Safe-injection sites save lives

Re. “Injection sites get tepid response in poll,” Jan. 18

Since our youngest son died from an accidental overdose to fentanyl in 2014, I have become an advocate for measures that reduce the harm that come from drug use. People who struggle with addiction don’t have a “choice” to just stop taking the drug they have become dependent on without access to treatment that is in very short supply.

Supervised injection services are one piece of the harm-reduction puzzle. In my conversations with even the greatest skeptics I found that most people support these services when I explain why they exist and what they do for people.

If the question is, “Do you support sites where people inject illegal drugs?” you get a different answer than to the question, “Do you support a health-care service that prevents overdose deaths, cuts infection risk, saves health-care costs, reduces public disorder (e.g. public injecting, unsafe needle disposal) and increases the number of people going into treatment by 30 per cent?” Supervised injection services are proven to do all these things.

As a mom, the most important aspect of harm reduction is to keep them alive, so they have a chance to make a better decision on another day.

Petra Schulz, founding member of Moms Stop The Harm, Edmonton

Published in the Edmonton Journal, January 20, 2017

Government Paradigm Shift Needed For Addiction And Mental Illness

Carol Mackie, Salt Spring Island, BC

This letter was first published in the Salt Spring Exchange, December 16, 2016

I am a Salt Spring Island-based mother of one of the over 622 people who have died from (primarily) Fentanyl overdoses in 2016 in our province alone.

I also am the mother of an adult son struggling with a mental health disorder. Both my children had the benefit of a loving, supportive and economically-secure home with parents willing to spend whatever it took to get them help.

The problem is that Canada simply does not have effective mechanisms in place to provide the kind of assistance that the most vulnerable among us desperately need.

What we need is a complete paradigm shift when it comes to helping Canadians with addictions and mental illnesses. Please let me share with you why I have come to believe that this is absolutely critical.

On July 6, 2016 I found my beloved daughter, Kate, splayed over the side of her bed: cold, hard and with a bluish/blackish mottled face. She had been dead for several hours. The on-site coroner and attending RCMP officer concurred that the scene had all the markings of a heroin overdose.

It took over 3 months for her toxicology report to arrive, thanks to the huge backload of Fentanyl-driven demands on the only lab on the B.C. mainland that handles coroner toxicology reports. There was no heroin in Kate’s system, only Fentanyl, a drug that my daughter specifically steered clear of as it had almost killed her once before in Calgary.

My daughter had been an addict since age 13. Very few treatment options existed then (or now) and all were designed exclusively for the wealthy. The two very expensive long term residential programs we tried had abysmal success rates as did the various short term free treatment programs. But what other choices did we have? About the same choices that my adopted father had when he unsuccessfully sought help for his alcoholism when I was a child growing up in the 50s.

With drug addiction comes the need for cash, which leads to crime, which leads to jail. Kate went through this vicious cycle and came out the other side. She got clean and was paying her debts to society. She moved to Salt Spring Island earlier this year at age 31 to start a responsible, hard-working and much beloved new life with me.

Unfortunately, as in so many B.C. and other Canadian locales, opioid addiction is big business on Salt Spring Island. Between the backyard chemists mixing up and pressing their own pills, the counterfeit drugs flowing in from Asia, and the money-strapped folks selling their prescription opioids on the street to supplement their incomes, we have a huge, unaddressed problem here.

Relapse is a part of addiction and Kate was not immune.

When my daughter relapsed and sought her drug of choice, heroin, she had no trouble finding someone who would charge her for heroin but, unbeknownst to her, sell her the much cheaper Fentanyl instead. When she inhaled what she thought was a maintenance dose of heroin, she was killed instantly by the far more powerful Fentanyl.

Is this not murder on the dealer’s part? If someone sold a lawyer an “all-natural” cookie laced with enough arsenic to be fatal, I’ll bet that someone would be charged with murder. Why aren’t dealers - trying to profit by selling a cheaper, deadlier drug for a more expensive one - not being held accountable for murder?

