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Canadian federal prisoners waiting for opioid treatment

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For the last 18 months, Ricky Leslie’s been cut off from Suboxone, the prescription medication the federal inmate relied on to keep his withdrawal symptoms of opioid addiction at bay, lessening his chances of yet another overdose.

“They’re making me suffer, they’re putting my life in danger every day,” Leslie said of Correctional Services Canada during an interview with CBC News from Port Cartier Institution, a federal penitentiary in Quebec, where he is currently incarcerated.

Leslie said his attempts at staving off cravings have led him to use illicit substances instead.

“Every time I use or whatever, it might be my last time,” he said.

“That’s not fair for me or my family.”

Leslie is on a wait list for what the CSC calls “opioid agonist treatment,” a catch-all term for medical substances, including Suboxone, that replace opioids to help those with addiction issues.

As of June, he was one of 14 people on the wait list in his prison alone, and across the country, the number of inmates waiting for the potentially life-saving treatment has continued to grow throughout the pandemic.

In the 52 penitentiaries run by the federal government, 494 inmates are on a wait list, an increase from 447 in March, the last month Ottawa publicly posted numbers.

“The longer the wait list you get, the more people that are high risk of a fentanyl overdose,” said Dr. Lori Regenstreif, an assistant clinical professor of family medicine at McMaster University in Hamilton, Ont.

The federal body declined an interview for this story, and would only address general numbers in statements, not Leslie’s situation.

“Throughout the COVID-19 pandemic, the provision of health services continued,” the CSC said in an emailed statement, “although there has been a need to prioritize services and resources.”

‘Treated unfairly’

The 50-year-old is from Edmonton, where he was serving his sentence for robbery and assault until the end of July, when CSC transferred him to Quebec.

“I got assaulted by four offenders in Edmonton,” Leslie said. “I wanted to mediate,” but federal authorities decided to move him instead.

The current distance from his loved ones has only exacerbated his addiction problems, he said, which he has been dealing with for decades.

 

Ricky Leslie, 50, seen here in November 2019, says he is finding it difficult to cope with the lack of medical treatment for his opioid addiction. (Submitted by Ricky Leslie)

 

“They’re the ones who support me and are behind me,” he said of his two daughters.

Leslie’s court record shows he has been in and out of the correctional system since 2001, mostly on robbery and assault charges.

He began serving his latest sentence in February 2017. At the time, it took more than a year and a complaint to the Canadian Human Rights Commission to temporarily put him on Suboxone.

According to that document, he had been addicted to opioids since approximately 1997, when he was working on oil rigs in northern Alberta. “I was stabbed by a dirty needle and contracted Hepatitis C,” he wrote. “This seriously affected me mentally and physically.”

He also wrote that he has overdosed approximately four times since then.

Leslie was placed on opioid agonist treatment in November 2018. But in March of last year, he said security guards accused him of “diverting” the Suboxone, which means trading it with other inmates instead of using it. They summarily removed him from treatment.

Leslie denied he ever did that.

“You’re standing in front of an officer and in front of a nurse,” he said. “How are you going to take powder out of your mouth? Wouldn’t it be all over your face? Wouldn’t it be all over your lips?”

Leslie, who is Métis, referred to himself as an Aboriginal offender, and said he was being treated unfairly. “How does a person have to wait that long to get back on Suboxone?” he asked.

Dangerous to cut off, experts warn

CBC spoke to two medical experts who warned it is dangerous to suddenly cut off patients from opioid substitutes.

“The symptoms are pretty debilitating,” said Josh Fanaeian, an emergency physician and addiction specialist in Edmonton.

 

Josh Fanaeian, an emergency physician in Edmonton, warns against cutting off those with addiction issues from medical treatment. (Trevor Wilson/CBC )

 

“It’s almost like the worst flu you can get. Severe sweats, shakes, fever-like symptoms, muscle and bone aches.”

