Public Safety Canada and CCSU Law Enforcement Round Table

Petra was invited to present to the Law Enforement Round Table in Ottawa on March 19, 2018. The presentation given was a slightly abbreviated version from the text below. 

Our youngest child Danny died from accidental drug poisoning in 2014. Danny was 25 years old.  

Danny was in recovery when one more pill, which he thought was a fake OxyContin, but was in fact Fentanyl, took his life.  We did not know about the increased risk in recovery, when the person’s tolerance for the drug is lowered and when they are less informed about the scene and dangerous drugs.  He was one of the early victims, before Fentanyl made the news, and before there were any health warnings. Those came several months after his death.

After Danny died we decided to be open about the cause of his death. We wanted to end the silence and the stigma. Friends and family, and his workplace were surprised. Danny did not look like an “addict” - a word I don’t care for much.  How does a person who struggles with substance use look like? In most cases, it is an invisible condition. When Danny died, he had been in recovery for a year and a half. He was a chef in one of Edmonton’s best restaurants, and he lived in a downtown apartment.

What worked for Danny was opioid agonist treatment with Methadone combined with counselling, which we paid for  privately. The only thing the public health system offered at the time was a list of 12 step groups, that are not evidence based and would not have taken him on methadone.

What did not work was the fact that both he and we were keen to have him “drug free” and he did not stay on the Methadone long enough to be stable.

For a while it seemed that we had the old Danny back, the kid we knew before he became dependant on drugs. On the outside, he looked like a successful young man, but he was struggling. His addiction started as his way of dealing with his severe social anxiety, but there were other risk factors: A learning disability, being gay, working in an environment were drug use is prevalent. Being impulsive and risk seeking.

He told me once that after he took an opioid he could just walk into any room and be himself, and I wondered if being yourself is too much to ask. Should we not help people to deal with their mental health issues, before they turn to drugs?

What I have since learned is that one of the greatest barrier to providing more effective supports is the stigma of mental health and substance use. 

It is because of stigma that people, like Danny, use and die alone.

These are the photos of some of the loved ones MSTH members mourn. The images we see in the media are mostly from Vancouver’s  DTES – of people who are living  with multiple risk factors besides substance use. These individuals been underserved for a long time and an effect of this crisis is the fact that this population finally gets attention and services, such as supervised injection.

People from all socioeconomic, ethnic or cultural backgrounds and all regions are affected by the drug poisoning crisis, but if there is one demographic  that is at high risk and difficult to reach:  men age 25 to 39 who use alone (80+%, BC and AB stats), mostly indoors (80%), in their own homes (65%)

The reasons why people use vary widely, but there are some common themes, especially for those where the use becomes problematic: physical or mental pain (mental health), trauma and adverse childhood experiences (ACEs), and a lack of hope. For many sexual exploitation causes and contributes to use.

In Canada this is slowly changing, but people are dying faster than we can respond, and our response to date does not match the magnitude of the crisis.

All too often the focus of information for parents and users is still to get “clean” - another term I don’t care for much. People relapse and we did not learn about potential lifesaving solutions, such as Naloxone and how opioid agonist treatment should work, until it was too late. 

Danny was as safety conscious as he could be, doing something very dangerous. He always bought new needles, but that day he was home alone, so nobody could assist him when he overdosed. I can’t tell you how many times I imagine myself finding him in time with a Naloxone kit in hand -  I always keep one with me now. I can visualize what I would have done, but never got a chance to do.  Before his death we had never heard of Naloxone, a safe medication that can reverse an opioid overdose, if  administered in time.

Anybody who takes drugs from the illicit market, including those who do so casually  and even those who take prescription opioids should have Naloxone on hand, and make sure that their friends and family know how to use it.

Ideally you should not use drugs alone, but if you must, always let others know and never take them in a place where you can’t be found, such as stairways or locked cubicles in public washrooms. We have mothers in our group whose children were found in those locations after it was too late.

These rules are like basic first aid, more important since the arrival of new and more toxic drugs, such as Fentanyl, and Carfentanil. Before Fentanyl, the people who were most at risk were people like Danny, injection drug users dependant on opioids.

For casual users, the situation has drastically changed, as Fentanyl and other toxic substances are contaminating drugs that should not contain an opioid, such as cocaine, methamphetamine and ecstasy.

Contrary to common assumptions not all drug use is problematic, and most people who use substances  do so without developing an addiction. I had a glass of wine last night and I will be ok tonight if I go without one.

