Opioid deaths have been rising again in the shadow of the pandemic, notably in the Canadian province of British Columbia, where overdose casualties have reached historic highs. Is enough being done to end this second public health crisis?
Every month or so, Garth Mullins has breakfast with his best friend. They go to the same place – an aging diner in downtown Vancouver with chipped wooden booths and neon signs. They always end up there around 1pm, talking through bites of bacon, eggs and white toast.
“And I always think, ‘Is this the last time I’m going to get bacon eggs with him?'” Mullins said.
Mullins was an injection heroin user for more than a decade, before moving to methadone. He is now a journalist and advocate for drug users and harm reduction policies in his home of Vancouver – at the centre of the overdose crisis in the province of British Columbia [BC].
When the coronavirus hit the province in March, one public health crisis collided with another, and overdose deaths began to climb. Two months later they reached all-time highs: 174 deaths in May, then 177 in June, 175 in July. So far this year, 909 people have died of an overdose in BC.
Deaths from illicit drugs continue to eclipse deaths from homicides, suicides, car crashes and Covid-19, combined.
It’s led to Canada’s chief public health official – and the face of the country’s coronavirus response – to warn of this second health emergency.
“Canadians should be seized with this particular crisis,” said Dr Theresa Tam last month. It is “escalating as we speak”.
The record-breaking figures reversed a period of relative stability in the province’s battle with opioid abuse.
In 2019, three years after the province declared the opioid epidemic a public health emergency, the number of drug deaths fell by more than a third from the year before – an encouraging trend that continued into the early months of 2020. Then the coronavirus hit.
Experts say the necessary response to the pandemic laid the foundation for a spike in overdose deaths.
First, there is the sheer toxicity of the drugs on the street, said Dr Jane Buxton, the medical lead for harm reduction at the British Columbia Centre for Disease Control.
Canada’s border closure has disrupted the country’s typical illicit drug supply chain, Dr Buxton said, leaving drugs more vulnerable to contamination as local dealers cut them with toxic additives to increase supply and lower costs.
A second factor is the clash in guidance between the two health emergencies.
Safety amid Covid-19 means social distancing and prolonged periods of isolation. Harm reduction for drug users means never using alone – and social distancing requirements have compelled some supervised consumption sites in Canada – where no overdose deaths have ever been recorded – to reduce capacity or shutter altogether.
And experts say some of the common side effects of the Covid-19 pandemic – anxiety, isolation and uncertainty – may drive people to use.
Mullins said Canada didn’t have an effective plan to address the opioid crisis to begin with, a shortfall that has been compounded by Covid.
“Everything is so precarious that if any one thing goes wrong, the statistics will jump up.”
These same factors are at play in the US. In August, the American Medical Association reported increases in opioid-related deaths in more than 40 states.
In Canada, the crisis is most pronounced in BC. A few years ago, Mullins said, he tried to tally the number of people he had lost to an overdose. When he got to 50 he stopped counting.
“It’s a terrible, morbid exercise,” he said. Lately, the deaths feel like a “constant stream”.
Last month, Mullins and other advocates in Vancouver gathered for a “mass memorial” and and eulogies for some of those who have died in recent months.
“It’s been a crisis for so long I feel like it’s rewritten a part of my personality. You just expect this kind of loss,” he said.
Advocates say the response to the coronavirus outbreak and the overdose crisis has exposed a gulf between the respective public and political attitudes.
Canada’s “bold and urgent” response to Covid-19 has not been matched by that to the overdose crisis, said Leslie Mcbain, who lost her 25-year-old son Jordan in 2014 to a drug overdose after he was prescribed opioids for a back injury.
“It’s the absolute worst thing that could happen to a family,” she said. “You don’t go through it, you carry it. We carry it forever.”
In the wake of Jordan’s death, Mcbain co-founded Moms Stop the Harm, a support group for families affected by substance use.
In August, both Mcbain and Mullins quit a provincial overdose response committee over what she described as governmental inaction.
“Nothing was happening,” she said, just as “everything” was being done to protect the province from Covid-19.
“We realised we were at the kids’ table,” she said.
In July, BC Premier John Horgan apologised for remarks suggesting that, while Covid-19 “affects anyone at any time”, the opioid crisis involves those who made an initial “choice” to use drugs.
Critics say the premier’s comments signal why the overdose crisis has not received the type of muscular response summoned for the coronavirus – that those dying of an overdose were “morally culpable”.
“The wrong people are dying,” Mullins said.
Among those struggling with addiction and those in the harm reduction community, the disparity seemed clear, according to Dr Buxton.
