Ben: Episode 2: Accessing Resources & Financial Security

In this episode, you'll hear Ben talk to Lucas Akai and Esther Cheung about the challenges of referring individuals to resources in the community, including housing and safer supply. He mentions issues with timely payment for peers and limited resource options.  

This episode was recorded on October 18, 2022

Transcript

Caitlin Burritt  00:00 

Thank you for listening to the Unsilencing Stories Podcast. We are in the midst of a public health crisis. More than 32,000 people in Canada have died from fatal opioid overdoses since 2016 according to Health Canada. Previously, this podcast featured interviews with bereaved people in smaller towns and communities in BC and Alberta who have lost loved ones to fatal overdose. In this phase, we're sharing interviews with seven harm reduction workers also known as peers in different parts of BC.  

Caitlin Burritt  00:27 

The BC Centre for Disease Control Harm Reduction Services defines harm reduction as support services and strategies that aim to keep people safe and minimise death, disease and injury from high risk behaviour. Peers face a lot of challenges. This has been documented by many researchers including Zahra Mamdani and colleagues in BC. In their 2021 paper, they outlined significant challenges peers face including financial struggles, difficulty finding housing and stressors at work. We wanted to explore these themes with peers and find out more about their experiences and share this information with the public. So we conducted multiple remote interviews with harm reduction workers and invited them to talk about the stressors they face.  

Caitlin Burritt  01:06 

Please note this podcast contains information about substance use overdose death, grief, trauma, and stressors that peers face and this may be distressing to listen to. The podcast is part of a research project led by Aaron Goodman, PhD faculty member at Kwantlen Polytechnic University in Surrey BC and conducted under the auspices of a grant known as the Chancellor's chair award. I'm Caitlin Burritt, a researcher with the project a number of researchers including Giorgia Ricciardi and Chloe Burritt, who happens to be my sister, and a number of students have played key roles in the study, and you'll hear many of their voices in this podcast.  

Caitlin Burritt  01:40 

In this episode, you'll hear Ben talk to Lucas Akai and Esther Cheung about the challenges of referring individuals to resources in the community, including housing and safer supply. He mentions issues with timely payment for peers and limited resource options.  

Esther Cheung  01:54 

So we talked about you getting into the profession. And I know, you said it's also because there is a limited amount of work when you are openly using drugs. And so I am curious if there's other reasons that continues to motivate you in your line of work other than it being, like, limited? 

Ben  02:16 

Um, well, primarily, as my spouse has a developing paraplegic condition, I was in a position where I was called on, increasingly, to dedicate my time to a caregiving role at home and being compensated for that in a small way through the Ministry of Social Development, if that's what they want to be called these days, anyway. It's a role that is... Not. Well, it's often played by women and not really paid for in the non, informal or non-professional capacity. 

Ben  02:59 

And I guess, because my background, I had a pretty comfortable upbringing and support from my family to sort of do what I wanted to do. I didn't really mind being in that position. I thought it was sort of normal, in a sense for a human being to take that role on and not be compensated particularly well. But as I've grown older, and my options have narrowed, like I previously, I trained as a holistic body worker, and could make good money doing that, but kind of requires regular retraining, and self promotion and stuff like that. 

Ben  03:48 

And with the other obligations I've had at home, and this other work I've been doing, wasn't really easy to keep that happening. So I've had to rely more on my work in peer education, as that's sort of where I got a reputation. And to the extent that it became possible to do that more formally in recent years. It's still disappointing, the lack of integration or sort of, consistency, in terms of support. Up until COVID there was more momentum in terms of developing networking opportunities and stuff like that, with conferences in the city and elsewhere. Like in the last year before COVID, we went to conferences in Edmonton and trainings in other communities around British Columbia, and we were well paid to attend these things and so, you know, it felt like a pretty comfortable role at that point.  