What substances are currently legal, such as alcohol and Cigarettes and soon cannabis, and what is illegal  is not always based on evidence. Alcohol is  dangerous and causes tremendous harm, such as family violence, and motor vehicle collisions, as well as a host of potentially fatal health conditions.

How drugs are regulated should be based on the best possible evidence on their harm and with a population health approach. Using substances is as old as the human race and, some people will always use.

Does arresting dealers help keep us  safe and save lives? Some dealers, who are part of large criminal networks,  yes, but the street-level dealer who is a user needs a different, more creative and compassionate approach. If more arrests and stricter punishment would keep us safer, the US would be one of the safest countries. 

Why do people deal?  Many of our children who used have also been involved in trafficking, mostly to finance their use, or to pay back dealer debt. People who use have also told us that the street level dealer who uses has a safety role, as they can advise on the strength and/or toxicity of a batch. You probably know of the turf wars that erupt when a dealer is taken out.

As a society, we need a paradigm shift away from treating substance use as a criminal justice problem, to approaching it as a health and human rights issue. Our mothers group calls for the decriminalization of the personal possession of illicit drugs. This is a big shift for Canadian society and probably for many of  you, but it has been shown to save lives and reduce crime in several European countries, where it is practised.  Since decriminalization in Portugal, rates of drug use have not increased, far fewer people arrested and incarcerated for drugs, more people receive drug treatment, and  incidence of HIV/AIDS, as well as drug-induced deaths have been significantly reduced.

How can we expect people to seek help for doing something that could result in a life altering criminal record?

For those within the criminal justice system we need to provide harm reduction (needle exchanges or naloxone), and evidence based treatment and effective follow-up services for substance use disorder (SUD) when the person is released. Loved ones of our members have overdosed in or right out of jail. Their tolerance is lowered and the addiction has not been addressed.

Locking people up for using drugs causes tremendous harm to the individuals, their families and to society, while it does nothing to help those in need of treatment nor to  reduce the supply of illicit drugs.

This young woman is was in recovery when she died in 2017. She did not die from the drug use itself,  but from endocarditis, caused by the dirty needles she shared and repeatedly used. She did not have access to a needle exchange, and the city where she lived still does not offer supervised injection services.  If she would have had access to both, she would not have had to die.

Prohibitive drug policies based on the false assumption that needle exchanges and supervised consumption encourages drug use, are causing harm.  These services keep people as healthy as possible and data from BC shows that those who have access to SCS are 30% more likely to seek addictions treatment. This young woman's ultimate cause of death should read bad drug policy.

The picture on the right is a vile o OxyNeo. When it be became clear that we were duped by Purdue pharma regarding their claims of the  “non-addictive & slow acting” properties of Oxycontin, and when the extend of the misuse and addiction attributed to prescription medication, Oxycontin was reformulated into a “tamper proof version” and rebranded at OxyNeo.

But users were left stranded. Nobody thought to combine the measures that influenced the supply with measure that addressed demand. When you are dependant on opioids you don’t just stop to take them because your supply has changed. Opioid dependence is a chronic condition and people need medical help to stop using.

Criminal networks quickly filled the void left with the reformulation with drugs that are easy to smuggle and can be sold with a huge profit.  Poorly planned and executed drug policy brought us fentanyl and other synthetic drugs.

Danny’s substance use started on prescription Oxycontin, readily available on the streets of Edmonton,  and ended with a fatal dose of fentanyl.

People do recover from substance use if we use evidence based (proven) treatment approaches, combined with harm reduction measures to keep them alive. Some people simply outgrow their dependence when they mature or life circumstance changes.

Our expectations of recovery have to change. These photos are from the SALOME study in Vancouver, where individuals, who have not succeeded with other treatment approaches, have access to injectable prescription hydromorphone. The results have been amazing and the stabilizing effect in people’s life is evident.

Without having to seek the illegal fix, people found housing, work, reconnected with loved ones, and most importantly have found hope for the future, some have moved to OAT or even stopped using.

People I know take a daily dose of Methadone or Suboxone, but you would never know. It is part of their health regime, just like some people take blood pressure meds or insulin.

Recovery does not have to mean to be or drug free. Recovery means being free from the chase of buying drugs on the street and all the activities that come with getting the money to do so. Activities that keep you busy.

For some people it may mean drug free, but making “clean” the benchmark has cost  the lives of many people for whom this was an unrealistic goal.

