A critical appraisal of, the "crime" data in Alberta's report on supervised consumptions sites.

By Dr. Jamie Livingston, re-posted from Twitter (Part II) on March 5, 2020, with permission.

A deeper dive into, and critical appraisal of, the "crime" data in Alberta's report on supervised consumptions sites.

“This review used a mixed method research approach” (P2) First off, this review didn’t use a mixed method approach. It used a multi method approach.

“Convenience sampling was employed” (P2) This isn’t inherently bad or unusual, but it carries significant limitations that could undermine the validity of the findings. Especially, when relying heavily on perceived impacts of an intervention on a community.

“we have attempted to compare before and after trends in neighbourhoods of interest with other parts of the community” (P3) The review does not report or perform any statistical analyses with appropriate statistical controls to make such comparisons . The neighbourhood effects or the effects of variables other than the SCS, such observations are scientifically unsound.

“Although the committee heard opinions that the existence of a SCS reduces crime or, at worst, has no impact on drug-related criminal activity in the immediate area, the preponderance of evidence provided by area residents and officials demonstrates that criminal activity near SCS has increased" (P4)

When the data does not support the desired conclusion, it’s called “opinions.” When the data does support the desired conclusion, it’s called “evidence”. This clearly signals biased interpretation.

“SCS, therefore, are assumed to geographically concentrate the street-level drug market and other criminal activities. The Committee finds this to be credible” (P4)

This conclusion is based solely on stakeholders’ subjective perceptions. The committee makes no attempt to evaluate this claim using other data sources, which is actually what a mixed method study does.

“Concerns were also raised that the exemptions to the legal possession of illicit substances at the SCS resulted in a lack of law enforcement in areas adjacent to the sites” (P5)

Again, no attempts were made to evaluate this claim with other sources of data.

“one respondent who did not live near a site noted, 'There are already a lot of homeless people who linger around my neighborhood, thanks to the LRT… crime rates have skyrocketed'" (P8)

Perceptions of crime often don’t reflect the reality of crime. For instance, since the early 1990s, the crime rate in most Western countries has been declining; however, the public perception is that crime rate has not changed or has increased.

“This inflection coincides with the opening of the SCS site. The seizure data, however, are for Calgary as a whole, which suggests that the problem is not unique to the SCS sites but is more widespread” (P13)

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Figure 3 is highly problematic since it has no value for evaluating the effects of the SCS. What then is the function of this figure, other than eliciting fear and creating moral panic?

“A primary concern of most people living near a SCS site was a perceived increase in crime” (P14) I’m pretty certain that people are more concerned about actual crime, as objectively measured, rather than perceived crime.

“The pertinent question thus became whether those areas near SCS experienced changes in the amount of crime disproportionate to other areas of the city after the sites were opened” (P14)

Actually, no, the pertinent question should be the extent to which changes in crime can be attributed to the SCS. This is how questions that evaluate interventions are framed. The methods employed in this report don’t allow for causal inferences between the independent (e.g., SCS) and dependent (e.g., crime).

“It should also be noted that crime is measured in calls for service and not actual rates of victimization. At the town hall and various in-person meetings, many individuals indicated that area residents were suffering from reporting fatigue and were increasingly reluctant to report less serious offences to the local authorities” (P14)

Wow. Um. Okay. So, the report doesn’t actually measure crime, but in the next breath concludes about Lethbridge that “immediately evident is the amount of crime increased substantially in the area immediate to the SCS”.

The criminological literature notes major limitations with using ‘police calls for service’ as a measure of crime. Which would have been known if an actual criminologist was involved.

The analysis of the data represented in these figures are particularly terrible. No criminologist would use a one-year change in crime to measure anything, since knowing about the longer-term trend is vitally important. Moreover, eyeballing two bar graphs and making simple comparisons of two communities to draw conclusions is as unsound as it gets.

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Regarding Calgary “it was not possible to perform an exact before/after monthly comparison around the opening date for the site. However, t is possible to get a reasonable impression of whether there was any relative increase in calls for service between 2017 and 2018.” (P15)

The review repeatedly sweeps away major methodological limitations and draws unfettered conclusions from flawed data, including this sections that, in the absence of quality data, methodological rigour, or statistical analysis, states that the data “indicates that residents’ concerns are well founded”.

