MSTH Regional Updates - November, 2019

First regional meeting of MSTH Alberta - by Angela Welz (AB & national leader, MSTH Society board member)

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The MSTH AB regional meeting was held in Red Deer, AB on September 13, 14, 15, 2019. We had 21 representatives from all across the province who attended:

Sylvana, Tyla, Deborah, Shauna, Lori H, Rhonda, Petra, Ann, Cindy, Heather (PhD Student in the School of Public Health UofA and research assistant), Lori V, Ashley, Dana, Rosalind (also representing Change The Face Of Addiction), Rory, Tracy, La Vonne, MaryAnne, Carissa, Petra and myself. 

It was a wonderful opportunity for many of us to not only meet in person, but to brainstorm with regards to the political climate affecting us in Alberta at this time. We discussed actions in response to the SCS reviews being held across the province and strategies and responses for the upcoming federal election along with a conversation about other activities or actions we should initiate or be involved in. Part of our meeting included peer support as we spoke about our loved ones both those who have passed and those still struggling with their addiction and those who are in recovery.  After our meeting we ordered pizza and delivered it to Turning Point OPS. It was a wonderful experience and very poignant for the clients of the OPS and for us as well. 

Here is an article link: https://www.reddeeradvocate.com/news/moms-visit-red-deers-overdose-prevention-site/ 


IOAD day proclaimed in Toronto, ON - by Irene Paterson (ON leader and national leader)

I organized an Overdose Awareness Day Flag raising event at Toronto City Hall for IOAD, where Mayor John Tory made a proclamation for Overdose Awareness Day. Speakers included advocates, activists and public officials. The event was well attended with Media coverage on  all channels, CBC, Global, CP24 and social media. 

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In June I represented MSTH at an televised event called Opioid Summit at Crossroads. The purpose of the event was to show that people who are experiencing addiction are humans , they are friends, sisters, brothers, parents. We want to break down any or all negative stereotypes that people have surrounding consumption and treatment sites and show the effectiveness of these centers because they save lives; this also includes building awareness around the decriminalization of drugs. 

FLOOD the documentary - Adam D’Addario came to my home to interview me for the documentary. It was in depth  and personal documenting my son Roger’s struggles and his fentanyl overdose. The movie premiered on October 31st at the Carlton Cinema in Toronto.  I will be there with Adam for the premiere. https://caughtintheflood.com


Funding for new research initiatives Toronto, ON - by Sheila Jennings (ON leader and national leader and MSTH Society board member).

Sheila reading the poem “Think of me” on IOAD in Toronto. Photo by Angie Hamilton, FAR Canada

Sheila reading the poem “Think of me” on IOAD in Toronto. Photo by Angie Hamilton, FAR Canada

Sheila (ON MSTH Lead and Board Member) was interviewed for and appeared in the new documentary by Adam D'Addario entitled "Flood: The Overdose Epidemic in Canada". She also attended the premiere of this documentary, held in Toronto in October 2019.

Sheila is a MSTH collaborator in a grant application to Canadian Institutes Of Health Research entitled "Palliative and end-of-life care delivery and experiences among people with opioid use disorders." applied for by Lau and the collaborators on this project.


MSTH come out to support supervised consumption services in Lethbridge, Alberta by Lorna Thomas (co-founder, AB and national leader)

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In August I helped to organize a group of MSTH members to attend a rally in Lethbridge, AB. I traveled from Edmonton to  Lethbridge and others travelled from Medicine Hat to attend the rally on August 19, to show support for our MSTH Lethbridge  members. The rally was organized to support harm reduction generally and specifically the work of ARCHES which includes a Safe Consumption Site . It is the busiest SCS  in North America with 650 visits PER DAY. The rally included hundreds of people from the two sides ( pro / con SCS). The racist neo-Nazis were. The day ended with “good newss” in that a motion by the City Council to close down some of the services at the ARCHES harm reduction site was defeated..  While we waited for this happy news we visited the SCS in Lethbridge and saw for ourselves the important work and services being done by Arches Lethbridge.