To fight these symptoms, he said patients who are cut off from treatment might try accessing drugs off the street, which could lead to further health issues, including overdoses. “You put a penny into prevention,” he said, “saves a dollar in treatment down the road.”

Regenstreif, who has worked as a physician an Ontario jail, also said that prevention while behind bars would help once an inmate is released into the general public.

“The sooner you set them up for treatment, the better,” Regenstreif said.

Both physicians likened addiction to a chronic disease.

“You wouldn’t fault someone for going on medication if they had diabetes,” Fanaeian said.

 

Dr. Lori Regenstreif, an assistant clinical professor of family medicine at McMaster University in Hamilton, Ont., says federal correctional facilities too often examine opioid agonist treatment through a correctional lens rather than a public health lens. (Craig Chivers/CBC )

 

For Regenstreif, one problem in the federal penitentiary system is that priorities are set though a correctional lens, instead of public health.

“Once a facility has X amount of funding, are they going to spend it on nurses or are they going to spend it on more correctional officers? I don’t know how they budget,” she said.

Treatment increases over four years: CSC

Correctional Services Canada cited Ricky Leslie’s human rights complaint in explaining why it could not comment about him.

In its statement, it said the number of patients on opioid agonist treatment increased from 920 in December 2016 to 2,242 in June 2020, with a 21 per cent increase since December 2019.

“Over the past three years, in the context of the Canadian opioid crisis, the demand for treatment has dramatically increased and continues to increase,” according to the CSC’s website.

The federal body also said all decisions related to a prescription of medication are “made by a health care professional.”

CSC did not provide an explanation for exactly why the wait list grew between March and June, other than mentioning COVID-19.

Regenstreif acknowledged the pandemic has made many things more difficult, but said waiting for prescribed medication is not the same as waiting for a hair cut.

“We’re not talking about … an optional thing, we’re talking about an essential service,” she said.

Regional disparities

The CSC’s statements also could not explain the regional differences between its penitentiaries.

According to the June 2020 figures, of the 494 inmates on wait lists in Canada, 169 — more than one-third — were in Alberta, and wait list numbers grew more in that province from March to June than in the entire country.

Though the CSC did manage to eliminate wait lists completely for two Alberta locations, the Drumheller Institution and Grierson Centre, the number of Alberta inmates waiting for opioid agonist treatment grew from 118 to 169 over that time.

By contrast, Ontario’s wait list shrunk, from 48 inmates in March to just 20 in June.

As for Ricky Leslie, he enlisted the help of the Alberta Prison Justice Society to try and get him back on Suboxone.

“When he’s released, if he’s treated, he’s less likely to reoffend,” said Kate Engel, a lawyer and the secretary for the society. “If he’s languishing in jail without treatment, that’s going to increase his chances of reoffending.”

 

Kate Engel is a lawyer who works with Alberta Prison Justice Society, which has taken up Ricky Leslie’s case. (Sam Martin/CBC)

 

The society was urging Correctional Services Canada to put him on Suboxone by Aug. 14. That date has now come and gone, with no sign of when his wait might end.

Source: – CBC.ca

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Armstrong scores, surging Vancouver Whitecaps beat slumping San Jose Earthquakes 2-0

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VANCOUVER – As the Major League Soccer season ticks down, Vanni Sartini wants his Vancouver Whitecaps to make a declaration — the team is ready to compete.

“The time of hiding ourselves, I think it’s over,” the coach said after the ‘Caps earned a 2-0 victory over the San Jose Earthquakes on Saturday.

“We need to really say that we are here to try to be at the ball until the end and trying to shoot for the highest position. That doesn’t mean that we’re going to make it, but we have the quality to do it.”

With seven games left on their regular-season schedule, the ‘Caps (13-8-6) sit in fifth spot in the congested Western Conference, just two points out of fourth.

Saturday’s loss officially eliminated the last-place Earthquakes (5-21-2) from post-season action.

