Thunder Bay high school addressing opioid addiction among Aboriginal students

In brief

institutional building with a grass front yard
Dennis Franklin Cromarty High School

Some First Nation high school students in Thunder Bay have complex mental health issues. Fallout from a 20-plus year epidemic of youth suicide in their home region has impacted these students negatively as there is an overwhelming burden of unresolved grief among the generations. These students have lost siblings, parents, aunts and uncles to suicide: 451 community members of Nishnawbe Aski Nation.

A high rate of opioid addiction among the students at Dennis Franklin Cromarty (DFC) High School in Thunder Bay prompted DFC administrators to develop an opioid withdrawal management program that would reduce addiction and increase student success. EENet’s Kim Karioja has produced a new edition in its Promising Practices series, focused on the program and its use of suboxone.

Promising Practices profiles innovative practices and initiatives from around Ontario. Read it below or download the PDF.

What’s the problem?

Some First Nation high school students in Thunder Bay have complex mental health issues. Fallout from a 20-plus year epidemic of youth suicide in their home region has impacted these students negatively as there is an overwhelming burden of unresolved grief among the generations. These students have lost siblings, parents, aunts and uncles to suicide: 451 community members of Nishnawbe Aski Nation. In 2011, several students at Dennis Franklin Cromarty (DFC) High School admitted to struggling with opioid addiction. This prompted the DFC administrators to develop a program that would reduce addiction and increase student success.

DFC provides secondary education for First Nation students from 19 remotes reserves in Northwestern Ontario. It was designed for and by First Nations people. OxyContin addiction was a problem: students were missing class and having trouble concentrating due to opioid withdrawal symptoms. 

What are they doing about it?

DFC designed an in-school program that includes an opioid withdrawal management program using suboxone. Suboxone is the brand name for the pill that is a combination of buprenorphine and naloxone. It is used to help control withdrawal symptoms in a person who has stopped taking opioid drugs, by acting on the brain receptors and nervous system.

Suboxone has been used for many years in the United States and Europe but is fairly new to Canadian treatment providers. The goal of the program is for safe detoxification under the supervision of a professional team that includes a physician, nurse practitioner, case manager, and addictions counselor. Treatment initially focuses on harm reduction with the ultimate goal of abstinence.  

The program began in February 2011. Students self-selected to participate. Although nine students signed up for the Cycle 1 program one student was not able to participate due to a medical condition. A second group of 9 students entered the program in March 2011 as Cycle 2 got underway. Thirteen students enrolled in the program in October 2011, as part of Cycle 3. A total of 50 students have been treated and 9 have graduated from grade 12. Most are now attending post-secondary education programs.

The majority of students who started the program were successful in quitting OxyContin by the end of the first week. All students did experience challenges and relapsed at one point or another and dosage changes were able to decrease craving and allow for further recovery. Some students stopped using Oxycontin but turned to alcohol as a way of fitting in with their peer group.

But since motivation was high, most students followed through with treatment and were supported by clinicians when relapses occurred. Also, with each new group of students starting treatment, the treatment team made adjustments to the program based on what was learned from the previous group. The team was always looking for ways to improve care and adhere to the goal of offering respectful, reliable and confidential service.

Why does it work?

The young people who require supports and services are new to the city of Thunder Bay and are often overwhelmed by the cultural changes in a large centre. Offering the program within the school makes it easier to monitor the students and to provide other psychosocial programming for them. Students feel safe in the environment because they have the support of school staff and they are familiar with the services of the clinical team. Allowing flexibility in the program increased student success in the program as the treatment team engaged with the student based on their current situation.

What’s next?

The treatment team will be applying for continued funding as the pilot program grant has expired. Members of the treatment team will be making presentations about the success of the program at Canadian and American health conferences in late 2013.

For more info, please contact Mae Katt, Primary Health Care Nurse Practitioner, Dennis Franklin Cromarty High School, maekatt [at] shaw [dot] ca.

Author: Kim Karioja