Canadian Association of Suicide Prevention National Conference by Lorna Thomas (co-founder, AB and national leader)

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On October 16, 2019 I co-presented at the Canadian Association of Suicide Prevention National Conference, along with my husband ​Phil Haug and PhD student Heather Morris. Here is the title and synopsis of our presentation: 

SUICIDE, , SUBSTANCE USE DEATHS AND STIGMA:  CALL FOR A UNIFIED APPROACH TO PREVENTION

‘The mental health and social risk factors preceding suicidal behaviours and substance overdose or poisonings are largely overlapping. This presentation is a call to action for public health strategies, research and education aimed at preventing both suicide and substance-related deaths. During the session one such educational initiative, the ‘Seeing Beyond the Numbers’ (see-beyond.ca) video project, will be introduced.  Lorna, Phil and Heather’s presentation aims to promote connectedness between families, researchers, educators, politicians, helping professionals and the general public. There needs to be a unified approach to reducing stigma and preventing suicides and substance-related deaths. It is time to end the siloed approach to prevention.’


See-Beyond at UofA Women’s & Children’s Health Research Institute (WCHRI) Research Day in Edmonton by Petra Schulz (co-founder, AB & national leader, MSTH Society board member)

In an effort to share our anti-stigma project See-Beyond (same project featured by Lorna, Phil and Heather at the Canadian Association of Suicide Prevention National Conference) with the widest possible audiences Petra Schulz and Heather Morris share the evolution of the project, what researchers have learned and the message of the videos with students and faculty of WCHRI. WCHRI is a UofA Faculty of Medicine research institute that includes physicians, health professionals and researcher in pediatrics and obstetrics, nursing and other affiliated disciplines. Our videos and presentation resonated with the audience as we won for best oral presentation of the day, among dozens of excellent presentations.

The anti-stigma videos (see link below) are a result of an on—going research project on mother’s advocacy and the team (Dr. Rebecca Saah UofC, Dr. Elaine Hyshka, UofA, Dr. Emily Jenkins, UBC, Heather Morris, UofA and Petra Schulz, MSTH) are currently applying for funding to expand the video project to BC. In the first round of videos three moms (Kym Porter and Petra Schulz, MSTH, Donna May, mumsDU, and Phil Haug, husband of MSTH Lorna Thomas) read letters to their children sharing what they wish they had known. Each video is about 90 seconds long and is linked from a website that includes resources and a study guide with discussion questions about each video.

More information and a link the the videos at https://www.see-beyond.ca/.


MSTH represented at the CCSA Issues of Substance conference - Petra Schulz (co-founder, AB & national leader, MSTH Society board member) & Leslie McBain (co-founder, BC & national leader, MSTH Society board member)

The Canadian Centre on Substance Use and Addiction is holding the CCSA’s Issues of Substance 2019 conference from November 25–27, 2019 in Ottawa. The theme for this year’s conference is Evidence and Perspectives, Compassion and Action, reflecting the importance of relying on research and real-world experience as we identify sustainable solutions to meet the needs of Canadians suffering from substance use disorder.

Leslie McBain and Petra Schulz will be presenting a workshop at this conference entitled “Supporting, Engaging and Building Capacity of Families Affected by Substance Use in Canada”. Leslie is speaking about the “Stronger Together” meetings held throughout BC and Petra will talk about the work of our Healing Hearts MSTH grief groups.

Marie Agioritis will be joining Leslie and Petra in Ottawa on behalf of Say Know organization. Petra will also be a keynote speaker on the closing panel that will be discussing the topic: If I Were the Minister of Health: Best Advice for Addressing Substance Use and Addiction”.

The conference is sold out, but more information is available on the website https://issuesofsubstance.ca/.


Kelowna, BC moms raise the bar in their anti-stigma campaigns

By Helen Jennens (BC - Kelowna, national leader and MSTH Society board member)

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Our IOAD event was great this year. We kept it to an evening agenda with live music and a candlelight vigil. We handed out and trained 150 injectable Naloxone kits and 150 nasal Naloxone kits. Living positive had a booth and talked about their drug testing services. Attendance was about 200 people and some brought chairs and stayed for the whole evening.

You all know about our bus initiative which we are so proud of. We had lots of media coverage and deem it successful at raising awareness. The photo and message is contracted for the Penticton city buses the end of December. We are currently trying to raise funds to have the bus photo and message displayed on a digital billboard for 36 weeks. This is costly and we very well might not reach our financial goal.