In my advocacy work  I am always amazed at the time, creative energy and a money spent on keeping people safe from a toxic illicit drug supply. Would it not be so much easier if giving safe drugs on prescription, to those who are addicted, could be a first line of defence rather than a last resort?

Living with substance use disorder should not have to come with a risk of sudden death.

Danny came close to reaching recovery. He had hopes and dreams.  He is on our mind every day and I try to think about the loving, caring son he was and the great meals he cooked. I can’t help to also think about how different the outcome could have been.

The lack of health warnings (Letter to Dr. James Talbot), the rising number of deaths and our experience with the health system lead me to speak out and find like minded individuals. Lorna Thomas, Leslie McBain and I founded MSTH in 2016 and today there are close to 400 Canadian families in our group and 3500 followers on  our Facebook  page

We have learned much about the challenges our families experience trying to help their loved ones. Families struggle with:

Personal Safety – setting healthy boundaries, protecting the child who is using, other children and the rest of the family, personal threats from dealers over debt, dealing with sexual exploitation.

Economic strains – lost time of work, paying for drugs (while waiting for treatment), paying off dealers, paying treatment, paying lawyers and ultimately funerals

Social isolation from family and peers due to stigma –  Before Danny died not even his grandparents new about his addiciton.

[last slide for law enforcement round table]

As you have heard drug policy has four distinct pillars : prevention, treatment, harm reduction and enforcement. Your concern is the fourth pillar, but if we do not invest in the other 3,  we will not be successful and you are not able to do your job effectively.

I would like to quote Sargent Jason Walker, one of my fellow members from the AB MOERC, who works for Calgary Police services: He has learned that “We can’t arrest ourselves out of this problem”. We have to look for solutions in the other 3 pillars. 

As mothers and families we want to keep our loved ones  alive and as healthy as possible until they can arrive at a place in their lives where treatment or abstinence works for them. Please help us achieve that outcome!

[Text I used in my last slide for a healthcare audience]

In closing, I would like to share this final message to you: When a person with SUD presents in to you, remember how hard it is come forward and ask for help. Welcome them, thank them, and be kind. Watch not only your words but also your body language. Check the person’s knowledge of harm reduction. Do they know that all pills and power may contain Fentanyl? Do they know not to use alone, but to have a safe observer? Do you and your loved ones have Naloxone?

Most of all welcome the person, tell them that you are glad they are here and help keep them alive. Someone’s mom will thank you for it. 

[This slide was not part of the law enforcement round table, but is included in most presentations - it is included here to show the complete talk]

I am part of a research project on mothers advocacy (with Dr. Hyshka from the school of public health and others) and in our project we are examining what a family centred approach to substance use could look like. We have learned that families have a central role in keeping  people alive and helping them reach recovery, but our system neither recognizes nor encourages that role. Not considering the needs of families can have negative health outcomes both for the individual in treatment as well as other family members.  Affected family members can develop chronic medial and psychiatric conditions and become high users of health services

Evidence based interventions for families have been shown to improve health outcomes not only for other family members, but also for the individual receiving treatment.  A paradigm shift is required to move to a family centred model. (1)

(1) Ventura, A.S. To Improve Substance Use Disorder Prevention, Treatment and Recovery: Engage the Family. Journal of Addiction Medicine. Volume 11, Number 5, September/October 2017

In 2018 more people will die from causes related to substance use in Canada than ever

Welcome to 2018, the year when more people will die from causes related to substance use in Canada than ever.  When I wished my family and friends a happy New Year last night it was with a heavy heart. 2018 is the third year that begins without our youngest son Danny, and the first year for over 4000 Canadian families who lost a loved one to an overdose or other causes related to substance use in 2017.

How do I know that 2018 will be worse? I follow provincial (Alberta, British Columbia) and federal overdose surveillance reports on fatal overdoses and the reported trend is sharply upward.  The users, advocates and front-line workers in my social media and personal networks have also seen significant increases in deaths. Every day more families join Moms Stop the Harm (MSTH). Most organizations would view growth from 3 founding members (Lorna Thomas, Leslie McBain and I) in May 2016 to over 300 members in December 2017 as a success, but in our case every new submission via our website comes with a story of desperation, fear, and pain. Desperation and fear for those who have a loved one struggling with substance use and the extreme pain of the newly bereaved. Too many times this year we received a cry for help from a family who do not know where to get treatment for a child, or how to deal with the loss of someone who had so much promise and their entire life ahead of them. The stories are so familiar showing bright young faces from all walks of life, backgrounds and regions of the county.

