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Category "Fentanyl"

9Mar

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.

Related

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.

dbramham@postmedia.com

twitter.com/bramham_daphne

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25Feb

Daphne Bramham: It’s not enough to just keep overdose victims alive

by admin

There was some good news in the 2019 data from the B.C. Coroners Service. Overdose deaths in the province declined for the first time since fentanyl-tainted drugs hit the streets and a public health emergency was declared in 2016.

The decrease was significant — down 36 per cent from 2018 — even though the death toll remains heartbreakingly high. As B.C. enters its fifth year of the crisis, nearly three British Columbians are dying every day.

It does mean that all of the money poured into this crisis — for naloxone kits, the training for paramedics, medical professionals and laypeople in how to use naloxone, more supervised consumption sites, and more people now on prescriptions for drugs like methadone and Suboxone to staunch addicts’ opioid cravings — is keeping more people alive.

But that’s really where the good news ends.

Alarmingly, the number of 911 calls has continued to climb.

Paramedics and other first responders took more than 24,000 calls last year, with calls spiking to more than 130 overdose alerts on “cheque days” or “welfare Wednesdays.”

Being revived from an overdose or living with an opioid addiction comes at a high cost.

Opioids affect the receptors in the brain, causing breathing to become dangerously slow, which in turn slows the heart and sometimes causing cardiac arrest. When the hearts doesn’t pump at capacity, less oxygenated blood makes it to the brain. Without oxygen, brain cells die — and they don’t regenerate.

It’s called toxic brain injury.

Within the coming weeks or months, the B.C. Centre for Disease Control will release data on the prevalence of brain injury among opioid users, including those who have been successfully restored to life with naloxone.

“We know that many hundreds of people will need a lifetime of care,” said Dr. Perry Kendall, who raised the alarm during the coroner’s news conference earlier this week. “It will be a tremendous burden.”

It’s far from the only one.

The burden carried by first responders is different and no less costly. They are burning out and checking out of the system, unable to cope physically, mentally or emotionally with the constant stress of being called to deal with all the overdoses.

Related

This is not to say that harm-reduction measures aren’t working. No one disputes that they are keeping many people alive.

But until now, little attention has been focused on the quality of their lives, post-overdose.

Five years into the public health emergency, Chief Coroner Lisa Lapointe said B.C. still doesn’t have a comprehensive system that includes prevention, treatment and recovery.

The lack of a seamless system is particularly problematic and even deadly for people in rural areas and those coming out of jails and prisons, according to Dr. Nel Wieman, senior medical officer at the First Nations Health Authority.

The numbers back that up. The death rate in the Northern Health Authority, at 22.5 per 100,000, trails Vancouver Coastal, which has the highest rate, by a mere half a percentage point.

Regardless of where they live, Lapointe said families frequently tell coroners how their loved ones managed through detox only to come out and die while on the waiting list for a recovery bed.

The problem isn’t necessarily that there aren’t enough treatment beds. On most days, some lie empty because the government only funds treatment for welfare recipients. Everyone else has to pay their own way. And except for those with generous employee benefits, many can’t afford treatment that comes at a cost of $900-plus a day.

Lapointe also decried the lack of provincial treatment standards. Different operators have different approaches. Some aren’t evidence-based. Some are strictly abstinence-based and refuse to accept people on drug therapies such as methadone and Suboxone, even though without that, they are more vulnerable to overdose if they relapse.

Decriminalization is touted by some as the answer. Without fear of criminal charges, the theory is that people would be more willing to seek help.

They point to Portugal, where decriminalization was brought in as part of a massive overhaul of its drug treatment system.

But decriminalization has only worked there because Portugal also boosted spending on the other three pillars — prevention, enforcement and treatment.

Here, the crucial elements are missing. With a minority government in Ottawa, the Liberals already have enough problems on their plate to risk raising the controversial idea of decriminalization.

Meanwhile, most provinces, including B.C., haven’t invested enough in the infrastructure to put a Portugal-style model in place.

This week, Mental Health and Addictions Minister Judy Darcy agreed that there are enormous gaps in B.C.’s fragmented system.

When the New Democrats were elected less than three years ago, she said the drug treatment system had been neglected for so long that it was not able to cope with regular tasks, let alone a public health emergency.

The government is taking steps to fix that. But whether it’s moving fast enough is a conversation that both the coroner and chief medical health officer are pushing British Columbians to have because the lives of many loved ones depend on it.

dbramham@postmedia.com

Twitter: @bramham_daphne

16Jan

Vancouver Coastal Health will soon hand out drug testing strips

by admin


Fentanyl test strips will soon be available for people to take home from designated sites throughout the Vancouver Coastal Health.


