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Category "Overdose"

28May

COVID-19: New substances used to cut street drugs much harder to ‘reverse’

by admin

Article content continued

“There’s a real lack of skill providers out there and we don’t have a functioning addiction treatment system in B.C.,” she said.

Karen Ward, drug policy adviser for the City of Vancouver, said overdoses and deaths in the city’s Downtown Eastside skyrocketed when COVID-19 measures came into effect mid-March and shut down services and facilities in the neighbourhood.

“That was a lot, all at once, in a very short period of time,” she said. “April … it’s bad but compared to March it’s actually not as bad as I feared.”

Ward said she was heartened, however, to see the coroners report that average daily drug deaths had fallen during income assistance week in April to 3.9 deaths per day, after spiking to 6.6 deaths per day in March. It was the first time she could recall cheque week being less deadly than the rest of the month.

She believes $300 in provincial emergency aid for people on income and disability assistance, along with new banking measures implemented by Pigeon Park Savings and Vancity, played a role in saving lives.

“That (April) was the first time we got our $300 emergency supplements,” she said.

“It’s about poverty. So many of deaths during cheque week are about the fact that the government dumps a huge pile of money in a very small space, on some very desperate people.”

neagland@postmedia.com

twitter.com/nickeagland

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

16Dec

Daphne Bramham: Self-governing pharmacists or government? Who should keep bad health professionals in line?

by admin


Last year, an estimated 15,400 British Columbians were using methadone as a treatment for opioid addiction.


Jason Payne / PNG

The disciplinary action taken against Diamondali Tejani paints a stark picture of the challenges that the College of Pharmacists of B.C. has had reining in bad operators.

Tejani finally had his registration suspended beginning Sept. 1 and has been forbidden from being a pharmacy manager, director, owner or shareholder in a pharmacy for two years and fined him $15,000 for what he did and didn’t do in 2016.

It was the third time he’d been disciplined. In 2012, his methadone dispensing privileges were suspended for 30 days, but there were no other details included in the college’s posting on its website.

In 2000, he was suspended for three weeks following his conviction in provincial court for tax evasion.

The cause for the most recent suspension dates back to between July 8 and Nov. 25, 2016. Tejani paid cash incentives to drug users to fill their daily dispensing orders.

As owner, manager and a pharmacist at Surrey’s Boston Pharmacy, the College also said he would have, or should have, known that a patient consultation was required every day.

That wasn’t the end of it. His staff didn’t enter or reverse daily dispense prescriptions on PharmaNet when the patient didn’t show up. Instead, they’d provide patients with missed doses and also dispensed several prescriptions without prescription labels.

Daily dispenses of methadone can be a lucrative business. British Columbia allows pharmacists to charge up to $10 for each prescription for up to three prescriptions each day. That’s in addition to the fees they collect for witnessing the ingestion of methadone.

The most recent figures show the total pharmacy costs for methadone maintenance for 13,894 patients was nearly $46 million in 2011/2012 — $40 million of which was paid by Pharmacare. Last year, an estimated 15,400 British Columbians were using methadone as a treatment for opioid addiction.

Providing methadone daily is lucrative enough that pharmacists like Tejani have actively courted business. Some still do.

Physicians, recovery house operators and recovering addicts have all told me about pharmacies offering incentives as well as threats.

The kickbacks include money to recovery house operators who insist on residents going to a particular pharmacy for their three daily dispenses and money or gifts to customers themselves.

I’ve been told about some recovery house operators threatening to evict residents unless they go to those pharmacies with their three daily scripts. I’ve heard physicians folding under pressure from patients who will be evicted unless they get daily scripts for methadone and usually a sleeping pill or an over-the-counter pain medication like naproxen (a.k.a. Aleve). Their justification? It’s better for recovering addicts to have a roof over their heads than be homeless.

The College gets those complaints. But many of the complaints are never filed because as several recovery home residents have told me, ‘Who’s going to believe an addict?’

The College’s members also haven’t always supported its actions. When the College passed a bylaw in 2013 to outlaw incentives, it resulted in a three year court battle with Safeway and Thrifty Foods who wanted prescriptions to be part of their loyalty rewards programs.

But the appellate court sided with the College and, finally, it was able to enforce the bylaws similar to what Quebec and Newfoundland and Labrador have had in place since 2008.

Still it’s fair to say that professionals’ ability to regulate themselves has been a long-standing issue here, dating back at least to a 2003 ombudsman’s report that found public trust lacking.

This April, British expert Harry Cayton filed a report to the government that recommended a new regulatory framework for health professionals that will significantly reduce their autonomy.

Instead of members electing half or two-thirds of college’s boards, the health minister would appoint them along with all the public members. All college boards would also be required to have equal numbers of professionals and members of the public.

The College of Pharmacists would be one of only five professional regulatory bodies because of its unique jurisdiction over drug schedules regulation and operation of pharmacies.

The others would be the two largest — the College of Physicians and Surgeons and the nurses. The other 15 would be lumped into two new colleges — one for oral and one for everything else from chiropractors to lab technicians to speech and hearing professionals.

Colleges would be overseen by a separate body that reports to the minister. Colleges would continue to investigate complaints, but another separate, independent panel appointed by the minister would make the disciplinary decisions.

Cayton also recommended firm time limits for each stage of investigations and the elimination of professionals’ ability to negotiate agreements/settlements late in the process.

The government is accepting online feedback until Jan. 10 Presumably after that, it will move ahead with changes.