We have seen progress over the past year: more supervised consumption sites have been approved; peer and volunteer lead overdose prevention sites can soon operate legally; and Naloxone (an antidote that can reverse the effect of an overdose) is being distributed more widely in BC, Alberta, and Ontario. Access to treatment is improving and innovative treatment approaches, such as rapid access programs in emergency rooms and the provision of safe drugs, are being implemented. Several provinces and the federal government are developing anti-stigma campaigns, and the federal government has made funding available through its Substance Use and Addictions Program and other initiatives.

Why do people continue to die despite this progress? There is not one clear answer to this complex question, but part of the answer is that the federal government, provincial and territorial health care providers let the crisis get out of hand before taking action and the response has not been commensurate with its magnitude. Have we ever had 4000 people die from a disease or other health condition without a comprehensive national strategy?

Many of the measures taken to date , such as supervised consumption and overdose prevention sites, are most effective for people who are homeless or unstably housed. Data from the BC Coroners Service,  released in October 2017,  shows that 87% of overdoses occur indoors, often in people’s homes (59%) and presumably when people use alone. These at-risk users include casual users and those who have developed an addiction. Casual users seem to be most at risk, as they have not developed a tolerance for opioids and they may be unaware that other drugs are contaminated with fentanyl (tests at Insite in Vancouver show that around 80% of all street drugs contain a synthetic opioid, such as Fentanyl).   Most casual users do not know how to recognize and respond to an overdose. According to a CBC News report from Winnipeg  a young man who died when he and his friends shared pills they thought were Oxycontin. His friends and his brother thought he was “sleeping it off” when he was in fact dying from an overdose.

One of the greatest barriers to addressing the problem is the stigma that surrounds substance use, which causes both casual users and those who live with an addiction to hide their use, including by using alone. When people use alone, no one is there to help when they overdose, like our son Danny who we found dead in his apartment in downtown Edmonton, in walking distance to one of the approved supervised injection services.

Distributing Naloxone will not help if people use in secret and alone as they cannot administer Naloxone on themselves. Even effective anti-stigma campaigns will not fully eliminate the misconception of the person who uses substances as someone who lacks willpower and has a problem that is entirely self-inflicted. Problematic substance use is still seen as a moral failing and not as a health issue.

What would it take to prove my dire perdiction wrong and reverse the deadly trend?

Instead of a patchwork of federal and provincial initiatives, a clear and coordinated national strategy with levels of investment at least equal (per person) to those made during the AIDS crisis in the 1980s—when half as many people died in peak years as did in the opioid crisis in 2017 alone —is required. Such a strategy should be guided by people with lived experience, affected families, and be based on the best available evidence. This evidence tells us that we need to stop criminalizing substance use and start investing in prevention, treatment, and harm reduction as Portugal has done and Norway plans to do. Portugal has since reduced its overdose rate to 6 deaths per million of population, while the US is at 185. Canadian data from March 2017 shows 78 per million nationally, however, the hardest hit provinces and territories are much higher: BC's rate is 200 per million, the Yukon at 160 and Alberta at 138. These rates are not adjusted for year end numbers. 

As the experience of European countries shows, decriminalizing the possession of drugs for personal use will help end the stigmatization of substance use and allow users to come forward and seek help through harm reduction measures and treatment.  Decriminalization will also permit an open discussion about substance use that will lead to truly innovative approaches and more research findings.

Decriminalization is a bold step that our current government has been unwilling to take. In our most recent campaign we have asked Prime Minister Justin Trudeau to “Do Something”, starting with acknowledging the magnitude of the opioid crisis and initiating a national strategy. So far, he has not responded to hundreds of Canadian families who have sent photos of loved ones who have died or purple hearts for individuals who are struggling. His silence is deafening and a slap in the face of those who have suffered so much.

As a society we should not accept the deaths of thousands of Canadians in the prime of their lives as the new normal. As families we will not be silent and stand by while our loved ones die from preventable causes. We should not have to start the New Year without our sons, daughters, brothers, fathers, mothers, relatives, and friends.

Individuals struggling with substances use have a right to access appropriate medical services and deserve the same level of support and care offered to those with other health conditions. We call on the Prime Minister, and all levels of government,  to “Do Something”, to match investment in this crisis to its magnitude and to take the bold step of decriminalizing the possession of drugs for personal use. 

