Downtown Eastside pharmacy tackles patients' addictions with a return to Mother Nature

Pier Health Resource Centre patients and staff are making outdoor excursions to Metro Vancouver mountains with an eye on mental health

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      Alex Gibb has always loved fishing. But, during the years he spent homeless and addicted to drugs in Vancouver's Downtown Eastside, he didn't have a lot of opportunities to practice his hobby.

      "I didn't have any fishing rods," Gibb told the Straight with a small laugh. "I had pawned them all."

      Then Gibb enrolled in Pier Health Resource Centre's opioid-substitution program, which supplies him with a regular and clean dose of hydromorphone, a prescription drug similar to heroin. It's meant Gibb no longer had to hustle for money on the street or deal with contaminated drugs that likely contain fentanyl. Not long after enrolling in the program, he was back in stable housing. Now, roughly a year and a half later, Gibb works at the pharmacy as a peer. He's also returned to fishing, and now is sharing his affection for the sport with other Downtown Eastside residents who struggle with addiction.

      "I mentioned to one of the nurses at the pharmacy that I was going fishing," he recounted in a telephone interview. "She said that was interesting. So we organized a group of people and went up to Capilano [River]."

      Since then, the loose group of pharmacy patients and staff has made a number of outdoors excursions to various forested locations around Metro Vancouver. Gibb said it's been great for participants' mental health.

      "It's been good to get a group of people together and just get out of the downtown core," he explained, "away from all the chaos down here, to a peaceful area where one's reminded to take a breath.

      "One can easily become complacent or fall into a routine or negative rut," Gibb continued. "So it's good to change your environment and exercise your options. I think it triggers positive things within yourself."

      A recent bestselling book by U.K. journalist Johann Hari delves into the mental-health benefits of a return to nature.

      "It’s been known for a long time that all sorts of mental health problems—including ones as severe as psychosis and schizophrenia—are considerably worse in cities than in the countryside, but the psychological effects of being cut off from the natural world have only begun to be studied properly in the past fifteen years," Hari writes in Lost Connections: Uncovering the Real Causes of Deprssion — and the Unexpected Solutions.

      "When you are feel that 'now everything is about you', Hari recounts University of Oxford primatologist Isabel Behncke explaining to him on a hike in the Alberta mountains. "You become trapped in your own story and your own thoughts, and they rattle around in your head with a dull, bitter insistence. Becoming depressed or anxious is a process of becoming a prisoner of your ego, where no air from the outside can get in. But a range of scientists have shown that a common reaction to being out in the natural world is the precise opposite of this sensation—a feeling of awe.

      "Faced with a natural landscape, you have a sense that you and your concerns are very small, and the world is very big—and that sensation can shrink the ego down to a manageable size," the book continues. “'It’s something larger than yourself,' Isabel said, looking around her. 'There’s something very deeply, animally healthy in that sensation. People love it when it occurs—its brief, fleeting moments.' And this helps you see the deeper and wider ways in which you are connected to everything around you."

      Travis Lupick / B.C. Coroners Service

      It's never been more dangerous for one to struggle with an addiction to opioids. Last year, there were 1,450 illicit-drug overdose deaths in B.C., up from 993 in 2016, 526 in 2015, and 368 the year before that.

      Pier Health Resource Centre's director, Bobby Milroy, said the outdoors program that Gibb brought together creates a unique opportunity for Downtown Eastside residents to escape limits that an opioid addiction can place on travel. It allows them to work on their mental health in an environment they might otherwise seldom have the chance to visit," he continued.

      "We live surrounded by natural paradise," Milroy told the Straight. "But if you're trapped in the urban core and you can't get out, it's a tragic thing. All of this is all around you but you can't access it because you're addiction compels you to stay near your doctor, your pharmacy, or your dealer."

      Pier Health Resource Centre director Bobby Milroy (left) and Alex Gibb, a peer worker at the pharmacy, have both noticed their mental health improve on trips they've taken to Metro Vancouver's great outdoors.
      Bobby Milroy

      Milroy said his patients are not the only ones feeling the benefits of Pier's outdoor program.

      "I looked at myself and I had the exact same problem," he explained. "I get trapped at work, doing the daily thing in the Downtown Eastside. This gave me a chance to get out in nature and just relax."