Vancouver has been on a hot streak since returning from the Leagues Cup break and is unbeaten (3-0-1) in its last four outings across all competitions. The team has not allowed a goal in those matches.

“It’s the fact that we play really well,” Sartini said of the clean sheets. “We have the ball a lot, we finish our attack most of the time in their box. So it’s really hard for the other team to attack us. And then when they attack us, in the rare times that they arrive in the final third, we’re very solid.”

Recent additions have bolstered the team’s ranks, including the club’s newest designated player, Stuart Armstrong. The 32-year-old Scottish midfielder scored his first MLS goal Saturday.

Three minutes after coming on as a substitute for Alessandro Schopf, Armstrong gave Vancouver a two-goal cushion in the 87th minute.

Midfielder Pedro Vite dished a short pass to ‘Caps captain Ryan Gauld, who tapped it toward Armstrong. The former Southampton FC player then blasted a shot into the top of the net for his first strike in a Whitecaps’ jersey.

He was mobbed by teammates in the corner of the field.

“I think everyone was happy. Also for the first goal, but also that it was an important three points,” said Armstrong, who signed with the ‘Caps on Sept. 3.

“It kind of felt a little bit like last week, when we had a lot of chances and we didn’t get the three points. So today, I think everyone was just relieved to have that two-goal cushion.”

Vancouver was the dominant team from the outset Saturday and did not relent, outshooting the visitors 19-5 and controlling 54.1 per cent of possession.

Fafa Picault also found the back of the net for Vancouver, while Gauld contributed a pair of assists.

Whitecaps goalkeeper Yohei Takaoka stopped both shots he faced to collect his seventh clean sheet of the year, while Daniel made nine saves for the Quakes.

Gauld and Picault teamed up in the 22nd minute when Gauld curled a cross in and the Haitian striker headed it down toward the net, only to see Daniel catch a piece of the shot with his forearm and redirect it out of harm’s way.

The duo connected again in the 35th minute on a Vancouver corner. Gauld swung a ball in and Picault jumped up from the pack to send a glancing header in past Daniel for his ninth MLS goal of the season.

San Jose briefly appeared to level the score in the 68th minute when an unmarked Ousseni Bouda collected the ball, froze Takaoka and tapped a shot into the Vancouver net. An official quickly raised the offside flag and waved off the tally.

Daniel kept San Jose’s deficit to a single goal with a pair of solid stops in the 82nd minute.

First, the Brazilian ‘keeper dove sideways on his line to tip away a bomb from Alessandro Schopf. He was tested again on the ensuing corner and jumped up to send a header from Picault over the crossbar.

“I think we created a lot of chances again,” Gauld said.

“We probably should have put the game out of their reach sooner. But we’d be more worried if we weren’t creating the chances. Three clean sheets in a row in the league, I think it’s a big thing for us. And it gives us a good platform to go forward.”

NOTES

Vancouver played without leading scorer Brian White for a third consecutive game as the American striker works his way back from a concussion. … Gauld’s second assist marked his 15th goal contribution (six goals, nine assists) in his last 15 Whitecaps games across all competitions. … An announced crowd of 21,309 took in the game at B.C. Place.

UP NEXT

The Whitecaps kick off a two-game road swing Wednesday against the Houston Dynamo. The Earthquakes host the Seattle Sounders the same night.

This report by The Canadian Press was first published Sept. 14, 2024.



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As plant-based milk becomes more popular, brands look for new ways to compete

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When it comes to plant-based alternatives, Canadians have never had so many options — and nowhere is that choice more abundantly clear than in the milk section of the dairy aisle.

To meet growing demand, companies are investing in new products and technology to keep up with consumer tastes and differentiate themselves from all the other players on the shelf.

“The product mix has just expanded so fast,” said Liza Amlani, co-founder of the Retail Strategy Group.

She said younger generations in particular are driving growth in the plant-based market as they are consuming less dairy and meat.

Commercial sales of dairy milk have been weakening for years, according to research firm Mintel, likely in part because of the rise of plant-based alternatives — even though many Canadians still drink dairy.

