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Why decriminalizing drug possession won't fix Canada's toxic supply – CBC.ca

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This is an excerpt from Second Opinion, CBC Health’s weekly health and medical science newsletter. If you haven’t subscribed yet, you can do that by clicking here.


Canada’s toxic drug supply problem can’t be fixed by decriminalizing the possession of small quantities of drugs alone — a move that advocates say is a step in the right direction but a far cry from addressing the worsening overdose crisis.

In response to the crisis, the federal government announced a plan this week to allow adults in British Columbia to possess small amounts of some illicit drugs — up to 2.5 grams of opioids, cocaine, methamphetamine and MDMA within British Columbia.

But in the past decade, the illicit drug supply has gone from unthinkably bad to unimaginably worse as fentanyl has completely overtaken heroin and even more dangerous drugs have entered the supply. 

Since 2016, 26,690 Canadians have died from suspected opioid overdoses, and in B.C. alone there were 2,224 suspected overdose deaths in 2021 and more than 9,400 since 2016 — the leading cause of unnatural deaths in the province.

“No one knows, no one can know, what they’re selling or what they’re putting in their bodies,” Karen Ward, a drug user and advocate in Vancouver’s Downtown Eastside, told CBC News in a recent interview.

“I don’t even want to think about how much worse it could get.” 

7,000% rise in fentanyl in last decade

The dramatic rise of fentanyl in Canada has been stark. In 2012, only 217 of the street drug samples seized by law enforcement agencies across Canada tested positive for fentanyl. In 2021 that number grew to over 16,000 samples — an increase of more than 7,000 per cent.

Of the more than 24,000 opioid drugs seized by law enforcement agencies across Canada last year, 72 per cent contained fentanyl or fentanyl analogues, as well as 45 per cent of the heroin samples confiscated.

But at the same time, the actual amount of heroin in Canada fell by more than 60 per cent over five years as fentanyl took over — leading to an unpredictable and dangerous supply. 

“A lot of people talk about the heroin supply being contaminated with fentanyl, but we haven’t had heroin supply for a long time — the supply is fentanyl,” Nick Boyce, director of the Ontario Harm Reduction Network, said in a recent interview. 

Nick Boyce, director of the Ontario Harm Reduction Network, says the heroin supply has been completely overtaken by fentanyl in Canada. (Evan Mitsui/CBC)

“You don’t know what dosing you’ll get and there’s many different fentanyl analogues out there, some which are more potent than others.”

Carfentanil in particular is one of the most dangerous opioids in the drug supply: 100 times more toxic than fentanyl, 10,000 times more toxic than morphine and undetectable by sight, smell or taste. And after declining in 2019, it’s now on the rise in Canada again. 

The statistics are compiled by Health Canada’s Drug Analysis Service (DAS), which tests approximately 125,000 samples of drugs apprehended by the Canada Border Services Agency, the Correctional Service of Canada and police forces across the country each year.

And while it merely provides a snapshot of the crisis, it also paints a tragic picture, one that simultaneously shows the disappearance of heroin as fentanyl and other dangerous opioids contaminated the supply while the number of overdose deaths skyrocketed. 

“It’s a scary situation — it’s like the well was poisoned,” said Ward. “This whole community is just falling apart because so many people have died.” 

WATCH | Fighting an opioid overdose epidemic during a pandemic:

Fighting an opioid overdose epidemic during a pandemic

2 years ago

Duration 9:24

The opioid crisis was a problem in British Columbia before the COVID-19 pandemic, but combined with an unsafe drug supply and fewer safe injection sites, the crisis has become an overdose epidemic.

In the first year of the pandemic alone, there was a 95 per cent increase in suspected opioid-related deaths, with 7,224 lives lost in Canada, compared to 3,711 in 2019. 

“This is the worst public health crisis we’ve ever seen with regard to toxic drugs in the history of our country,” said Donald MacPherson, executive director of the Canadian Drug Policy Coalition, a policy advocacy group made up of about 50 organizations.

“We have never seen anything like this before.” 

Decriminalization won’t have ‘huge impact’

But the federal government’s decriminalization plan doesn’t come into effect for another seven months and falls short of the 4.5 gram threshold that the province and harm reduction advocates called for — an amount that many critics already believed was too low

“If this is intended to make enough of a difference to save lives, why does it not take effect for another seven months?” Ward said in reaction to the announcement, adding that it does little to address the toxic supply of drugs in Canada.

WATCH | Small-scale illicit drug possession decriminalized in B.C.:

B.C. receives exemption to decriminalize small-scale illicit drug possession

4 days ago

Duration 2:02

The federal government has granted an exemption that will see the decriminalization of small-scale possession of certain illicit drugs in B.C. The exemption comes into effect in 2023.