The Kelowna Moms have been incredibly busy gathering for our street entrenched. We have delivered lots of blankets, jackets, boots, socks, hats and mitts, toiletries and many other things the folks are in need of. One Friday a month three of us go and serve dinner at the Gospel Mission and engage in conversations with those in severe need. Our campaign to keep the street entrenched warm will continue throughout the winter. If you are looking to supply blankets in your area, call the local hotels and they re-cycle their blankets and are keen to contribute.

We also have a campaign happening for the Hope Society which caters to the homeless women on the streets that are dealing with mental health, addictions and prostitution. On the 18th of November we are attending a Christmas party for these women. We are supplying the food and 50 Christmas parcels that we are putting together on November 14th. Not all but most of the items for these parcels have been donated by both retail outlets and compassionate people.

We will be attending the Addiction Awareness Day program at Interior Health on November 21 and Pam Turgeon and Arlene Howe will share their sons stories.


A Bench to remember those we loved and lost. Kamloops, BC

By Sandra Tully (BC - Kamloops - national leader)

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Healing Hearts in Kamloops peer grief group is continuing to support fellow community members that have lost a loved one to substance use. We meet on the 3rd Tuesday of every month at the United Church downtown. We have a small intimate group, with new people joining us all the time. We will also be collecting donations of necessary items, at the November meeting, for the PIT Stop Christmas dinner.

International Overdose Awareness Day was well attended, where we unveiled our memorial community bench to remember our loved ones lost. We started a GoFundMe page for the bench last year, and were able to secure the funds needed to reveal the bench on IOAD 2019. We had over 200 people in attendance for the unveiling and premier showing of Addiction Matters Kamloops PhotoVoice Video. Very successful in bringing awareness to the current overdose crisis in British Columbia.


Opioids Don’t Discriminate exhibit coming to Medicine Hat, AB

By Kym Porter (AB - Medicine Hat - national leader)

This year we held our second IOAD event outside our public library. Many community groups had tables set up displaying information for various populations. We again held an open mic as well as we had musical performances including a piper who had lost his son to an overdose.

A few of us travelled to Lethbridge to attend a rally in support of the tireless work of Arches Lethbridge.

Photo from the November 2018 Opioids Don’t discriminate exhibit in Sherwood Park, AB.

Photo from the November 2018 Opioids Don’t discriminate exhibit in Sherwood Park, AB.

Earlier this spring, I met up with the film crew for Flood in Calgary where she was asked to prepare answers to a number of questions specific to the Medicine Hat community, the pending SCS and the stigma associated with advocating for such an important harm reduction support while living in a smaller city.

We have arranged for the Opioids Don’t Discriminate exhibit to come to Medicine Hat Nov 18-19 in conjunction with the MH Drug Coalition, Alberta Health Services and through the generous support of a private donors along with funding from the Primary Care Opioid grant.

In September I attended a workshop with Heather Morris, PhD student at the University of Alberta, in Prince Albert, Sask at the UofS School of Nursing. We presented the See-Beyond videos and spoke about advocacy work. https://www.see-beyond.ca/

A highlight was to facilitate and help with training all the athletes at our college in the use of naloxone. Students were taught how to recognize an overdose and left the session with their own naloxone kit. I will also be presenting later this month to the students in the Addictions Studies program. I was asked has to speak about the See-Beyond project as well as my advocate work.

All this is incredibly rewarding and at the same time difficult and painful, as we miss those who are gone too soon, including my sweet Neil.


Working to create awareness in the South Okanagan, BC

By Jill McCullum (BC leader)

To promote Naloxone training with Interior Health I shared our son’s story with health professionals in four communities (Osoyoos, Oliver, Keremeos, and Princeton).

In July I was part of the team that created the powerful photo with our Okanagan mothers standing on Knox Mountain holding crosses, which was featured in the Globe and Mail. This very same image is not used on BC Transit buses in our region that I helped fundraise for and we hope that further fundraising will allow us to purchase a billboard with the image and the “End Overdose” message.

