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Outreach workers call for new tools to combat toxic new street drugs

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Walking through the Glengarry non-profit housing complex in Windsor, Ont., harm reduction outreach co-ordinator Lacie Krzemien is exhausted.

The recent news that Windsor’s only safe consumption site, Safepoint, will pause operations at the end of December has left her despondent.

“I’m upset, because it’s taking away another resource. It means more of my clients are at a higher risk of death,” said Krzemien, who distributes safe supplies for people using drugs with Pozitive Pathways Community Services.

She says the announcement comes at a time when the drug supply has become increasingly toxic. The arrival of drugs such as “tranq,” fentanyl mixed with xylazine, an animal tranquillizer that’s resistant to naloxone, is making the overdose crisis even more complicated.

Tranq has also become infamous for causing users to develop seeping wounds.

Earlier this year, Health Canada released a report that said tranq was spreading rapidly across Canada. In 2022, 75 per cent of the drug samples tested that contained xylazine were from Ontario. According to Ontario’s coroner, xylazine has been detected in 184 drug toxicity deaths since 2020.

At least two of those were in Windsor.

Lacie Krzemien, left, does outreach in Windsor, Ont., speaking to people about the changing drug supply and how it complicates overdoses. (Mia Sheldon/CBC)

“I’m sure that it’s a lot worse than what we’re seeing, you know, in the statistics right now,” said Krzemien.

She used Safepoint as a resource for clients with tranq wounds and testing the drug supply. It’s one of the few places in Windsor that offers fentanyl drug testing. But that won’t be the case come January.

CBC News spoke with Windsor Mayor Drew Dilkens before Safepoint announced it would be pausing operations. The Mayor, who said he spends the majority of time working on the city’s mental health and addiction problem, was opposed to the site.

“We want to find, and have the money spent, in a way that’s actually going to make a material difference. And that is with mental health and addiction support, and helping people get the treatment that they need to become productive members of society again.”

CBC News asked the Ontario Ministry of Health about the current review and how it impacts drug testing and safety. In an email, they replied that the review will determine the next steps and that, “CTS [Consumption and Treatment Services] sites are expected to build trust in the communities where they are located through consultation and ongoing engagement.”

Krzemien says the decision to pause Safepoint’s operations erodes that trust.

“We want to keep people alive,” said Krzemien. “We want to keep them breathing.”

‘It’s just getting worse’

Xylazine is just one of the many dangerous additives being found in the illicit drug supply. Benzodiazepines, which are depressants, have been present in up to 60 per cent of the fentanyl supply, according to the Toronto Drug Checking Service.

There are also stronger synthetic opioids, like carfentanil, which are even more deadly than fentanyl.

In October, Health Canada announced an extra $21 million in funding to try and get ahead of a worsening overdose crisis. But when the drug supply — specifically synthetic opioids — keeps changing, so do the tactics needed to catch up.

The Toronto Drug Checking Service is one of the recipients of Health Canada’s new funding. The service, which uses a lab in St. Michael’s Hospital, tests street drug samples to identify exactly what’s in them.

“It’s important for people to know what it is that they’re using, just so that they can make safer choices,” said the lead for the Toronto Drug Checking Service, Karen McDonald.

“When we’re using any type of pharmaceutical or when we’re drinking alcohol or eating any type of food … we have, like, an ingredients list or we know exactly what is in those products.”

A person in a white lab coat and protective gloves uses a handheld machine to take a sample of material from a small glass dish.
The Toronto Drug Checking Service is an anonymous public health service that analyzes street drugs to see what is in them. (Mia Sheldon/CBC)

Both tranquillizers like xylazine and depressants like benzodiazepines (benzos) are highly sedative and are especially dangerous when people are unaware they’re consuming them.

Nicknamed the “zombie drug” for the blackout states it can cause, xylazine is normally used to sedate cattle or horses and is not approved for human consumption. As a central nervous system depressant, it dangerously suppresses vital signs like heart rate and blood pressure.

“What that means is the drug supply is getting stronger,” said McDonald, noting that the amount of xylazine found in Toronto samples in the last two years has ranged from six per cent to 20 per cent.

“It’s just getting worse and worse and worse — more contaminated, less predictable.”

