Category "Canada"


Daphne Bramham: Canada’s other public health crisis also needs urgent attention

by admin

There is a very real and deadly health crisis in B.C. from which two people died yesterday and two more will likely die today, tomorrow and the days after that.

It’s not COVID-19, and no news conference was hastily called to talk about it.

Most of those dead and dying are blue-collar guys in what should be the prime of their lives.

This is the reality as B.C. lurches into the fifth year of an opioid overdose crisis. It’s a seemingly unending emergency that by the end of 2019 had already killed 5,539 people here and more than 13,900 across Canada.

Five years in, this crisis has become normalized, with the only certainty as we face another day is that first responders are now better at resuscitating victims because, year over year, the calls have only continued to increase.

Last week, Prime Minister Justin Trudeau appointed his top ministers to a committee tasked with responding to the COVID-19 crisis. At that point, Canada had only 30 confirmed cases. Of the 21 B.C. cases, four of the patients have fully recovered.

Not to belittle the concerns about COVID-19 becoming a global pandemic, but with nearly 14,000 dead already, no committee — high-level or otherwise — has yet been struck to devise a national addictions strategy that would deal not only with opioids, but also the biggest killer, which is alcohol. A 2019 report by the Canadian Institute for Health Information found that 10 Canadians die every day from substance use, and three-quarters of those deaths are alcohol-related.

During the 2019 election, the issue flared briefly after Conservatives placed ads — mainly through ethnic media — claiming that Trudeau’s Liberals planned to legalize all drugs, including heroin.

Already beleaguered, Trudeau not only denied it, he quickly disavowed the resolution overwhelmingly passed at the party’s 2018 convention that called on the Canadian government to treat addiction as a health issue, expand treatment and harm reduction services, and decriminalize personal-use possession of all drugs, with people diverted away from the criminal courts and into treatment.

Trudeau disavowed it again this week when a Liberal backbencher’s private member’s bill was put on the order paper.

Liberal member of Parliament Nathaniel Erskine-Smith (in front) pictured in 2018.

Adrian Wyld/The Canadian Press

Depending on how you read Bill C-236, it’s either calling for decriminalization or legalization. Regardless, the fact that Nathaniel Erskine-Smith’s bill will be debated at least gets it on the political agenda because unless there are some major changes, Canadians are going to continue dying at these unacceptably high rates that have already caused the national life expectancy to drop.

Erskine-Smith, an Ontario MP from the Beaches-East York riding, favours a Portugal-style plan of which decriminalization plays only a small part.

But parliamentary rules forbid private member’s bills from committing the government to any new spending, so he said his bill could only narrowly focus on decriminalization.

The slim bill says charges could be laid “only if … the individual cannot be adequately dealt with by a warning or referral (to a program agency or service provider) … or by way of alternative measures.”

Erskine-Smith disagreed with the suggestion that it gives too much discretionary power to police — especially since in B.C., it’s prosecutors, not police, who determine whether charges are laid.

Still, what he proposes is quite different from what happens in Portugal.

There, police have no discretionary power. People found with illicit drugs are arrested and taken to the police station where the drugs are weighed, and the person is either charged with possession and sent to court or diverted to the Commission for the Dissuasion of Drug Use to meet with social workers, therapists and addictions specialists who map out a plan.

Since private members’ bills rarely pass, Erskine-Smith doesn’t hold out much hope for his.

It created a firestorm on social media, with some recovery advocates pitted against advocates for harm reduction, including full legalization.


Federal Conservatives also repeated their trope that drug legalization is part of Trudeau’s secret agenda.

Meanwhile, Alberta’s United Conservative government inflamed some harm-reduction advocates with the release of a report on the adverse social and economic impacts of safe consumption sites, even though it didn’t recommend shutting them down.

The report acknowledged that they play an important role in a continuum of care, but it also called for beefed-up enforcement to lessen the chaos that often surrounds them.

The committee questioned some data provided to them that suggested Lethbridge — population 92,730 — may be the world’s most-used injection site.

The committee also questioned why some operators report all adverse events, including non-life-threatening ones as overdoses, leaving the impression that without the sites “thousands of people would have fatally overdosed.”

Among its recommendations are better data collection using standardized definitions as well as better tracking of users to determine whether they are being referred to other services.