No alert was issued island-wide after Kate’s death that Fentanyl was being passed off as heroin to our children and neighbors. Her many friends, co-workers and loved ones were left with no answers and certainly no solutions. I have since heard via the medical community of more unreported Fentanyl deaths on Salt Spring Island. Why aren’t warnings being shouted from the rooftops by police, health officials, social workers, pharmacists, etc? Or as a society, are we really okay with this kind of silent carnage? Please ensure that the answer to this troubling question is “no.”

Let’s talk about common sense solutions, some of which are admittedly Band-aids while others require systemic change.

On the systemic change front, it is imperative that as a civilized society, we stop punishing people for their illnesses and start helping them to live productive lives in spite of their afflictions. For this to happen, the boondoggle that is the racist, U.S.-led “War on Drugs” must end. How much more proof is needed of its abject failure? It is time for Canada to show real leadership and break with this incredibly destructive “war” that is tearing apart families, neighborhoods, communities and the very fabric of our nation itself.

  • Legalize all drugs. There is no other way to drag drug addiction out of the shadows, the prisons and the morgues. Take the power away from the street dealers/cartels/murderers and stop treating their victims like they deserve what they get.
  • Surely it is the government’s role to oversee the safe production and distribution of all drugs as they do with alcohol and tobacco. Sensible guidelines are expected but the Nanny State doesn’t work so our individual rights as citizens to make decisions about our own health and consumption must be respected. It is only when we cross the line to purposefully do harm to others via illegal drug manufacturing and dealing that the long arm of the law is needed to step in.
  • Use the tax money currently being squandered on drug enforcement and punishment and use it for addiction research and education which leads to proven and humane treatment methods.
  • Stop using police SWAT teams to “take down” the mentally ill, either by shooting/tasering them or dropping them off at overwhelmed hospitals or remand centres that take cookie-cutter approaches to medication. My 34-year-old son cannot handle any of the side effects of the medications for his condition. He therefore, is considered by psychiatrists as untreatable and is refused any help. The legal system was unable to complete two court ordered psychiatric assessments even though he was held for 4 months, moving back and forth between a forensic psychiatric unit and a remand centre. His sister, Kate, was the only person he trusted and is really the only person that has ever actually helped him cope with his illness. He is, once again, back in the forensic psychiatric centre and his cycle of doom continues.
  • The availability of the opioid antidote, Naloxone, or more accurately, the lack thereof, is one of those Band-aid approaches that nevertheless can save lives, unless an addict is alone and cannot self-administer, or the addict has been fed a brand-new designer drug that is Naloxone-resistant. That said - is there any legitimate reason why Naloxone is harder to find than Fentanyl? Why isn’t Naloxone standard issue for every Canadian police cruiser, every EMT kit, every Pharmacy, every walk-in health clinic, every legal shooting gallery, etc?
  • Also part Band-aid but necessary nonetheless is the banning of the unregulated sale of pill presses. Why make it easier for say, freelance research chemists to “break bad” by using their knowledge to make and press Fentanyl pills that then kill our loved ones? Making the over-the-counter ingredients of meth less easily obtainable in the U.S., for example, has cut down on the number of mom and pop meth cook labs with all the social, health and environmental nightmares that go hand-in-hand.
  • We were promised more treatment beds in B.C. We are still waiting while our children die. However, more treatment beds are only effective if effective treatments are being administered in them. We need to kick our national habit of classifying people with addictions and mental illnesses as less -than-human, castaways to be left to the fate they brought upon themselves through weakness of character. We must reclassify addiction and mental problems as illnesses - just like Parkinson’s disease, epilepsy and Alzheimer’s disease. Real dollars must be dedicated to thinking outside-of the-box to address addiction and mental illness. Surely, best practices from around the world could provide better solutions than we are getting right now here in Canada. Psychiatry also must undergo a major paradigm shift. Offering the same unhelpful solutions over and over and expecting different results is one definition of insanity, isn’t it?
  • Education is crucial to correct the many false assumptions and unhelpful, damaging, and discriminatory behaviour towards those who are afflicted. People who are not directly related to an addict or someone with a mental illness often don’t realize that there is much more to these folks than just their diseases. I have known a large number of addicts and many people with mental illness and most of them are or were kind, creative, talented and intelligent. My son, for instance, is very intelligent and excelled in math. He could work out the square of a 4 digit number in his head when he was 6 years old. He has a diploma from Loyola in electrical engineering and computer programming. Little good it has done him. My daughter was very much a people person. On Salt Spring Island, she was hard-working and well respected by staff and customers according to the owner of a building supplies company where she worked until her death.