Clearly, there are problems with the current system. But it’s an open question whether a complete overhaul will to lead to better quality services care or whether it will mean more government control and more bureaucracy.

dbramham@postmedia.com

Twitter: @bramham_daphne

 

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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9Aug

Daphne Bramham: Why won’t B.C. fund Karly’s addiction recovery?

by admin

As of today, Karly has been clean and sober for 30 days after four years of battling addiction.

Addiction made the 17-year-old from Chiliwack vulnerable to exploitation and bullying. It disrupted her schooling, left her psychotic, suicidal, near death and unable to care for her year-old baby.

“In addiction, I never thought I could be this happy without drugs,” she said earlier this week.

“There’s obviously times when I’m feeling like I don’t want to live any more. But I realize a lot of people do care for me, and it would hurt a lot of people if I did leave.”

Up until now, Karly didn’t worry that fentanyl laced in the cocaine, crystal meth and other street drugs she’s used might kill her, as it has more than 4,000 other British Columbians in the past four years.

“Honestly, I just thought I wasn’t going to get that wrong batch. I thought I could trust my dealers. Now, I’m starting to realize the risk. I was using alone. It’s pretty scary now that I think about it.

“I could have overdosed, my poor son he would have had no mom.”

But Karly’s recovery is at risk because the B.C. government is refusing to pay for her treatment. The question of why was bounced from the Ministry of Mental Health and Addictions to the Ministry of Children and Family Development, back to addictions, then back to MCFD, and finally to Fraser Health over two days.

Friday afternoon, MCFD responded that due to privacy concerns it could not discuss the specifics of the case.

The spokesperson did confirm that the government pays for youth residential treatment. Funds are allocated by the health ministry to regional health authorities. MCFD social workers are supposed to refer youth and families to the health authority, which is supposed to do the assessments and placements.

Reached late Friday afternoon, Fraser Health said that it does not have provincial funding for youth beds at Westminster House, where Karly is getting treatment, only adult beds.

Postmedia editors and I are also concerned about Karly’s privacy and vulnerability. For that reason, we are not using her real name, or that of her mother.

•••

On July 10, her mother Krista found Karly white-faced and barely breathing on the floor. It was a moment she had been bracing for since 2015.

Krista, who is a nurse, didn’t need the naloxone kit that she keeps at the ready. She shook Karly awake and got her into the car to take her to Surrey Creekside Withdrawal Management Centre.

En route, Karly flailed about, kicking in the glove box, banging her head against the window and screaming.

“She was in psychosis. She was not my child,” Krista said. “It took six nurses and two doctors to get her inside.”

At 9 p.m, Karly called her mom to say that if they didn’t let her out, she was going to escape, prostitute myself and get enough money to kill herself.

“I felt in my heart that she was really going to do it.”

Panicked, Krista called Susan Hogarth, Westminster House’s executive director, and begged for help. Westminster House is a residential treatment centre for women, with four designated youth beds in New Westminster.

Even though it was past midnight, Hogarth agreed to take Karly.

“We can’t not put a child somewhere,” Hogarth said this week.

The cost for treatment at Westminster House is $9,000 a month, meaning Krista needs $27,000 to pay for the three months of treatment that counsellors say Karly needs to be stabilized enough to go into second-stage care.

The crucial first month of treatment was covered using donations from individuals, and Hockey for the Homeless.

Now there are bills to be paid.

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Krista’s only contact with the government has been through MCFD. A social worker helped Karly get mental health services, pre- and post-natal care and helped Krista gain guardianship of her year-old grandson last month.

It’s the social worker who told the family that the government would pay for a 10-week, co-ed live-in treatment program at Vancouver’s Peak House, but not Westminster House.

But Krista and Westminster House’s director believe a co-ed program that has no trauma counselling is not a good fit for Karly.

The only other option suggested was outpatient treatment. But Karly’s already tried and failed at that. Besides, her dealer lives two blocks from their home.

If Karly was an adult on welfare, the Ministry of Social Development and Poverty Reduction would pay $30.90 a day for her room and board in residential care.

Bizarrely, Krista said the social worker suggested maybe Karly could just wait a year and then her treatment would be fully covered.

“This is f–ing BS. I can’t wait until she’s older. She’ll be dead,” said Krista, who has had her own problems with addiction. An alumni of Westminster House, she is four years into recovery.

Concerns about how to pay for Karly’s treatment in addition to caring for Karly’s baby and Karly’s younger sister are wearing heavily on Krista. She’s had to take a medical leave from her job, and is worried about how she will pay her rent.

She’s already spent four years in a constant state of readiness in case Karly overdoses. There’s naloxone in the house. The razors are hidden because “Karly cuts, cuts.” Every time Karly took a bath, Krista stood apprehensively by the door because her daughter had threatened to drown herself.

But now?

“She is doing amazing,” Krista said. “The first time I saw her was 15 to 16 days in, and she had colour in her cheeks and they were my kid’s eyes, beautiful brown . . .

“When I brought her son to see her, her smile so genuine. I had not seen it in so many years. The smile was what I remember of her as a kid.”

Hogarth wonders why the government can’t look at the bigger picture of what Karly’s untreated addiction might cost — from more overdoses to her mother’s fragile state to the fate of her son.

Everybody, Hogarth said, deserves a chance at recovery and not just harm reduction interventions.

“Karly is not the easiest client in the world,” she said with a laugh. “But she’s worth it because we want her to go home to her son and to be able to raise him.”

For now, the non-profit Westminster House is covering Karly’s costs with donations augmented by a GoFundMe campaign organized by Krista’s friends.

But it can’t do that forever, or without more donations.

As for Karly, for the first time in years she’s thinking about a future. She won’t be ready to start school in September, but plans to go back as soon as she can for Grade 12 and then go on to study so that she can work in health care.

“I feel like my story can help other people.”

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