MacPherson said that while the announcement “signals the direction that we need to go” as a country, it should have been rolled out at a national level in order to make a real impact in Canada given that the overdose crisis isn’t just a B.C. problem. 

“This is discriminatory, if you live in another province, you’re not really going to have the benefits of this model. It’s for B.C. residents only, so that’s disappointing,” he said. 

“And it’s really not going to have a huge impact on the toxic drug supply — that is the number one problem.” 

The federal government has signalled it is open to discussing expanding the scope of decriminalization beyond just B.C. to other provinces and cities across the country, but Saskatchewan, Manitoba and Nova Scotia already said they won’t be next in line. 

Kayla DeMong, executive director of Prairie Harm Reduction in Saskatoon, said that while decriminalization overcomes a century of “highly discriminatory” drug policy, it falls short of addressing the overdose crisis in a meaningful way. 

“Do I think it’s going to have a huge impact on our toxic drug supply? No,” she told CBC News. “What I do hope is that it will provide better support and resources and less criminal enforcement for people that use substances.” 

A drug user injects heroin at the Moss Park Overdose Prevention Site in downtown Toronto in December 2018. (Evan Mitsui/CBC)

Focus needs to be on toxic supply: advocates

MacPherson said that while some drug users in B.C. who are stopped by police with small amounts of drugs will benefit from the decriminalization move, police already don’t arrest many people for possession in Vancouver and it likely won’t lead to major changes there. 

“It also means we’re going to be spending the next seven months putting together a model of a policy change that really isn’t about the toxic drug supply,” he said. “So the focus of the response is in the wrong place.” 

Advocates have been calling for a safe and regulated drug supply for decades in order to enable people who use drugs to access regulated substances, such as medical-grade heroin, from a legal source, rather than potentially toxic versions from the illicit market. 

“There’s so much so much more to do in the area of giving people alternatives to the toxic drug market that is not happening — that’s where the real crisis is,” MacPherson said. 

“That kind of action needs to start happening, and in combination with decriminalization that would make sense. But decriminalization on its own? When over 90 per cent of people who die are dying from drug toxicity? That needs to be dealt with.” 

Karen Ward says the federal government’s decriminalization announcement does little to address the toxic supply of drugs in Canada. (Rafferty Baker/CBC)

Ward said until the toxic drug supply issue is addressed head on in Canada, people who use drugs will continue to die at an unfathomable rate.

“The problem is they’re not illegal because they’re dangerous, they’re dangerous because they’re illegal,” Ward said. 

“People are dying. I’m surprised I’m still alive. People are falling apart. We’ve been through so much. They’ve suffered so much, and they’ve been poisoned to death by the policy that we’ve decided not to change.” 

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ERs in Canada overwhelmed, face closures – CTV News

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Hospitals overwhelmed by the pandemic’s onslaught are still facing a number of challenges, causing unprecedented wait times in emergency rooms across the country.

Along with limited hospital beds and a backlog of surgeries, a primary cause for dysfunction has been a shortage of physicians and nurses.

Many of the problems facing hospitals are not new, but experts say that the pandemic has exacerbated the situation, leading to a crisis so dire that patients are now starting to see emergency department closures in hospitals near them.

A LONG, ‘LONG WEEKEND’ FOR EMERGENCY ROOMS

On Saturday, Perth and Smith Falls District Hospital (PSFDH) announced a shutdown of its emergency department until Thursday, citing a COVID-19 outbreak. However, its doctors say the real reason is an ongoing staff shortage.

“Yeah, COVID caused the closure of the emergency department, but the reality of it is that we had no built-in resilience of our nursing staff,” Dr. Alan Drummond told CTV National News on Saturday.

Drummond said that PSFDH’s emergency room dropped from 50 nurses down to five, leaving the unit exceptionally thin.

“Somebody needs to be held accountable for the fact that we lost 50 per cent of our nursing staff within several months, which set us up, basically, to fail,” he said.

Drummond said the catchment area for the PSFDH is about 25,000 people in a large geographic area between Smiths Falls and Peterborough, meaning many patients travel long distances to get to the emergency department.

Patients needing urgent care will now have to drive 20 kilometres from Perth to Smiths Falls.

“I don’t think it’s fair for the people in this community,” local resident John Hastings told CTV News on Saturday.

The Town of Clinton in Ontario was without an emergency room for the entire Canada Day long weekend, as the Clinton Public Hospital’s emergency room announced a shutdown from July 1 to 5.