Vancouver Coastal Health / PNG

Take home test strips that are able to detect the presence of fentanyl in recreational drugs will soon be made available to the public at designated sites throughout the Vancouver Coastal Health region.

“Providing people with a simple, convenient way to check if their drugs contain fentanyl may help them avoid an overdose, and reduce the number of lives lost due to the contaminated illegal drug supply on our streets,” said Judy Darcy, B.C.’s mental health and addictions minister.

The VCH says the strips were shown in a study to be just as accurate as drug checking at a health care facility in identifying opioids contaminated by fentanyl, the toxic drug responsible for killing thousands of people in B.C.

According to the research study conducted last year by the VCH, Interior Health and the B.C. Centre for Disease Control, take-home strips found 89.95 per cent of opioid samples contained fentanyl, while on-site drug checking found 89.14 per cent of samples contained fentanyl.

“We’ve been offering drug checking at community health centres, overdose prevention and supervised consumption sites but we know that not everyone can or wants to go to these sites, especially in light of the stigma that people who use drugs can face,” said Dr. Mark Lysyshyn, medical health officer at Vancouver Coastal Health. “We know most people who die from overdoses are using alone. Being able to check their drugs for fentanyl may help them make safer choices and ultimately prevent overdoses.”

Originally intended for urine drug tests, the use of fentanyl testing strips to check the drugs for fentanyl was pioneered by VCH in 2016. A small amount of a drug is mixed with a few drops of water, the test strip is inserted into the solution, and a positive or negative for fentanyl is revealed within seconds.

The strips will be available at four Vancouver pilot sites — Insite, Molson overdose prevention site, Overdose Prevention Society and St. Paul’s Hospital overdose prevention site — by next week and at other sites in the following weeks.

At VCH sites, clients voluntarily have their drugs checked an average of 500 times each month.

13Dec

Daphne Bramham:

by admin


The UGM has a long, respected record of providing supportive recovery housing for people with addictions, including this one, The Sanctuary, for women. Yet it is on a government list of “unlicensed” operators. Blame the government’s confusing and opaque rules.


Jason Payne / PNG

For 80 years, the Union Gospel Mission has provided services in Vancouver’s Downtown Eastside, feeding people, providing shelter and helping them deal with addictions.

It has annual revenue of just over $22 million and assets of nearly $7 million. A couple of weeks ago, it served 2,500 people at its annual Christmas dinner.

It is one of the largest providers of supportive recovery housing for people with addictions.

For women, whose needs are greatly underserved, UGM has the eight-bed Lydia Home in Mission and 13 beds at The Sanctuary on Heatley Avenue in Vancouver.

For men, it has a purpose-built facility with 62 beds for addictions recovery, 72 shelter beds and 37 affordable housing units that opened in 2011.

The provincial government put up $12.1 million for the $29 million facility and the city waived $420,000 in development fees, which explains why former housing minister Rich Coleman and then-mayor Gregor Robertson were among the dignitaries attending.

Clearly, UGM is no fly-by-night organization.

But it’s a testament to the complexity and opacity of the B.C. government’s assisted living registry that UGM has found itself on a list on of 26 unregistered (a.k.a. illegal) facilities, which includes both supportive addictions recovery houses and seniors’ assisted living.

“We feel terrible and embarrassed about our mistake as we take regulatory compliance seriously,” programs director Dan Russell said in an email. “We believed our recovery programs did not require registration or licensing because we did not provide any prescribed services.”

When UGM learned that its recovery program “could be interpreted as a therapy program” under the Community Care and Assisted Living Act, Russell said it immediately contacted the Health Ministry, which sent inspectors on Oct. 10.

In their report posted on the ministry’s website, the inspectors listed two prescribed services that were being offered at all three houses as “psychosocial supports and medication administration.”

UGM was ordered to reduce the number of people receiving services to no more than two at each location, cease providing the services or immediately apply for registration.

UGM sprang into action, gathering documentation to meet all 30 requirements on the registration checklist. It was ready to submit the application on Nov. 20. But by then, the online application form had disappeared because of new regulations that came into effect Dec. 1.

It meant UGM (along with any others attempting to get off the bad list) had to gather more documentation to prove that it meets the new guidelines. UGM is still working on completing it, but it had hoped that its good intentions would have meant it would be taken off the list.

Among the many reasons that UGM is so eager to get off a list is that the list includes several very bad operators.

Those bad actors are the reason that after years of inaction, the province has finally taken some steps to strengthen regulations and enforcement to protect vulnerable addicts searching for help.

Vancouver Recovery Centre is one of those. Operated by Kyle Walker, four of its houses are on the unregistered list with complaints against them.