The No. 1 reason people opt for plant-based milk is because they see it as healthier than dairy, said Joel Gregoire, Mintel’s associate director for food and drink.

“Plant-based milk, the one thing about it — it’s not new. It’s been around for quite some time. It’s pretty established,” said Gregoire.

Because of that, it serves as an “entry point” for many consumers interested in plant-based alternatives to animal products, he said.

Plant-based milk consumption is expected to continue growing in the coming years, according to Mintel research, with more options available than ever and more consumers opting for a diet that includes both dairy and non-dairy milk.

A 2023 report by Ernst & Young for Protein Industries Canada projected that the plant-based dairy market will reach US$51.3 billion in 2035, at a compound annual growth rate of 9.5 per cent.

Because of this growth opportunity, even well-established dairy or plant-based companies are stepping up their game.

It’s been more than three decades since Saint-Hyacinthe, Que.-based Natura first launched a line of soy beverages. Over the years, the company has rolled out new products to meet rising demand, and earlier this year launched a line of oat beverages that it says are the only ones with a stamp of approval from Celiac Canada.

Competition is tough, said owner and founder Nick Feldman — especially from large American brands, which have the money to ensure their products hit shelves across the country.

Natura has kept growing, though, with a focus on using organic ingredients and localized production from raw materials.

“We’re maybe not appealing to the mass market, but we’re appealing to the natural consumer, to the organic consumer,” Feldman said.

Amlani said brands are increasingly advertising the simplicity of their ingredient lists. She’s also noticing more companies offering different kinds of products, such as coffee creamers.

Companies are also looking to stand out through eye-catching packaging and marketing, added Amlani, and by competing on price.

Besides all the companies competing for shelf space, there are many different kinds of plant-based milk consumers can choose from, such as almond, soy, oat, rice, hazelnut, macadamia, pea, coconut and hemp.

However, one alternative in particular has enjoyed a recent, rapid ascendance in popularity.

“I would say oat is the big up-and-coming product,” said Feldman.

Mintel’s report found the share of Canadians who say they buy oat milk has quadrupled between 2019 and 2023 (though almond is still the most popular).

“There seems to be a very nice marriage of coffee and oat milk,” said Feldman. “The flavour combination is excellent, better than any other non-dairy alternative.”

The beverage’s surge in popularity in cafés is a big part of why it’s ascending so quickly, said Gregoire — its texture and ability to froth makes it a good alternative for lattes and cappuccinos.

It’s also a good example of companies making a strong “use case” for yet another new entrant in a competitive market, he said.

Amid the long-standing brands and new entrants, there’s another — perhaps unexpected — group of players that has been increasingly investing in plant-based milk alternatives: dairy companies.

For example, Danone has owned the Silk and So Delicious brands since an acquisition in 2014, and long-standing U.S. dairy company HP Hood LLC launched Planet Oat in 2018.

Lactalis Canada also recently converted its facility in Sudbury, Ont., to manufacture its new plant-based Enjoy! brand, with beverages made from oats, almonds and hazelnuts.

“As an organization, we obviously follow consumer trends, and have seen the amount of interest in plant-based products, particularly fluid beverages,” said Mark Taylor, president and CEO of Lactalis Canada, whose parent company Lactalis is the largest dairy products company in the world.

The facility was a milk processing plant for six decades, until Lactalis Canada began renovating it in 2022. It now manufactures not only the new brand, but also the company’s existing Sensational Soy brand, and is the company’s first dedicated plant-based facility.

“We’re predominantly a dairy company, and we’ll always predominantly be a dairy company, but we see these products as complementary,” said Taylor.

It makes sense that major dairy companies want to get in on plant-based milk, said Gregoire. The dairy business is large — a “cash cow,” if you will — but not really growing, while plant-based products are seeing a boom.

“If I’m looking for avenues of growth, I don’t want to be left behind,” he said.