“There’s a lot of discontent around how much time, energy and money is being spent on Covid,” Dr Buxton said.
“There’s also that feeling of despondency: ‘We’ve been telling people this is an issue and nobody’s been listening and then it’s gotten worse. So what’s being done about it?'”
Amid mounting deaths, authorities have suggested two principal solutions: decriminalising the possession of illicit substances and providing a safe supply of prescribed alternatives – pharmaceutical-grade medication as a substitutes to illegal drugs like heroin.
Both steps have been sought by advocates for decades.
In recent weeks, BC provincial health officer Dr Bonnie Henry, Premier Horgan, the Canadian Association of Chiefs of Police and health officers in Toronto and Montreal have all called on the federal government to decriminalise possession.
Dr Henry has joined BC’s chief coroner Lisa Lapointe and Guy Felicella, a harm reduction campaigner and advisor with the BC Centre on Substance Abuse in advocating for prescribed alternatives.
“Access to a safer supply remains the number one, most urgently needed intervention to stop overdoses and stop people from dying,” Felicella told reporters.
Early in the pandemic, the BC government announced new guidelines to allow more people – those at risk of Covid-19 infection, those with a history of ongoing substance abuse and those at high risk of withdrawal or overdose – to access prescription alternatives.
Nearly 2,000 people in the province can now use prescribed opioids.
But this figure is a “drop in the bucket” for a province with an estimated 55,000 to 100,000 illicit drug users, said Leslie Mcbain.
And much of the legal control of drugs in Canada rests with the federal government.
“Even when we have a supervised consumption site [in BC] we have to get an exemption,” Dr Buxton said. “It’s not as easy just to go in and say, ‘OK we’re going to change this in BC.’ It all comes under the Controlled Drugs and Substances Act, which is the federal piece.”
Asked last month about the surge in overdose deaths, Canada’s Health Minister Patty Hajdu said the Liberal-run government had been “aggressively” providing support to communities affected by opioid abuse since the party came to power in 2015.
“I don’t believe there is any silver bullet,” she said, for “ending problematic substance use, or dealing with the crisis at hand – it’s really a suite of tools that’s needed.”
In July, Hajdu’s department announced C$2m ($1.5m; £1.15m) in funding for a safe supply pilot project in BC’s Cowichan Valley. Inside this roughly 84,000-person region, the program is reserved for those who have not responded to other treatments for opioid use disorder – about 25 people so far.
And the Canadian government is not currently considering the decriminalisation or legalisation of illegal drugs, said Health Canada spokesman Geoffroy Legault-Thivierge in an email.
For many advocates, including Garth Mullins, until both measures are mandated by the federal government, it won’t be enough.
Unlike the virus outbreak, the spike in drug deaths in British Columbia was “entirely predictable”, according to Mullins. Covid-19 was “a force of nature”, he said. Canada’s overdose crisis was “a force of policy”.
Source:- BBC News
Canada's biggest maker of paper towel concerned about supply amid COVID-19 – CBC.ca
The head of Canada’s largest manufacturer of tissue products says he’s concerned about the industry’s supply of paper towel ahead of a potential second wave of COVID-19.
Kruger Products CEO Dino Bianco says demand for paper towel has soared as people stay at home and clean more frequently.
He says the industry is “very tight” on paper towel inventory across North America, despite efforts to build up supply.
Bianco says Kruger, which makes SpongeTowels paper towels, is pushing to open its new plant in Sherbrooke, Que., to add more capacity in Canada.
Although slated to open in February 2021, he said the company is trying to get the factory up and running faster. Some machines started over the summer, while more are set to come online in October.
Bianco said the plant will increase the company’s paper towel and toilet paper manufacturing capacity by 20 per cent.
Meanwhile, he says the company is also seeing a shortage of the recycled fibres used in about 25 per cent of its tissue products.
Bianco says Kruger recycles white paper used in offices, but that the market has dried up because people aren’t in offices printing.
Woman suspected of mailing ricin to White House arrested at U.S.-Canada border – CBC.ca
Three U.S. law enforcement officials say a woman suspected of sending an envelope containing the poison ricin, which was addressed to the White House and President Donald Trump, has been arrested at the New York-Canada border.
The officials say the woman was taken into custody by U.S. Customs and Border Protection (CBP) officers and is expected to face federal charges. The officials were not authorized to discuss the ongoing investigation publicly and spoke on condition of anonymity.
Aaron Bowker of the CBP confirmed with CBC News that the arrest took place at the Peace Bridge in Buffalo, N.Y., and that the individual was travelling from Canada into the United States.