The Abbotsford News reported that neighbours of the one on Eagle Street in Abbotsford described it as a flophouse when they went to city council meeting in May to finally get it closed.It also reported that police had been called to the house 32 times between January 2017 and January 2019 for a sexual assault, a domestic dispute and threats and that residents were being charged $800 to live there.

The house was still operating despite orders from the city in April 2017 and the province in September 2018 to close.

For decades, the provincial government and municipalities have been playing whack-a-mole with scammers who promise addictions recovery services and provide only shelter.

Yet, even some government-registered recovery houses have critical failings — failings that have cost five people their lives in the past year.

Union Gospel Mission is not one of those and there are many registered and licensed houses operating to the highest standards.

Protecting them from guilt by association is why registration, licensing, regulation and enforcement are all crucial.

More importantly, a robust system and a credible registry are only ways that anyone — let alone desperate addicts and families — can determine whether a recovery house is safe or whether the best thing about it is a slick website.

Soon British Columbia will mark the fourth anniversary of a public health emergency caused by overdose deaths from a fentanyl-laced supply of illicit drugs.

The number of deaths dropped 30 per cent in the first half of 2019. But the number of times paramedics were called to deal with overdoses remains near its all-time high.

Addiction isn’t going away nor is the need for high-quality treatment and recovery services.

dbramham@postmedia.com

Twitter: @bramham_daphne

11Dec

Daphne Bramham: More oversight and enforcement needed at addictions recovery houses

by admin

If ever there were a need for more harm reduction, it’s at the registered and unregistered, licensed and unlicensed addictions recovery houses in British Columbia run by operators who have no regard for residents’ health or safety.

Within the last year, five people have died in provincially registered recovery homes. Two of those deaths were in the last three months.

On Dec. 1 — years too late for too many — new legislation and regulations finally came into effect. But they apply only to operators on the provincial Assisted Living Registry and not to those licensed by the local health authorities. There is also no provision to shut down those that are operating illegally. On its website, the Health Ministry does list 26 unregistered houses that it has received complaints about. But people in the recovery community say it’s only the tip of the iceberg.

The regulations themselves are “thin,” according to Carson McPherson, the chair of the B.C. Centre on Substance Use’s recovery committee.

“They’re easy to work around. There’s no real specificity anywhere,” said McPherson.

“There are no specific requirements for level of staffing qualifications tied to prescribed services. If you’re delivering trauma-informed services, you ought to have someone qualified. But that doesn’t exist (in the regulations).”

Prior to the regulations coming into effect, the Addictions Ministry provided $4,000 grants to operators for 16 hours of staff training.

But McPherson argues that’s hardly enough. “You’re dealing with health care and life and death situations.”

Beyond that, what’s been left in place is a confusing system that’s almost impossible for recovering addicts and their families to navigate. While some recovery houses are registered on the province’s Assisted Living Registry, others are licensed by local health authorities.

Still others operate illegally, which has forced municipalities like Surrey to use their limited business licensing and bylaw enforcement systems to try to shut them down. The government provided no new tools or authority to deal with those.

Despite that, there’s plenty of catch-up work that B.C.’s assisted living registrar needs to do.

Until now under the old, so-called “progressive system,” registered operators were given multiple chances to fix problems and there were no consequences if they didn’t.

On Nov. 26, for example, it cancelled Step by Step Recovery Society’s registration. But two  days later, a man in his 30s lit himself on fire and died at one of its five Surrey houses. He was the third resident in less than a year to die in one of Step by Step’s houses, which had 65 substantiated complaints registered against them.

Even now, at least one of its houses remains open. The Addictions Ministry says it has asked the city to help the remaining residents find spots at other recovery houses.

Why wasn’t Step by Step immediately closed on Dec. 1 when the legislation and regulations came into force? Because they’re not retroactive and the actions begun against Step by Step are covered by the old rules.

Also exempt from the new regulations areOptions Recovery Centre in Surrey and Reaching Out in Vancouver where the two other deaths occurred earlier this year.

On July 1, a beloved young man died at Options on 100A Avenue. The 24-year-old was the brother of a friend of mine.

Among the most cynical of Options’ substantiated failings is that it failed to even meet the legislated requirement of filing a serious incident report to the registrar within 24 hours of his death. It was only reported on Aug. 8 after complaint had been filed.

But that was the only substantiated complaint to which John Alan Murphy, Options sole proprietor, has responded.

Investigators have substantiated complaints that it fails to provide many of the key services required of supportive addictions residential care homes.

In July, investigators found that staff and volunteers are not qualified for their jobs or knowledgeable about their roles.

