Canada's Opioid Crisis: Do You Care?

[someone123]

Originally Posted by BIMBAM

That's not exactly true, they can come on to the methadone maintenance program and be slowly tapered down off opioids at their own pace, so yes there is a legal, responsible path for them to take besides buying street drugs. What else would you have us do? We even have a pilot program with heroin instead of methadone running in Vancouver.

Does this happen much with methadone? My impression is that, once people start taking methadone, they tend to need it every day and they tend to go on needing it indefinitely (see e.g. http://www.straight.com/life/458281/...roin-addiction).

Even when it comes to methadone some areas in Canada have long waiting lists. Maybe it has gotten a lot better in the last couple of years?

But my wider point is that the correct way to assess this is to ask whether or not treatments are working rather than wagging fingers at people for getting addicted to drugs. I don't think the current legal and medical regime is working very well, because a lot of people are taking unsafe drugs and later treatment for them doesn't seem to work out well.

[GlassCity]

People aren't talking about it because there isn't all that much to say. It's clearly a serious issue, but what can be done about it? I know 4 people that have died from that stuff now. Fentanyl isn't just in heroin, it's in "regular" party drugs like cocaine too, and people are doing these drugs not knowing they could kill them. At this point, I think drug users have to just stop, at least those for who that's an option.

But as far as police or government intervention go to help the addicted, what do you do? Illicit drugs are obviously inherently unregulated, and there's no way to tell what's in them. Who do you go after? Dealers are hard to track and drug producers even more so. I know they're trying to cut off the supply of fentanyl to Canada overall, but who knows how that will go. I wonder if this is one of those things that will just blow over. Perhaps it will have a silver lining in providing a wake-up call that hard drugs are better left untouched, even if they're done responsibly.

[CanSpice]

Originally Posted by GlassCity

People aren't talking about it because there isn't all that much to say. It's clearly a serious issue, but what can be done about it? I know 4 people that have died from that stuff now. Fentanyl isn't just in heroin, it's in "regular" party drugs like cocaine too, and people are doing these drugs not knowing they could kill them. At this point, I think drug users have to just stop, at least those for who that's an option.

But as far as police or government intervention go to help the addicted, what do you do? Illicit drugs are obviously inherently unregulated, and there's no way to tell what's in them. Who do you go after? Dealers are hard to track and drug producers even more so. I know they're trying to cut off the supply of fentanyl to Canada overall, but who knows how that will go. I wonder if this is one of those things that will just blow over. Perhaps it will have a silver lining in providing a wake-up call that hard drugs are better left untouched, even if they're done responsibly.

You can set up more ways to help people get off the drugs. Turns out that you can't "just stop", as you suggest, you actually need help from trained professionals. That's where the government comes in, they can set up the services to employ and train those professionals to help people get off drugs.

"Just stop doing drugs" is nice and all but is completely unrealistic.

[MrOilers]

Addiction is taking more and more lives, and is now the cause of a lot more secondary crimes (robberies, thefts, prostitution, violence, etc.) from people trying to feed their addiction.

[someone123]

Originally Posted by GlassCity

I know they're trying to cut off the supply of fentanyl to Canada overall, but who knows how that will go.

I doubt it will be successful unless the production of the substance is difficult and can be prevented in China itself. The lethal dose of carfentanil is around 20 micrograms. So if you smuggle 1 gram of it into Canada that is enough to mix into drugs to kill 50,000 people. There is no way we can accept millions of tons of imports from China and reliably detect mere grams of certain substances.

I agree that the only reasonable thing to do now is to reject drugs unless you know where they come from and that they are safe. I think people who take random pills display very bad judgement now and did even before fentanyl made its way into the illegal drug supply here.

However, I am also not sure that it is reasonable that we have a prohibition on drugs like MDMA, cocaine, LSD, or mushrooms. They can all be harmful but people are taking them anyway and adults are free to make all kinds of decisions for themselves, harmful or not. I doubt the current regulatory system (with a focus on law enforcement and punishment) is providing a net benefit to society compared to alternatives. I think it would be better to refocus on providing mental health services, honest education, and safe supplies of the drugs for people who still want them.

[GlassCity]

Originally Posted by CanSpice

You can set up more ways to help people get off the drugs. Turns out that you can't "just stop", as you suggest, you actually need help from trained professionals. That's where the government comes in, they can set up the services to employ and train those professionals to help people get off drugs.

"Just stop doing drugs" is nice and all but is completely unrealistic.

Just to be clear, in that statement I meant those that take them recreationally when partying, or at clubs, on the weekends or something like that. I think for those people, "just stopping" is a legitimate option, and the only real viable one.

I am of course not so ignorant to suggest that regular drug users with dependencies can "just stop." That's where I was going with my second paragraph. Of course treatment is the ultimate goal, but for now at least making sure the drugs are safe is needed. But that's virtually impossible to do under current laws. Safe injection sites and naloxone are a great start, but more needs to be done.