For the upcoming holidays we plan to display a white Christmas tree decorated with ornaments honouring our loved ones in Oliver and Penticton. This was done in 2018 by our Powell River (BC Sunshine Coast) members Maureen Christensen, who made an ornament for her son Anton Christensen-Lemieux, Darlana Treloar who made for her son Sean Treloar, and Lyn Nicol for her brother Neil Kulcheski. https://www.prpeak.com/community/memorial-in-powell-river-aims-to-raise-awareness-and-end-stigma-surrounding-substance-use-1.23533350

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VANCOUVER AREA MSTH PHOTOGRAPH

Most of us have seen the” terribly beautiful” photo of MSTH Kelowna area members holding crosses.  That photo has made a powerful impact and has been on the sides of buses throughout the Kelowna area. We in the Vancouver area thought that we might like to have a similar photo shoot for our area MSTH members.   Gabrielle Beer, professional photographer (she did all the photos for the Olympic Torch Relay as it travelled through Canada) has offered to take the photos.  If you can come, RSVP Sharene just so we get an idea of numbers!  sharene@telus.net

 Who:  any MSTH member who has lost a loved one

Where:  Jericho Beach- where we can get Vancouver’s Skyline in the background.  Meet outside the Jericho Hostel, which is at 1515 Discovery Street, Vancouver.  GPS it so you don’t end up at the wrong beach!

Date:  Saturday, November 30, 2019. Time:  1PM- photo shoot will start

What to wear:  all black What to bring: a photo of your loved one that has left us in a frame and no larger that 8x10, a white cross (see below for instructions)

To Make  Crosses: Base board- 3” wide, primered white, total of 6.6-7 feet; Height:  4 feet, Cross bar 2 feet six -3 feet, Cross bar placed at 2 feet six inches

Sometimes Home Depot, etc. has offcuts and these are often quite reasonable.

The crosses were made of baseboard that is available already painted with white primer. Baseboard is available at Home Depot type places.  Sometimes they have off cut left overs that will work and sometimes they will cut it for you.

Just nail the cross bar to the four foot section at the 2’6 ‘ If you want a cross but are having difficulty getting one, please email Deb at dhbailey@telus.net

 MEET UP AFTER THE PHOTO SHOOT: After the photo shoot, for those that can make it, we will have a gathering at Sharene Shuster’s house, 6050 Larch (45 and Larch).  UP for discussion is what we can do with our photograph and planning for Vancouver Area Actions for 2020.  We have not done this before but we have a lot of members, progress has been slow, and so we want to gear up!!!  Mail out! March! Confront!  Billboard!  We have some ideas and I am sure you do to!


Manitoba’s Overdose Awareness Month in August 2019

by Rebecca Rummery (MB national leader)

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August was busy month for us!

We kicked off our 2nd Annual Purple Ribbon Campaign on August 2nd at City Hall. Winnipeg Mayor Brian Bowman hosted the event, and Arlene and I spoke. We also played our “Gone Too Soon” video which includes the faces of 29 Manitobans that have been lost to substance use.

Here is a link to our video https://www.youtube.com/watch?v=416TYgZJD14&t=38s

Our purple ribbon campaign was a huge success and Winnipeg was painted purple for August. We also lined Wavell Ave and our Gone Too Soon memory garden with 29 pictures of those we have lost and it had a huge impact.

On the evening of August 14th we hosted a viewing of Painkiller: Inside the Opioid Crisis and Cory Guest from Winnipeg Fire and Paramedic Service gave a presentation on opioids and talked about Naloxone.

At the end of August, 20 people gathered on the steps of the Canadian Museum for Human Rights. 20 loved ones represented 19 losses due to substances in our community. We have always felt that this is a human rights issue and why we chose the location. 


New Regional Leader for QC by Isabelle Fortier, Montreal

I lost my daughter Sara-Jane in May of this year, of an accidental overdose of heroin and carfentanil.  She had just turned 24 years old a month before. Nothing had prepared us to face her death to this awful and unfair monster which is addiction.  Soon after her passing, I started to read about substance use, addiction, mental health issues to try to better understand what led to her using and…ultimately to her death.  We knew that she was using, but we didn’t know that she was mixing her own benzodiazepine prescription with other hard drugs.

Dopamine SCS in Montreal

Dopamine SCS in Montreal

In my quest for answers, I got in contact with the wonderful advocates of MSTH and wanted to reach out to other families as well.  I spoke about our experience at the International Overdose Awareness Day in Montreal, started a fundraiser in memory of Sara-Jane with Dopamine, one of our local supervised consumption site, gave a press conference during the federal election campaign about decriminalization and safe supply to support our local NDP candidate, Catheryn Roy-Goyette, and met with the wonderful and amazing former NDP Libby Davies to talk about those issues while she was visiting Montreal.  And amidst all this, I continued to inform, teach and share information to family and friends about stigmatization, addiction and the overdose crisis.