No help is provided for residents to work toward long-term recovery, maximize their self-sufficiency, enhance their quality of life or help them reintegrate into the community. The food was deemed not to be nutritious or safely prepared.

Two months earlier, investigators substantiated a similar list of complaints.

Unsafe meals. Unsafe site management. Unqualified staff and volunteers. No support to assist in recovery and reintegration.

Sometime in September, a resident died at Reaching Out, a house in Vancouver operated by Changing Addictive Attitudes Recovery Society of B.C.

On Nov. 25, investigators substantiated complaints about Reaching Out that are chillingly similar to those at Options.

Reaching Out failed to report the death at its facility within 24 hours. Staff and volunteers were unqualified. There is no 24-hour emergency response system for residents and staff to summon help. And investigators deemed it an unsafe place for residents to live.

To gain some modicum of credibility, the registrar needs to act swiftly to bring all of the houses into line and hope that no one else dies in the meantime.

As for Health Minister Adrian Dix and Addictions Minister Judy Darcy, they ought to draft even more sweeping changes, bolstering enforcement to ensure that illegal operators can also be rooted out.

Vulnerable people aren’t just dying on Downtown Eastside streets in the midst of the opioid overdose crisis. They’re dying in places that promise to help them attain a healthier lives.

dbramham@postmedia.com

Twitter: @bramham_daphne

Unregistered supportive housing in B.C.

Anyone who provides assisted living services for more than two seniors, people with mental health issues or those in recovery from addictions is required to be approved by B.C.’s assisted living registrar. Following is a list of unregistered homes by region from https://connect.health.gov.bc.ca/ext/ccala/assisted-living

FRASER HEALTH

• 3H Wellness Society

13297 78A Avenue

Surrey

• A:yelexw Women’s (Seabird Island Recovery Homes)

2835 A:yxalh Lane

Agassiz

• Patricia House — Abbotsford Women’s Centre

15 Winson Road

Abbotsford

• Cozzolino Home

24990 36th Avenue

Aldergrove

• Good Samaritan Delta View Care Centre Ltd.

9341 Burns Drive

Delta

• Hope for Freedom Glory House

34641 Lougheed Hwy

Mission

• Inspire Change Wellness House

13936 — 28 Ave

Surrey

• Union Gospel Mission — Lydia Home

33170 70th Ave

Mission

• Mann Ford Recovery Center

4131 Lakemount Road

Abbotsford

• Union Gospel Mission

Men’s Recovery Program

601 East Hastings Street

 

VANCOUVER

• Night and Day Recovery Centre Ltd. (108A)

14677 108A Ave

Surrey

• The English Manor

16963 22nd Ave

Surrey

• Union Gospel Mission

The Sanctuary

361 Heatley Ave

Vancouver

• Vancouver Recovery Centre

1880 Eagle St

Abbotsford

• Vancouver Recovery Centre

2323 Southdale Crescent

Abbotsford

• Vancouver Recovery Centre — Suncrest

7822 Suncrest Drive

Surrey

• Vancouver Recovery Society

6122 168 Street

Surrey

 

INTERIOR HEALTH

• Resurrection Recovery Resources Society

Freedom’s Door #6

1340 Belaire Ave

Kelowna

• Round Lake Treatment Centre

200 Emery Louis Road

Armstrong

• Shuswap Lodge Retirement Residence

200 Trans Canada Highway SW

Salmon Arm

• The Mustard Seed

181 Victoria Street

Kamloops

• Valiant Recovery — The Crossing Point

3525-3527 Lakeshore Rd

Kelowna

 

VANCOUVER COASTAL HEALTH

• Giving Back Support Recovery (house One)

3608 Knight Street

Vancouver

 

VANCOUVER ISLAND HEALTH AUTHORITY

• Heritage Manor

1051 College Street

Duncan

• Mile Zero Sober Living

647 Niagara St

Victoria

• Oceanview Manor

468 Battie Drive

Ladysmith

5Dec

Daphne Bramham: ‘Terrible, terrible tragedy’ at Surrey recovery home should have been preventable

by admin

Late last month, a man in his 30s with a long history of addiction doused himself with gasoline and set himself on fire in the garage of a Surrey recovery house.

Two other residents went to hospital and were treated for smoke inhalation as a result of the two-alarm fire.

The B.C. Coroners Service is investigating. So is the Surrey fire department.

Self-immolation is tragedy enough. But what makes it worse is that the man’s death is directly attributable to years of appalling neglect. For two decades, B.C. failed to regulate residential addiction treatment facilities or ensure that they met even the most basic standards.

The man, who has not been officially identified, died in a government-registered treatment home where he was supposed to be monitored, supervised and helped to attain long-term recovery.