The report notes that “calls for service decreased by about 1.3 per cent in the area immediately adjacent to the sites” (P19). Unlike the other figures which support the authors’ narrative this is then followed by a disclaimer about the quality of this particular data “Edmonton was also a location where area residents indicated that they were refraining from calling police because of a perceived lack of response.”

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The city-specific conclusions in Chapter 4 are scandalous. For instance: “During the limited time the Review Committee spent visiting the area around the site, members directly observed several instances of open drug use, with individuals injecting drugs on the sidewalks close to the SCS site" (P25) Haphazardly seeing drug use near an SCS site is not a finding of scientific or evaluative merit. It was also not described in the methods section of the report.

A conclusion of the report indicates that "Evidence suggested a level of 'de-policing' near some sites." First, this wasn't measured. Second, it is contrary to the supposed finding that police calls for service increase in these areas. This is a baffling conclusion.

MSTH Regional Updates - Spring 2020

Find out what MSTH advocates and leaders in various regions have been working on.

If you have a story and some photos to share, please send it to Jennifer Howard for the next issue.


Quebec

Isabelle Fortier, Montreal

Every February since 2014, Fondation Jean Lapointe organizes a fundraising event called “Défi 28 Jours Sans Alcool/28 Days Sober”. Thousands of people pledge to stay sober for the full month of February while giving/collecting funds that go directly to a drug and alcohol prevention and risks reduction program.  This is offered to high school students from secondary 1 through 5. More than 492,000 students have received these workshops since 2008!

This is the biggest fundraiser in Quebec in terms of public awareness. The focus is on advocating for safe behaviors in youth when it comes to using drugs and alcohol. This year I’ve been asked to become a regional ambassador for the Défi, which I’ve accepted with great honour. We created a team #PourSaraJane, in memory of my daughter and raised more than $6,150.00 to help reach the $550,000.00 provincial goal.  We have connected with thousands of people, relayed important information regarding substance use disorder, shared Sara-Jane’s story, and opened eyes and hearts. This has been a wonderful journey, bound to be repeated next year! Thanks to Petra Schulz, who connected me with the Foundation's people while we were attending CCSA’s meeting last November. This has been a perfect match for me!!!


Ontario

Sheila Jennings, Toronto

Sheila Jennings and other participants with the #StigmaEndsWithMe message at the School Matters federal forum in Toronto.

Sheila Jennings and other participants with the #StigmaEndsWithMe message at the School Matters federal forum in Toronto.

Amnesty has endorsed and posted on their website an Opioid Crisis Human Rights Statement that Sheila was invited to work on with several other advocates: physician Bonnie Larsen, Amnesty Canada's Charlene Scharf and Catherine Sauve, Professor Rebecca Saah. Law professor Lorian Hardcastle, Dr. Alan Yao-Chi Chu and others This had to do with the current Alberta governments regressive and harmful Safe Consumption Site policy.

On February 11-12, 2020, Sheila attended a full two day federal forum called School Matters: Building a Blueprint for Action for School Communities to Help Prevent Substance Use Harms. The aim was to re-evaluate and reframe our existing approaches to preventing substance-related harms, including those that impact youth.  The forum included the aim of considering opportunities to better integrate evidence-based approaches to preventing substance-related harms in the context of Canadian school communities. Sheila spoke at Humber-Guelph University February 19 to a group of students in the graduate program for Public Administration about the ways in which MSTH advocates in areas of government policy making. 


Simcoe Moms For Overdose Awareness - Evelyn Pollock

We have a formed a very active moms’ group in Simcoe County Ontario. We call ourselves: Simcoe Moms For Overdose Awareness. Some members of the group, including the leader Evelyn Pollock are also members of MSTH.

We started a self-funded Forever Campaign in September 2019 to remember our children who died of opioid overdose. Our goal is to raise awareness and save lives, one life at a time. We developed and launched a poster with the faces of 14 of our children.

