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‘I wouldn’t be here’: Ontario supervised consumption site users speak out on closures

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TORONTO – Reggie Garrett remembers snippets of the first time he was saved from a fatal overdose.

A few years ago, while at a supervised consumption site in downtown Toronto, he overdosed on fentanyl, with the powerful opioid working to shut down his body.

A staffer rushed to give him an opioid antidote and stood over him while it took effect.

“I saw his face and how worried he was, it was the first time in a long time that I felt like somebody cared about me,” Garrett says.

“I wouldn’t be here if it weren’t for them.”

The 35-year-old weeps as he speaks about the Parkdale Queen West Community Health Centre, which houses the supervised consumption site he uses. It is one of 10 such sites slated for closure after the province announced new rules.

Health Minister Sylvia Jones recently outlined a fundamental shift in the province’s approach to the overdose crisis. Ontario will shutter the 10 sites because they’re too close to schools and daycares, and the government will prohibit any new ones from opening as it moves to an abstinence-based treatment model.

Seven existing consumption sites will remain open.

Jones has denied that the changes would lead to harm, saying “people are not going to die. They are going to get access to treatment.”

But health workers, advocates and those who use the sites say the closures could prove deadly for those with opioid addictions.

Garrett is terrified.

“These people mean the world to me,” he says of staffers at the site he uses. “I’m very alone, but when I come here, I’m not alone anymore.”

The Canadian Press spoke to several people who use supervised consumption sites. Fear, anxiety and confusion dominated those discussions.

For Garrett, using the consumption site has allowed him to trust the health-care workers there, and that has led him to use other services offered at the community centre.

Staffers have even taken him to hospital – in one instance it was because they noticed signs of sepsis that eventually required two weeks of care.

“I guess I’ll end up in a park,” Garrett says of where he’ll use drugs in the future.

For Jeanne Hamilton, the Parkdale consumption site has become a safe haven.

She battled addiction growing up and says she lost many friends to opioids. She started a new life in Toronto after moving from New York but her troubles returned after a difficult pregnancy left her spine in poor shape, leading to nerve damage.

A prescription for opioid-based painkillers following the birth of her child left her hooked again, she says. She later went into a mental spiral after her best friend’s suicide and used fentanyl to cope, she says.

Hamilton eventually ended up using the consumption site and says that after coming to trust the staff, she was able to get herself off fentanyl.

Now on methadone, she’s received training to help others and walks the streets armed with an overdose-reversing naloxone kit.

“I’ve been able to save many, many friends,” the 27-year-old says.

She struggles to find words about the looming changes and worries about relapsing herself.

“I believe a lot of people are going to die because of this decision,” Hamilton says. “I may be one of them.”

The province has said it will be creating 19 new “homelessness and addiction recovery treatment hubs,” plus 375 highly supportive housing units at a cost of $378 million as it enforces its new rules.

But advocates have said that is not enough to meet demand and shuttering consumption sites will cost lives.

The province simply does not understand addicts, says Carmelita Baird-Gendlin.

“I feel like it’s very, very hard for them to empathize with the people like us,” says the 36-year-old.

Baird-Gendlin used to shoot heroin but that drug has largely disappeared from the streets, she says, because of the ubiquity of fentanyl.

“Heroin was enjoyable, but fentanyl, there’s nothing enjoyable about it,” she says. “I keep doing it to avoid being dope sick.”

Justin Smith has been taking fentanyl off and on for years. He was clean and living in Barrie with his fiancée and her three children when he got reacquainted with old friends. He overdosed on drugs he got from them one day, with paramedics rushing to save him.

Smith chose to move out of the couple’s home and stay away from his fiancée’s kids until he got off opioids. That was five years ago.

The 46-year-old says he still sees his partner and the kids weekly, but won’t return until he is sober.

Smith says he had a tough childhood, with his mother using drugs and his father committing crimes.

“My mom was actually the first person I used with,” he says. “My grandmother warned me not to get in touch with my mom because my life would turn out like hers and it totally has.”

He uses several supervised consumption sites because using drugs anywhere else is too dangerous, he says.

“These streets are terrible,” he says.

Smith says he’s been seeing a counsellor at one of the supervised consumption sites, along with a doctor. He’ll be able to get a prescription for medication used to treat opioid addiction when he’s ready, he says.

Angela Robertson, the director of the Parkdale Queen West Community Health Centre, has spent the past two weeks dealing with the worries of both clients and staff.

“We are not just shocked, but frightened for what this will mean for the clients who we have been serving,” she says.

“We feel the decision flies in the face of what has been good public health policy for decades.”

