Let’s Talk Opioids

Strengthening community through dialogue

Nicole Bodner, BA (Hon), and Kristina Jenei, BSN, RN

Reprinted from "Opioids" issue of Visions Journal, 2018, 13 (3), p. 37

In British Columbia, rates of overdose-related death are out of control. Community attitudes bounce between compassion, fear and rejection. The situation continues to be seen as a problem of individuals. But substance-related harm is not only about the individuals who use drugs. It results from a breakdown in human connectedness. 

Addressing the overdose crisis—in BC and beyond—must therefore include healing and nourishing the bonds of community. Strong communities make for healthier citizens. When our communities nurture human connections, we are better able to face social challenges. 

How can we build strength and resilience in communities, especially those already hit hard by overdose deaths?

Addressing complex issues such as problematic opioid use and overdose requires that we build a shared understanding. Different people hold different views about how to move forward. Yet even the best efforts of recognized experts in the medical research and health services fields have not been able to resolve the crisis or reduce the number of overdoses. No one has all the answers. Now is a good opportunity to begin having honest and open community dialogues about drugs and drug policy—dialogues that include input from a range of stakeholders, including those with lived experience around drug use.

What is dialogue?

Ironically, dialogue is more about listening than talking. The sort of listening that is important in dialogue demands our empathy and our genuine curiosity about the experiences of other people—including their assumptions, beliefs and values. When people feel listened to, they also feel validated and respected. The experience of being listened to empathically widens our minds and opens our hearts—and prepares us to listen appreciatively to others with the same kind of engagement and respect, even to people with radically different experiences and points of view.

Few of us ever take the opportunity to engage with people who hold different views. Our social networks are generally made up of people who share our beliefs. Yet when we engage with people who are different from us, we get to see another side of the human story. Even if we do not wholly agree with the new perspective, listening openly and empathically expands our understanding. 

How can we engage in dialogue? 

Unlike other forms of public communication (for example, debates or negotiations), dialogue is not meant to lead immediately to agreement or action. Instead, the hope is that we will come away from dialogue with a new understanding of the subject, of each other and of ourselves. This new understanding enables us to work together more effectively as community members. As a result, our communities become more flexible, and better able to respond to challenges. And as individuals and communities, we develop a greater sense of control over our own lives and well-being. 

Dialogue is more than a process or methodology—it is a way of being. It is an art that requires reflective practice. It is the skill of connecting and building bridges between individuals with different views, especially in times of change.

But meaningful dialogue doesn’t just happen. Genuine dialogue occurs only when enough of the necessary ingredients are present. We can do our best to provide those ingredients and maintain a certain flexibility and readiness for dialogue, but we cannot force it into being.

What are communities in BC currently doing to promote dialogue?

In the spring of 2017, 27 coalitions representing both rural and urban centres in the province’s five health regions received support from the province-wide Opioid Dialogues project, a community-based dialogue initiative funded by the Ministry of Public Safety and Solicitor General and managed by the Canadian Institute for Substance Use Research (formerly CARBC). These community projects included informal gatherings such as coffee-shop dialogues and booths at community events; meal-sharing at grassroots-style community dinners and facilitated dinner programs; art-based ventures that used drawing, painting, poetry, plays and photography to inspire open-ended conversation; programs that incorporated Indigenous traditions such as talking circles and other ceremonies; and community forums and other public-storytelling opportunities (such as podcasts and TEDx-like events). 

In October 2017, due to the continued interest in the Opioid Dialogues project, the Ministry provided a second, larger grant to the institute to support even more communities in their work to facilitate public dialogue. To date, dozens of coalitions from around the province have applied for funding and are working on enhancing their understanding of how to facilitate egalitarian, non-judgemental conversations with a range of community stakeholders.

Does dialogue really work?

Based on reports from participating communities, the practice of dialogue is already having some transformative effects on individuals and communities affected by the opioid crisis.

For example, Our Cowichan Communities Health Network, together with various partners, hosted an event at which people were separated into groups of 10 and encouraged to share their fears and concerns about the current opioid situation. Tables of service providers, members of the business community, parents and other stakeholders participated in a series of conversations before re-grouping to talk about what they had learned. At the end of the evening, the energy in the room of over 100 participants had shifted from “You need to do something about the needles” to “What role can I play?” and “I learned a lot because this problem belongs to our communities.” 

A member of the Surrey North Delta Local Action Team commented on how dialogue had increased a respectful understanding between community members: “I was pleasantly surprised at one table after hearing a mother talk about how badly the police officers had acted when she called 911 on her son who wanted to harm himself. A gentleman was sitting at the table who disclosed he is a police officer and then went on to apologize to the mother for what had happened. Both parties got to share their sides and then they both admitted to how hard it must be to be on the other side of things. Neither party defended their position or tried to make the other agree with them or change their mind.”

Finally, a dialogue facilitator with the non-profit PHS Community Services Society in Vancouver pointed out, “Everyone is open about the struggle of using drugs, but there is fear [of] what life would look like without drugs. They asked me what recovery meant to me. I said it’s about finding inner peace with who you are as a person. When our group was over, lots of participants stated that they are very grateful for having a place where they can use their voice. I believe everyone enjoys it because it’s not a place of judgement, but a place to heal.”

We can all contribute to the dialogue that needs to happen in our province. All it takes is the willingness to be curious about and connect with other community members holding different views. The more we devote ourselves to listening empathically and to caring about people who are different from ourselves, the healthier and stronger we will all be as we work towards freeing our communities from the opioid crisis and beginning the healing process. 

 
About the authors

Nicole is a research assistant for the Canadian Institute for Substance Use Research (CISUR, formerly CARBC) and the coordinator for the province-wide Opioid Dialogues project, funded by the Ministry of Public Safety and Solicitor General

Kristina is a research assistant for the Canadian Institute for Substance Use Research and the coordinator for the Let’s Talk Cannabis project, a national project funded by Health Canada on dialogue in view of upcoming changes to cannabis legislation

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