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A local newspaper, the Barrie Advance, joined us as partners. The Barrie Advance, is the only newspaper in Canada, to devote an entire edition to the opioid crisis (September 26, 2019).  Since that issue, they have included front page stories of interviews with affected moms and stories related to the opioid crisis on a weekly basis. Each week for the past few months our moms group has paid for a banner with a photo and short  statement about one of our children in local papers. (Examples below)

We advocate locally and with Municipal, Federal and Provincial  politicians, to raise opioid overdose awareness and influence change. On February 19, 2020 we worked with a local sponsor to put on an awareness forum called Orillia Talks.  The event was overwhelmingly successful and, despite a snowstorm,  drew over 200 community members, and many affected families. Photo below of some of our moms wearing red scarves.

We have started an online petition to the demand the Prime  Minister declare an opioid overdose public health emergency.  To date we have over 11,000 signatures.  We urge all members if MSTH to sign and share this petition.

We are working with our local Member of parliament, Bruce Stanton, Deputy Speaker if the House of Commons, to bring the petition to Ottawa.


The Grim Reaper - by Lorna Thomas and Phil Haug.

The Grim Reaper - by Lorna Thomas and Phil Haug.

Alberta

Lorna Thomas, Edmonton

It has been an incredibly busy few months.  I was part of a team of 15 people that organized a rally in Edmonton on February 27th that brought 13,000 people to ‘March for What Matters.”   Teachers, harm reduction activists, health sciences workers, the disabled,nurses, doctors, parents, and students all marched (or wheeled) from downtown to the Alberta Legislature to show their resistance to the policies of the current United Conservative Party.  I am also part of a group that coordinated the February 29th rallies that took place in towns and cities across the Province. That group helped to promote the rally that took place on February 26 wherein 150+ people, including myself, participated in a ‘die-in’ to show support for Supervised Consumption Sites. As a person living in Alberta with a provincial government that puts profit over people, a government that is so dangerous for vulnerable populations, such as persons who use drugs,  I recognize the need to form new allies. We must build capacity in order to facilitate the changes we want to see such as drug policy reform and wrap-around addiction services. We must resist the dangerous funding cuts the UCP government are implementing because they have a vision of privatizing health care and creating for-profit schools. We must find creative ways to resist. To that end I am meeting regularly with like minded artists to build things that will draw attention. One of the creations of our Alberta Arts Matter Coalition  is this giant 15 foot puppet which symbolizes the darkness, the tragedy, the void, that is sweeping across our Province. We will resist!


Petra Schulz, Edmonton

The election of a new government in Alberta brought with it a review of supervised consumption services (SCS) and protecting these services has been a focus of my efforts in the last few months.  MSTH has joined the coalition Albertans for Ethical Drug Policy and together we held powerful rallies in Calgary and Edmonton on February 26th that were attended by about 150 of our supporters. This is featured in a blog post about our rally included in this issue.

#Yes2SCS supporters gather at the Legislature in Edmonton, supported by Friends of Medicare.

#Yes2SCS supporters gather at the Legislature in Edmonton, supported by Friends of Medicare.

Some of the work I do for MSTH takes me to Ottawa to be the voice of families on a national level. I participated in a meeting co-organized  by the Canadian Public Health Agency to discuss ways to measure and address structural stigma in the health system.  It is important that we as families who, together with our loved ones, experience this stigma first hand, can shape needed changes.  

I am returning to Ottawa mid March for a “Public Education Partnership” meeting for communication specialists to help them be more effective in their messaging and for an advisory group meeting with the Canadian Centre For Substance Use and Addiction, together with Deb Hale-Bailey from Vancouver who is filling in for Leslie. 

On a local level I continue to give talks to nursing students and to many other community groups to spread the harm reduction message, often in conjunction with our friends from Streetworks, who provide on-site Naloxone training.

Our Edmonton team is really excited to host the annual general meeting #MSTH2020 and together with our chief organizer Angela Welz and her team we have put together an exciting agenda. Don’t delay, register today to join us in Edmonton from May 29 to 31 for our Annual General Meeting.