The issue is that my addicted and mentally ill children aren’t the only ones. So many people have been failed miserably by our dysfunctional systems and not helped whatsoever. That is why we need to consider a whole new way of solving this enormously difficult problem and archaic, savage way of dealing with our sick and downtrodden.

The broken mechanisms currently in place for addiction and mental illness help next to no one. Not the addict and their families; nor the overwhelmed police, justice and healthcare systems; nor the frustrated taxpayer; nor the politicians who insist on keeping useless policies and an unjust system in place. It is the politicians who should ultimately be held responsible by an increasingly infuriated and ever-growing group of disgusted voters. It is the politicians who have the power to make the necessary changes . . . if only they can find the will and the courage.

What does Manitoba need to do to address the opioid crisis?

An open letter Drug Awareness Day Participants in Winnipeg Manitoba:

Mothers and Fathers of children addicted to drugs of any kind live with a constant fear – the fear of losing their child to overdose. I am one Mother, of many, to have lost a child. My son, Adam, died from a Fentanyl overdose – he was 27 years old.

Adam struggled for six years trying to get appropriate help for his opiate addiction from the limited resources available in Winnipeg. Adam wanted to escape his addiction and tried to do so many times. Our health care system was not prepared for the opiate crisis, and therefore not prepared to help him appropriately.

We ask ourselves “how does a young man like Adam even begin taking drugs”, drugs that are so dangerous? I believe that, often, our youth begin to take drugs to fit in. They may suffer from self esteem and anxiety issues. As we know, mental health and addiction often go hand in hand. Those that suffered abuse or homelessness may turn to drugs. Doctors have over-prescribed opiates and have not appropriately monitored the patient using these strong pain killers.

I am pleased that events like this can be a catalyst for change. It is an opportunity to share the resources and the knowledge that we have in Manitoba to respond to this urgent crisis in opiate addiction.

Trying to navigate the system for help with addiction was, at the time, the most frustrating and exhausting part of trying to get help for my son. Since my son’s death I have gone on the AFM website and must say that the improvements are wonderful - will the call made on the Helpline be the same?

I must impress upon our government the need to support our agencies and work in partnership to:

  • provide the training and awareness to improve our understanding of opiate addiction to work with compassion or expertise.
  • recognise that parents and family can often be an integral part of the process and need to be informed when they are actively involved. Decisions for treatment should not be left solely to the addict, as their brains are incapable of making that kind of judgement.
  • provide training and support for family Doctors to treat and prescribe treatments such as Suboxone, or access proper medical detox opportunities.

Emergency waiting rooms had intolerably long wait times. When an addict is crashing and wanting to detox they need immediate help. The health care professionals do not have the appropriate knowledge of, or access to, resources to deal with the opiate crisis.

Methadone programs lack the proper supports for success and have long wait times for assessments and entrance into the program. Once enrolled, something as simple as extended hours of operation would be of benefit to clients who are maintaining employment. Counselling and on-site therapy is also required to retrain the brain.

There is only one detox centre in Winnipeg (Main Street Project) and it is non-medical. It was very difficult for my son to be in that setting.