As an osteopath, I’ve decided to start a one year university program on substance use and addiction.  I want to be able to better reach out patients who might be using but are not comfortable about sharing this information with health specialists. I want to be better equipped with treating chronic pain coupled with mental health issues and addiction. I’m also organizing student clinics in osteopathy with Dopamine’s patients, since they are often living on the street or unable to pay for osteopathic treatments.  This will be done on a volunteer base from the students, and free of charge for the patients coming to see us. I think that it is a wonderful way to connect with substance users and to let them know that we care about them.

If you live in QC and would like to get in touch, reach out to MSTH (contact us page) and they will pass the message along to me.


Book Review - Fentanyl, Inc.  How Rogue Chemists Are Creating the Deadliest Wave of the Opioid Epidemic

by Maureen Christensen (BC leader and newsletter editor)

Fentanyl, Inc.  How Rogue Chemists Are Creating the Deadliest Wave of the Opioid Epidemic, by Ben West is a deep, thorough, and compassionate work of investigative journalism into who contributed and why they did so in the opioid epidemic in North America. West interviews Chinese chemists in communist sanctioned industrial complexes while posing as a drug dealer and sees what really happens in China. He also talks to American politicians, physicians, persons with substance use disorder, law enforcement, and Global Harm Reduction workers to get a scope on the scale of the crisis that has hit the United States and Canada. He examines the Mexican border and drug cartels with a clear eye. He looks into the use of the internet and the dark web in modern drug trafficking, and clearly identifies in a readable way all the new NPS (novel psychoactive substances) that most people have limited knowledge. The book is readable and passionate about creating a world where drugs are accepted as part of the human experience and made safe as possible. Five stars. Published in Sept 2019, Atlantic Monthly Press, New York. 

Additional comments on this book by Petra Schulz: Not having read the book, I listened to an interview with the author on CBC. What struck me was that the author focused on fentanyl the substance as described above by Maureen, but he did not explore the role of prohibition and the war on drugs. As we all know, getting rid of fentanyl will not solve the overdose crisis, but will only mean it is replaced with something else, potentially more deadly. The answers are in changing our drug policies and ending the war on drugs. I am sure it is a captivating read if you want to find out more about the illicit back story on this substance.


Finally, please save the date for our Annual General Meeting to be held in Edmonton on May 29 to 31, 2020
More details will be made available in the coming weeks.


Save Consumption Site Coming to Saskatoon - Families filing lawsuits

Marie Agioritis, SK and National Leader, and MSTH Society board member

As always the last few months have been busy. We worked with Aids saskatoon to run an overdose awareness event. Moms Stop was on sight at a community barbeque and mass naloxone training day. An overwhelming number of people showed up for the training – a great success.

Two members in Saskatchewan filed human rights complaints. One mothers whose son was asked to leave a detox facility before he was even admitted. He died within weeks of that event, before he filed his own complaint but died before he was ever able to see it to completion. His mother carried out his wishes and was successful in her efforts. The other mother has filed a complaint that stems from her incarcerated daughter not being given her medications, including methadone, as prescribed with in the system. The complaint is currently in front of the commission. We have met with a lawyer from the justice department and a director with corrections Sask. There has been an agreement to look at the systemic issues that are preventing proper distribution of medications and an acknowledgment of the dangers this exposes the patient/inmate too. This is far from settled, I am working with the mother at the hearings.

My role in MSTH has lead me to be part of two research grants at the university of Saskatchewan. One will be looking at more concise tracking of patients who present with substance use disorder (SUD) in emergency and what needs to be done to better serve them. We will interview people in recovery and people in active use to get a better picture of their experiences and to find out what impedes them from reaching out for help. Help in the form of medical care related or unrelated to their SUD – and what significance their SUD has on the quality of treatment they receive.  The second project is just under way – meetings start this week.

I have had the chance to speak at numerous events. My primary focus has been – stigma and discrimination. We need to read past the headlines and rhetoric they produce and educate ourselves. We have a responsibility to our own children to ensure we understand as much as we can about SUDs and the need for empathy not tough love.