More than a year ago, Canadians overwhelmingly told the Angus Reid Institute that they supported mandatory treatment for opioid addiction.

Nearly half said they were willing to consider decriminalization. Nearly half also said that neither Ottawa nor the provinces were doing enough to ease the epidemic.

It seems Canadians are eager for change even if they’re not yet certain what it should look like. The only ones who seem reluctant are the politicians.



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Five things to know about coronavirus in B.C.

by admin

While the World Health Organization has not declared the coronavirus an outbreak on an international scale, the B.C. Centre for Disease Control has been closely monitoring for possible cases closer to home.

On Tuesday, officials announced the first case of coronavirus was presumed in B.C. Test results expected back by Thursday will confirm whether the individual has coronavirus.

Here are five things to know about the virus.

What is coronavirus?

The new coronavirus, named 2019-nCOV, is a respiratory infection. There are many types of coronavirus, some linked to the common cold, but this one is new.

It is similar to other respiratory illnesses and symptoms include a fever, dry cough, sore throat and headache. While most cases are mild, some individuals may experience more severe symptoms such as shortness of breath and difficulty breathing, and may experience pneumonia in both lungs. It may take up to 14 days after exposure for symptoms appear.

The illness was first detected in December in a group of people in Wuhan City, located in the Hubei province of central China, following exposure to live animals at the Huanan Seafood Market; the market has been closed since Jan. 1 for cleaning and disinfection.

Recent cases, however, have surfaced without exposure to animals or markets, suggesting that the virus can spread between people though it remains unknown how easily this happens.

The virus has been labelled the Wuhan coronavirus to reflect the location in central China where it was first identified.

Staff members (in black) check the body temperature of passengers after a train from Wuhan arrived at Hangzhou Railway Station in Hangzhou, China’s eastern Zhejiang province.

STR/AFP via Getty Images

How far has it spread in Canada and B.C.?

The first case of coronavirus has been presumed in British Columbia, according to B.C. provincial health officer Dr. Bonnie Henry.

Henry said Tuesday that the patient, a B.C. man In his 40s, arrived in Vancouver last week after travelling to Wuhan, China. He started experiencing symptoms 24 hours later. Henry says the man is not in hospital but is being kept isolated at home and no members of his family have shown any symptoms as they are being monitored by health officials.

The province expects to have test results from the man’s case back from the National Microbiology Laboratory in Winnipeg within 48 hours. If confirmed, it would be the first case of coronavirus in B.C.

Elsewhere in Canada, a man in Toronto was reported as the first case of novel coronavirus, while his wife is presumed to be the second. A man in Seattle has also been confirmed to have coronavirus, after he started experiencing flu-like symptoms.

China has confirmed more than 4,500 cases of a new form of coronavirus, with at least 106 deaths. It has also been reported in Japan, Taiwan, South Korea and Thailand.

As of Jan. 28, the World Health Organization reported:
• 4,593 cases confirmed around the world
• 4,537 of those cases were in regions of China (including Hong Kong SAR, Macau SAR and Taiwan)
• 56 cases confirmed in 14 other countries outside of China
• 106 deaths, all located in regions of China

Jan. 28, 2020 report on coronavirus cases, courtesy of the World Health Organization.

Are there precautions I can take against coronavirus?

Health officials say special precautions are not necessary other than the usual steps taken during a regular flu or winter season.

Regular handwashing, coughing or sneezing into your elbow sleeve instead of your hands, disposing of tissues properly, and avoiding contact with people who are sick are adequate steps to prevent the spread of respiratory illnesses, say health officials.

While some have opted to wear surgical or face masks during this time, experts say the masks are not entirely effective or necessary for the average person going about their daily lives.

Surgical face masks do not provide a tight seal around the face so while it does protect from respiratory droplets from a sneeze or a cough, the coronavirus is still present in airborne droplets that can get around a surgical mask.

A N95 mask, which features a structured cup shape, does provide a secure seal if worn properly and filters more particles; however, the current level of risk is still low enough that unless you’re a medical professional, a N95 mask isn’t needed.

A man wears a masks as a precaution due to the coronavirus outbreak as people arrive from the International terminal at Toronto Pearson International Airport in Toronto on Saturday, January 25, 2020. Canadian health officials announced a first presumed case in Ontario.