I want to thank the AFM for bringing awareness today and all the other agencies that are here this week. The more we can do to collectively to combat this terrible epidemic the better for this generation.

Christine Dobbs
Winnipeg Manitoba

'I was dead for 10 minutes': Vancouver's opioid overdose crisis

Petra's letter to CBC the current in regards to their broad cast of 'I was dead for 10 minutes': Vancouver's opioid overdose crisis on December 19, 2016.

We lost our youngest son Danny (age 25) to a Fentanyl overdose in 2014, and I have since become an advocate for harm reduction and drug policy reform.

Your documentary provides insight and draws attention to this health crisis, which is important and appreciated. What it does not do and where it falls short, is in identifying the obvious solutions to address this health crisis. The solutions are clear, simple, evidence based, inexpensive, and practiced in other countries.

The solutions fall under the umbrella of harm reduction and they are not new. In the face of this crisis they need to be implemented rapidly to end the carnage. They involved the following measures: We need ensure there is ready access to Naloxone, and replacement therapies with Suboxone and Methadone, across the country. We need access to treatment programs that embrace harm reduction. We need supervised consumption services across the country and we need them now. We need to offer heroin assisted treatment (heroin on prescription) to those with chronic addition issues for whom other treatment options have not worked. Physicians need to change their prescription practices so Canadian’s are no longer the second highest users of opioid based pain medications in the world, and we need to offer real drug education for young people, not scare tactics, with approaches used to teach about safe sex and drinking and driving.

It is essential that we end the failed war on drugs, and we need to shift our thinking from blaming the person to realizing that people who are drug dependant need medical help.

For me, and the others members of Moms Stop The Harm, who all have lost loved ones due to substance use, the definition of harm reduction is simple. It means keeping them alive so they can make a better decision on another day.

Regards,

Petra Schulz

Link to the CBC broadcast 'I was dead for 10 minutes': Vancouver's opioid overdose crisis

On Pragmatism and the Overdose Crisis - in support of prescription heroin

Imagine for a moment: you visit your family doctor because you have been feeling unwell. The doctor assesses you and says that you have dangerously high blood sugar or high blood pressure, or heart disease. The doctor says, "there are drugs for that, but unfortunately , it is not legal for me to prescribe them to you and that you will need to find what you need on the street." Just imagine…

A larger more pragmatic view must be taken on the opioid overdose crisis. We need to begin to shift our focus from one of more law enforcement, more border security, more statistics, more research, onto the immediate overdose crisis, and place it on what will work today. As the documentary, ‘Unstoppable’ on fentanyl, recently pointed out, the ‘chemists’ will continue to pump out unregulated, even more toxic versions of fentanyl, which has the effect of killing more people and further addicting the ones that don’t die. And there is a ridiculous amount of money for all involved in the supply side.

We will never catch all illicit fentanyl, or have enough beds, or catch in the safety net all those people who are addicted. Besides, what is going to take the place of heroin in their lives? Will they get jobs, housing, medical and mental health treatment, counselling? No they will not. Not in the present system.

So we need to be pragmatic and realistic. Our resources need to be going into assessment and dispensing safe, regulated, cheap or even subsidized opioids in safe venues. This will put the black marketers out of business by eliminating or drastically reducing their market. They will surely find some other nefarious work.

Let us accept that a segment of the population needs to ease its pain through drug use. Let us accept that this is not a moral failing, and let us treat it like the health issue that it is. If the medical community is allowed to treat drug dependent people with the medicine they need, i.e. opioids, they won’t die, they are healthier, they will not have to resort to crime to fund their needs. Their families will be safer. The whole community is healthier. The billions of dollars saved in law enforcement, border services, incarceration, and emergency healthcare can easily fund the recovery and social services we need. .

Let’s get real in ending the overdose crisis. Let’s try what will surely work. That would be a gift.

Leslie McBain