Ben  05:06 

But since COVID, those training opportunities have sort of, haven't carried on, they're sort of just beginning to reemerge. I guess there's a conference coming up next month, hopefully, we're going to attend in person. But since COVID, there hasn't really been much of that at all. And, you know, I don't know what to expect, as far as this upcoming conference, I don't think it's going to be at the same level of compensation. Perhaps it will, I guess.  

Ben  05:38 

But I guess we'll have to wait and see. But you know, typically, a three day event might make $600 or something. And that happened, you know, regularly enough to, that was, was pretty comfortable sort of income on top of my regular stipend, or whatever. But it's been a long time since that has been happening. So. 

Lucas Akai  06:05 

And so these, these conferences, are they primarily centered around the types of people that work in your position or [are] these conferences, something that anybody can attend? 

Ben  06:16 

Well, more in terms of service providers and peer educators, I think, pretty much a mix. But usually, it's a harm reduction, harm Reduction theme. Sometimes it's more specific than that. But typically, harm reduction is the theme. So you get a range of service providers and peers and various workshops and things on site. Usually, I guess that's, you know, there's international conferences on harm reduction. There's something called Stimulus, that's one that we went to in Edmonton, I think. It has happened since then, elsewhere, I think online, as far as I recall. 

Lucas Akai  07:01 

And so for peer workers, for harm reduction workers, would you say that these conferences are the primary source of financial support that you might have access to? Or, or maybe expand upon that?  

Ben  07:18 

Well, other than my gig with [bleeped] and then, briefly, with the CAT team, which was much more limited, I've, I've only been able to earn any kind of regular income at meetings or workshops. So I guess that's been my experience. But I don't know if it's typical, exactly. It's hard to say. For lots of peers, I think training opportunities and things like that are the, are pretty, as far as, like, a single chunk of cash coming in, is probably pretty typically the main thing. 

Ben  07:49 

I don't know, some people get jobs working for the OPS or the housing unit, that kind of thing. But there's not a lot of positions really to find out there. As far as that goes, I guess on the mainland, there's probably quite a lot more, but I don't live there so I don't pay that much attention to that.  

Lucas Akai  08:12 

Sure. And so if these like conference[s], and these training type, um, like, would you say, like, short term jobs, almost? Would you say it's more limited or less so for maybe the people that would take part in your workshops? Like, how common are the workshops that you run? Is that like a community by community type of thing? Or is it vary in other ways? 

Ben  08:37 

Oh, it's definitely a community by community type of thing. And I don't think that there's many communities where peers are organised enough to get a grant like we got. So we've been able to run fairly regular workshops. And because of our connection to the CAT team, we have support there to organise the workshops and find venues and provide the snacks and honoraria to attendees.  

Ben  09:07 

But if we were doing that all ourselves, it would be considerably more demanding. And I think that as far as rural British Columbia communities go, it's, it's pretty tough to pull that kind of thing together. I don't know of very many places where that's happening. I mean, there's, I think there's about 30 groups or something like that in the, around BC there's about 30 organisations of peers that have some kind of grant like we've got or if they're, they have society status, then they have twice as much as we got, so $40,000 for the year, which is for the entire everything, workshops and salaries and everything. So rent is just a tiny portion of what they give you. So in terms of having a place for people to, to gather on a regular basis, that's, that's extremely rare. And so getting people acquainted with the organisation or the opportunities that could be provided, it's, it's pretty tough. In my experience, anyway.  

Lucas Akai  10:17 

And so with how limited these these grant funded societies are, do you see a lot of participants travelling from, like, locations where maybe there's not as much support? Like, is there a lot of long distance participants? Or does it pretty well strictly stay community-based even in terms of participants?  

Ben  10:36 

Well, when there's, when there's an opportunity to gather at a, an event in the city or something like that, and people come from all over the place. I mean, it was very, it was very impressive for a while, the amount of support for that kind of gathering, up until COVID. And so it felt much more comfortable up until COVID. To sort of rely on that. And I think that, but there's really only a small handful of people that would show up on a regular basis. And so, you know, there's, there's people inside the service provider establishment, if you like, that it's their job to find people to bring to these events.  