For some time I have been working to arrange for online store for our MSTH shirts, which proved to be more challenging than anticipated, but we will finally have tshirts for order. The website should be up and running in the next couple of weeks. One challenge has been the cost of shipping. We wanted to find a company that would set up a website for us and link it to our own. They will drop ship and ship from their door to yours and we don’t have to carry and merchandise ourselves ( we have no office so this is hard to do for now). Anyhow it will be operational soon. Watch for it.

Moms Stop in Saskatchewan has been asked to lend their support of the new safe consumption site in Saskatoon. Doors for the sight will open in the spring of 20/20. Open houses are being held this week and last. An excellent facility on second to the well thought out plan developed from the team at Aids Saskatoon. If your interested in seeing the sight please text me or visit Aids saskatoon on face book to register.

 

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Ask a person who uses – about the illogic of prohibition.

Meg Inwood @InwoodMeg from a thread first posted to twitter August 30, 2019.

Note: The author uses strong language to describe the challenges a person who uses drugs lives with.  Drug busts are often celebrated as a way to curb crime and substance use, but how do these butss actually affect users? Let’s hear what Meg Inwood has to say about her experience with a recent bust in Toronto, ON.

The illogic of prohibition: a case study.

So. Three weeks or a month ago, there was a highly publicized fentanyl bust in the GTA [Greater Toronto Area]. "Biggest EVAR! $45 million worth of drugs off the streets!" Cops dislocating their shoulders patting themselves on the back, etc.

Well now. Let's examine the purpose of prohibition. It's not to save our lives. Prohibition exists for the stated purpose of MAINTAINING SOCIAL ORDER. Any arguments? Leave them in the comments and they better be intelligent cause I'm pretty sure of my ground here.

Now, let's examine the effects of this bust on me, the end consumer, as a case study. Then we can extrapolate from the effects on me, to the probable effects on others, and decide whether those effects are conducive to the maintenance of social order. An end goal I support btw.

Up until a week ago, I'd been doing the same stuff every day for 8 & 1/2 months. The same amount every day, with a (very) slow downward trend. I knew the stuff. I knew its effects. Predictable. ORDERLY. Well a week ago the bust hit my guy's guy's guy. Trickle down shit. What was my nice predictable orderly supply replaced with? Worse dope. Had to do an extra $50 worth a day to stay well. Got used to that, kinda. Yesterday, different stuff. Worse again. Very similar, just weaker. Today, something new again. Someone got trippy stoned from it.

Two others did not. I am on a bus heading home to go use myself as a guinea pig to find out if I'm gonna be able to do this crap. If I can't my only other options are to try copping on the street, or to do stuff I have a violent reaction to. Now look. How is it conducive to social order to ensure diminution of quality, requiring - since the black-market drug industry is the best example of unrestrained capitalism in existence - the end user to come up with more money by any means necessary to stay functional?

I guaran-fucking-tee that cars will be broken into, purses and wallets will be snatched, panhandlers will be working longer hours and lots of them will be desperate enough to get noticeably more aggressive than usual...all because we're having to spend more. It's gotta come from somewhere. Oh also minor bank fraud will see a small jump. Empty envelope deposits. And that's just when the quality goes down. What happens when the guys at the top can't get enough pure stuff, even crappy pure stuff, to supply their clients?

I'll tell you what happens: they cut the dope. You start getting Frankenstein shit - a grab bag of everything and anything. I got home; I tried my purchase. There's a fentanyl analogue that works well for me, a morphine analogue to which my reaction is relatively mild, and something pharmaceutical I can't identify which produces extremely mild hallucinatory effects for about three minutes for me. Frankenstein dope. My dealer and I now both believe that the person who reacted badly this stuff did so because he's ADHD and his brain's different from ours. Now how many junkies [Not a term we as advocates to use, but we respect the right of a person to self-identify] with ADHD do you think there are in Toronto? Probably more than you think there are. How many of them will get this dope? How many of those are homeless and thus can't lock themselves away from the world while they go through reaction?

And if even ONE of those people is out of control in public and commits a crime while they can't control themselves - that crime WOULD NOT have been committed if not for the bust. The same is true of the additional petty crimes committed to increase one's income to stay well, when the dope changes for the worse after a big bust. 15 years' experience says it takes 1-3 months for supply lines settle back down after a disruption like this. Now multiply these effects by every big bust of coke, opiates or crystal meth. Imagine it. I'll wait.

