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Canada's opioid crisis: The people and communities fighting for change and finding solutions – The Globe and Mail

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Photos: Chad Hipolito/The Globe and Mail and Nicole Richard

The families fighting for action

Nicole Richard/Handout

It was a photo that stirred hearts across Canada: A group of 15 women who lost loved ones to drug overdoses posing together with crosses to illustrate the depth of the crisis – and to remind people that those who are dying “are somebody’s someone.”

The picture was circulated online by Moms Stop the Harm, a national organization lobbying for better drug policy. The group is calling on the federal government to declare the opioid crisis a national health emergency, to increase safe supply of drugs and to decriminalize possession of illicit substances.

The government response: The Liberals have repeatedly rejected calls to decriminalize possession of hard drugs. The party has said it will proceed on the issue of “safe supply” – that is, helping provide a regulated, quality-controlled source of drugs. The NDP and the Greens both support decriminalization. And while drug policy is a federal mandate, provinces and municipalities can take steps to de facto decriminalize. That’s what B.C.’s top public health officer is urging, but the NDP government has resisted the proposal.

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Why decriminalization? Advocates say decriminalizing personal possession – a measure Portugal took in 2001 – would play a critical role in responding to the crisis. “The societal stigma associated with drug use leads many to use drugs alone and hidden, increasing their risk of dying. B.C. cannot ‘treat’ its way out of this overdose crisis, or ‘arrest’ its way out either,” health officer Bonnie Henry wrote in a report.

The Globe’s view: Our editorial board argues that decriminalization would be a key step in treating addiction as a health-care issue, not a criminal-law problem. “Decriminalization of drugs is not a magic bullet that will end drug addiction. But it can be part of a broader harm-reduction strategy that includes many other steps.”

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What a forgotten 1970s experiment can teach us about today’s drug crisis

Outreach efforts

Combining resources

Vancouver Fire and Rescue Services captain Jonathan Gormick and Vancouver Coastal Health social worker Robyn Kelway visit residences in Vancouver in August, 2019.

Jackie Dives/The Globe and Mail

How do you deliver services to drug users who are often hard to reach? A new outreach initiative in Vancouver pairs firefighters with social workers to follow up on recent overdose calls. At each location, a worker with Vancouver Fire and Rescue Services asks for the patient by name but says only that they’re following up on a recent call. If the patient is there and consents to further help, they wave over a Vancouver Coastal Health (VCH) social worker, who is waiting just out of sight.

The response: During an August trial period, the Combined Overdose Response Team made 107 visits, making contact in 22 of them, with 21 patients consenting to further help. That can include connecting people to housing supports or drug counsellors, and even teaching a user’s partner how to use a naloxone kit. “It doesn’t surprise me that they want help,” said Patricia Daly, chief medical health officer for VCH. “People don’t want to die; they want to get out of the cycle of repeated overdoses.”

The fly-in doctor

Dr. Todd Young, centre, and ‘recovery coach’ Craig Wiseman, right, carry charts and luggage off a small airstrip in the rain after landing in Clarenville, Nfld.

Darren Calabrese

For many patients in far-flung Newfoundland and Labrador towns, Todd Young is the only person who will prescribe opioid-replacement medication – and he flies his own plane to get to them. Dr. Young heads to eight-and-counting towns each month to provide access to methadone or Suboxone, allowing patients to receive help within five days as opposed to waits of one month or more in other rural parts of the province. Dr. Young manages about 600 patients that range in age from 15 to 94.

A long way to go: “This is not a popular form of medicine in Newfoundland,” said Dr. Young, who said many physicians “look at addictions patients as problem patients.” It’s not uncommon for him to show up to work to find a patient who has hitchhiked hundreds of kilometres to beg for treatment, or another waiting in her truck before office hours begin, trembling with the onset of withdrawal and the determination to get help. Dr. Young hopes that his willingness to treat addictions will eventually entice other physicians.

A multilayered response

Yellow boxes to dispose of used needles are now a fixture in Brantford.

Fred Lum/The Globe and Mail

As Brantford’s hospital admissions for overdoses soared in 2016 and 2017, leaders in the Southwestern Ontario city knew they had to act. Police Chief Geoff Nelson huddled with other local officials and put together a plan. Start treating users as sick people rather than criminals; make it easier for them to get addiction treatment; spread the word about the dangers of fentanyl; hand out lots of free naloxone kits.

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Promising results: Although officials are quick to say the crisis is far from over, overdose figures were down sharply in 2018 from their peak in 2017. Emergency services responded to 35 per cent fewer overdose incidents in 2018. The hospital emergency department received 44 per cent fewer overdose visits.

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Drug checking takes on elevated role as illicit fentanyl sweeps country

Pilot programs

PHS Community Services Society medical director Christy Sutherland said the idea to dispense hydromorphone in tablet form came from patients themselves, who were not satisfied with the injectable program.