This marked the longest 24-hour closure of the Clinton Public Hospital’s emergency room.

Physician and nurse shortages are to blame, according to Deborah Wiseman, the chief nursing executive with the Huron-Perth Health Alliance, who anticipates more service disruptions this summer.

“Not just this weekend, but what you’ll see is more to come. I’m going to say for the next six months to several years, with our human health care shortages, both in the nursing and physician areas. We are really struggling to maintain services,” Wiseman told CTV National News.

Wiseman said they are investigating everything to try to resolve the health-care worker shortage and keep their emergency rooms open, including using paramedics in emergency rooms.

Other provinces are experiencing similar issues. Six emergency departments in Quebec will be partially shuttered this summer owing to a staffing shortfall, the provincial government announced on Thursday.

Nova Scotia Health says people should expect long wait times in all four health zones because of high demand during the long weekend.

“Unfortunately, we’re currently experiencing what we call ‘bed block,’ where we have a large number of admitted patients and nowhere to send them,” Dr. Margaret Fraser, a physician at Cape Breton Regional Hospital in Sydney, N.S. told CTV National News on Saturday.

Bonnie Nunn, a resident from Trehern, Manitoba, told CTV National News on Saturday that her daughter recently needed emergency treatment and had to be taken to Portage la Prairie, about 45 minutes away, because the Trehern emergency department was closed due to a lack of staff.

“I’m really angry, angry at everything. I don’t think enough thought went into this,” she said.

“I’m not angry at nurses. They need time off too.”

WHAT IS CAUSING THE STAFF SHORAGES?

Dr. Katharine Smart, president of the Canadian Medical Association, told CTV News Atlantic in May that the rate of physician and nurse burnout is double what it was pre-pandemic.

“Our health-care system is at a level of crisis we’ve never really seen, and the health workers are in a state of crisis we’ve never seen,” said Smart.

A June survey released by Statistics Canada showed that 95 per cent of health workers feel that the pandemic has impacted their mental health and has added stress to their work-life balance.

During the pandemic, health workers have faced extended work hours, decreased vacation time, and changes in the method of delivering care.

In the fourth wave of the pandemic between September to November of 2021—the period in which the survey was conducted—many health workers were looking to leave or quit due to job stress or concerns around their mental health.

“How do we retain workers? Probably a raise,” Halifax-based ICU nurse, Elinor Kelly told CTV News Atlantic in May.

“Probably a decent one. I think that’s going to have to help. Especially for critical care nurses because critical care, we have a lot of people that we train and recruit, but after a year or so they can go work privately at triple the amount of money I’m making after 27 years.”

Dr. Paul Saba, a family physician and president of the Council of Physicians at Hôpital de Lachine in Montreal, said he wants the government to make substantial changes.

“The health-care system has to be improved. And it can’t just be a short-term electoral promise … for the next few years, but long-term,” he told CTV National News on Saturday.

With files from Deena Zaidi and CTV News Atlantic

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Missing 13-year-old Edmonton girl found alive in Oregon, 41-year-old man arrested

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EDMONTON — Police say a 13-year-old Edmonton girl missing for more than a week has been found alive in the United States.

She was located following a week-long search that began when she was seen arriving at her junior high school but didn’t show up for class.

Edmonton Police Insp. Brent Dahlseide says the girl, who was reported missing June 24, is currently in an Oregon hospital for a precautionary examination after being found safe in the state early Saturday morning.

Dahlseide says a 41-year-old Oregon man will be charged with child luring and is expected to face additional charges in Canada and the U.S.

He says Edmonton police received assistance from other agencies in Canada, as well as from the FBI and other police services in the U.S.

Dahlseide says it’s believed the suspect came to Edmonton, but it’s not yet clear how he initially made contact with the girl or how she crossed the U.S. border.

“We would be speculating to say they crossed the border together, but I do know that they were located together, again, in the U.S. once they gained entry,” Dahlseide told reporters during an online news conference Saturday, noting he believed the two had been communicating online.

“I don’t know how long they may have been in contact with one another. I do know that the reason we’re going with a child-luring charge at this point is that it’s one we can support because of some of the online history.”

Photos of the girl have appeared on billboards and posters across Alberta this past week asking people to be on the lookout for her and contact police with tips.

Dahlseide said an Amber Alert was not issued because investigators lacked a description of a suspect or a suspect vehicle. He said police got that information on Friday and were drafting the alert that afternoon when they learned from Canada Border Services the suspect had crossed into the U.S.

At that point the suspect was no longer in Canadian jurisdiction, Dahlseide explained, which is another criteria for an Amber Alert. He said they made a deduction about where the suspect was going and alerted authorities on the U.S. side.