Tyla Savard, Grande Prairie

Our Community Opioid Response Task Force is building an action plan based on the 4 pillars. We are putting together advocacy action items, communication plans and much more. Finally, things are coming together where there is huge positive impact and community engagement. Everyone is encouraged to check out the website we have created www.everyoneisimpacted.com where we host an array of support services for individuals and families to navigate systems. The site also hosts a video series we launched last spring giving the local perspective and understanding of the impact of the opioid crisis and our community. I’m also a part of the Peace Country Drug Awareness Coalition who are planning various community engagement opportunities to connect with all demographics, raise education and come together to create positive connections at various times throughout the year verses only at International Overdose Awareness Day.

I’ve recently been given the opportunity to work with Alberta Health Services who partnered with the Canadian Centre for Substance Use and Addictions to execute the Improving Treatment Together program. It will include community workshops with those with lived experience. It will involve ensuring that first hand experience/knowledge is included in the resource materials. It’s a 12-18 month project and is taking place in various Alberta communities. 

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British Columbia

Sandra Tully & Sherry Robinson. Kamloops

The Kamloops Silent Night Memorial Tree was warmly welcomed at the Kamloops North Shore Library over Christmas 2019. As the Librarian expressed on the TV news,  “The Library is like the living room of the community.” The library staff welcomed the presence of the memorial tree near the front entrance where many people openly commented about its beauty and tribute to the loved ones lost to substance use related causes.  The presence of the tree opened up casual conversation and acknowledgment of the ongoing crisis. Members of the Kamloops MSTH and Healing Hearts support group came out to set up and decorate the white tree that was donated by the Kamloops Canadian Tire store. As well, various decorations were also donated by Second Chance SPCA Christmas Thrift Store and  local families. Ornaments were available that could be decorated and personalized. This provided a way for the community to interact in an inclusive way and also facilitated time for people to have discussions. This included front line workers who came to visit to acknowledge their grief at losing so many people important to them. We are so pleased that the Library has welcomed us back again for Christmas 2020.  


Helen Jennens, Kelowna

November was Addiction Awareness month.  In respect of that, MSTH members Arlene Howe and Pam Turgeon shared their lived experience at an event put on by Interior Health.


Members of MSTH Okanagan at the Welcome Inn opening. L2R front row: Helen Jennens, Pam Turgeon, Deana Rainey, Carrie Koskii. Back row: Kirsten and Jorin Wolf, Arlene Howe, Anne-Marie Honkenen & Jill McCullum.

Members of MSTH Okanagan at the Welcome Inn opening. L2R front row: Helen Jennens, Pam Turgeon, Deana Rainey, Carrie Koskii. Back row: Kirsten and Jorin Wolf, Arlene Howe, Anne-Marie Honkenen & Jill McCullum.

I had a speaking engagement at a Grade 12 psychology class which I love doing as the kids are so engaged and give me great feedback.  We started a blanket and warm clothing drive for the homeless and shared our love with a hundred street entrenched community members. We raised funds( primarily among ourselves) and put together Christmas packages for the Hope Society which support women living on the streets.  Our beautiful MSTH cross photo started its twenty-six week run on a digital billboard. It is visually prominent as you enter or leave our city. In February, I spoke with a UBCO psychology class. The presentation focused mainly on MSTH, our goals as a network and the work we do to reach them.  On April 18th we have organized a walk through Kelowna promoting decriminalization. On May 9th, together with Interior Health, we will host a photo voice exhibit at the Rotary Centre for the Arts. The photos will remain there for the month of May. May is usually the kick off month to our meetings as we prepare to organize for International Overdose Awareness Day.


Jill McCullum, Oliver

Apparently ‘great oaks from little acorns grow’... 

The Moms Stop The Harm acorns planted to date in the Oliver BC region are many and continue to grow! Two BC Transit buses in Penticton displayed the “Stop Overdose” signage and great efforts were made in the distribution of the new MSTH pamphlet to critical sites in Penticton and Oliver BC.

Plans are underway as we organize a guest speaker as a MSTH fundraiser for April 2020 in Penticton BC. Attendance at this event will be by donation with all proceeds channeled towards MSTH. In addition, the creation of a thank you postcard was made in collaboration with MSTH artist and mother Arlene Howe. The promotion of MSTH as an important resource for families in the South Okanagan BC has been achieved through an amalgam of grief, a desire to effect positive change, and love. It has taken a collective of dedicated loved ones and a receptive audience to make this happen. I am indebted to the support given to MSTH in my region. 