B.C. has been the hardest-hit province in the overdose crisis, but it has also paved the way with innovative responses. Insite, North America’s first supervised consumption site, opened in Vancouver in 2003. Today, there are dozens of supervised sites across the country. There are also newer initiatives under way to stanch overdoses:

Pharmaceutical-grade pills: A pilot project from Vancouver’s largest social-service provider is allowing about 50 patients at a time to access the opioid hydromorphone in tablet form and ingest them on site while staff observe them. Hydromorphone is an opioid medication used to treat moderate to severe pain that is commonly used in palliative and acute care. One Vancouver study found that hydromorphone could be an affordable and effective substitution therapy for heroin.

Fighting fentanyl with fentanyl: A program launched in July, 2019, sees patients get a fentanyl patch – commonly used to treat chronic pain for conditions such as cancer – that is applied to the skin and changed every two days by a nurse. To address misuse, the patches are signed and dated, and a transparent film is applied to prevent tampering. It is believed to be the first formal program of its kind.

A proposal for regulated retail heroin sales: British Columbia’s authority on addictions care is recommending allowing regulated retail heroin sales in the province to reduce overdose deaths caused by fentanyl-tainted illicit drugs and to generate funds for addiction-treatment services. Members would be permitted to purchase personal amounts of the drug from a location connected to health-care services.

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Community challenges

Men in trades

Sam Stahnke in Campbell River, B.C.

CHAD HIPOLITO/The Globe and Mail

Sam Stahnke was making good money working three weeks a month in Alberta’s oil sands. Then a knee injury forced him to go on opioid painkillers, and soon he was buying Oxycontin, hydromorphone and morphine pills by the thousands. Soon, he started crushing the pills into powder, mixing it with saline solution and injecting the liquid with a big syringe. Then, he turned to heroin. But he kept working, never telling anyone as he used drugs in the isolation of his house in Campbell River, B.C. “I’m lucky to be alive,” he says, recalling the years before his recovery.

The ‘working-man’s code’: B.C. statistics show that of those who died by overdose that were employed, 55 per cent worked in transport or the trades. In Ontario, one-third with known employment status were in construction. The vast majority of victims are men, and most die in private residences. But stigma remains pervasive, with working men reluctant to seek help. “This has been a neglected population that nobody is talking about,” says Andrea Furlan, a scientist at the Institute for Work and Health in Toronto.

Addressing the problem: Authorities have been aware of the issue for trades workers for years, but action has been slow. Mr. Stahnke found the courage to tell his family doctor, and was put on Suboxone, a substitute opioid that reduces the craving for drugs without producing a high. He hopes that telling his story will encourage others in his position to get help.


The prison system

One of the letters sent by Spencer Kell to his friend Manie Daniels.

Tijana Martin/The Globe and Mail

When Spencer Kell got out of jail in the spring of 2018, leaving his cellmate Manie Daniels behind, the two friends started exchanging letters. Both had used drugs in the past; they shared their struggles – and hopes – in the notes. The pair hoped to reunite soon after Daniels’s release that July. “I’m waiting for you! Write me soon. Stay safe,” Mr. Kell wrote. But Daniels died less than two days after getting out, overdosing on hydromorphone.

Transitioning to civilian life: Mr. Kell told a Senate forum in February, 2019, that with nowhere else to go, just-released prisoners often head “right back to the dealer’s house.” The numbers bear that out: A study on overdose deaths in Ontario showed that, between 2006 and 2013, one in 10 happened within a year of release from a provincial jail.

The services available: After his release, Mr. Kell ended up at the Salvation Army’s Ottawa Booth Centre, a Christian non-profit that offers help to the capital’s homeless and the addicted. He subsequently found an apartment and finished a college course on becoming an addiction worker. In Ontario, when prisoners are released they get naloxone kits and training about how to use the overdose-reversal drug, as well as a wallet card on how to avoid an opioid overdose. But the families of victims say that’s not nearly enough. They are advocating for more treatment programs and beds.

ontario Drug Toxicity Deaths

after incarceration

Number of deaths by day in the year after release from provincial incarceration, up to day 60, 2006–2013.

Days since release from incarceration

JOHN SOPINSKI/THE GLOBE AND MAIL

SOURCE: pols.org

ontario Drug Toxicity Deaths

after incarceration

Number of deaths by day in the year after release from provincial incarceration, up to day 60, 2006–2013.

Days since release from incarceration

JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE: pols.org

ontario Drug Toxicity Deaths after incarceration

Number of deaths by day in the year after release from provincial incarceration, up to day 60, 2006–2013.

Days since release from incarceration

JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE: pols.org


Compiled by Arik Ligeti, based on reports from Marcus Gee, Andrea Woo and Jessica Leeder

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Five big box stores fined for violating COVID-19 orders in one day | News – Daily Hive

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Multiple big box stores have been fined for failing to follow provincial COVID-19 orders.

Ontario’s Minister of Labour, Training, and Skills Development said on social media that inspectors had visited 110 retailers on January 16 as part of a weekend big box blitz.

As a result, five stores were fined for “failing to keep workers and customers safe,” Monte McNaughton tweeted.

McNaughton did not specify which retailers were fined.