 Petra Schulz, Co-founder of Moms Stop The Harm,  Edmonton, AB January 1, 2018

Do Something Prime Minister Photo Campaign

See results of our follow-up survey below campaign photos.  More than 450 photos were sent to the Prime Minister, who so far has not replied to anyone. 

Dear friends, fellow advocates and drug policy reformers, 

We have all been feeling the pain of the rising death toll in the opioid crisis, as numbers of families in mourning grow. The actions of all levels of government are inadequate considering the magnitude of the problem. We need to see leadership at the top, starting with our prime minister, Justin Trudeau. Over the past months he has spoken on a number of issues, but has been relatively silent regarding this crisis and did not cover this topic at all at town halls this summer, that some MSTH members had a chance to attend. 

To help him recognize how this impacts Canadian families we propose the following initiative, which we call the Do Something Prime Minister Photo Campaign starting on November 13, 2017 – on-going after that:

• Take a photo of your loved one (4x6, 5x7, or 8x10 – bigger is better)
• If you do not have a photo cut out a purple heart from construction paper and proceed. Also use a purple heart if you are sending on behalf of a person with living experience. 
• On the back write 
  • their name [NOTE: If you are not able to use the actual name, chose a name, every person counts];  and the year they were born and the year they died. 
  • cause of death (e.g. accidental fentanyl poisoning, overdose, from substance use, using a drug that was laced with fentanyl, substance use related suicide, overdosed on prescription medication, etc.) and 
  • your relationship (son/daughter, brother/sister, spouse/partner, grandson/daughter, niece/nephew etc.). [NOTE: Multiple people can send a photo of the same person, illustrating how many are affected by each death]
  • If you wish and have room, add a slogan. First, we tried to pick one, but our strengths as advocates is in our diversity, so write your own or chose from one of these: The Deaths Must Stop! - Stop the deaths! - Do something Prime Minister! (quoting Zoe Dodd) - How many more need to die? - Stop the deaths - save the future of your country - Why Are Canadian Children Dying? This Must Stop! - Somebody's Someone - Anyone’s Child - Empty Chairs - A Picture- More than a thousand words
• Use a regular envelope and write your return address on the envelope. You may also add that to the photo, so you can get a reply from the PM office.
• Send the envelope to [NOTE: no postage needed]:  Prime Minister Justin Trudeau, Office of the Prime Minister 80 Wellington Street Ottawa, ON K1A 0A2
• Please take a photo of your project and post it to one of our Facebook pages or email to Petra Schulz, so we can add the photo here. 

Feel free to share this as widely as possible!

Thank you

The families of MSTH

Here are the results of our follow-up survey, conducted in January 2018: 

LOOKING BACK < MOVING FORWARD>
The 'Do Something Prime Minister' advocacy campaign was a success in many ways. More than 400 letters were sent to the office of the PM by MSTH Members and allies from other groups. And after that, 118 people filled out the survey to gather information and thoughts about the advocacy initiative. Thankyou to everyone who participated. Below are some of the common themes and suggestions that were offered about the campaign and some ideas on what MSTH could do next. Let us know what you think. (If you don't know about this advocacy campaign, a link in Comments will take you to that information)

THE SURVEY: Common Themes and Follow up Suggestions

COMMON THEMES OF COMMENTS OFFERED THROUGH THE SURVEY
1. Was a good way to get family and friends involved in the issue
2. Mail in campaign caught people’s attention on social media ( as opposed to on line messaging or petition.)
3. Got good media coverage which in turn may influence public education and understanding, empathy.
4. ‘do something’ message was weak. Rather than ‘do something’ could it have been ‘here’s what you need to do.’ Could have included information and action plan from MSTH on what the Prime Minister needs to do
5. disappointed that there has been no response from the PM office yet.
6. Campaign focused specifically on opioids/fentanyl. Could have included other drugs such as cocaine, meth, crack, ecstasy…given that a good number of the loved ones of MSTH members did not use opioids.
7. The campaign could have included images of those loved ones who are still alive and in recovery, not just those who have died. 
8. A person who has worked on advocacy campaigns advised that putting the hearts on the outside of the envelopes was a mistake. Those receiving the letters might have just put them all in one pile and not opened them (yet).
9. The tone needs to be just right. “Research has shown that expressing anger and laying blame does not work. It puts people on the defensive and has the opposite of the desired effect…
The assumption should be that if they (the person(s) receiving the messages) were aware, surely they would be doing something about it.
In other words, instead of accusing them of inaction, you make it sound like you are giving them the benefit of the doubt... so you explain the situation to them.”