On the health minister’s stance that shuttering safe consumption sites will not cost lives, Robertson says she’d like that to be true but knows otherwise.

“All of the evidence tells me that will not happen,” she says. “In fact, there will be deaths.”

This report by The Canadian Press was first published Sept. 3, 2024.



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STD epidemic slows as new syphilis and gonorrhea cases fall in US

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NEW YORK (AP) — The U.S. syphilis epidemic slowed dramatically last year, gonorrhea cases fell and chlamydia cases remained below prepandemic levels, according to federal data released Tuesday.

The numbers represented some good news about sexually transmitted diseases, which experienced some alarming increases in past years due to declining condom use, inadequate sex education, and reduced testing and treatment when the COVID-19 pandemic hit.

Last year, cases of the most infectious stages of syphilis fell 10% from the year before — the first substantial decline in more than two decades. Gonorrhea cases dropped 7%, marking a second straight year of decline and bringing the number below what it was in 2019.

“I’m encouraged, and it’s been a long time since I felt that way” about the nation’s epidemic of sexually transmitted infections, said the CDC’s Dr. Jonathan Mermin. “Something is working.”

More than 2.4 million cases of syphilis, gonorrhea and chlamydia were diagnosed and reported last year — 1.6 million cases of chlamydia, 600,000 of gonorrhea, and more than 209,000 of syphilis.

Syphilis is a particular concern. For centuries, it was a common but feared infection that could deform the body and end in death. New cases plummeted in the U.S. starting in the 1940s when infection-fighting antibiotics became widely available, and they trended down for a half century after that. By 2002, however, cases began rising again, with men who have sex with other men being disproportionately affected.

The new report found cases of syphilis in their early, most infectious stages dropped 13% among gay and bisexual men. It was the first such drop since the agency began reporting data for that group in the mid-2000s.

However, there was a 12% increase in the rate of cases of unknown- or later-stage syphilis — a reflection of people infected years ago.

Cases of syphilis in newborns, passed on from infected mothers, also rose. There were nearly 4,000 cases, including 279 stillbirths and infant deaths.

“This means pregnant women are not being tested often enough,” said Dr. Jeffrey Klausner, a professor of medicine at the University of Southern California.

What caused some of the STD trends to improve? Several experts say one contributor is the growing use of an antibiotic as a “morning-after pill.” Studies have shown that taking doxycycline within 72 hours of unprotected sex cuts the risk of developing syphilis, gonorrhea and chlamydia.

In June, the CDC started recommending doxycycline as a morning-after pill, specifically for gay and bisexual men and transgender women who recently had an STD diagnosis. But health departments and organizations in some cities had been giving the pills to people for a couple years.

Some experts believe that the 2022 mpox outbreak — which mainly hit gay and bisexual men — may have had a lingering effect on sexual behavior in 2023, or at least on people’s willingness to get tested when strange sores appeared.

Another factor may have been an increase in the number of health workers testing people for infections, doing contact tracing and connecting people to treatment. Congress gave $1.2 billion to expand the workforce over five years, including $600 million to states, cities and territories that get STD prevention funding from CDC.

Last year had the “most activity with that funding throughout the U.S.,” said David Harvey, executive director of the National Coalition of STD Directors.

However, Congress ended the funds early as a part of last year’s debt ceiling deal, cutting off $400 million. Some people already have lost their jobs, said a spokeswoman for Harvey’s organization.

Still, Harvey said he had reasons for optimism, including the growing use of doxycycline and a push for at-home STD test kits.

Also, there are reasons to think the next presidential administration could get behind STD prevention. In 2019, then-President Donald Trump announced a campaign to “eliminate” the U.S. HIV epidemic by 2030. (Federal health officials later clarified that the actual goal was a huge reduction in new infections — fewer than 3,000 a year.)

There were nearly 32,000 new HIV infections in 2022, the CDC estimates. But a boost in public health funding for HIV could also also help bring down other sexually transmitted infections, experts said.

“When the government puts in resources, puts in money, we see declines in STDs,” Klausner said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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World’s largest active volcano Mauna Loa showed telltale warning signs before erupting in 2022

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WASHINGTON (AP) — Scientists can’t know precisely when a volcano is about to erupt, but they can sometimes pick up telltale signs.

That happened two years ago with the world’s largest active volcano. About two months before Mauna Loa spewed rivers of glowing orange molten lava, geologists detected small earthquakes nearby and other signs, and they warned residents on Hawaii‘s Big Island.

Now a study of the volcano’s lava confirms their timeline for when the molten rock below was on the move.

“Volcanoes are tricky because we don’t get to watch directly what’s happening inside – we have to look for other signs,” said Erik Klemetti Gonzalez, a volcano expert at Denison University, who was not involved in the study.