Are you starting to get a sense of it? How much constant seething shifting chaos and otherwise needless crime these busts create down the line? Every time one part of town gets itself sorted back out after a bust, either one happens that affects a different area, or users of a different drug in the SAME area, or both. It becomes impossible for PWUD, taken in the aggregate and over the course of years, to predict what their money will buy them. So when supply lines are fucked from a big bust and our money is even more meaningless than usual, what will people do to make the money they need to function? Anything they have to. That's. Just. Human. Nature. It's also human nature to want to catch a buzz so it's not as though you can solve this problem by telling kids not to start.

The DARE program was totally successful in the States, after all! (Read that sentence in Sarcastica. Twitter, give us Sarcastica!) So, tell me how do these busts increase social order? Wait - maybe they remove "violent criminals" from the streets? What happens afterward?

A vacuum is left where the top guy busted once was. Nature abhors a vacuum. It will be filled, sure as sunrise. Can someone give an estimate of what percent of the time a big supplier is replaced without violence over turf or money? I'm sure it happens...sometimes.

But I'm equally sure it's a minority of cases. Again the bust creates more crime. More fear. More disorder. A century - a CENTURY! - of evidence says that prohibition creates crime and disorder. And countries that have ended prohibition show the opposite results.

Can we please stop LYING to ourselves and each other? Keep prohibition if we must. We're a democracy. I'll accept the majority vote. But be honest. We're not keeping it because it works. We're keeping it because we're prejudiced. We're keeping it because we need a group to be our "Untouchables" and PWUD fit the bill. We're keeping it because we'd rather blame someone for a problem than ask ourselves how to solve it and then DO something. We're keeping it because it only hurts "them", not US, not OUR people. But it does hurt you and your people.

If we decriminalized all drugs tomorrow and stopped busting big dealers - if we did not one thing more than that - I will bet you my heart pulled beating from my chest (no firstborn to put on the line) that within a year petty crime would be down by ten percent or more. And I bet it would keep falling for a few years at least though I'm not as sure. To finish: my friend I pick up for called just now. She feels as though she just did speed. She sounded shaky and scared. She uses to avoid being crippled by those exact feelings.

Increased social order. O...kay. FUCK!!!

An hour after my poor friend called, she called again. It seems her first, awful reaction may have been that weird initial paradoxical reaction some people get sometimes with some things. She phoned back and she was like, I'm so stoned and so happy and so energetic and an hour ago I felt like I was on a bad crack comedown, what the fuck is happening to me and am I going to start feeling horrible again? I explained paradoxical reactions. I explained why they don't always happen. I told her to call if it went bad again but no matter what if it went bad again, I could get her something else tomorrow. And then I was happy because she wasn't feeling awful anymore, but I was still so fucking mad.

Creating a near infinite number of situations like this when all that needs to be done to ensure a stable supply in the practical if not the laboratory sense is NOTHING. Government doesn't need to provide us with a stable supply (though it'd be lovely). All they need to do is stop fucking up the supply we have, and Adam Smith's invisible hand will do the rest. Not neatly.

Not painlessly. Not without some deaths. And not immediately. But it would happen, to a large extent. And all they'd have to do to accomplish it - something that would ACTUALLY maintain and improve social order - is NOTHING. They'd save money too. On cops. On jails. But no.

Ask a doctor - about safe supply.

By Nanky Rai, Gillian Kolla, Andrea Sereda, Jess Hales Emmet O'Reilly and Tom Man

This information is directed to a medical audience, but we at MSTH felt that many of our followers also want to learn more about #SafeSupply because the lives of those we love depend on it. We thank Dr. Nanky Rai and others like her who have decided to change the system, because we can’t wait.

In [square brackets] is text MSTH added for clarification.

Text from a twitter thread by Dr. @NankyRai

This is information about our program development process & guidance document [on safe supply] in the spirit of building greater community accountability and transparency. As clinicians and researchers its important for us to acknowledge that calls for ‘Safe Supply’ come from communities of PWUD [People who use drugs].

Demands have been clear: access to a regulated drug supply & decriminalization to address structural violence facing PWUD.