Ben  11:22 

And people that are lucky enough to sort of catch wind of that, those opportunities, they can have the experience of of getting to go to a fancy hotel and eat well and be paid quite well for their time for just a small window. And then that can be inspiring in terms of going home and doing more of that kind of work. But depending on how stable the individual is, there can be a lot of turnover, because people are typically, if they're in a position where they're comfortable identifying as drug users, they might not have a lot of other things going on in their lives. And so that can also include, as you sort of referenced in your list of questions, lack of stable housing or other work opportunities, and that sort of thing. So. 

Ben  12:21 

And there's also the risk of overdose, of course. So there can be quite a lot of turnover there. So there's really just a handful of people that show up on a on a regular basis over, over the years, so to speak. 

Lucas Akai  12:36 

And just for some clarification for the transcript purposes, you had mentioned support being greater in the pre-COVID period for these workshops, maybe just clarify where the support was coming from, was it government? Was it other third parties?  

Ben  12:50 

Yeah, I guess mostly, for a long time I think [bleeped] and the Centre for Disease Control and the health authority are the main two. There's also the BC Centre for Substance Use and a couple of other organizations. But I guess on a federal level, Health Canada has some role to play. For less frequent, larger events, it's kind of weird because of the COVID thing and the overlap with the toxic drug crisis, there's really been a lot more money poured into policing, and first responder kind of pay and training and that sort of thing.  

Ben  13:36 

And there's certainly a lot of lip service given to peer support. But I think that, in general, it's just a lot easier for people in the establishment to carry on supporting or funding, well understood, organizations and career paths, I guess, in terms of health care providers, and that sort of thing. And people who maybe have had some experience with drug dependence at some point in their lives, but typically are well into long term recovery take those roles on a sort of a salaried level, more typically in our in our society, as opposed to like I said, in Australia, where you get people that are active drug users, or maybe part time drug users, who can get a salary and go to these kinds of events, but don't need to see that as their main source of income.  

Lucas Akai  14:49 

You mentioned that these workshops when they, when you find people to participate, is that done by a third party? You had mentioned that there was another group that was involved in that?  

Ben  14:59 

Oh, the Community Action Team is a variety of stakeholders. So, like, the OPS and VCH, and the local, regional district government bodies and stuff like that. And sometimes, initially, there was more involvement from first responders and police. But usually these days, we don't see them at meetings. So the organizations that I just mentioned, are mainly responsible for getting out the word about workshops that we are hosting. The CAT team is sort of the umbrella organization that tries to pull all those people together to address the overdose crisis. 

Ben  15:49 

But more generally, it's [bleeped] and the overdose prevention sites and the, I guess, the opiate replacement clinic, and that harm reduction outreach teams and stuff like that, that provide the promotion for the kind of events that we put on.  

 

Lucas Akai  16:15 

And so in terms of financial compensation, for the participants that these organizations find, is that handled by like [bleeped], they would handle compensation for any of the individuals that might have been referred by them? Or how does that work for the participant, rather than maybe the host?  

Ben  16:31 

The, since the overdose crisis was announced, I guess, there's the, the main funding body is the Overdose Emergency Response Council or something like that. And the Community Action Initiative, they kind of are the two parts of that, that have the majority of the funds. They gave us, our grant and these other 30 organizations across the province, and I believe they also fund the CAT team. So the money is all kind of coming from the same source. 

Ben  17:12 

And like I say, it's kind of a pittance compared to what they, what the government puts into the police or first responders, sort of thing. So it's a bit frustrating, and I don't know, disappointing, I suppose. But it's better than nothing. But I mean, $25 an hour is what we're paid to do our work. And we also pay peers, I think that the CAT team, for some reason, pays people $20 instead of $25 an hour. 