Gregoire said there’s a potential for consumers to get confused with so many options, which is why it’s so important for brands to find a way to differentiate themselves, whether it’s with taste, health, or how well the drink froths for a latte.

Competition in a more crowded market is challenging, but Taylor believes it results in better products for consumers.

“It keeps you sharp, and it forces you to be really good at what you’re doing. It drives innovation,” he said.

This report by The Canadian Press was first published Sept. 15, 2024.



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Inflation expected to ease to 2.1%, lowest level since March 2021: economists

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Economists anticipate that Canada’s annual inflation rate in August fell to its lowest level since March 2021.

Ahead of Statistics Canada’s consumer price index set to be released on Tuesday, economists polled by Reuters are expecting the report to show prices rose 2.1 per cent from a year ago, down from a 2.5 per cent annual gain in July. The forecasters also anticipate inflation remained flat on a month-over-month basis.

“Unless there’s something lurking out there that we’re not aware of, it looks like we’re headed for a pretty favourable reading,” said BMO chief economist Douglas Porter.

RBC economists Nathan Janzen and Claire Fan said in a report last week that those expectations would put the headline inflation rate just a hair over the Bank of Canada’s two per cent inflation target.

“Most of that August slowing is expected from a pullback in gasoline prices, but the (Bank of Canada’s) preferred core CPI measures are also expected to trend lower, with the closely-watched three-month annualized growth rate easing from an average of 2.6 per cent in July,” the RBC economists said.

The continued progress on slowing inflation comes as the central bank has signalled a willingness to speed up cuts to its key lending rate if circumstances warrant.

The Bank of Canada reduced its key lending rate by a quarter-percentage point earlier this month — the third consecutive cut — to 4.25 per cent. Governor Tiff Macklem said the decision was motivated by falling inflation, noting if the CPI moving forward “was significantly weaker than we expected … it could be appropriate to take a bigger step, something bigger than 25 basis points.”

On the other hand, Macklem said if inflation is stronger than expected, the bank could slow the pace of rate cuts.

Inflation has remained below three per cent since January and fears of price growth reaccelerating have diminished as the economy has weakened.

Porter said despite progress on the inflation rate, it’s still “not in a place where it’s a compelling argument that the bank has to go even faster.”

He forecasts the central bank will cut its key lending rate by a quarter-percentage point at every meeting until July 2025, bringing it down to 2.5 per cent by that time. That prediction also comes after data released last week that showed Canada’s unemployment rate rose to 6.6 per cent in August from 6.4 per cent in July.

However, Porter said it’s possible the bank could speed up its rate cutting cycle if inflation continues easing.

“If we’re going to be wrong, it’s that we’re going to get to 2.5 per cent even more quickly and possibly lower than that,” said Porter.

“There is a case to be made that if the economy were to weaken further, there’s little reason for the bank to keep rates in what they consider to be the neutral zone. They could go below that.”

Shelter costs have remained the main driver of inflation as Canadians face high rents and mortgage payments. Porter noted that when factoring out housing costs, inflation in both Canada and U.S. is hovering slightly above one per cent.

“So really, the only thing keeping Canadian inflation above two per cent is shelter and it does look like shelter costs are probably going to fade,” he said.

“It looks as if rents are starting to moderate. They’re not necessarily falling, but not rising as quickly. And of course with interest rates coming down, ultimately the big kahuna here, mortgage interest costs, will recede as well.”

With the U.S. Federal Reserve set to meet on Wednesday, Janzen and Fan said they expect the American central bank to announce its first rate cut in four years.

“Gradual but persistent labour market softening and slowing inflation make it clear that current high interest rates are no longer needed,” they wrote.

“We think governor (Jerome) Powell’s comments will likely stay on the cautious side — hinting at future rate cuts without committing to a pre-determined path to allow for more flexibility in future decisions.”

—With files from Nojoud Al Mallees in Ottawa

This report by The Canadian Press was first published Sept. 15, 2024.

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