A graph.
B.C., Alberta and Ontario made up 97 per cent of identified xylazine substances in Canada last year, according to Health Canada’s drug analysis service. (Statistics Canada)

A deadly threat

Tranq has not only been detected across Canada but in 48 of 50 U.S. states, and is especially acute in places like Philadelphia, where it is estimated up to 90 per cent of the opioid supply has xylazine in it.

The situation is so bad that U.S. President Joe Biden has called the xylazine-fentanyl mix a deadly threat.

“The thing is, you don’t know you’re doing it,” said Ryan Green, who has been homeless in Philadelphia for more than a year. He’s used fentanyl before, but when he got to the city’s Kensington neighbourhood, it was different.

A young man in a hoodie pulls aside a bandage on is forearm to show a large wound.
Ryan Green, 36, shows CBC the ‘tranq sores’ on his body. The wounds are caused by using drugs cut with xylazine. (Mia Sheldon/CBC)

“It just knocks you out,” Green told CBC. “You end up unconscious to the point where people just drop.”

Those who consume tranq also develop wounds and infections. Some people can have dozens of sores on their body.

“I’ve been out here a year, and I thought this was the extent of my tranq sores,” Green said, pointing out some of the lesions on his body. “I guess the way it works is it just kind of goes through your body and it picks a soft spot of flesh. And that’s where it comes out.”

Green was having his wounds treated at a mobile medical clinic operated by the city and a neighbourhood hospital. It started operating in May 2022 because of the dramatic number of tranq wounds in the area.

Michelle Murphy-Rozanski, the nurse practitioner at the clinic, has seen all kinds of wounds, some “going down to the bone, the muscle, the cartilage.” She said some patients have been permanently disfigured or faced amputation.

“It used to be [people who use drugs] would lose their house, they would lose their job, they would lose their kids, they would lose their spouse. Now, they’re losing body parts, arms, legs, fingers, parts of their neck. They’re still unable to quit.”

A woman wearing protective gloves works at a counter preparing medical supplies.
Nurse practitioner Michelle Murphy-Rozanski treats people in a Philadelphia neighbourhood who have physical wounds caused by using tranq. ‘It used to be [people who use drugs] would lose their house, they would lose their job, they would lose their kids, they would lose their spouse. Now, they’re losing body parts, arms, legs, fingers, parts of their neck.’ (Mia Sheldon/CBC)

Xylazine in Canada

There isn’t much research on how xylazine affects humans, including its addictive nature or withdrawal. Recent papers in the United States have called for more research and understanding of xylazine’s effects.

“[There’s] a lot of fear,” said Krzemien. “There’s a lot of uncertainty.”

The RCMP has been aware of xylazine in Canada’s drug supply since 2012, but since xylazine is a veterinary drug and not technically a narcotic, enforcement is difficult.

The RCMP told CBC News it could be used as a cutting agent with synthetic opioids like fentanyl and trafficked at street level.

It’s not known why xylazine is being added. There is speculation that it prolongs the high of fentanyl or that adding it increases weight to the drug supply, making production cheaper.

Michael Brennan, executive director of Windsor’s Pozitive Pathways Community Services, says that you can see a bad batch of drugs travel from Toronto to Windsor by tracking the overdoses.

“You’ll see an alert come out of Hamilton. Then it’ll show up [in Windsor] a couple of weeks later,” said Brennan.

Regional health authorities and law enforcement agencies across Canada have issued alerts about xylazine being found in the community.

Brandon Bailey, who has been an active drug user in Windsor but is currently clean, says the unpredictability of the drug supply scares him.

A man in a t-shirt and shorts sits on a park bench speaking to a woman who has her back to the camera.
Brandon Bailey tells CBC News that it’s not just people who are homeless or on the street who are hurt by a more toxic drug supply. It’s anyone who uses. (Mia Sheldon/CBC)

“In a way, that has helped me … keep away from stuff now, because I don’t know what’s in it. But also, there are times where I’ve relapsed,” Bailey said, noting there is little drug testing in Windsor.

“[Everyone is] susceptible to this. It’s not just people who are living in poverty or people who are homeless. It’s happening to everybody.”


 

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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