Ben  17:59 

So, but most of our funding is actually dedicated to providing that money to peers who attend our workshops, or the actual infrastructure or organizing and paying for the venues and food and that sort of thing. So like, I typically only pay myself for maybe in a given week, I might, if, I might pay myself for four or five hours on a sort of a good week. But if I'm actually putting on a workshop, like next week I'm putting on a workshop with my partner. And so we got more, I think we got actually $50 an hour for the facilitation of the workshop. 

Ben  18:46 

And I think that comes through the CAT team. So we don't have to take the money out of our grant, when we're, at this point just because the CAT team has this money dedicated to these events, otherwise, we wouldn't earn that much, I don't think.  

Lucas Akai  19:07 

So these, these grants that are issued to the different societies, is that done on a provincial level or federal level? 

Ben  19:15 

That's just provincially. So I don't think that, I'm not aware of anything like that going on in Ontario or Alberta, or there might, there might very well be something similar, but it's a British Columbia thing. I'd, I don't think that there's as many groups in other provinces getting funding of that sort, as far as I know. 

Lucas Akai  19:38 

So you mentioned that the CAT team, for example, provides participants with, you had mentioned 20, $20 an hour, others $25. Is that the same across like the societies in BC or is, does it vary in terms of the societies and the communities?  

Ben  19:55 

No, that's kind of been established as the best practice kind of thing in British Columbia at this point.  

Lucas Akai  20:02 

And so then in that case, like, the societies themselves, they, they wouldn't really alter any of the compensation platform and that's strictly run through, like the, like the CAT team, the upper level organizations or? 

Ben  20:17 

Yeah, we've heard that First Nations, maybe just our local First Nation was only paying $10, which was something that we felt should be addressed. And I don't know why that would be, exactly. It's pretty unfortunate. But for the most part, that's not altered. Like I said, I don't know why. Because 25 is what we're given to understand is the standard rate. So I don't understand why the CAT team pays a little bit less than that. But I guess they have some more people on regular salary. So they probably put more of their money towards that. I don't know.  

Lucas Akai  21:04 

And so you actually brought up something interesting. The, the Indigenous groups, are they separate to the other societies? Or do they run on different governance? 

Ben  21:16 

The First Nations Health Authority is kind of a new organization, and they were doing really good work with the, not just Naloxone workshops, were some of the bigger training opportunities that were happening, leading up to COVID, we were able to go to a few of those, and they were really good. And so they've done some really good work, but they've only been around for a few years. And they do tend to run things separately.  

Ben  21:46 

So, like with safe supply, the First Nations Health Authority seemed to be out front, providing more solid opportunities for people with First Nations status to get fentanyl patches and that sort of thing early on, which thankfully, did catch on in other health authorities eventually. But there's still a lot more stigma in the actual First Nations communities, understandably, because they have taken the brunt of the fallout, so to speak. They were the only people that were able to get free. First Nations were able to get free nasal Naloxone, which is more easy to administer. And it's more, substantially more expensive.  

Ben  22:49 

But, still actually, as far as I know, that you can't get free nasal Naloxone except through the different, in Ontario, you can but, and Alberta, I guess but. First Nations in BC are the only people that get free nasal Naloxone at this point. 

Lucas Akai  23:08 

And so do they draw from the same pool of grants that your community would draw from or even the funding? 

Ben  23:15 

 No, I don't think so. Yeah.  

Lucas Akai  23:17 

And so maybe going back to the compensation for the individual participants, would this be a regular thing? Or do the participants themselves vary from workshop to workshop? Like how many recurring participants do you think there might be? And maybe how many total people would attend a workshop as well on average? 

Ben  23:39 

Well, again, prior to COVID, we were able to get maybe 30 people out to a given workshop in, especially in [bleeped] where we did one training, I guess, earlier on in COVID was it, or maybe halfway through or something. Maybe more towards the end of the lockdown, I guess. There was one workshop we did at the public market and in uh, we had 14 people turn out but that was because of [indiscernible] particular outreach worker who transported all the people there. 