What intensifies the tragedy is that his was the third death in a year in a house run by Step by Step Recovery Society. One of the society’s five directors, Debbie Johnson, owns the house at 138A Street that was badly damaged in the fire.

Between November 2018 and March 2019, there were 65 separate breaches of the Assisted Living Registry’s regulations at the five Surrey houses that the society was operating.

Those infractions — the most recent of which were investigated in March — range from inadequate food to unqualified staff to unsafe facilities to failure to ensure residents are not a danger to themselves or others.

At the house on 138A Street where the most recent death occurred, there were 11 substantiated complaints. Only one was dealt with, according to the most recent report posted on the Assisted Living Registry’s website.

The pest control people did get rid of the mice.

But, according to the report, no action had been taken to address verified complaints about safety, about untrained, unqualified staff, and about the lack of any psychosocial supports aimed at helping people attain long-term recovery.

The society voluntarily closed two of its houses earlier this year.

But of the three still on the registry, all have substantiated complaints that haven’t been dealt with. In March, nothing had been done at the houses on 78A Avenue and 97A Avenue that were deemed unsafe for the needs of residents. Verified complaints posted in February about safety and the quality and training of staff remained outstanding.

The question that screams for an answer is: Why wasn’t Step by Step shut down earlier?

The legislation didn’t allow it. The Assisted Living Registry had no power to take immediate action to suspend or attach conditions to a registration.

Instead, all that the registry staff could do was try to work with the operator to get them to conform.

There are dozens of other niggling questions. If this were a well-staffed facility, someone might have realized that the man was struggling before he went to the garage. If it were a well-run, supportive house, it’s unlikely he would have had access to gasoline.

With better rules and oversight, those other two deaths at Step by Step might not have occurred either, and maybe other deaths could have been avoided over the past two decades.

Two decades. That’s how long B.C. went without any regulation of residential treatment centres.

That finally changed on Dec. 1 — 21 years after a previous NDP government brought in regulations only to have them scrapped in 2001 by the B.C. Liberal government that described them as too onerous.

The Liberals did promise new and improved rules in 2016 after a Surrey mom was killed outside a hockey arena by a resident of one of the unregulated facilities. But those rules were never enacted.

In 2017, a coroners’ jury recommended regulations following a 20-year-old man’s overdose death in a Powell River treatment centre. Those regulations were finally released in August 2019 and operators — including Step by Step — were given three months to get ready for the changes.

In the last four days, the registrar has cancelled all five of Step by Step’s registrations. A letter has gone to the operator. And, according to the emailed response from an addictions ministry spokesperson, the operator is “expected to begin an orderly transition of current residents to other registered supportive recovery homes.”

The email also said that Surrey’s bylaw department will work with the operator to place the remaining residents to ensure that no one is left homeless as a result of the closures.

It’s a glimmer of good news. But it all happened four days too late for the unnamed man, for 21-year-old Zachary Plett, whose family will grimly mark the first anniversary of his death at Step by Step last Dec. 15. And it comes nearly 13 months after Step by Step staff took two full days to discover the body of a 35-year-old who overdosed in the house on Christmas Eve.

“Why they had to wait to get these regulations in place is beyond me,” Zachary’s mother Maggie Plett said Thursday. “They should have been done sooner.

“It’s just a terrible, terrible tragedy.”

dbramham@postmedia.com

Twitter: @bramham_daphne


Recovery house regulations timeline:

1998: The NDP government brings in the first regulations under the Community Care Facilities Act.

2001: The B.C. Liberal government scrapped those regulations as part of its deregulation drive, declaring the requirements too onerous.

2014: A Surrey mother is murdered outside a hockey arena by a man living at one of the unregistered houses. At the time, Surrey alone had as many as 250 flophouses purporting to offer supportive housing for recovering addicts.

2016: In the spring’s Throne Speech, B.C. Liberals promise regulations, enforcement and a public registry.

In December, Surrey council voted to require all recovery houses to have business licenses, capping the number at 55 and requiring all of them to be listed on the B.C. government’s Assisted Living Registry.

The amendments to the Community Care and Assisted Living Act were never enacted or enforced.

2018: The B.C. coroners’ review of an overdose death in a Sechelt recovery house recommended that by September 2019 there needed to be better regulations for public and private residential addiction treatment facilities, as well as heightened enforcement.

The government agreed and set up a committee to develop standards to “help ensure quality and consistency and enhance understanding of the services across the province.”

April 2019: The deadline set by the coroner for a progress report came and went, but in a letter from the Ministry of Mental Health and Addictions in May, it promised to have a final report ready for September.

