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Long-term opioid users suffer with crumbling bones, brain injuries and little hope of treatment

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Hugh Lampkin says he abused drugs — everything from pot to PCP — for decades. He started at about age 12 in Toronto.

Now in his late 50s, he’s an overdose survivor who has beaten back his demons. But his past has taken a toll on his body, leaving his back bent at an impossible angle, and surgery out of reach.

Lampkin has lost count of the friends he’s lost to overdoses and organ failure.

The opioid crisis has claimed more than 13,000 lives in his province since 2016. On Nov. 1, the B.C. Coroners Service confirmed another 175 suspected deaths in September. That’s 10 per cent less than died in Sept. 2022, but still 5.8 drug deaths per day, with most deaths reported in Vancouver, Surrey and Greater Victoria.

Of the 225,000 British Columbians using unregulated substances, fewer than 5,000 receive safe supply prescriptions, according to provincial data.

Opioid overdoses have claimed 38,514 lives in Canada in the past seven years, according to the Public Health Agency of Canada. Many others survive, like Lampkin, but are left with injuries or chronic health issues that then hinder their rehabilitation.

Medical experts say those problems need more study and those people need more support. Today the B.C. Coroners death review panel urged the government to expand safer supply access to save lives and prevent injuries.

According to data from the Canadian Institute of Health Information, some 5,807 overdoses were recorded at Canadian hospitals (not including Quebec) between April 2022 and March 2023.

Of those, 327 suffered anoxic brain injury, meaning their brain was damaged due to a lack of oxygen. Anoxic brain injury is just one of the ailments that can affect overdose survivors. Statistics on the others are scarce.

It’s not clear if Lampkin has a brain injury. He says his memory isn’t what it was, and his once-long stride is now an agonizing shuffle along an East Hastings Street sidewalk in Vancouver’s Downtown Eastside.

About a year and a half ago, a fall bent his spine almost 90 degrees.

“We were stacking some boxes one day and I fell off — and when I went to stand back up I couldn’t stand up straight and it’s been there ever since,” he said.

Scan the sidewalks that border the Downtown Eastside and it’s common to see residents with contorted spines, walkers and wheelchairs. Brian Conway, director of Vancouver’s Infectious Disease Centre, says there are 500 or more hospitalizations per day across Canada as a result of overdoses and many more involving infections that can be introduced where an injection pierces the skin that can then spread to the blood, heart, brain or bones.

Two men are seen on East Hastings Street in Vancouver’s Downtown Eastside on July 25. It’s common to see area residents with contorted spines, walkers and wheelchairs. (Ben Nelms/CBC)

“The health-care system, currently designed, is failing the inner city,” said Conway.

“There are more people that need more help in a different way.”

These include a need for more monitoring and research of drug harms, especially as people age.

“There are many consequences well beyond, unfortunately, dying,” Conway said.

“If infection spreads to the bones, causing osteomyelitis” — a serious bacterial infection — “this will cause the bones to collapse so that people will have collapsed spines; not be able to stand up straight, not be able to walk properly.”

Organ damage, paralysis

Conway says opioid abuse can also lead to chronic health issues and damage to the heart, liver or pancreas.

Infections can spread through the bloodstream and cause abscesses and damage that can lead to mobility issues or even stroke or paralysis. In severe cases the mechanisms and glandular systems that help grow bone become damaged, and bones become decalcified, crack or even collapse.

 

Why a safer supply is needed to combat B.C.’s drug crisis

 

Featured VideoWith British Columbia facing its deadliest year for drug-related deaths, chief coroner Lisa Lapointe talks to Ian Hanomansing about why a safe supply of drugs is needed to curb the steep rise in toxic drug-related deaths.

Conway works at the Vancouver Urban Health Centre on Main Street, where he offers medical care for people often failed by traditional hospitals.

Research around the effects of opioid damage and how that impacts rehabilitation is also lacking, according to Nora Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health in Bethesda, Ma.

Volkow says too little is understood about effects of multiple anoxic brain injuries — or how they could affect memory in old age.

“Does overdosing, particularly with multiple overdoses, increase your risk for dementia? And I predict it will,” Volkow said.

And Volkow says new dangers are spiking right now in the U.S. where a non-addictive drug called Xylazine (often referred to as “Tranq”) — which affects the vascular system and blood vessels — is often found combined with opioids like fentanyl. Volkow says these so-called Tranq cocktails often cause aggressive lesions that, if not treated properly, end in amputations.

‘Tranq’ ups risk of amputations

“This is a rising problem that we’re actually right now seeing in the United States. We are seeing it accelerate because of the presence of a new drug that is being used to lace fentanyl,” said Volkow.

A man sits on a bench in Vancouver's DTES covered by quilt with dog
A man sits with his dog while city employees work to dismantle tents along East Hastings in the DTES neighbourhood of Vancouver, British Columbia on Wednesday, April 5, 2023. (Ben Nelms/CBC)

The mechanisms of why Xylazine causes such aggressive lesions, are not yet clear, Volkow told CBC News.

Xylazine is showing up in small amounts in Vancouver, according to the dashboard that logs drug testing for the BC Centre on Substance Abuse.

Volkow says the weakening of the skeletal system and osteoporosis are more common problems; made worse because spinal surgery, like organ transplants, are rarely offered to long-time drug users.

A man sits in a wheelchair in an SRO in Vancouver's DTES
Cecil Creighton is pictured at The Portland Hotel at 20 W Hastings St in Vancouver, British Columbia on Thursday, April 27, 2023. (Ben Nelms/CBC)

“Those are extraordinarily complex surgeries in the best of circumstances… the spinal cord is not an easy place to do surgery,” Volkow said.

‘I’ve learned to live’

For Lampkin, the three-block walk from his apartment to his job at the Vancouver Area Network of Drug Users is excruciating.

“I try to use the walker because it’s kind of painful and it tires me out quite a bit,” he said.

By the time a specialist told Lampkin that he would not be considered for spinal surgery, due to past drug use, he’d been shuffling around — bent almost in half — for more than a year and a half.

Long before his fall, a previous infection in his neck vertebrae had spread into his spine.For now he’s doing physio and trying to fix himself, by walking as much as he can. He says he used drugs as a kid for “comfort” to escape memories of abuse he suffered after a stranger abducted him as a child, derailing dreams he had of becoming an engineer.

“It was always popping in my head,” Lampkin says. “My life wasn’t the life that I picked,” he said. “Some days I don’t feel so good. But that’s life, right? I’ve learned to live.”

A man in a red check shirt looks at the ground.
Lampkin says his memory isn’t what it was, and his once-long stride is now an agonizing shuffle. (Ben Nelms/CBC)

 

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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.

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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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