Suggestions for the Focus of Future MSTH initiatives:

1. Keep up the pressure on the office of the Prime Minister and send the key message(s) c/c to others such as Health Minister, MPs.

2. Education for front line workers
--doctors need more education on substance use
--emergency rooms need to be more responsive to those in distress due to mental illness and substance use
--anti stigma education for front line workers.

3. Education for youth
--have bereaved parents speak to youth groups.

4. A Campaign directed at Provinces, Members of Legislature given the Provinces have a lot of say in where Health dollars are spent.
--Tip: when mailing send Express post with tracking number

5. Campaign focusing on anti stigma
--avoid labels
-increase understanding the addiction is a health issue. 
(note: Both B.C. and Alberta have just released their anti-stigma campaign. Health Canada will be releasing their anti-stigma campaign shortly)

Why are so many people dying? What needs to happen to stop it?

Leslie McBain, September 14, 2017

It is difficult in this complex crisis to know which way to go first. But as Moms Stop The Harm (MSTH) has always stated, first, we need to save lives. We know that a dead drug user will never recover. And we know the solutions.

Why are people dying? Simple - it is the toxic black-market drug supply.

Why does that black market exist? Because of the money and because of bad drug policy that drives people into the black market.

How do we rid ourselves of the major part of the black market? Supply safe drugs to those with substance use disorder (people living with addiction).

How do we provide safe drugs in the face of a federal government that refuses to consider decriminalization and regulation? We look at the Crosstown Clinic in Vancouver as an example.

How do we encourage those with substance use disorder to go into effective and proven treatment? Provide multi path, low barrier, rapid access treatments combined with housing first strategies for those who are unstably housed. We must build the system and ensure that it works. Provide connection, empathy and humane treatment to those people addicted to drugs.

Sadly providing connection, conversation, and anti stigma community dialogue will have little impact on the death rates without the previous steps (safe supply and rapid low barrier access to effective treatment).

I know people will say, 'but we can only do what we can do”. True, but with courage, and passion, we can push the envelope. We must begin to think out of the box immediately. As the CAPUD (The Canadian Association of People Who Use Drugs) says: #theytalkwedie. It is a slogan that comes to my mind every day.

Our actions must be guided by what is most important. First we have to stop the drug related deaths. We need to get naloxone on in the hand of every drug user, train people on the street, in bars, in educational institutions and every environment where people may be at risk in regular, widely advertised sessions in public places. Provide targeted intense messaging about not using alone, knowing about overdose and how to respond, and about the 911 emergency law. Saves lives and then look at housing and access to treatment.

Sorry to rant, but it is very frustrating to hear more talk, more research, more indirect, soft solutions to the overdose epidemic. In Canada more  than 2,816 people died of a drug overdose in 2016, almost 1000 in BC alone. We must put our energies where they will make an immediate impact. Only the government bodies can provide the infrastructure. It comes down to creative thinking, courage, and funding! But first and foremost, we must save the lives of everyone's children.

Shanell Twan from AAWEAR Speaking at International Overdose Awareness Day in Edmonton

August 31, 2017

Tansi…Hello and Good afternoon,

I would like to start first and foremost by acknowledging that we are gathering here today on treaty 6 territory on which out of respect for the land and its people must be honored and respected.

For those of you who don’t know me my name is Shanell Twan I am a proud member of AAWEAR [Alberta Addicts Who Educate And Advocate Responsibily] which is one of the co- host Organizations for today’s event.

We are Gathered here today FOR International Overdose Awareness day and to Acknowledge That We fight for those we love and have lost. The harms being caused by the war on drugs can no longer be ignored – so we are calling for more humane drug policies that support, and don’t punish, people who use substances. It is time to leave behind the harmful politics, ideologies and prejudices – and prioritize the health and welfare of those affected. I am here today as a concerned Albertan and an indigenous woman who values the recent truth and reconciliation events that happened across our country. I believe it is time for us to reconcile with the truth and i feel that one of my truths is that as indigenous people we are often overrepresented in a variety of systems: the legal and justice systems, health care, and social service systems.