Ben  24:16 

There can be a lot of repeat attendees, but because people have unstable housing and their situation can change a lot in a short time, like workshop to workshop. You might see most, I would say maybe half, half and half new people and, and people that have been there before, and as I've said it's been difficult in the last little while and people were still getting over lock down. It was difficult to get people out. I'm kind of anticipating a better turnout now, we've had a bit more enthusiastic volunteer efforts from other people working with different organizations, who are aware of what we're up to, I think getting the word out for us at this point.  

Ben  25:21 

So I kind of expect more of a sizable turnout for the next couple of workshops that we're doing in the fall here. But that remains to be seen. So we didn't have confirmation of the venue for our workshop next week until yesterday. So it might actually work in our favour to get people to show up with less lead time. I don't know, when we've posted previously, weeks in advance, sometimes people have gotten confused about when or where it's happening. And so we don't get that many people showing up. I think also, we've relied too heavily on posters as opposed to pamphlets or leaflets or flyers, or that sort of thing that people can take with them.  

Ben  26:12 

So I'm thinking that that is probably a more sensible way to distribute the information than a poster that people have to write down the information to take it with them. Something that they can carry away is probably more efficient. I don't know why I didn't think of that before, but. 

Lucas Akai  26:36 

And so in terms of getting the word out, when you say posters, these are put up in, like, community centers, or like, local clinics, or like? 

Ben  26:45 

All that sort of thing. And just bulletin boards and also on social media. But I think that for people that aren't housed or don't have an income, then obviously, staying abreast of social media isn't likely to be that easy. So the best way to do it is through the places where people gather regularly, like the overdose prevention site, opiate replacement clinic, or that sort of thing.  

Lucas Akai  27:15 

And so would these be considered, like, open attendance events? Like anyone can walk in and attend? Or do you have to, like, register? And then how does that work in terms of the compensation aspect, like, by showing up as your compensation or is there, like, a registration to that? 

Ben  27:33 

Well, we like to encourage people to register, but usually, we want, because of the stigma involved, we have had general public attend sometimes. But usually, we try to restrict it to people who are actually active drug users, so that they feel comfortable being there, and we try to compensate people, even if they attend for only part of the event, or whatever, we try to compensate everybody equally, because we understand that just, people have a lot going on typically, and don't have a lot of opportunity for earning income. So we want to, you know, we want people to be motivated to show up and remember that they can be compensated significantly for showing up. 

Ben  28:32 

So we try not to punish people for not getting there on time or having to leave early or whatever. Although it's hard to coordinate paying people if they're leaving at, I think you kind of got to stay to the end to get paid, but. Or be there at the end. Yeah. 

Lucas Akai  28:51 

The position you hold and with[in] the crisis, working with the peer health workers, what what would that position be called? 

Ben  28:58 

Peer support worker or peer educator is mainly what I call my position, although I would say I'm a project coordinator for [bleeped] peer support project. So but the work we do is peer outreach through peer education. 

Lucas Akai  29:13 

And so the the participants then, would they be like, peer support workers or trying, like, learning more training more, are they?  

Ben  29:23 

Well, as peers, peers are the people that, it just means it's, it's kind of a, an, I guess it's an somewhat ambiguous term. But most people's, most people who are saved from overdose, over 50%, anyway, as far as I understand, are saved by a peer or somebody else, living a similar lifestyle who's been trained in how to apply naloxone. And so just the term peer is used to refer to anybody in the lifestyle of drug use, who's motivated to help their friends stay alive, basically, or stay healthy. So, prior to the overdose crisis that was a lot more focused on disease prevention.  

Ben  30:18 

And nowadays, it's been much more emphasized to do Naloxone training with people. And that's also something that I think the general public is increasingly are, throughout the last few years of the crisis, there's been more interest in the general public to get that kind of training, if, if you work anywhere where somebody might overdose, at a restaurant in the bathroom, or any place where there's public lavatory, or there's, I guess, some reason why people might, you know, sheltering there or taking the opportunity to be out of the elements or that sort of thing. 