Nancy Murphy, Victoria - Holding Hope

Under the umbrella of MSTH, Holding Hope Victoria launched support groups for families affected by their loved ones substance use starting in the Fall of 2019.  There were three pilot group locations held throughout the Victoria region. The groups were at a maximum capacity of 12 participants. As we look ahead to 2020 we are looking forward to partnering with the Songhees Nation and will be starting a support group at the Songhees Wellness Centre.  

MSTH Holding Hope has a strong educational component to the group.  A variety of guest speakers are often invited to speak with our families.  Guest speakers have included: BC Provincial Health Officer - Bonnie Henry, Bernie Pauly (Professor at the University of Victoria School of Nursing and a scientist with the Canadian Institute for Substance use Research), Evan James (Umbrella Society for Addictions and Mental Health), Lana Fine (Harm Reduction worker at Aids Vancouver Island), Shauna Janz (Grief Counsellor) and many more. Holding Hope continues to provide invaluable support to families in Victoria BC. We are looking forward to expanding our groups in other regions.  If you are interested in starting a Holding Hope group in your community, please contact Nancy Murphy via email


Victoria and Vancouver Island MSTH regional gathering.

Victoria and Vancouver Island MSTH regional gathering.

Jennifer Howard, Victoria

On November 24th, 2019 Moms Stop The Harm members joined forces with the South Island Community Overdose Response Network to stage a loud protest outside the conference centre where the annual convention of the Provincial NDP party was taking place.  A critical resolution for “Safer Supply & Decriminalization” was being tabled. Over 700 delegates attended. We were happy to see that the resolution passed without a single vote against it.  

In January 2020, Victoria kicked off a BC writing campaign “Mom’s Stop The Harm New Year’s Resolution” as a way to continue putting pressure on our Provincial government to follow through on the NDP party resolution of “Safer Supply & Decriminalization”. 

Victoria Healing Hearts Bereavement Support participants gathered to enjoy a moment of fellowship over a Christmas luncheon in December.  It was an opportunity to support each other through a very difficult month. Healing Hearts Victoria has recently connected with the local Hospice and will be supporting their efforts to start a closed 6 week support group specific to Substance Related loss in the Spring 2020.   

Our Victoria/Vancouver Island regional members gathered for a networking and brainstorming session on January 24th.  We will continue to hold quarterly meetings in the coming year. Moving forward MSTH Victoria will be taking the lead as we begin plans for three events in the new year: A Mother’s Day of Action  (May 10th/2020), International Overdose Awareness Day (August 29, 2020) and a regional group photo in the Spring. 


Introducing Jennifer Howard, MSTH Program Manager

MSTH Program Manager Jennifer Howard is based in Victoria, BC.

MSTH Program Manager Jennifer Howard is based in Victoria, BC.

I am grateful for the opportunity to introduce myself to the general MSTH membership in this newsletter.  I feel very privileged to be working in a new role as Program Manager with Moms Stop The Harm. My journey with Moms Stop The Harm began in 2016 when I lost my only child Robby to Fentanyl poisoning. Like many MSTH families my life has forever changed and Robby’s loss propelled me down an unexpected path of advocacy.   After working for over 30 years with a non profit agency in Community Living services and foster parenting for over 20 years, I am energized to bring that knowledge and experience to my work with MSTH. MSTH is now receiving National and International recognition. Our membership has grown rapidly. With that growth in mind, I will be focusing on supporting MSTH Co Founders and the  leadership team in the very important work they are doing across Canada. Developing structure, policies and procedures that will compliment our growth and recognition will be part of my role. I will also continue to sit as a Mom Stop The Harm representative on the South Island Community Overdose Response Network (SICORN), the Sicorn lobby group for Safe Supply & Decrim and oversee the Healing Hearts Bereavement group development for BC.  I am but one of an army of advocates throughout this amazing network of families. I feel very honored to be working with our leadership and MSTH members to ensure that those most vulnerable in our communities receive the support they so rightfully deserve.  