For #medtwitter [or any of our readers] interested in understanding #SaferSupply, I urge you to read the position statement on Safe Supply by CAPUD (Canadian association of people who use drugs) first: https://vancouver.ca/files/cov/capud-safe-supply-concept-document.pdf

Current Emergency Safer Supply Programs (ESSP) that exist in London & Toronto are HARM REDUCTION PROGRAMS that aim to respond to calls from PWUD re #SafeSupply AND use existing medical evidence to create a hybrid medicalized model focusing on opioids called #SaferSupply.

Medicalizing a community call to action comes with implications & demands more accountability from healthcare workers. Models that exist outside institutions altogether are desperately needed, example: #HeroinBuyersClubs read more on the BCCSU website https://www.bccsu.ca/wp-content/uploads/2019/02/Report-Heroin-Compassion-Clubs.pdf.

The scale of the devastation from #OverdoseCrisis has prompted direct action from PWUD. Right now, prescribers [primary care physicians and others] are uniquely positioned to act re: the poisoned drug supply. It means we [physicians] must embrace discomfort, act thoughtfully and urgently with tools we have access to. #WeActTheyLive

Safer Supply programs do not claim or aim to replicate the paradigms of traditional addiction medicine. Safer Supply programs are lower barrier community-based programs situated in primary care that meet people where they are at. We do not pathologize drug use.

Many PWUDs have had repeated negative experiences within the addiction treatment system. Many PWUDs don’t want to experience stigmatizing health"care". And many PWUDs in this fentanyl and analogues era feel 1st line options/meds (MMT/bup) [Treatment with Methadone or Suboxone] alone are not enough. Therefore ESSP [Emergency Safe Supply] programs are grounded in the belief that people who use drugs are experts. We are invested in treating our clients with dignity and respect and repairing their relationships with the health care system.

Our programs are trying to radically shift how health care protocols, programs & practices are created and evaluated by building direct involvement of PWUDs. Upholding the principles of #NothingAboutUsWithoutUs

We started with focus groups with PWUDs in our communities to better understand what would and  what wouldn’t work and/or feel respectful. Other ways we are building greater community accountability? Advisory committees made up of PWUDs for our programs. Based on the feedback we've received and the med literature we have access to, we've developed a guidance document for #SaferSupply. In this we offer clients access to dilaudid 8 mg IR tabs AND SROM to combat the toxicity and potency of the street supply.

And yes we do offer bup(+microdosing)/SROM [Naloxone and Slow Release Oral Morphine, e.g. Kadian]. We also have client health navigators that support people in attending appointments for MMT [Methadone Maintenance Treatment] when desired. But we can’t keep relying on the same tools & hope for different outcomes to get through this evolving unprecedented crisis.

We provide #SaferSupply because we can't wait for healthcare system to catch-up & provide anti-oppressive, non-stigmatizing care for PWUD (ex. methadone mills). Harm done needs to be repaired but we can't wait for that while people in our communities are dying.

We provide #SaferSupply because people have the right to access health care whether they want to stop drug use or not, whether they want to get high or not. People have the right to live and survive through this crisis.

We provide #SaferSupply because building just relationships is what's important. The antidote to violence is connection, not paternalism and oppressive medical institutions and providers.

This is why we are sharing our guiding document here & are open to feedback/criticism, keeping in mind we will be prioritizing feedback we get from directly affected communities. We are committed to centering PWUD in this process https://docs.google.com/document/d/1hXRmNaOTB60wbmNqhBi5P_xxktEZnXFDWKMkJMu5ALM/edit

We are grateful for the support & leadership of our respective institutions that are invested in building responsive programs accountable to the communities we serve.  @PQWCHC @SRiverdaleCHC @StreetHealthTO @HealthCentre

 We are also engaging in rigorous research of our work.

There has been widespread support for #SaferSupply from organizations including  @AllianceON @FCM_online and the federal government who launched the SUAP call for low barrier safer supply programs earlier this year: https://www.canada.ca/en/health-canada/services/publications/healthy-living/substance-use-addictions-program-call-for-proposals-guidelines-applicants.html#a3

We commit to valuing and supporting the lives of PWUD. We call on our colleagues to take brave, urgent action to stop the unnecessary deaths, marginalization & stigmatization of PWUD. Just like communities of PWUDs have always done, we need to Keep Six.

 

 

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