane dot current. K E R N s@avenueb.ca and arrange it that way, but we'll also what they call, we'll get them set up first people who might not know what the Naloxone program is. Could you explain what it is for sure. So if somebody has overdosed. Naloxone, is a substance that reverses that overdose. And so it's, you can't hurt anybody with Naloxone. You can give a newborn baby Naloxone and it won't harm them. It's just reverses opiates. So, it's very important. Because we don't want to keep losing people. You know, we're an agency that we go in every Monday morning and wonder who died over the weekend. So we need to stop that from happening. And one of the ways to do that is to make sure that every possible person is Naloxone trained. So we, the lock zone train all the peers, fire departments, you name it, we'll go and do training. Is there any fees associated none and a free kit? So the training, the kits are free of charge. And what about the services that you offer? I'm assuming that they're all for you. Everything's free of charge. We don't charge for anything. So where is your main source of funding coming from? We, the provincial government actually provides a funding for the needle distribution program. And then we have some federal funding as well that, helps a bit with the operational pieces and the train. And because part of our role also is to work with healthcare professionals and, try to reduce stigma, open doors and, just make it so that people want to go and see a doctor if they can find. You really do promote that overall wellness. And, though you do support people where they are, your goal is to keep them alive, healthy, and safe. And you really can't ask her for more from an agency. So I really appreciate the work that you guys do. Well, thank you. Do you have any thoughts or suggestions for how we can as a community strengthen our quality of care or, collaboration with one another? Well, you know, one of the things I been thinking about was that I was recently part of the ASIS training that happened in St. John. And I think that if we could get more people understanding, about ASIS, you know, adverse childhood experiences and bring more people to the table so that they could, because I like to think of ASIS is being used to help people understand that where they're at is not necessarily their fault at all. You know, th the factors that might've created, where they're at today, might've been, in the womb. Right. So I, I would like to see the community doing more whether they're larger groups, support groups, talking with people gently about where they are. how to acknowledge how they might've got there and why it's okay for them to move on beyond that, that they don't have to own it all, even though it brought them to where they are. So I believe that we could really do so much more for people. If we could get rid of some of their stigma, shame and guilt. Because when you carry those sayings, it's very difficult to move forward. You're spot on there and. I think that bringing that awareness to more people, more agencies, even our community members would do wonders. Yeah. We were all set of the 30 of us that have been trained to really go out and train people and give presentations. But then of course COVID happened and it's really not quite the same doing these things online. Although some people are doing them online. But I really just think like St. John is already just a terrific community in terms of, people will say to me like, oh, I meet somebody some and they say, oh yeah, how much flat do you get for, passing out needles, say, well, almost none. And you know, I can count on one hand. One hand the times that there have been, pushed back about our needle distribution program. And mostly it's a phone call. For example, we had somebody call a couple of months ago and her son had died with cancer. And, but she had all of these syringes that she didn't know what to do with that were on you. And could we take those, so that's the kind of call that we get. We have, several churches in the area that are outstanding that deliver us frozen soup, homemade soup and cookies every Monday. I just can't say enough about this incredible community that we live in and their willingness to provide support. What we need is the bigger support. You know, we don't have housing and we're coming into winter and there's already hundreds of people. Living rough, our homelessness problem in St. John tends to be more hidden than in Monkton or Fredericton, but we're working hard with others to try to change that picture so that people see we're in a dire situation right now just dire the boat, the shelters. It's encouraging to hear that the response from our community has been so positive and welcoming with open arms, to this harm reduction initiative. It is unfortunate that we are in the situation with hosing that we are in. And I know that there's active communities in our area that I'm hoping to have more contact with, to talk about those things and what their thoughts are, because at the end of the day, it's all about learning and growing. And how can we address the. Bigger issues because you're right. If people don't have their housing and basic needs met, it's really difficult to address those larger issues. Like the addiction and mental health. Yeah. You can't do anything if you don't have a safe place to lay your head at night. I mean, you just don't have anything. We've got a couple of women telling us they're sleeping in porta-potties because they're safe places to sleep. We're talking about changing laws in big cities like Toronto, so that we can add more rooming houses, like what is wrong with us? There's all this wealth, centralized in some companies, some people, and the best that we can do for veterans and other people are built some rooming houses for them. And, we're not even doing that here where they're homeless or living in tents. So anyway, that's my little rant, sorry. That's under the goal and it can be discouraging. However, I do know that there's a lot of activity in that area with different committees. It's just, we're building. We have a new build. The shovel-ready in the spring together with fresh start, the community loan fund and human development council, the homelessness money. So we're going to have a new build on Waterloo street across from the cathedral that will house. now I can't give you exact numbers because we're waiting, for the architect and how things shipped down, but we've been through planning advisory. We've got, the permits from the city. And so up to 12 chronically homeless women will be housed there with supportive housing. And so that's because we know, it's all well and good to say, uh, well, you're going to have$570 a month or whatever that social development gives you because we consider you employable. Well, we know that hundreds of our people are not employable. And so for instance, these wins. That we have in mind, they're not going to go out and get, jobs and stabilize to that extent, because I don't think that a lot of people realize that very prolonged drug use. And especially now with crystal meth, had some very, very serious mental health side effects. Like with crystal meth people go into psychosis. And, it's a challenge because then we're working with people that are in psychosis and you can't do much there. So yeah, this is a, that's also Tara, a huge challenge, this crystal meth and what it does to people's brains. Yeah, absolutely. It's, it's a battle that we are certainly