[MonkeyRonin]

Originally Posted by GlassCity

Just to be clear, in that statement I meant those that take them recreationally when partying, or at clubs, on the weekends or something like that. I think for those people, "just stopping" is a legitimate option, and the only real viable one.

Here's a better, and more realistic option: just take harm reduction seriously. Things like drug purity testing kits should be easily and readily available (especially at higher-risk places like nightclubs, music festivals, and schools), instead of being an admission of guilt of breaking the law and encouraging drug use.

Better yet would be to just legalize & regulate all drugs. I don't see that happening any time soon though.

Either way, pushing abstinence as the only solution - whether it's trying to solve risky drug use, teen pregnancy, or anything else - is never a very effective strategy. People like to do fun things, and they're going to do them whether it's safe or not.

[Architype]

I don't have a whole lot of faith in the way Canada's drug issues are handled generally. I'm not suggesting there is an easy solutiion, but history doesn't provide much evidence of a strong understanding and unified or competent managing of these issues. I find we are shamefully backward, provincial, and stubborn in identifying the real issues and solutions to these problems.

[Bluenote]

All you people that are so upset buy it need to maybe step out and live it. Not saying take the drugs. But live the life of a user.

Because I doubt ANY of you would stop on the street to help one out. You'd just walk by and mumble something about them being a low life drug addict and to get a job.

It's easy to preach from your computer and get your info off the news and Facebook. But to actually see it and do something in person about it. That's the REAL world.

[GlassCity]

Originally Posted by MonkeyRonin

Here's a better, and more realistic option: just take harm reduction seriously. Things like drug purity testing kits should be easily and readily available (especially at higher-risk places like nightclubs, music festivals, and schools), instead of being an admission of guilt of breaking the law and encouraging drug use.

Better yet would be to just legalize & regulate all drugs. I don't see that happening any time soon though.

Either way, pushing abstinence as the only solution - whether it's trying to solve risky drug use, teen pregnancy, or anything else - is never a very effective strategy. People like to do fun things, and they're going to do them whether it's safe or not.

Yeah, more widespread drug testing is a good idea, I wasn't thinking about it while I wrote it. Especially if they were made cheaper so that everyone could have one, it could solve a lot of problems.

I'm on the fence about full legalization of all drugs, though I do see merit in it.

My point is, that at this very moment, I just wish that current casual drug users refrained for a while, at least while this crisis is ongoing. I have no problem with people doing drugs overall, as long as they know what they're doing. Just at this very moment, it's not so great seeing obituaries on facebook once a week. I like to smoke cigarettes every now and then. It's fun. If I saw that people around me were dying from it, I would give that fun up until it was deemed safe again. I by no means expect people to refrain from doing risky things because they're enjoyable. Just when the risk is so great and so high at the moment, I think abstinence is a fairly sensible ask for those that have it as an option. Just until drug testing becomes more widespread or we have proof fentanyl is cut off, for instance.

[Acajack]

Figures reported in the Ottawa media in recent days indicate a major spike in potentially life-threatening opioid overdose cases at local hospitals. The rate is about 30 a week or more.

[BIMBAM]

Originally Posted by someone123

Does this happen much with methadone? My impression is that, once people start taking methadone, they tend to need it every day and they tend to go on needing it indefinitely (see e.g. http://www.straight.com/life/458281/...roin-addiction).

Even when it comes to methadone some areas in Canada have long waiting lists. Maybe it has gotten a lot better in the last couple of years?

But my wider point is that the correct way to assess this is to ask whether or not treatments are working rather than wagging fingers at people for getting addicted to drugs. I don't think the current legal and medical regime is working very well, because a lot of people are taking unsafe drugs and later treatment for them doesn't seem to work out well.

It works out well for plenty of people, but you don't hear about them, you're only ever going to hear about the inevitable percentage it doesn't work out for. Long waiting lists for methadone? Do you mean to see physician's who can prescribe it? That's not really my understanding of my local environment but I suppose it could be true elsewhere. As for the tapering down, it's complex and individually variable, we can't be too aggressive about it in every instance, but for the most part it's not true that everyone is on it for ever, almost all of my patients are being tapered down at some rate and actively seen every week or every couple of weeks by their physician and every day or at minimum weekly by their pharmacist. Aside from that, it shouldn't concern you if people are on it chronically, since that's not your concern, harm reduction is, and methadone is a safe, untainted, legal source of opioids.

[Sarah89]

A lot of addicts have co-morbid mental heath problems and mental disabilities. They lack the impulse control to even understand to stop because of what I just mentioned above.

[Sarah89]

Originally Posted by Bluenote

All you people that are so upset buy it need to maybe step out and live it. Not saying take the drugs. But live the life of a user.

