How a small town rallied together to address alcohol use

The Interior region, sometimes called the “Wine Capital of Canada,” has long had higher rates of alcohol-related hospitalizations and deaths compared to the provincial average. And like many towns in the region, Princeton hasn’t escaped the health and social challenges of alcohol.

But thanks to a chance meeting in Kelowna in 2021, Princeton has become one of the first towns in Canada to champion a medical approach to alcohol use disorder (AUD): treating AUD as a health condition like we do cancer and diabetes.

Nienke Klaver and husband Ed Staples, both long-time advocates for health care in Princeton, were shopping in Kelowna when they ran into Lori Motluk, the board chair of the Canadian Alcohol Use Disorder Society (CAUDS).  

Lori spoke to them about groundbreaking work that was being advanced by Dr. Jeff Harries, a pioneer in taking a medical approach – including prescribed medicine – to AUD. She also spoke about CAUDS’s community engagement work and their interest in pursuing a community engagement project.

Nienke and Ed jumped at the chance to bring the CAUDS engagement project to Princeton. Both had been on their own journeys with alcohol: Ed had stopped drinking five years before, but Nienke, a retired professional violinist from the Netherlands, had been unable to find an option that fit her goals and life.

Following a CAUDS presentation at a Princeton Community Health Table meeting – a coming together of community champions and partners, health-care providers, researchers from UBCO and the University of Alberta, and local government – the pilot project was launched.

In collaboration with a variety of community partners, including the Community Foundation of South Okanagan-Similkameen, and University of Alberta professor Dr. Tom Barker, CAUDS held its first community mobilization workshop on alcohol use disorder Nov. 16, 2022.

The workshop featured presentations from CAUDS, local physician Dr. Andrew Ashley, and three speakers from Interior Health including Dr. Silvina Mema, now IH’s deputy chief medical health officer (MHO), who authored the 2020 MHO report on alcohol. Nienke and Ed also spoke as people with lived and living experiences.

“At the workshop, we underscored Princeton’s success in managing disasters,” said Lori. “We asked, what would it look like if you used all your learnings from managing disasters to applying it to AUD, and what could we accomplish. We were looking at using community members’ skills to change how people seek care, how they are cared for, and the culture of drinking.”

From the workshop, a working group was formed and empowered to identify events and activities that resonated with the community’s needs. The objective was to spread the word about the medical approach to AUD, and encourage healthy, stigma-free conversations around alcohol. Some of these initiatives included:

• Support our Healthcare Society—founded by Ed and Nienke—attended a Princeton Volunteer Fair to introduce the community to CAUDS and the Princeton Alcohol Use Disorder Group that Nienke and Ed founded
• A school wellness conference and health fair with conversations with grade 9 students. ICBC lent the group special goggles so the students could see what it was like when inebriated
• The formation of a student-led AUD group at Princeton Secondary School. A group of students who are part of the PSS Student Council volunteered to develop initiatives aimed at informing the student body about AUD and available treatment options.
• A meeting with town council. Members of the working group including met with the mayor and council to encourage their support and participation
• A community-wide mocktail party in the town square called TGIF—thank goodness it’s free (as in alcohol-free). Coasters and coffee sleeves were also printed in support of the event and got people talking around the community
• A screening of the film “Smashed: Breaking the Cycle of Alcohol Use Disorder” which documents the work of Dr. Harries and his battle with ALS. The screening was followed by a panel discussion
• The formation of a Facebook Princeton Alcohol Use Disorder Group

The local Save-On-Foods also got on board with the changes that were happening in Princeton. “Non-alcoholic beverages are definitely a fast growing grocery category,” said Brandon McArthur, store manager at Save-On-Foods Princeton. “As the demand for non-alcoholic beverages has increased, we’ve doubled our shelf space for them in the past couple of years, and the innovations and products in this category are a hit with our customers. We’re thrilled to support events like Mocktail Party as part of our commitment to be an active member of the community and a good neighbour in Princeton.”

One of the clinicians who spoke at the workshop was Karen Fulton, a psychiatric nurse and nurse prescriber at Interior Health (IH). “Our physicians in Princeton have been operating in this model for some time,” said Karen. “But the working group came and was able to raise awareness in the community of the CAUDS approach.” After the group came together, Karen reached out to local restaurants to encourage them to add mocktails to their menus.

Karen also works closely with Dr. Andrew Ashley, a family physician in Princeton and clinical advisory member of CAUDS. “If I have a patient struggling with AUD, Dr. Ashley can step in and support them,” she says.

Since the working group was formed, Karen has also noticed changes in how patients are cared for in Princeton. “It’s been easier for the patients I’m working with to talk about their alcohol use. The conversations have been easier,” she explains.

Tanya Osborne, a community health facilitator with Interior Health’s Healthy Community Development team, has been involved with the Princeton Alcohol Use Disorder Working Group and project since its inception. She and her team helped create a government alcohol toolkit after the 2020 MHO report was published.

“The workshop was a great opportunity to bring this toolkit forward,” says Tanya. “It was an opportunity to share some ideas about how municipalities could support a change in the culture around alcohol.

“All of these things really do add up and make a big impact. It’s about changing the way society thinks about alcohol and alcoholism,” says Tanya.

The community of Princeton has come together to create grassroots change in how alcohol is viewed and talked about. Thanks to informal information sharing, social media, events and initiatives, there’s a buzz in town about how AUD can be treated. What has been a topic surrounded in stigma and shame, conversations are now more positive and energized.

While Ed and Nienke are taking a well-deserved rest and have stepped away from their busy health advocacy work for now, they plan to continue working with the high school. “The students have such great ideas,” says Ed. “We’ve talked about having booths at Princeton Posse hockey games, for example, to engage the hockey community which traditionally encompasses a culture of drinking.”

“I feel like I’ve gotten my life back since I started taking [AUD medication} Naltrexone,” adds Nienke. “I am so happy knowing that other people do not have to suffer needlessly anymore.”

Help is available for alcohol use. Your doctor or trusted health-care provider can help show you how to safely reduce consumption and offer medications to reduce cravings. Ask your doctor about medications used to support people in changing how much alcohol they drink. 

Call 310-MHSU (6478) if you have any questions or doubts. You can also explore these resources:

• My experience with alcohol use disorder – Matthew’s story
• Individual or group counselling
• Bed-based treatment services
• Outpatient withdrawal management (detox)
• Pregnancy support
• Cultural and spiritual care
• Your Guide to Medications for Alcohol Use Treatment: English; Punjabi; Chinese; German 

For some people, stopping drinking alcohol without medical support can be life threatening.

If you’re experiencing feelings of hopelessness and thoughts of self-harm, these services are available 24 hours a day, seven days a week, including holidays:

• Interior Health Crisis Line: 1-888-353-CARE (2273)
• Suicide Crisis Line: 988
• KUU-US 24/7 Indigenous Crisis Line: 1-800-588-8717
• Metis Crisis Line: 1-833-638-4722