facing as a community, but we are, you know, we are, and now they're mixing the crystal meth with fentanyl because of course, crystal meth is a stimulant. But we've had people say, oh yeah, I smoked that. And then I went to sleep for three days, which is not normal. So, you know, they're, they're probably pretty close to death at that point. And yeah. I don't know what the solution is to all of that, except that a game we work to keep people alive. I would say that that is a pretty amazing accomplishment. And it's something that you guys are working for every single day tirelessly. I'm sure. And it's something that we do need to have more awareness about as a community, even as service providers, even for myself, learning about all of these things and the needs that our community has is I think it's part of the battle is just being aware and cognizant of what's going on. Absolutely because I'm a big believer in the drop in the bucket theory. Otherwise I'd never been able to hang in here for 21 years, but I really do believe in that drop in the bucket, your bucket will fill up and already we've seen tremendous changes in the things that are happening in the community. So we just have to keep pushing for more. Do you, apart from some more training opportunities for people to be more familiar with the things that you had mentioned earlier, do you have any other suggestions for how we, as, community service providers can work together and try to, improve the way that we deliver our services? Well, joining other committees, like we have lots of fine committees. We host the sex trade action committee, which was a committee that, began when the police force in 2003 put, an ad in the paper that said this prostitution effects. And at that meeting, they had this tiny little room and I think they thought 10 or 15 people might show up who were irate and people who worked in the sex trade. And instead what we had were wonderful people like gamery McGrath, who was there, the room was overwhelmingly full 50, 60 people. It was elbow room on. And people like Emory McGrath are saying, the problem with the sex trade is I can't sleep well at night because when I see girls, I'm watching them. When they get into a car, I can't go to bed till they're back. You know? So. That really, changed everything. And so we meet monthly, we've been meeting monthly since 2003. We have representation from a lot of the agencies in the committee, including the police force has never left. And, we meet every month to talk about what's happening in the sex trade, a bad joke. Um, bad drugs. What can we do? How many are homeless? so it's a great committee too, and there's lots of them, lots of them. They're very encouraging to know that they're still happening and that there's members that are committed to serving on those committees. It's crucial for us to have that activity. And it's something that I encourage, people to reach out and become more involved with because like you said, When we're informed, we can make, better decisions and clinical judgment and what we can do and our roles, whatever we're doing to improve the quality of life of our community, who we're working for. So I, I really do appreciate the time that you guys put into these initiatives. Well, thank you. And maybe you never know, you might want to join the sex trade action committee or something, and he's open to, um, you know, preparing you in as a guest, you know, with, with, when we do a support. To, maybe give people a few ideas about some coping skills and yeah, absolutely. Definitely. Keep me in mind. I'm always open to doing things like that and helping out I can. Do you have any other questions or thoughts, You know, we're always happy to have phone calls, to talk to people. You know, again, it's about keeping people safe, just keeping people safe. And I always tell people, The people that we see on the street, the homeless, the addicted, these are people beamed in from some other planet. These are our people, their friends, their sons, their mothers, their uncles, they belong to us. And one of the things that we need to think about is we can approach harm reduction with our head or our heart. If you approach it with your head, you're thinking about, why am I spending money on people that use drugs? Well, because if you don't, your Medicare system is going to make you pay. If you do it with your heart, you do it just because you want to not see people so downtrodden that you can't help lift them up. And that's actually cheaper because you know what? We've had a huge outbreak of endocarditis in new Britain. Endocarditis is so expensive to fix. And it's just outrageous, maybe 50,000 to 200,000 a person, depending on what they need. So if we could have prevented that with better services and programs, that's why you do it with your head. But, sadly people that get endocarditis have been mostly young people, and I believe we've had quite a number of cases in the last couple of years and their long-term prognosis is never good once you've had endocarditis, which is an infection of the lining of the heart. you don't have a good long-term prognosis. No matter what you do after that point. And can you just explain what typically would cause that in the addiction realm, what kind of stuff? It's a bacterial infection. So it's, bacterial from often just from the skin that somebody, when they push, you know, inject, they pushed that bacteria into their blood system. It's a simple little bacteria that. Can wrecked habit, hence the importance of the things that you guys do, yeah. I really appreciate your time. Explaining a little bit more about what avenue B is all about, and I'm sure that, people out there listening are going to have a better understanding of what harm reduction is and how we can get involved. But there's tons of committees. There's great things happening. And I encourage people to get out there and become more involved in these types of initiatives. Thank you for having me avenue B, come and talk, because I think that it's so important that we all know what everybody else is doing. It just makes us stronger as a community. And thank you very much. It was my absolute pleasure and I'm sure that we will continue to be in collaboration as we move forward. Sure. Thank you, Tara. I want to take a moment to thank Julie for taking the time out of her busy schedule, to talk with me about what she does and how our community can benefit from the services avenue B offers. I want to extend my deepest gratitude to Julie and all of those out there. Listening. Julie gives us a raw look into what it means to work within a harm reduction program and assist our community in providing safe and life-changing resources to those who reach out for help. Harm reduction is a framework that I have embraced as a social worker. And believe that working from this lens can give us a gift of reducing barriers and stigma associated with substance use and reaching out for help and treat. You can find more information on how to best contact Julie and the services she offers through avenue B by checking out my website@wwwdothvcounseling.com and clicking on the podcast. There you will find a list of episodes, information about each one and contacts join me next week. As we continue on our journey of navigating our local resources, I wish you all a wonderful day together. We can climb any mountain. Sincerely your community partner. Thank you for joining us today for a weekly topic and tune in next week for another dose of wellness.