The human cost of health care cuts: An Alberta nurse speaks out on the closure of the iOAT program

The human cost of health care cuts: An Alberta nurse speaks out on the closure of the iOAT program

Following the recent report released by the supervised consumption services review committee, the fate of Alberta's SCS and other harm reduction services is more uncertain than ever. The next day, Albertans learned that funding for injectable opioid agonist therapy (iOAT) would not be continued, and that the 63 patients in the program would be given one year to transfer to alternate treatment. Given that clients are only referred to the iOAT program when other treatments fail, the impacts of this funding cut will likely be devastating for the people who depend on it, and their families.

The following was reposted with permission from an Alberta nurse:

When I try to put my feelings about the UCP into words, I get completely choked. It's a lot to unpack. The level of suffering that we've seen, and will continue to see, because of this government's policies is not only unconstitutional, it's beyond inhumane.

I have worked for the iOAT program for the last year, and it's been cut. With the UCP's purposeful, ignorant opposition to clinically proven harm reduction measures to combat the opioid crisis, I'm not surprised at this outcome.

Before the cuts, the gaps in the system were already blatantly obvious, the systemic oppression and racism that lets people fall through the cracks with almost purposeful, self congratulatory ambivalence. Our governments have never seen colonialism, capitalism, homelessness, poverty, mental illness, addiction as interwoven web; this is an understatement, but the UCP even less so.

Under Kenney's cuts, I've already witnessed clients not getting housing they've worked hard to obtain because of the changes to support payments. I've seen tweets about buying bus passes in advance by people who could not imagine living on $1200 a month. Before we found out about the termination of our program, two doctors were already leaving or cutting hours at our clinic because they hadn't been paid for months. All this "therapy" the UCP seems to care about? One of those doctors was there specifically to serve clients open to it.

I think about the hours of unpaid time I and my colleagues have worked as nurses, and imagine what Kenney or Luan or Shandro would do with some of the hard days we've worked. Rubbing a 36 year old client's back as she is in unimaginable pain from metastasized cervical cancer while her exhausted husband takes a breath. Just think about the term "funingating vulvar wound", and imagine what it is like to require her husband to assist in changing her incontinence pads because you can't find assistance every hour on a busy day shift. Hear my Indigenous client tell me he starting using opioids at age 7 after he was shot. Care for another Indigenous man ~my age~ with a leg so infected it will lead to amputation or death without treatment we cannot provide, and reading that he was "discharged with approval" on Netcare after we send him to the hospital. Oh and beyond that, these few examples are always combined with a full patient work load, and each and every one of them have their own needs. Tell me about the mysterious 6 figure incomes nurses make, and tell me how you're earning yours.

Nurses and other HCPs earn our wage. Teachers earn their wage. And these are not the only public services under fire, and by a man who has only ever been a politician, who has never had to deal with the blood, shit, pus and trauma that make up a significant part of the human experience.

In my work, the focus isn't on "getting people off drugs". Our clients' victories are very different. It's a severely underweight client gaining 10 lbs because they've been able to take some time to sleep and eat, because they aren't hustling and on meth 24/7. It's a client reaching out to peer support so they can feel able to go to court and deal with their warrants. It's celebrating when a client completed their Hep C treatment and their blood work came back negative. It's a client just being open to talking to a counsellor about their trauma, or seeing a dentist, or going to the ER because we've built that trust with them. It's a client proudly telling us that they were homeless months ago, and now they're managing their apartment building. Heck, it's even them telling us they haven't used fentanyl, meth, other street drugs in 2 days. These are the joys of our work, and the hardships as well. Recovery is not a one way street. This is known, it is undisputed in the literature, and relapse is a part of it. Sending someone to rehab doesn't work, especially when they have nowhere to sleep at night once they're out.

Please tell me how we are saving money when they go to the ER to sleep with their partner, or when they're found passed out or overdosing in public. Tell me how we're saving money when they're arrested and held for a day or two in holding cells, then released and miss their hearing, and have active warrants for their arrest. Tell me about all the help they are getting from being incarcerated and exposed to more violence and trauma, more drugs and dirty needles, and all the ~money~ we're saving with the added costs to our justice, social assistance, and healthcare systems.

The UCP has an obvious agenda, and it is regressive beyond words. This is not a question of balanced budgets, whatever the fuck that means, but basic human compassion and dignity. My heart is broken, and I am so enraged when I think of how this will impact our clients, and our society as a whole. We all have a pie with Kenney's name on it, whether you're ready to throw it or not.