Nathan Denette /


What should I do if I’ve been travelling or will be travelling soon to an affected region?

If you’ve recently travelled and become ill either during or after your return, notify your health care provider, local public health office or call 811. It’s best to call for information and advice before heading to your local doctor’s office or emergency room.

If you have plans to travel to any affected regions and no longer feel comfortable doing so, check with your airline or travel specialist to see if it’s possible to cancel or reschedule your trip. China Eastern is among the airlines that are now offering refunds or exchanges for eligible flight itineraries, free of charge, while United was the first U.S. airline to cancel some flights to China.

Travellers who go ahead with their plans are reminded to wash their hands regularly, avoid contact with live animals at farms and markets, avoid eating raw animals or meat, and avoid surfaces with animal secretions such as blood and droppings.

The Canadian government is encouraging Canadians to avoid all travel to the Hubei province where the virus was first detected.

How are other countries or health authorities dealing with coronavirus?

As a result of fears around coronavirus, some cities around the world cancelled or banned large gatherings during the recent Lunar New Year weekend to prevent the virus from spreading.

Both the Hong Kong Disneyland Resort and Shanghai Disney Resort were both shut indefinitely in recent days to prevent spread, along with Hong Kong’s Ocean Park amusement park. The 2020 Standard Chartered Hong Kong Marathon was also cancelled.

The U.S. State Department had coordinated an evacuation flight to ferry American consulate staff, their families and a small number of private citizens out of Wuhan and over to California on Tuesday. Japan had also sent a first plane to Wuhan to evacuate its nationals, after the Chinese city was locked down following the outbreak.

Closer to home, the Live in Langley Chinese Association cancelled a gala this weekend that was sponsored by the Township of Langley. Vancouver’s Chinatown celebrations, however, went on as planned.



Daphne Bramham: B.C. group’s call for legally regulated heroin sales is unfounded

by admin

Desperate times call for desperate and often unfounded measures. And, that’s exactly what a new report from the B.C. Centre on Substance Use is proposing in response to the unabating opioid overdose crisis.

It wants government to immediately clear the way for “heroin compassion clubs.” These would be free-standing co-op stores staffed by health care providers selling untainted heroin — diacetylmorphine — to members at the same price or less than street heroin. It would be free to members who can’t afford it, even though the report acknowledges that the risk of street resale of prescription opioids is greatest when the drugs are free.

And that would all be possible, the report says, because of things like volume discounts and “other economies of scale.”

“It would be precisely measured and dispensed in known quantities and at relatively safe doses,” says the report that was released Thursday. The emphasis has been added.

The heroin would be in powdered form, rather than an injectable liquid, just like it is on the street except this would be untainted heroin, not heroin cut with caffeine to prevent overdoses or any other additives to bulk up the product.

Members would be able to buy a couple of days’ supply and take it home with them.

Membership would be low-barrier, a term that’s not defined in the report.

Applicants would be screened by staff members who are “health care providers,” although not necessarily addictions physicians.

The co-op’s board members would be people with “lived experience” — a.k.a. users and former addicts.

Evan Wood, the head of the B.C. Centre on Substance Abuse, says the proposal is unprecedented so there is no evidence that it would reduce overdose deaths or disrupt organized crime’s role in fentanyl, money laundering or housing affordability, which is what’s advertised on the report’s cover.

“To be fair, we are in an unprecedented situation with fentanyl and the prescription opioids overdose crisis,” Wood said. “We are in uncharted waters.”

The two main goals are keeping users alive and disrupting the evils of organized crime.

These are ambitious albeit inappropriate goals for an organization whose mandate is to “develop, help implement, and evaluate evidence-based approaches to substance use and addiction.”

Using heroin to treat users isn’t new. But every other trial or program has a treatment component whether they’re at Vancouver’s Crosstown Clinic, the PHS Community Services or in European countries.

In Europe, heroin is prescribed with the goal of stabilizing users to a point where they can get jobs, form relationships or switch to other (cheaper) opioid replacement therapies such as methadone or Suboxone. (The annual cost per patient in European prescription-heroin programs ranges from $19,000 in Switzerland to $30,000 in the Netherlands.)

But there’s nothing like this in Canada.

