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Ottawa comes out in favour of injectable opioid therapy, urging Alberta not to shutter program

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Canada’s health minister is calling on the Alberta government to reconsider the closure of its injectable opioid agonist treatment program, which Premier Jason Kenney says will end in the spring when the province stops funding it.

The service provides patients with severe opioid use disorder, a recognized condition, with injections of pharmaceutical-grade heroin, known as diacetylmorphine, or hydromorphone.

“We are disappointed by this decision from the Alberta government, and we urge them to reconsider,” a spokesperson for Patty Hajdu said.

The health minister’s call comes one week after a group of patients benefiting from Alberta’s injectable opioid agonist treatment (iOAT) pilot program filed a lawsuit seeking an injunction to stop Alberta’s provincial government from ending it.

If the three Alberta clinics that offer the treatment close, few people east of British Columbia would have access to the program, which is a cornerstone of the federal government’s latest strategy to combat the opioid crisis.

“Many people are struggling with substance use, and in too many communities, the COVID-19 pandemic is compounding this ongoing public health crisis,” the minister’s statement said.

From January 2016 to March of this year 16,364 Canadians died from opioid overdoses according to figures from the federal government. The numbers have shown an increasing trajectory, with 3,799 deaths last year, and over 1,000 in the first three months of 2020.

The federal government began opening the door to community-based iOAT treatments in 2018 and has provided funding for pilot projects.

The move followed decades of research — first in Europe, then in British Columbia. Multiple studies suggested that providing daily access to pharmaceutical grade injectable opioids allowed long-term chronic users to stabilize their lives, find homes and stop engaging in criminal activity many relied on to support their addictions. Most stuck with the program long term, and some were able to stop using injection drugs altogether.

Alberta’s previous NDP government launched the pilot program in late 2017. Premier Jason Kenney is giving the 60 patients currently enrolled one year to transition to other programs that do not involve injecting opioids. He has called the federal government’s approach “facilitating addiction.”

“Handing out free narcotics to addicts is not compassion,” the premier said in response to questions from CBC News in September.

Patients file lawsuit to keep Alberta program operating

Patients enrolled in the program have have filed 11 affidavits in a lawsuit that is attempting to put a human face on the treatment. People who had focused their entire lives on the pursuit of drugs described awakening to a new world free of the stress and danger on the streets.

 

Taylor Maxey receives injectable opioid agonist treatments at a clinic in Calgary. He fears a return to the streets when the program is ended. (Taylor Maxey)

 

Among them a once nationally ranked swimmer. Taylor Maxey began taking opioids following an injury in his late teens. He was soon homeless, panhandling on the streets and committing petty crimes.

Maxey’s drug habit was costing $900 a day. He watched friends die around him. He attempted suicide. He tried and failed multiple treatment programs.

Today, at the age of 32, he says in an affidavit that he has stable housing, a new network of supportive friends, and hopes of becoming an outreach worker. Instead of hustling for street drugs, he is injected with opioids at the Calgary clinic slated to close in the spring.

Maxey is terrified of what will happen.

“My life would be shorter and much harsher if I returned to the streets and were denied access to iOAT,” he says in an affidavit. “I would be subject to the violence of the streets and the unsafe and precarious world of opioid use. I would be exposed to unsafe supplies of opioids.”

 

Patients of Edmonton’s injectable opioid agonist treatment program meet outside the office of lawyer Avnish Nanda on October 8, as they announce legal action to block the program’s closure. (Sam Martin CBC News)

 

The Alberta government has not filed a statement of defence in the case. The injunction application will be heard in November.

What the research shows

Beyond personal testimonials, iOAT is supported by a range of clinical research that began in Switzerland in the 1990s. on what was then known as heroin assisted treatment, or HAT. A  two-year study of 1,000 people across several centres in Switzerland found “substantial improvements for illicit heroin use, health status and crime among HAT patients,” according to a published review of the evidence. It also found a positive cost-benefit ratio because those provided with drugs had fewer medical issues and committed less crime.

A groundbreaking study published in 2009 in the New England Journal of Medicine concluded heroin-assisted treatment was safe and effective. Researchers followed 251 people in Vancouver and Montreal over 12 to 15 months. They found 88 per cent of patients receiving heroin stayed with the program, and among them, there was a 67 per cent decrease in criminal behaviour.

Overdoses and seizures were the most common adverse events recorded, though the study noted that since the patients were under close medical supervision, the overdoses were treated and the patients recovered.

As fentanyl and carfentanil have increasingly tainted the illicit drug supply, creating an overdose crisis, the provision of pharmaceutical heroin has increasingly been seen as a potential solution.

In 2019, the federal government formalized regulations, and the Canadian Research Initiative on Substance Misuse added clinical practice guidelines. At the time, Theresa Tam, Canada’s chief public health officer, said expanding the availability of pharmaceutical-grade heroin “will save lives.”

Availability limited as overdose deaths increase

But in spite of expectations the therapy would expand across Canada, it remains limited to a handful of sites in B.C., mostly in Vancouver. If the Alberta program shuts down, the only other places in Canada offering it will be Ottawa’s Managed Opioid Program, which treats a maximum of 25 people in a residential setting, and a newly opened program in Fredericton, which currently serves seven patients.

Rob Boyd, the program director of another Ottawa treatment centre, would like to offer iOAT but says he can’t, because the drugs are not adequately covered by Ontario’s health plan.

“Lots of places want to do it,” he said. “We would fill up right away.”

As overdose deaths increase — there have been more than 1,000 in British Columbia alone this year — Canada’s health minister is urging provinces and regulatory bodies to adopt the treatment.

“Do all you can to help provide people who use drugs a full spectrum of options for accessing medication,” she wrote in a letter to her provincial counterparts and regulatory bodies on Aug. 24.

“We need immediate action from all levels of government and health care practitioners to prevent further deaths from the contaminated illegal drug supply and COVID-19.”

Source: – CBC.ca

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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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