For the past few years, David Keeler’s addiction has been treated like a medical issue.
“I’ve worked out [that] I can wake up in the morning without using, come to work until 5 o’clock at night and only use [drugs] once in the day when I get home,” said Keeler, an outreach worker at SOLID, a peer-based harm reduction organization in Victoria.
“That is due to the fact that I am a patient of the Safer Initiative, so I get doctor-prescribed fentanyl.”
He is one of a few dozen people in Victoria who has access, via a doctor’s referral, to a Health Canada-funded program that provides what’s known as safer supply, or pharmaceutical alternatives to the increasingly toxic street drug supply.Keeler said another safeguard is going to known suppliers and always getting substances checked at a drug-checking facility.
According to Keeler, and researchers in B.C. and Ontario who monitor illicit substances sold on the street by testing anonymous samples, trends have indicated that substances now have stronger concentrations of potent combinations, from fentanyl to animal sedatives, that create a more volatile and dangerous situation for people who use drugs.
In B.C., the coroners service reports that the first seven months of 2023 have been the deadliest since 2016, when the province declared a public health emergency over drug poisoning deaths.
More than 7,300 people died across Canada last year, most of whom were in B.C., Alberta, and Ontario. First Nations people in B.C. died at nearly six times the rate of other residents last year, according to data from the First Nations Health Authority in B.C.
With the toxic drug supply continuing to claim thousands of lives across Canada every year, experts, advocates, and drug users are drawing attention to a growing demand for harm-reduction services — like drug checking and doctor-prescribed substances, called safer supply — that are currently only available in a select few communities.
This International Overdose Awareness Day, there are 123 events and marches across Canada — and hundreds more worldwide — to commemorate the lives lost and call for action.
Technicians at the Spectrum drug-checking site on Jasper Avenue in Edmonton use a spectrometer to analyze drug samples, including opioids and stimulants. (Ty Ferguson/CBC)
More demand for drug checking
Bruce Wallace, a professor at the University of Victoria and co-lead of the university’s drug checking project, and Hayley Thompson, manager of Toronto’s drug check program run out of St. Michael’s Hospital, found the toxicity of substances on the street were further exacerbated during pandemic-induced lockdowns.
“We started to see that there are often what we would call multiple actives,” Wallace said. “Most opioids were then combined with some other drugs.”
These include high potency benzodiazepines, fentanyl analogues like fluorofentanyl, and in smaller quantities, xylazine, an animal sedative that has been detected in recent years across North America’s drug supply.
Bruce Wallace, professor at the University of Victoria and co-lead of the university’s drug-checking project, says there is not enough access to harm-reduction services during the worsening overdose crisis. (Mike McArthur/CBC)
According to Wallace and Thompson, drug checking in B.C. is more prevalent than elsewhere in Canada. The province has 25 Fourier Transform Infrared (FTIR) spectrometers for drug checking, with several in each health authority. Other provinces have had this service either in their largest municipalities or not at all.
“We’ve actually been the only drug-checking service in the province [of Ontario] up until this year,” Thompson said.
“There’s [now] one in Thunder Bay and there’s one in Peterborough and we know there are a number of other municipalities that are getting them up and running, but they’re not receiving funding from the Ontario government to do so. They’re doing it independently.”
In 2016, when the public health crisis was declared by the province, it was never an expectation that we’d still be in the same spot so many years later.– Bruce Wallace, University of Victoria
Wallace thinks the declaration of a public health emergency has been helpful for drug checking in B.C., as well as prompted regular data gathering and other harm-reduction measures in the province.
“It would have been harder for us to be able to implement things like overdose prevention sites and decriminalization and drug checking without the declaration, I believe,” said Wallace, who is also a scientist with the Canadian Institute for Substance Use Research.
WATCH | Drug checking in Alberta:
‘If they are using substances, they know what’s in their substances’
29 days ago
Duration 2:37
A first-of-its kind drug checking site opened in Edmonton allowing users to have their substances tested before they are consumed. Technicians can test a range of drugs for toxic substances and levels. Once the drugs are tested, users are alerted to the contents in person, by phone or email.
Toronto has a Health Canada-funded program that operates out of five supervised consumption sites, and local initiatives exist in Alberta, Saskatchewan, Yukon, Quebec, and Prince Edward Island.
“The demand for our service is definitely increasing,” said Thompson. “We get calls from people or organizations all over the province and country, who are like, ‘How do I get this in my community?'”
In the past year, the Victoria drug-checking project has developed a new method to reach smaller communities in central Vancouver Island; so far in 2023, this region has had the second highest rate of drug poisoning deaths in B.C. after Vancouver, according to B.C. Coroners Service data.