“I’m not aware of the existence of ‘heroin clubs’ anywhere else,” Jann Schumacher from the Swiss-based Ticino, an organization of addictions specialists, said in an email. “In Switzerland the heroin assisted therapy is strongly regulated and always under medical control.

“Our Swiss model (heroin assisted treatment) has strong evidence as a harm reduction method, in getting people into treatment and stabilizing their lives, and in reducing the illegal market.”

To qualify, Swiss patients must have at least two years of opioid dependence and at least two failed tries using other addictions treatment methods. They are only allowed to the drug in pill form and take it with them after being in the program for six months and only if it’s necessary to hold down a job.

Drug-related crime in Switzerland has decreased 90 per cent. But compassion clubs would have no effect on drug-related crimes because members would still have to find some way to buy the heroin.

As for disrupting organized crime, the report suggests that compassion clubs would be competing for sales, influencing both the demand and market for heroin.

“The establishment of a regulated and controlled supply of fentanyl-unadulterated heroin may increase demand for street heroin among persons who use street opioids and force organized crime groups to return to the provision of heroin as part of the illicit drug market,” the report says.

And since violence is criminals’ usual response to unwelcome competition, it seems likely that they will attempt to terrorize compassion clubs out of business.

What makes this proposal all the more absurd is that it is aimed only at British Columbia. Surely, low-barrier access to pure heroin would be a magnet to every opioid user across the continent, let alone Canada.

British Columbia is already the epicentre of the overdose crisis just as it was ground zero for the cannabis legalization movement that began with compassion clubs dispensing so-called “medical marijuana,” which led to an explosion in unlicensed and unregulated pot shops.

It’s also where Canada’s harm-reduction model was birthed with free needles, supervised injection sites and readily available naloxone. But it was supposed to be part of a four-pronged strategy just as Switzerland’s is — a strategy that includes access to treatment and recovery as well as education aimed at dissuading drug use.

But since 2017, the $608 million spent by the B.C. government has gone almost exclusively to harm reduction. Yet, the number of overdose deaths is still rising.

It’s clearly not working and Canadians can’t help noticing now that 9,000 are dead including more than 4,000 in British Columbia. According to an Angus Reid poll released last week, 85 per cent of Canadians want mandatory treatment for opioid addiction. Forget legalization or free drugs, decriminalization was favoured by only 48 per cent.

Although the B.C. Centre on Substance Abuse is proposing a radical and untried solution, Wood dismissed mandatory treatment as an option because it’s unsupported by evidence.

As for decriminalization, Wood said, “The problem with it is that you still leave control of the market to organized crime. The user is not criminalized, but they still have to go to the black market.”

Yet, 20 years’ worth of evidence from Portugal show that paired with assertively promoting treatment and recovery, providing universal access to those programs and enforcing drug trafficking laws, decriminalization works.

There, it not only effectively brought an end to Portugal’s heroin overdose crisis, addiction and usage rates for all drugs including cigarettes and alcohol are now among the lowest in Europe.


Twitter: @bramham_daphne


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Nova Scotia says it won’t appeal accessibility ruling by human rights board – Halifax

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The province says it won’t appeal a Nova Scotia human rights ruling that it discriminated against people in wheelchairs by failing to enforce a regulation requiring restaurants to have accessible bathrooms.

The independent board of inquiry said in a decision released in September that the province did not regulate food safety provisions on accessible washrooms in restaurants with patios.

READ: ‘Accessible washrooms should include everyone’: N.S. human rights inquiry begins

Chairwoman Gail Gatchalian ordered the Environment Department to interpret, administer and enforce the regulations as they appear.

The Justice Department says it will fast track an action plan to ensure the human rights decision is implemented in a timely fashion.

WATCH: Nova Scotia’s Accessibility Advisory Board holds inaugural meeting in Halifax

It will be developed in collaboration with the disability community and the restaurant industry.

The department says its effort will be supported by the newly established Accessibility Directorate and the Nova Scotia Accessibility Advisory Board.

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‘Accessible washrooms should include everyone’: N.S. human rights inquiry begins – Halifax

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Imagine only being able to go to a limited number of food establishments because the majority of them don’t have restrooms you’re able to access. Those living with physical disabilities in Nova Scotia say that is their ongoing reality.

Four people are now fighting the provincial government to address accessible bathrooms in a human rights inquiry.