Our Newsletter Team: MSTH Program Manager Jennifer Howard, and Millie Schulz, our website and technical advisor (Photo at Recovery Day in Victoria in 2018), with content and formatting help by Angela Welz and Petra Schulz

Our Newsletter Team: MSTH Program Manager Jennifer Howard, and Millie Schulz, our website and technical advisor (Photo at Recovery Day in Victoria in 2018), with content and formatting help by Angela Welz and Petra Schulz


Albertans for Ethical Drug Policy Rally in Support of SCS in Edmonton and Calgary #yes2scs

Edmonton SCS supporters stage a die in at the steps of the Legislature as a reminder of the lives lost to substance use related causes.

Edmonton SCS supporters stage a die in at the steps of the Legislature as a reminder of the lives lost to substance use related causes.

Edmonton Supporters Hold Their Rally at the Steps of the Alberta Legislature


Calgary SCS Supporters Gather at Central Memorial Park


Albertans for Ethical Drug Policy - Joint Statement

For release: 2020-02-26

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The overdose crisis in Canada represents the single greatest public health emergency we, as a nation, have experienced in modern times. Our beloved province has not been left unscathed in the turmoil inflicted by a toxic drug supply. Since January 1st, 2016, we have lost a devastating 2,026 friends, family, and loved ones; we have buried our children, siblings, and parents over what can only be described as a crisis of misaligned drug policy. As the crisis took hold of Alberta, a rapid upscaling of evidence-based and life-saving initiatives were implemented to stem the rising tide of deaths. The Minister’s Opioid Emergency Response Commission (MOERC) identified six key areas of focus: treatment, prevention, harm reduction, analytics, enforcement, and collaboration. Each strategic area was bolstered with supports and resources, understanding that no single method would resolve such a complex problem.

Among these initiatives, we saw the urgent implementation of supervised consumption services (SCS); these sites have seen massive uptake, and despite managing a demand no standalone service should ever face on its own, their efficacy cannot be denied. By March 31st, 2019 SCS in Alberta had successfully responded to 3,563 overdoses. If that weren’t enough, these services endeavour to connect clients to housing, legal, medical, and social supports with an efficiency that outmatches traditional models of care. There has never been an overdose death in an SCS.

The narrative surrounding SCS has seen a dramatic shift in tone—in recent months, our government has vilified these services with misinformed vitriol meant to incite disdain for both supporters and clients alike. A false dichotomy has been established, regrettably pitting the treatment/recovery and harm reduction communities against one another. In truth, all evidence-based services along the continuum of care require support, rather than leading the public to believe it is one or the other. This is not about politics. In fact, politics has no place in responding to a public health emergency. The following joint statement is a call to action; a call to reason; a call to ethics. Any moving, restriction, or closing of existing sites in Alberta will undoubtedly lead to more preventable deaths. Our request is simple:

  1. Maintain funding for existing sites

  2. Unfreeze funding for both pending sites

  3. Make no restrictions or moving of existing sites

History will not favour any decision that willfully puts Albertans at greater risk. The choice, and subsequent outcome is in your hands. Please cast aside the rhetoric, and listen to the evidence. We, as a community of caring Albertans will continue to advocate for the rights of our most vulnerable. They are loved, and deserving of care, regardless of circumstance.

This joint statement is endorsed by: Alberta Addicts Who Educate and Advocate Responsibility (AAWEAR), Alberta Federation of Union Retirees (AFUR), Alberta Nurses Coalition on Harm Reduction (ANCHR), Alberta Public Health Association Albertans with Lived Experience Advocating for Safe Supply Canadian, Association of People who Use Drugs (CAPUD), Canadian Association for Safe Supply (CASS), Canadian Drug Policy Coalition Canadian Students for Sensible Drug Policy (CSSDP), Canadian Union of Retirees – Alberta Chapter, Change the Face of Addiction, Council of Canadians Council of Canadians – Edmonton Chapter, Council of Canadians – Red Deer Chapter, Council of Canadians – Medicine Hat Chapter, Crackdown Podcast, Friends of Medicare Friends of Medicare – Lethbridge Chapter, Friends of Medicare – Palliser Chapter, Harm Reduction Nurses Association (HRNA/AIIRM), Hat Overdose Prevention and Education (HOPE), Health Sciences Association of Alberta (HSAA), Moms Stop the Harm, Public Interest Alberta, Red Deer Area People Who Use Drugs (RADPWUD)