August 2019: Addictions Minister Judy Darcy announces that the 2016 regulations will finally be enacted along with some additional requirements on Dec. 1. To prepare for the changes, the government offered $4,000 in grants to operators licensed by the health authorities or registered by the ALR to offset staff training costs as well as an increase in per-diem rates for residents after more than a decade of having been stuck at $35.90.

14Sep

Former Port Alberni mayor pushes for drug decriminalization as path to treatment

by admin

https://vancouversun.com/


John Douglas, special projects co-ordinator for the Port Alberni Shelter Society and a former mayor and councillor for the city. [PNG Merlin Archive]


Submitted: John Douglas / PNG

The former mayor of Port Alberni has released a report in which he supports calls for drug decriminalization in order to protect British Columbians from overdoses and other related harm, and help them find appropriate treatment.

John Douglas, who was a paramedic for 23 years, wrote “Working Towards a Solution: Resolving the Case between Crime and Addiction” following an information-gathering trip to Portugal, and recently released it to the media.

Douglas, now special projects co-ordinator for the Port Alberni Shelter Society, explained Thursday that the paper is not a scientific analysis, but rather a “from-my-gut” exploration of what he has learned while working in the fields of social housing, mental health, poverty and addiction.

He calls for the province to engage doctors, lawyers and police, as well as the public, to make addiction and possession of addictive substances solely a health issue, under healthy ministry jurisdiction. He wants the government to develop a supply model for addictive drugs to eliminate health problems associated with contaminated street drugs.

More than 4,300 people have died of an illicit-drug overdose in B.C. since the provincial government declared a public health emergency in April, 2016. Fentanyl was detected in most cases.

Douglas recommends the development of long-term, affordable and flexible treatment communities and “health teams” to provide services. He asks the province to tell the federal government “politely and firmly” that it intends to move forward with a pilot program which is open to federal participation.

“I’ve been a politician myself — no higher than a municipal level — but I find political people, as well-meaning as they are, tend to lag behind movements, sometimes, in society,” Douglas said. “I’ve talked to so many people in the health, enforcement and legal fields that all agree (addiction) should be treated as a health issue, but the political end is lagging behind because they’re afraid of losing votes or saying the wrong thing and offending somebody.”

Douglas entered politics in 2008 as a councillor in Port Alberni and served as mayor from 2011 to 2014. After the fentanyl-related overdose crisis emerged, he helped bring a sobering centre and overdose prevention and inhalation sites to the city.

His decades of experience in health care and helping people who have addictions helped him come to the conclusion that people with addictions should be in health care, not the criminal justice system.

Earlier this year, he attended a forum in Portugal where he learned about the country’s approach to addiction and overdoses. In 2001, Portugal decriminalized all drugs for personal use in response to a surge in heroin use.

“With the shelter, we’re working toward researching models of therapeutic communities that could work for treatment, if and when we can get the government to start moving in the direction of decriminalization and the direction of adequate treatment for people with addictions, instead of these pathetic 30- to 60-day treatment programs that are commonplace over here,” Douglas said.

Decriminalization would apply to all drugs — even heroin and methamphetamine — but falls short of legalization, which removes prohibitions but also develops regulations for the production, sale and use of a substance (Canada’s approach to cannabis is an example).

In a special report released last April, Provincial Health Officer Dr. Bonnie Henry urged the B.C. government to implement decriminalization for simple possession for personal use.

Henry said B.C. could use its powers under the Police Act to allow the Ministry of Public Safety and Solicitor-General to set broad provincial priorities with respect to people who use drugs. Or it could enact a regulation under the act to prevent police from using resources to enforce against simple possession offences under the federal Controlled Drugs and Substances Act.

Solicitor-General Mike Farnworth shot down Henry’s proposal, saying laws around the possession of controlled substances remain federal and “no provincial action can change that.”

Douglas sides with Henry on the issue.

“I wanted to be an additional voice to echo those findings,” he said. “I agree wholeheartedly with her. We don’t have to wait for the federal government to do this.”

neagland@postmedia.com

twitter.com/nickeagland

13Sep

Municipalities back Vancouver motion to push Ottawa for safer drugs

by admin

https://vancouversun.com/


Vancouver mayor Kennedy Stewart joined Dr. Patricia Daly, Chief Medical Officer for Vancouver Coastal Health, and Vancouver Fire and Rescue Service’s Capt. Jonathan Gormick to discuss the epidemic of drug-related deaths, at a press conference in Vancouver on Friday, September 6, 2019.


Jason Payne / PNG

Local governments across Canada will press the federal government to increase access to safer drugs, and declare a national health emergency in response to the fentanyl-driven overdose crisis, after a motion by Vancouver Mayor Kennedy Stewart was passed Friday.