Because I doubt ANY of you would stop on the street to help one out. You'd just walk by and mumble something about them being a low life drug addict and to get a job.

It's easy to preach from your computer and get your info off the news and Facebook. But to actually see it and do something in person about it. That's the REAL world.

None of these people here will because they're not in the at risk demographic for addiction.

[Metro-One]

Man, don't want to step into this topic, because there is no clear answer...

It feels like a entire package of things must be done.

First and foremost, our entire culture needs to be overhauled, starting from school ages. More focus on the strength of community (and respecting it in return) while also learning / building better skills for personal responsibilities.

More facilities and programs need to be established for those with mental disabilities / mental health problems.

Lower level drugs need to be legalized and regulated (very happy that pot will be by next year), but on the flip side I actually feel that stricter laws and harsher penalties are needed for extremely hazardous drugs (and by that I mean for pushers and producers, not end users). There are some things that should not be legal for general recreational use.

More money for education and awareness programs.

Increased social services, but also delivered at times with a little bit more "tough love" for extreme addicts (I actually do support forced rehab).

Living for years in Japan I am sometimes embarrassed by the choices Canadians and Canadian culture in general makes. I teach at high schools here and there have essentially never been drug problems or even the idea of a student over dosing on some bullshit. I think this also comes down to stronger family units in Asian culture (and I work a a low income / low grade high school).

While I do feel that Japans laws on drugs are too strict (even possession can get you 5 years in prison) maybe our youth in Canada are lacking some discipline?

I guess in the end I really don't know how to fix it, and in the end there likely is no magic bullet for doing so, but maybe at least some aspects of what I have said could help the situation.

I also write this as someone who suffered from chronic depression for years, yet was well educated enough to never be tempted to use illegal drugs as a crutch / numb my problem. Also I have had family members spend years living the life of addicts in Vancouver, including the DTES, and each them now have pulled themselves out of the fire, and while social services, family, and therapy did help big time, they were really only able to do so once they stopped blaming other people for their problems and took responsibility for themselves.

[SignalHillHiker]

I care, of course, but it was abstract until recently. It's just now starting here. We've had our first publicly known fentanyl incidents - 17 overdoses including two deaths in the past two weeks. The province is scrambling to provide take-home naxalone kits, safe injection sites, etc.

It appears none of the victims were aware they were talking fentanyl and there's a chance it all came from one supplier.

[wave46]

Originally Posted by MonkeyRonin

Better yet would be to just legalize & regulate all drugs. I don't see that happening any time soon though.

I'm not sure I agree with this stance. I work in healthcare and by far the most damaging drug in terms of social cost is alcohol, which is legal and very regulated.

I'd say alcohol is the number one damaging drug in our society - implicated in more crime, suicide and death than any other drug. I'm sure the police would agree with me on that count.

I'm not trying to discount the damage done by opiates, but I don't think legalization will be the cure that fixes everything. It might limit some of the damage (there aren't too many deaths from methanol poisoning these days due to the absence of bootlegging), but it won't cure the underlying problem of addiction.

[mistercorporate]

To which I would also like to add that smoking is one of the most expensive drugs in terms of the cost to our healthcare system, it is also responsible for numerous very painful ways to die that often hit you decades after you quit smoking. I've spent a lot of time in hospitals and one thing with smokers is that they often have symptoms such as blood in urine and blown up kidneys...really painful and undignified situations.

[1overcosc]

Originally Posted by Metro-One

Lower level drugs need to be legalized and regulated (very happy that pot will be by next year), but on the flip side I actually feel that stricter laws and harsher penalties are needed for extremely hazardous drugs (and by that I mean for pushers and producers, not end users). There are some things that should not be legal for general recreational use.

This is a very important point. I very strongly believe that individual drug users should never, ever be criminally prosecuted for their usage. Only the sellers and producers should ever be. Buying & possessing small quantities of any drug should be decriminalized. Drug addiction should be treated as a health problem, not a legal problem. All countries that have taken "health-oriented" approaches to fighting drugs have seen major successes compared to countries that have taken the "war on drugs" route.

Some of the biggest harms stem from the fact that drug users are often scared to get help because of legal fears. People who are about to die of an overdose won't call 911 because they're worried the cops will find their drugs. Thankfully, this specific example is about to go away because the Liberals are about to pass the "compassionate exception" law which would grant amnesty to drug possession charges if the evidence is found during a medical emergency call.

[Acajack]

The geographic expansion of the opioid crisis is very bizarre and uncommon.

Over the weekend in Le Journal de Montréal there was an ominous headline like "IT'S COMING!" and it mentioned the crisis had reached Ottawa but had yet to hit Montreal.

In the Ottawa-Gatineau region the buzz in police and healthcare is that it's still very concentrated in west end of the region on the Ontario side. There was a noticeable mediatized flare-up in Kanata over the winter.

It's all very odd.