I find it disheartening that substance use has long been viewed as a criminal and moral issue rather than a health issue. In reality, it is an unpleasant fact that has touched many families. Mine included. I feel it is here that a tectonic shift must take place…treating someone who uses substances must be seen as a bonified health issue.

Because I currently see a disconnect between all systems with class and race often playing a role in how we view substance use or addiction. I feel that people who use substances should be viewed as just that people rather than offenders. Law enforcement and public health should have the same goal of wanting people to do good and stay alive to make a different choice on another day.

We are desperately in need of supervised injection services to help decrease the high number of overdoses we are seeing in communities across our country. When substances are used inside of a health setting and substance use becomes decriminalized people then come into contact with nurses, social and peer support workers that are there to provide them with voluntary drug tapering strategies, education, advocacy, health and social interventions available to them if they so choose. I see a valuable opportunity for us to take a stand on the forefront of this overdose crisis, and provide people using substances with services that will prevent further loss of life due to overdose. Because as it was said in Ottawa at the Canadian drug future forum: ’’the drug supply in Canada has gone toxic’’!

We should all know by now that we cannot arrest our way out of this crisis. We know that mental health factors contribute to substance use and that mental health sufferers are twice as likely to use substances that being said i feel that we need to look around the country and maybe even the world to see what’s working well and look at applying some of those ideas here and now (coughs-like Portugal’s model). Because the death toll rise in spite of current actions and at best a glacial pace is what things seem to be moving forward at. What evidence based things can we look too… where other interventions have failed heroin assisted therapy has had great successes Portugal even greater successes.

At ungass2016- 22 governments from around the world advocated for all drug decriminalization here is a small part of a statement from the idpc- international drug policy consortium-…” the gold standard of decriminalization is the removal of all punishment for drug use and the provision of voluntary health and social services ’’the sad reality is our current drug laws and policies have failed us. I believe herein lies an opportunity for us to show some leadership.

We need to show good models and then scale them up building an evidence base that demonstrates what works safely and effectively to save lives …because the government doesn’t hold all the answers and neither do we. This is why evidence must form the basis of all policies in place. I feel that we are at a crossroads where I think we must acquire the knowledge to build upon societal support to expand upon these services.

I urge you to push pass ideology, prejudice, and fear to step up to help our citizens. Let’s roll up sleeve take bold steps and help people, so no more families have to lose a mother, a father, a son, a daughter, a sister or brother. Or in my family’s case an aunt and two cousins.

We need our governments to make evidence based decisions when it comes to drug policies. We need progressive evidence based policies. We need you to take the ideology out of it and only make evidence based decisions. I do believe we need an integrative knowledge exchange about best practices from across our country, and maybe even the world, we need support from all levels of government to help build upon this knowledge base so we may integrate and facilitate the effective use of this knowledge into practice. To the provincial & federal government i implore you. The evidence is there use it!!

On February 21 2017, a first national day of action was held across Canada by CAPUD to demand concrete actions to put an end to the war on drugs, remove barriers to health care, and implement policies that are informed by real life experiences of people who use drugs and Service providers. At that time, we met Government Officials to share Our thoughts with them and forward our list of CAPUD’s federal demands: in no particular order they are

• End the War on Drugs. In the short-term, decriminalize possession of all drugs. In the long term, full legalization and regulation of drugs.
• Grant immediate exemptions to all supervised injection service (SIS) applicants and/or define them and any future SIS as health services implemented solely by provincial authorities;
• Create a specific harm reduction initiative as part of the new Canadian Drugs and Substances Strategy, to support, expand and adequately fund harm reduction programs and strategies including explicit funding for the development of drug user-based organizations and advocacy groups.
• Remove barriers and increase access to opioid substitution therapy including access to prescription heroin.
• Implement harm reduction in prisons: needle exchange programs, increasing access to opioid substitution therapy and continuation after release

We should be identifying smart policies and implementing them to apply solutions to save lives. I can honestly tell you the vast majority of deaths I am seeing are related to illicit drugs, Fentanyl and Carfentenyl, and now even cocaine and methamphetamine can contain these. I can also honestly tell you that i have attended numerous funerals in the past few months. And i am now at a point where I have to acknowledge my own personal experiences with tackling issues related to my own mental health, because as of lately I feel as though I’ve been plagued by depression. Thoughts and memories of those we’ve lost leave me holding on to hope, hoping those who hold the power can and will do something to help. Now is the time to remember, it is also the time to act!

Hyi hyi ..thank you