Ben  31:10 

People working in those kinds of situations, might want to learn to administer Naloxone in case there's an overdose, since there's been such an uptick in overdoses, generally, one of the last events we had was the International Overdose Awareness Day. And there was a Naloxone training set up on site in the park, where this event was taking place. And I think they did quite a few... 10, 10 people learned to administer Naloxone, just in that one afternoon, which I thought it was kind of surprising, but pretty impressive that there was that much interest. 

Ben  31:56 

I'm kind of sick of it myself, as far as this being the main focus in terms of helping people because it's like the very last resort kind of thing, the person is already almost dead at that point. And unfortunately, people go through that again and again, because of the lack of treatment opportunities and that sort of thing. So I haven't been motivated personally, to focus so much on training people to use naloxone in the last few years, because I just like to see, I've been focusing more on safer supply as a way of helping people avoid overdosing in the first place. 

Ben  32:44 

And I would like to see more effort put into, I guess, changing the laws and just changing public attitudes, rather than saving people from death's door at the last minute, its, you know, typically people are, they're saved from an overdose and they often just overdose again. And then you have to do that again. Or you're lucky, you can do it again, and, or they just die after that. So I just would like it if there was more resources went into preventing that from happening in the first place. 

Lucas Akai  33:25 

And do you think that there's a specific reason why the preferred, like, method or instructing or funding is going towards, like, Naloxone training over the preventative? 

Ben  33:36 

Well, it's a lot more complicated to provide treatment for people. And I don't know, I think it's just a level of cynicism and apathy in general that, saving lives is a priority, and that's good, but having a life would also be a good thing. 

Lucas Akai  33:59 

Is there any areas with the financial compensation, financial security that go, I don't want to say necessarily neglected, but like under the radar? 

Ben  34:09 

Well, it's particularly challenging in my position at the moment because of most of my income coming from the benefits for, disability benefits sort of thing. The income that I earn during the outreach work is considered exempt from the deductions that are usually applied to earning an income if you go above and beyond a certain amount in receiving benefits, but it's kind of complicated and when I worked for [bleeped] they had me sign a letter saying that because I have a mental condition, that is substance dependence or whatever, a mental health condition I'm allowed had to earn this income without it being deducted from my benefits.  

Ben  35:05 

Yeah, the taxes part is particularly tricky. And I guess I expect support from my fiscal agent, because they're very supportive generally. But it's a bit crazy just to be in this position where I'm trying to do something to benefit my community, but I have this sort of threat of potential negative impact to my financial reality. Sorry, my cat is very demanding.  

Lucas Akai  35:39 

No worries. No worries. Um, so are there any other, like, closing thoughts on the financial topics that you might want to share?  

Ben  35:49 

Just I guess I've, I've, in general in my life, because I've had so much support from my family, I've been able to focus on this without really worrying about it too much. But as I'm now over 50 years old, and my family lives far away. And I have increasing challenges in terms of maintaining my, my home. It's just the realities of not having stable income in terms of a salary or benefits or retirement plan or that sort of thing are much more looming large in my reality, then, prior to it all kind of happened at the same time, I got to be older and COVID happened and my house became more rundown.  

Ben  36:54 

And so I'm just dealing with all these things at the same time, which is pretty tough. That's just my individual situation. Most people have a harder time all of the time. And you know, I guess I wish I made more progress earlier on in terms of getting more opportunities established for people, including myself, but, you know, you can't really foresee these things or, especially with the COVID situation in the mix, really had a big impact on my sense of security and stability, as it did on many people. But that's, I guess, my final thought. 

Caitlin Burritt  37:42 

That brings us to the end of this episode of the Unsilencing Stories Podcast to listen to more interviews in the series, please go to www.unsilencingstories.com. And if you'd like to share your thoughts on the episode message us at unsilencingstories@gmail.com Thank you for listening