The letter had been intercepted earlier this week before it reached the White House.
An RCMP spokesperson told CBC News on Saturday that it was assisting the FBI in the investigation and that “initial information from the investigation suggests that the letter originated in Canada.”
An official from the Western District of New York told CBC News on Monday they “don’t have a time yet for a court appearance.”
There have been several prior instances in which U.S. officials have been targeted with ricin, which can be derived from castor oil plants.
A navy veteran was arrested in 2018 and confessed to sending envelopes containing the substance from which ricin is derived to Trump, CIA Director Gina Haspel, FBI Director Christopher Wray and James Mattis, then the secretary of defence. At least two of the letters made it to a Pentagon mail sorting facility.
The Utah man has yet to be tried in the case and could face life in prison if found guilty.
In 2014, a Mississippi man was sentenced to 25 years in prison after sending letters dusted with ricin to then-president Barack Obama and other officials.
The previous year, a woman was accused of mailing ricin-laced letters to Obama and Michael Bloomberg, then the mayor of New York City. The woman, who tried to frame her husband for the scheme, was sentenced to 18 years in prison after reaching a plea deal.
Canada confirms 873 more coronavirus infections as cases continue to surge – Global News
Canada has diagnosed 873 more people with the novel coronavirus, bringing the country’s surging case count to 143,527 on Sunday.
Provincial and territorial health authorities reported six more people had died from the virus, although those numbers are incomplete as British Columbia, Alberta, Prince Edward Island, the Yukon and Northwest Territories did not report updates over the weekend.
Since the pandemic began, 9,217 people have died from COVID-19 in Canada, while 124,691 have recovered from the virus after falling ill. So far, more than 7.8 million tests have been administered across the country.
Twenty new cases and no new deaths were reported in Saskatchewan. A total of 1,807 infections have been diagnosed there since the pandemic began. Of those, 24 patients have died and 1,643 have recovered.
Health officials have administered 171,945 tests so far.
In Manitoba, provincial health authorities detected 29 new confirmed cases of the virus, though one previously announced diagnosis was removed from the total. Overall, the province has recorded 1,586 cases.
As of Sunday, the province had administered 164,177 tests in total, while 1,216 people had recovered after becoming infected and 16 people had died.
Ontario has diagnosed 46,849 people with the the virus, including 365 announced Sunday along with one more death.
To date, 2,827 people have died throughout the province while more than 3.5 million tests for COVID-19 have been conducted and 40,968 people have recovered.
In Quebec, the province hit hardest by the COVID-19 pandemic, health officials confirmed 462 new cases of the virus, bringing the provincial tally to 67,542.
In total, the province has confirmed 5,802 people have died from the virus, including five deaths on Sunday. One of those deaths occurred within the last 24 hours, while the other four occurred earlier this month. So far, more than 2 million people in Quebec have been tested for the virus, while 58,796 have recovered.
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New Brunswick reported no new cases of COVID-19 or deaths relating to the virus, and only one case remains active. The provincial tally remains at 194 confirmed diagnoses and two deaths.
There have been 69,791 tests for the virus administered by the province.
Nova Scotia’s provincial cases numbers remained at 1,086 after health authorities detected no new infections or deaths. In total, 88,514 people have been tested, 65 have died and 1,021 are in recovery.
Newfoundland and Labrador saw no new cases of COVID-19 reported Sunday. The provincial total remains at 272, while health authorities said a total of three people had previously died from the virus.
N.L. has conducted more than 37,738 tests for COVID-19, while 268 people have recovered from the virus.
Nunavut confirmed its first two cases of the virus on Saturday. However, a spokesperson from the territory said the cases will not be counted in Nunavut as the individuals who contracted COVID-19 were not residents.
“[The cases] will be counted in the jurisdiction where they contracted the virus,” they said.
So far, 2,593 tests have been administered in Nunavut.
In British Columbia, provincial health officials reported a total of 7,720 cases on Friday and 223 deaths.
In Alberta provincial health officials recorded 107 new infections Friday for a cumulative total of 16,381 infections and 255 deaths.
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No new cases were diagnosed in Prince Edward Island during its most recent update on Wednesday, keeping the provincial tally at 57. The province has yet to see its first COVID-19-related death.
To date, 56 in the province have recovered from the virus.
All 15 confirmed cases in the Yukon have recovered. Nobody in the territory has died from the virus.
All five confirmed cases in the Northwest Territories have also recovered.
© 2020 Global News, a division of Corus Entertainment Inc.
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