The Forgotten Pandemic

Leslie Dan Faculty of Pharmacy alum operates methadone program in Sudbury community hard-hit by opioid crisis.

More than 150 crosses stand on land near Sudbury’s City Hall, each one a memorial for someone in the Sudbury area who died from an opioid overdose.

Not far from the memorial, pharmacy manager Kathy Jarvis works in the midst of this crisis. She cares for a number of patients with opioid use disorder, and her downtown pharmacy includes a methadone program.

“I know I can’t change the world and I know I can’t save everyone,” she says. “But sometimes people can move forward in their lives, and it’s great if I can be a little part of that. That gives me a lot of satisfaction.”

While communities across Canada are struggling with the opioid epidemic, Sudbury has been hit particularly hard, and the number of deaths from opioid overdoses has been increasing. According to Public Health Sudbury and Districts, 32 people in the Sudbury and Manitoulin area died of an opioid-related overdose in 2018. In 2019, 56 people died. And from January to September 2020 (when data was last available), 71 people died.

Jarvis explains that Sudbury’s history as a mining city has contributed to the challenges it currently faces. For many years, people who worked physically demanding jobs in the mining industry were freely prescribed Tylenol #3 with codeine for back pain, and stronger opioids were prescribed as they became more available.

Then a shift in medicine meant that many people who had been taking opioids for years were cut off – sometimes quite suddenly. And some of those people turned to illicit supply.

“Some of these families have a culture of using opioids to take away pain because it has been part of their family for so long, and that’s hard to navigate as a pharmacist,” says Jarvis. But as the street supply has become more dangerous in recent years,

“We’re losing a whole generation of kids, and people in their 20s to 50s. And we’re losing them to these overdoses.”

Patients in smaller centres feel like family, says Jarvis

Jarvis grew up in Sudbury and moved to Toronto to complete her Bachelor of Science in Pharmacy at the Leslie Dan Faculty of Pharmacy. When she graduated in 1989 into a difficult job market, she knew she wanted to return to northern Ontario to practice. Not only would she be closer to family and friends, but she knew she would always be able to find a job.

“In the north, you have the stability of knowing you’re always going to have a job,” she says. “There aren’t as many pharmacists in the north, and you’re really needed up here.”

While working in northern Ontario has its challenges, one of the things she enjoys the most about working in a smaller community is that she has the opportunity to get to know and become close with her patients. And having been in the same role for nearly 20 years, she’s seen her patients raise their kids that then have their own families.

“You become an integral part of these people’s lives,” she says, “And when they get to know you, you become a member of their family and a trusted advisor.”

Being a trusted and accessible health care professional has become even more important during the COVID-19 pandemic, when many other health care providers have not been able to see patients in person.

“We still see our clients regularly. We can see if someone is going downhill physically or mentally, and we can put them in touch with their doctor if we feel they need to be assessed right away,” she says. “Our role has always been a bridge, but I think that bridging has been much stronger during the pandemic. Everybody else can close their doors and go on the phone, but we’re still seeing patients and assessing them every time we see them.”

COVID-19 pandemic has made opioid crisis worse

The COVID-19 pandemic has changed Jarvis’s practice significantly. Layers of personal protective equipment and plexiglass barriers between pharmacists and patients have made connecting with her patients more difficult.

In addition, the pandemic has worsened the opioid crisis in Sudbury. Services to help people with opioid use disorder became more limited, leaving many people without access to support.

Jarvis says it has been difficult to watch the crisis affect her hometown. But operating the methadone program is one way to take care of the patients who have become like family. Methadone is a long-acting opioid, usually given in a drink, that helps people with an opioid use disorder avoid drug cravings and the physical effects of withdrawal while they rebuild their lives.

“We make every experience we have with them a positive experience. We treat them with respect and dignity because not everybody does,” she says. “People are trying to rebuild their lives, they’re trying to move forward, and they’re trying to not die. You really want to make sure that you treat them with as much compassion as you can.”

By: Eileen Hoftyzer