Dahlseide said he believed the arrest was made outside Gladstone, Oregon, just south of Portland, away from the suspect’s residence. He said the suspect’s name would not be released until charges are formally laid.

He said the girl’s family were informed early Saturday she’d been found safe and they are making arrangements to bring her home.

“I’m sure we likely woke them up, showing up at their door so early,” Dahlseide said.

Canadian investigators have not had a chance to speak with the girl or the suspect yet, Dahlseide said, and other questions remain.

He said investigators believe the suspect was in Mission, B.C. for three to four days, so they’ll be asking RCMP there to speak to people who may have seen him or the girl during that time. The FBI will also be able to help supply bank or credit card information to piece together the suspect’s movements, he said.

This report by The Canadian Press was first published July 2, 2022

 

Rob Drinkwater, The Canadian Press

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People planning to attend AIDS conference in Montreal still struggling to get visas

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MONTREAL — International AIDS organizations say people from Africa, South America and Asia who are planning to attend a major AIDS conference in Montreal are still struggling to get visas from the Canadian government.

The groups say a growing number of activists — including some who were scheduled to speak at the conference which begins at the end of the month — are having their visa applications denied, often on the grounds that the Canadian government doesn’t believe they’ll return home after the event.

Tinashe Rufurwadzo, the director of programs, management and governance at Y+ Global, an international organization of HIV+ youth, said the chair of his organization’s board and another of its employees, who are based in Malawi and Kenya, are among the young activists who have been denied visas to attend the conference.

He said both have travelled extensively to speak at AIDS-related events.

“Personally, I’m sick and tired of seeing young people from Africa mostly portrayed on PowerPoint slides as pictures, as photos on banners, as footnotes on case studies. Why can we not have them at conferences to share their lived experiences of what exactly is happening?” he said in an interview Friday.

Rufurwadzo said representatives of populations most at risk of HIV — such as people who inject drugs, transgender women, sex workers and gay men — need to be able to participate, as do adolescent girls, who are increasingly affected by HIV.

If people from the most affected countries aren’t able to attend, he said he doesn’t know how realistic the learning at the conference will be.

While those whose applications are denied will be able to attend the conference virtually, Rufurwadzo said that won’t allow the same level of participation. He also said young people, especially those from rural areas, may not have consistent access to the internet.

Last week, almost 250 organizations from around the world sent a joint letter to Immigration Minister Sean Fraser calling on him to take action to ensure participants can attend the International AIDS conference.

Aidan Strickland, a spokesman for Fraser, said in response to earlier questions from The Canadian Press that the department has been working closely with event organizers and that applications “have been assessed in a timely manner.”

“While we cannot comment on the admissibility of any particular individual, we can say that, in general, all visitors to Canada must meet the requirements for temporary residence in Canada, as set out in Canada’s Immigration and Refugee Protection Act,” Strickland said in an email. “All applications from around the world are assessed equally against the same criteria.”

Javier Bellocq, an Argentine who runs a community journalism project called the Key Correspondent Team which focuses on people living with HIV and high-risk groups, said from the stories he’s heard, it seems like each Canadian consulate is applying different rules.

In some places, he said, applicants have been required to pay for medical examinations as part of the visa process.

“The conference, in theory, arranged with the Canadian government that there will not be medical examinations, but there are, there are many medical examinations.”

Of a group of 40 Argentines, including Bellocq, who are planning to participate in pre-conference activities, only two have received visas so far, he said.

Tumie Komanyane, who runs programs for international NGO Frontline AIDS in South Africa, said groups she works with were planning to help more than a dozen young people attend the conference, but decided not to even bother applying for 10 visas after the first four applications were rejected.

Komanyane said she’s aware of other young people from the region, including some who had scholarships to attend the conference funded by the Canadian government, who have had their visa applications denied.

“It’s incoherent,” she said in an interview Saturday. “With the strides that Africa is making in the HIV field, all the lessons and evidence that could be coming from the beneficiaries directly is going to be lost.”

While she works with young people, she said, she doesn’t want to speak for them.

“They have agency, they have voice, and they shouldn’t be represented by people like me. They should be able to go and share what this work means for them,” she said.

Bellocq said he’s not worried about himself, noting the Argentine passport is relatively powerful and he’s a professional who has been travelling internationally form more than 30 years. But he worries about people  from countries with less passport privilege and members of marginalized groups who are at high risk of HIV.

With pre-conference events starting in just over three weeks, he said, “time is not on our side.”

This report by The Canadian Press was first published July 2, 2022.

 

Jacob Serebrin, The Canadian Press

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