“We have under a public health law, a requirement that every licensed food establishment has washrooms for the public that are convenient and those aren’t administered in any way that takes into account accessibility and our point of view is the public includes everybody, includes people who use wheelchairs for mobility and a convenient washroom for them is one that is accessible,” David Fraser said, the lawyer who’s representing the case on behalf of the complainants.

READ MORE: Nova Scotia Human Rights Commission to hold inquiry into restaurant washroom access

Fraser says the start of the inquiry is the latest stage in what’s been a “long process.”

He says his clients originally went to the Human Rights Commission to register a complaint about the way the province enforces accessible washrooms in the realm of public health. The commission rejected their complaint.

Fraser then took on the case pro-bono and the matter went before the Nova Scotia Supreme Court, where a court order was issued to accept the complaint.

That was last year, and since then the commission has appointed a tribunal to hear the matter.

The inquiry is being overseen by Gail Gatchalian, a human rights and labour law lawyer. Gatchalian has also granted intervenor status to the Restaurant Association of Nova Scotia, meaning they have the right to participate and provide comment on any legal issues being considered throughout the proceedings.

Fraser says the public-health law and regulations requiring accessible restrooms are in place, but how the government interprets them are key.

“Right now as we understand it, the government interprets the regulation in such a way that the public is the ‘average’ public and ‘convenient’ is only seen as a matter of, ‘Does the location of the washroom compromise food safety?’ And in our view, accessibility to the washroom actually has a big impact on that,” Fraser said.

One of the complaints is from Gus Reed, who wrote to the municipality when accessible patios were being considered, asking to consider the lack of accessible washrooms.

“I didn’t receive a response to that and in my own way, I pursued that by trying to speak with the minister of the environment,” he said.

Reed said he did have a meeting with the Department of Environment but that it was “inconclusive,” leading him to file a human rights complaint.

Reed ultimately wants the government to view inaccessibility to washrooms as a food-safety issue because if people with physical disabilities can’t wash their hands, it could impact the health safety of the restaurant as a whole.

Fraser reinforces that point by referencing an outbreak of Norovirus that occurred in a Halifax restaurant.

“Somebody came for a cruise ship and they transmitted Norovirus — a whole bunch of people on the staff got sick and hand hygiene is the number one thing that deals with those issues,” Fraser said.

The Department of Environment says regulations state that washrooms be in a convenient location, and the government recognizes the importance of accessibility.

“The province is working to address issues of accessibility through the Accessibility Act, with the goal of being accessible by 2030,” the department said in a statement to Global News.

The inquiry will run over the next several days.

© 2018 Global News, a division of Corus Entertainment Inc.

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Justice orders N.S. Human Rights Commission to accept accessibility complaint – Halifax

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The Nova Scotia Human Rights Commission (HRC) has to accept a complaint by a group alleging systemic discrimination by the province in how it enforces regulations regarding washroom accessibility.

READ MORE: Wheelchair users ask court to force human rights commission to hear their complaint

The commission rejected the complaint twice last year and referred it to an ombudsman.

In a written decision dated March 28, Justice Frank Edwards said the decisions made by two human rights officers dealing with the initial complaint were “unreasonable.”

One argument made in court from the commission involved the number of requests it gets.

“Counsel for the Commission argues that the HRC would be overwhelmed if every inquiry had to be treated as a complaint. I am not impressed with that argument,” said Edwards.

He also said that the HRC has to inquire into complaints, per the Human Rights Act [PDF].

David Fraser, who represented the six applicants on a pro bono basis, said the group didn’t take issue with specific restaurants but, rather, how the relevant government departments would waive the requirement for an accessible bathroom in a number of instances.

“So when a restaurant builds a patio, they have to make that patio accessible, but they don’t have to provide an accessible washroom,” he said on Wednesday.

Paul Vienneau, an applicant who uses a wheelchair, said it’s important for him to be able to wash his hands before eating at a restaurant.

“I carry an unnamed hand cleaner with me constantly, which is not a legit answer to this problem,” he said.

A spokesperson for the HRC said that no one was available for an interview on Wednesday, but a statement was provided.

“While the Commission will accept direction of the court to process this particular complaint, the Commission will be appealing the Court’s interpretation of the Human Rights Act,” it read.

© 2017 Global News, a division of Corus Entertainment Inc.

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