The method, which Thompson says is ahead of the game while Ontario facilities await long-term funding, involves training front-line workers in smaller central Vancouver Island communities to collect drug samples, usually at an overdose prevention site, and sending them to a technician in Victoria for analysis.
It uses new technology developed by the UVic drug checking project and eliminates the need for a skilled technician in a rural community, but the turnaround time can be a couple of days, versus 20 minutes in Victoria.
Few have access
Drug checking and collecting data about drug-poisoning deaths, like B.C. does, is an important step to help drug users make an informed decision about their consumption, experts said, but is not enough on its own.
“We have more data in B.C. and more routine reporting of everything but to continually report how bad the situation is obviously doesn’t respond to the situation,” Wallace said.
“In 2016, when the public health crisis was declared by the province, it was never an expectation that we’d still be in the same spot so many years later.”
The death rate has more than doubled since the public health emergency declaration 2016, and now stands at 42 per 100,000 in B.C — making unregulated drugs the leading cause of death in B.C. for people aged 10 to 59, according to the B.C. Coroners Service.
“Despite recommendations for the urgent expansion of a safer drug supply, very few have access to a stable, lower-risk alternative,” said the province’s chief coroner, Lisa Lapointe, in a statement on Aug. 29.
B.C. reports that in June 2023, 4,619 people were prescribed safer supply opioid medications.
But experts say these and other harm reduction measures are not available on wide enough scales to have a more tangible impact.
“We learned through the decades of [data from] supervised injection sites like Insite, [that] having a dozen booths to serve a whole health authority was really a limited response,” Wallace said. “You just can’t expect that to really reach the range of people and I think we also have that challenge with drug checking.”
In Vancouver, advocates and health officials have decried the city’s decision to not renew the lease of an overdose prevention site in downtown, meaning the facility has until March 2024 to find a new location.
Overdose consumption sites in Ontario are undergoing a critical incident review after a woman was killed in a shooting outside the South Riverdale Community Health Centre in Toronto in July.
“It’s a much different political landscape [in Ontario],” Thompson said. “Also the number of consumption treatment services in Ontario was capped by the Ford government a number of years ago.”
The province’s revised strategy under Doug Ford’s Progressive Conservative government in 2018 limited the number of supervised consumption sites allowed in Ontario to 21.
WATCH | What’s standing in the way of more supervised consumption sites:
Safe inhalation sites save lives. Bureaucracy makes them hard to build
2 months ago
Duration 5:50
The majority of opioid overdose deaths in Canada — as much as two-thirds in some provinces — are now caused by smoking drugs, but government red tape is slowing efforts to save lives. The CBC’s Jonathon Gatehouse explores why it’s so difficult to get safe smoking sites approved.
Supply and demand
It’s difficult for either Thompson or Wallace to say for sure why the drug supply is getting more dangerous, but they have several theories.
One, Thompson said, is that xylazine has been introduced into the drug supply as an alternative to benzodiazepines due to ease of access — it is used in veterinary care and is therefore readily available.
“There’s also this theory of the ‘Iron Law of prohibition,’ which is that as more measures are put in place to try and crack down on the unregulated drugs supply, whether that’s the scheduling of drugs, so making them harder to import, or whether it’s police intervention to cut drugs out of the supply…new drugs will continue to pop up when that happens,” Thompson said. “And often, they will be more potent in an effort to try and evade detection.”
The current mix of substances means those who rely on street drugs have developed multiple addictions, said Keeler. Through his outreach work, he says he has heard people are having more trouble accessing prescribed safer supply these days.
“I’m seeing that people are getting cut off of safe supply more than getting put back on it,” Keeler said, adding his belief that doctors are unwilling to prescribe the large doses needed for people in active addiction. “I think [governments] need to put money towards practicums for nurses to walk around with us … so that they’re able to to understand how to better help with the fentanyl crisis.”
According to Thompson and Wallace, compassion clubs like the Drug Users Liberation Front in Vancouver — through which people who use drugs purchase substances in large quantities, have it checked, and then disseminate them — are another grassroots-level initiative created to save lives during the toxic drug crisis.
But due to the level of personal risk, political landscapes, and availability of street substances that are in demand, compassion clubs are not considered a scalable solution at the moment.
“A lot of these responses can be useful but they’re limited and they’re not having a meaningful impact unless they can be really scaled up and reach the overall population of people who are using drugs and at risk of overdose,” Wallace said.
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.
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.
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.