Stewart’s motion, drafted with his overdose emergency task force, was approved by city council in July. Coun. Rebecca Bligh brought it to a Federation of Canadian Municipalities executive meeting this week.

The motion requires the federation to call on Ottawa to support health authorities, doctors, their professional colleges and provinces to “safely provide regulated opioids and other substances through a free and federally available Pharmacare program.”

The federation will also demand that the federal government declares a national public health emergency and provides exemptions to the Controlled Drugs and Substances Act, so that cities and towns can run pilot programs which prioritize a move toward a “safe” drug supply.

Stewart said Friday that there was some division among the federation’s membership over the motion but it passed following an effective speech by Bligh. He hopes it will “shift the national dialogue toward a safe supply” during the federal election.

He wants the substances act exemptions to allow health professionals with a non-profit organization to distribute diacetylmorphine, which local research has shown can be an effective treatment for chronic, relapsing opioid dependence.

Stewart met with Prime Minister Justin Trudeau two weeks ago and told him what Vancouver needs in order to replace fentanyl-tainted street drugs with a safer, regulated supply, he said.

“It was a private conversation but I can say that I left the conversation in good spirits,” Stewart said. “I was definitely heard and that was very important.”

Stewart said front line responders are fatigued, people are experiencing multiple overdoses and suffering brain injuries, and the city and province desperately need the federal government to step up.

“We’re going to have to take it to the next level here. We’re reducing overdose deaths but overdoses are increasing. Just not dying isn’t good enough,” he said.

“It’s got to be life and hope for people.”

Karen Ward, a drug user and advocate for others who use drugs, helped with the motion and was pleased the municipalities passed it.

“If a province is a bit hesitant, the idea is that this will give a city the power to take rapid action — and individual doctors, in fact,” she said.

“It’s a necessity to have safe supply at this point because the supply has become so contaminated everywhere.”

Ward said the federation can now send a clear message to Ottawa that municipalities want the power to treat the overdose crisis “like a real” public health emergency.

“This is one way to get them to talk about it, face it squarely and acknowledge this massive disaster, and say look, we need to change our (approach),” she said.

“We need to take it as seriously as possible. It’s a health issue. It’s also a justice issue.”

According to the federal government, there have been more than 9,000 apparent opioid-related deaths across the country since 2016.

Illicit drugs killed 1,533 people in B.C. in 2018 and 538 in the first half of 2019, according to the B.C. Coroners Service.

neagland@postmedia.com

twitter.com/nickeagland

31Aug

Woman refuses to burn out her torch as she marks Overdose Awareness Day, crisis

by admin


Tabitha Montgomery with free materials she’s distributing to B.C. libraries.


Francis Georgian / Postmedia News

It was during the International Overdose Awareness Day activities last year when Tabitha Montgomery really noticed it — events that had once been rallies had become vigils.

“There was a feeling that no one was listening. That it was not making a difference,” she recalled Saturday as she set up an information booth at the Vancouver Public Library.

Montgomery’s booth was one of several awareness activities happening in B.C. this weekend to mark International Overdose Awareness Day, a global movement designed to remember those who have died from drug overdoses. And to push for change.

However, some advocacy groups that organized activities in the past were noticeably absent from this year’s list of planned events.

Montgomery attributed that to burnout.

“It can be difficult to keep going,” she said. “I want to thank those who have been paving the path for so long.”

Montgomery’s father, her best friend and her daughter’s father all died from drugs. She believes the only way to end the overdose crisis is to remove the stigma and judgment around drug use and addiction and bring the issue fully into mainstream health care.

“This is a torch in my heart,” she said.

While she doesn’t represent any single group, the former director with From Grief to Action has had success asking B.C. libraries to display free books on grief and addiction in their community resources sections. She’s hoping to get the material into more libraries in the months ahead.

(Postmedia News photo by Francis Georgian)

In a statement, B.C. Minister of Mental Health and Addictions Judy Darcy recognized those who have died are “parents, children, co-workers, neighbours, partners, friends and loved ones.”

The politician said the B.C. Centre for Disease Control estimates 4,700 deaths have been averted by scaled-up distribution of Naloxone, more overdose prevention sites and better access to medication-assisted treatment, known as opioid agonist treatment.

“We have a responsibility to each other, our communities and the loved ones we have lost to keep compassion, respect and understanding at the forefront of our minds — and to continue to escalate our response,” she said.

In June, 73 people died of suspected illicit drug overdoses across the province, a 35 per cent drop from June 2018 when 113 people died, according to data collected by the B.C. Coroner’s Service.

But Montgomery said addiction is still treated like a “moral and criminal issue,” rather than a health issue.