Upswelling ground and increased earthquake activity near the volcano resulted from magma rising from lower levels of Earth’s crust to fill chambers beneath the volcano, said Kendra Lynn, a research geologist at the Hawaiian Volcano Observatory and co-author of a new study in Nature Communications.

When pressure was high enough, the magma broke through brittle surface rock and became lava – and the eruption began in late November 2022. Later, researchers collected samples of volcanic rock for analysis.

The chemical makeup of certain crystals within the lava indicated that around 70 days before the eruption, large quantities of molten rock had moved from around 1.9 miles (3 kilometers) to 3 miles (5 kilometers) under the summit to a mile (2 kilometers) or less beneath, the study found. This matched the timeline the geologists had observed with other signs.

The last time Mauna Loa erupted was in 1984. Most of the U.S. volcanoes that scientists consider to be active are found in Hawaii, Alaska and the West Coast.

Worldwide, around 585 volcanoes are considered active.

Scientists can’t predict eruptions, but they can make a “forecast,” said Ben Andrews, who heads the global volcano program at the Smithsonian Institution and who was not involved in the study.

Andrews compared volcano forecasts to weather forecasts – informed “probabilities” that an event will occur. And better data about the past behavior of specific volcanos can help researchers finetune forecasts of future activity, experts say.

(asterisk)We can look for similar patterns in the future and expect that there’s a higher probability of conditions for an eruption happening,” said Klemetti Gonzalez.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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Waymo’s robotaxis now open to anyone who wants a driverless ride in Los Angeles

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Waymo on Tuesday opened its robotaxi service to anyone who wants a ride around Los Angeles, marking another milestone in the evolution of self-driving car technology since the company began as a secret project at Google 15 years ago.

The expansion comes eight months after Waymo began offering rides in Los Angeles to a limited group of passengers chosen from a waiting list that had ballooned to more than 300,000 people. Now, anyone with the Waymo One smartphone app will be able to request a ride around an 80-square-mile (129-square-kilometer) territory spanning the second largest U.S. city.

After Waymo received approval from California regulators to charge for rides 15 months ago, the company initially chose to launch its operations in San Francisco before offering a limited service in Los Angeles.

Before deciding to compete against conventional ride-hailing pioneers Uber and Lyft in California, Waymo unleashed its robotaxis in Phoenix in 2020 and has been steadily extending the reach of its service in that Arizona city ever since.

Driverless rides are proving to be more than just a novelty. Waymo says it now transports more than 50,000 weekly passengers in its robotaxis, a volume of business numbers that helped the company recently raise $5.6 billion from its corporate parent Alphabet and a list of other investors that included venture capital firm Andreesen Horowitz and financial management firm T. Rowe Price.

“Our service has matured quickly and our riders are embracing the many benefits of fully autonomous driving,” Waymo co-CEO Tekedra Mawakana said in a blog post.

Despite its inroads, Waymo is still believed to be losing money. Although Alphabet doesn’t disclose Waymo’s financial results, the robotaxi is a major part of an “Other Bets” division that had suffered an operating loss of $3.3 billion through the first nine months of this year, down from a setback of $4.2 billion at the same time last year.

But Waymo has come a long way since Google began working on self-driving cars in 2009 as part of project “Chauffeur.” Since its 2016 spinoff from Google, Waymo has established itself as the clear leader in a robotaxi industry that’s getting more congested.

Electric auto pioneer Tesla is aiming to launch a rival “Cybercab” service by 2026, although its CEO Elon Musk said he hopes the company can get the required regulatory clearances to operate in Texas and California by next year.

Tesla’s projected timeline for competing against Waymo has been met with skepticism because Musk has made unfulfilled promises about the company’s self-driving car technology for nearly a decade.

Meanwhile, Waymo’s robotaxis have driven more than 20 million fully autonomous miles and provided more than 2 million rides to passengers without encountering a serious accident that resulted in its operations being sidelined.

That safety record is a stark contrast to one of its early rivals, Cruise, a robotaxi service owned by General Motors. Cruise’s California license was suspended last year after one of its driverless cars in San Francisco dragged a jaywalking pedestrian who had been struck by a different car driven by a human.

Cruise is now trying to rebound by joining forces with Uber to make some of its services available next year in U.S. cities that still haven’t been announced. But Waymo also has forged a similar alliance with Uber to dispatch its robotaxi in Atlanta and Austin, Texas next year.

Another robotaxi service, Amazon’s Zoox, is hoping to begin offering driverless rides to the general public in Las Vegas at some point next year before also launching in San Francisco.

The Canadian Press. All rights reserved.

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