On January 14, the Government of Ontario announced that approximately 50 ministry inspectors, as well as local bylaw and police officers, would be visiting big-box stores this weekend to ensure COVID-19 rules were being followed.

Inspectors were dispersed throughout Toronto, Hamilton, Peel, York, and Durham, which have been the province’s virus hotspots.

The government said the blitz would focus on ensuring workers and patrons were wearing masks, maintaining physical distance, and following health and safety measures.

Premier Doug Ford announced a second provincial State of Emergency on January 12. He has also issued a Stay at Home order, which went into effect January 14. Both measures will be in place for at least 28 days.

Under the Stay at Home order, people must only go out for essential trips, such as going to the grocery store or pharmacy, accessing healthcare services, exercising, or essential work.

To date, Ontario has seen 237,786 COVID-19 cases and 5,409 deaths.

Daily Hive has contacted McNaughton for more information and will update this story accordingly.

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Mental Illness in Canada

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mental

Mental illnesses affect 6.7 million Canadians annually—but how prepared are we as a country to support those who are suffering?

The million-dollar question has been presented.

Regardless of mental illness now becoming a much more talked about thing than before. There are still many people that tend to misunderstand mental illnesses. About 6.7 million Canadians suffer from metal illnesses and therefore this is something that the government should actively become a part of overtaking.

Let’s get the numbers in a much more understandable term. 1 out of every 5 Canadians is suffering form a metal health disorder. This means that they are diagnosed with some sort of mental condition that would be treatable under common circumstances. Which means that this does not includes people who did not or cannot go to a problem doctor.

Out of those diagnosed with mental illness annually, depression and bipolar disorder, substance abuse disorder or addiction, eating disorders, anxiety disorders, schizophrenia and PTSD are among the most common.

In any given week, 500,000 Canadians aren’t able to work due to mental illness,”

says Hosseiny.

This is how serious this issue is and not to mention that by 2020 mental issues would be a leading cause of disability in most Canadian workplaces.

“an estimated $50 billion is lost annually through unemployment, absenteeism and presenteeism,”

This is clearly going to have not only a personal but an economical impact as well.

When it comes to mental illness, our public health system is still set up in a way that concentrates on treatment versus preventative measures.

“We’ve done a lot of great work to tackle the stigma and, as a result, people are coming out and having discussions [and seeking treatment],”

says Hosseiny.

“But the problem is that the system isn’t ready to respond to that.”

While many say Canada has universal health care, it’s really universal medical care as mental health and illness are still not treated in the same way as physical care.

The government would need to take proactive prevention measures that would allow them to limit

“We don’t wait until stage 4 to treat cancer, so why do we [wait so long] with mental illness?”

We have a great set of initiative by the recent government but then again due to a lack of funding on the projects and ideas things have seen a lag. Lagging on such matters can be dangerous as can leave people scared for life. They should be treated the same as people that are going through physical pain.

Though making sure services such as addiction counsel, psychologists and social workers are publicly funded would be a major leap in the right direction but there is still a lot of effort that is needed when it comes to educating people about these problems and actually take control of the matters and solving them for real.

Lack of funding for a developed economy seems like a joke. This needs to end and things need to take care of soon. With out proper mental health, people, children, workforce and every other aspect of life and economy could be severely and negatively be effected by this.

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Ontario inspectors find 36 stores violating COVID-19 rules during big-box safety blitz – CTV Toronto

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TORONTO —
Safety inspectors found more than 30 businesses violating COVID-19 safety rules during a big-box blitz across the Greater Toronto and Hamilton Area, the Ministry of Labour, Training and Skills Development said Sunday. 

The ministry said that inspectors visited 110 stores on Saturday and found 31 stores in violation of provincial orders, which is equal to about 70 per cent compliance. 

The government said 11 formal warnings and 11 tickets were issued on Saturday as a result of the blitz. 

Five additional stores were found violating health orders on Sunday, Labour Minister Monte McNaughton said.  He added that on Saturday there were five box-box corporations slapped with fines.

The ministry did not name the stores they said were found violating the orders.

Individuals found violating the Occupational Health and Safety Act can be fined up to $100,000 and imprisoned for as long as a year, while corporations can be fined up to $1.5 million per charge.

More than 34,000 COVID-19-related workplace inspections have happened since the beginning of the pandemic.

McNaughton has said inspectors are focusing on compliance with masking and physical distancing rules, as well as other health guidelines. He said they have the authority to temporarily shut down facilities found to be breaching the rules, and to disperse groups of more than five people.

The government said big-box stores would remain a key target during the provincewide safety blitz. The ministry issued a document late last week saying inspections would also involve workplaces which reported COVID-19 outbreaks and businesses focused on manufacturing, warehousing, distribution centres and food processing.

Premier Doug Ford, who has faced criticism for allowing big-box stores to remain open for on-site shopping while smaller businesses are restricted to curbside pickup or online sales, vowed this week to crack down on big lineups and other infractions at large retailers.

The weekend blitz comes days after the province enacted an order requiring residents to stay at home for all but essential purposes, such as shopping for groceries or accessing health care.

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