“There’s so much misunderstanding,” she said.

Overdose awareness events were held around the world, including in many B.C. cities such as Vancouver, New Westminster, Kamloops, Kelowna, Powell River, Prince George and Quesnel.

In Vancouver’s Downtown Eastside, the Overdose Prevention Society supported the creation of a mural in the alley near its injection site. The project wrapped up with an art show.

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23Aug

Daphne Bramham: B.C. addictions minister targets province’s ‘wild, wild West’ recovery houses

by admin

B.C. Addictions Minister Judy Darcy has no illusions about the current state of British Columbia’s recovery houses and the risk that the bad ones pose to anyone seeking safe, quality care.

Nor is she alone when she calls it “the wild, wild West.”

Anyone able to build a website and rent a house can operate a so-called recovery house. Like a game of whack-a-mole, even when inspectors try to shut down the worst ones, they spring up somewhere else.

That said, the regulations they’re supposed to enforce are so vaguely worded that it’s easier for bylaw inspectors to shut places down for garbage infractions than for failure to provide the most basic of services like food and a clean bed to people desperate for help.

Even the most deplorable ones have never been taken to court by the province, let alone fined or convicted which makes the penalties of up to $10,000 moot.

It’s taken two years, but this week Darcy — along with Health Minister Adrian Dix and Social Development Minister Shane Simpson — took the first steps toward bringing some order to the chaos and overturning years of neglect.

In two separate announcements, what they’re offering is both the stick of tighter regulations and enforcement as well as the carrot of more money for operations and training staff.

The carrots announced Friday include $4,000 grants available immediately to registered and licensed recovery home operators to offset the costs of training for staff before tougher regulations come into force on Dec. 1.

On Oct. 1, the per-diem rate paid for the treatment of people on social assistance will be raised after more than a decade without an increase. Recovery houses on the provincial registry will get a 17-per-cent increase to $35.90, while recovery houses licensed by the regional health authorities will jump to $45 from $40.

The sticks are new regulations that for the first time require things like qualified staff, which common sense should have dictated years ago as essential. Recovery houses will have to provide detailed information about what programs and services they offer. Again, this seems a no-brainer, as does requiring operators to develop personal service plans for each resident and support them as they transition out of residential care.

As for enforcement, the “incremental, remedial approach” to complaints has been scrapped and replaced with the power to take immediate action rather than waiting for a month and giving written notice to the operators.

Darcy is also among the first to admit that much, much more needs to be done to rein in bad operators whose purported treatment houses are flophouses and to provide addicts and their families with the resources they need to discern the good from the bad.

More than most, the minister knows the toll that poor funding and lack of regulation is taking both on addicts who seek help and on their loved ones. She’s haunted by meetings she’s had with the loved ones of those who have died in care and those who couldn’t get the services they needed.

“It’s the most difficult thing that I have to do and, of course, it moves me to my core,” she said in an interview following the announcement. “People say, ‘Do you ever get used to it?’ Of course I don’t. If you ever get used to it, you’re doing the wrong job.

“But I try and take that to drive me and to drive our government to do more and to move quickly and act on all fronts and having said that, there’s a lot to do. There’s really, really a lot to do.”

Among those she’s met are the two mothers of men who died within days of each other in December under deplorable conditions in two provincially registered recovery houses run by Step By Step.


B.C. Minister of Mental Health and Addictions Judy Darcy shares a laugh with Scott Kolodychuk, operations manager of Surrey’s Trilogy House One recovery home where Friday’s news conference was held.

Mike Bell /

PNG

It was four to six hours before 22-year-old Zach Plett’s body was found after he overdosed and died. On Christmas Eve, a 35-year-old man died at a different Step by Step house. It was two days before his body was found by other residents.

Two years before those men died, the provincial registrar had received dozens of complaints and issued dozens of non-compliances orders. Both houses remained on the registry until this summer when owner/operator Debbie Johnson voluntarily closed them.

After years of relentless advocacy Susan Sanderson, executive director of Realistic Recovery Society, was happy to host the ministers’ Friday announcement at one of its houses. She wants to believe Darcy that these are just first steps since the per-diem rate is still short of the $40 she and others lobbied for and remains a small fraction of what people who aren’t on welfare are charged — charges that can run up to $350 a day.

Having taken these long overdue and much-needed initial steps, maybe Darcy and her colleagues can take another logical next step to support working people getting access recovery who — without access to employee benefit plans — can’t afford the cost of treatment.

They shouldn’t have to wait until they’re destitute to get care, any more than someone on welfare should be deprived of help.

dbramham@postmedia.com

Twitter.com/bramham_daphne

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