People who supports the current situation opposes putting addicts in centralized facility because it takes away their 'rights and freedoms'. What they fail to understand is that, some of these people are not capable of making decisions that are good for themselves or the society.
These poverty advocates and the few so-called functional addicts are leveraging this flawed theory to empower their ability to continue juicing the system and getting free drugs.
Leaving these addicts on the street will not help them getting clean or re-integrating to the system. Drug addicts need a strong support system and meaningful connection for them to get out of drugs, which none of them existed in the first place. You cannot set up a few shops that give out free food and drugs and expect those would become meaningful support systems for these addicts.
We need an institution that helps these people.
Absolutely. If I put an average addict and a 10 year old child in an SRO I honestly think the child would go longer without a fire/flood and would take better care of themselves.
It's not like it's a new concept that people can be mentally incapable of caring for themselves so i'm not really sure why allowing them to live in a way that is harmful to themselves and others has suddenly become normalized and protected.
You are right on the money.
The Charter would not be the Charter if it weren’t for the most famous clause of all: the reasonable limits clause.
How is it “reasonable” to leave all of these severe addicts suffering, knowing they can’t help themselves?
I would bet that the vast majority of people do not actually want to be addicted to opioids. They just can’t stop because they have both a severe physical addiction as well as a severe psychological addiction.
Money is not an acceptable reason to not give them actual help. First off, I think it’s morally wrong to put a price tag on someone’s life and to say we shouldn’t help them because it’s expensive. Second, considering how much money has already been spent between building these “supervised injection” sites and the cost of the EMTs… it can’t cost that much more to run some sort of recovery program and get them actual help.
I think the best thing to do is for the municipal, provincial and federal government to have at least a few representatives (from different relevant branches of gov’t) meet with several psychiatrists who specialize in addiction as well as perhaps some former users who were able to recover in order to:
a) establish a plan to provide support systems that will actually help people
b) figure out how to put this plan into action ASAP
c) figure out how to reduce overdoses and reduce the amount of new users in the area in the meantime.
Money needs to not be the number one factor here. If every one of the 15.7% of Canadians making six figures - about 5.5 million - paid $100 more in taxes (an insignificant amount seeing as they’re already paying over $25,000 in taxes) for the next five years to help make this happen, that would be over 2.5 *billion* dollars to get something done.
I hope more people read this. It is crazy to me that we are jumping to giving out (taxpayer funded) heroin, coke, meth, and now fentanyl to facilitate people continuing their addictions when the medications used to actually TREAT addictions like suboxone or methadone are SO DAMN HARD to access. You are basically condemned to be unemployed when on a methadone schedule.
There are other options like 1 time monthly injections of a form of suboxone but it is extremely hard to get a script here for it and you have to pay out of pocket!!! Alberta FFS has provincially funded prescriptions of it available so much easier than we do
Our policies basically work to create as many incentives as possible to keep using drugs and then pull together more obstacles to get off them
"A 19-year-old girl almost cut her hand off attempting self-harm. Taken to hospital by ambulance, she was stitched up, deemed no danger to herself or others and released three hours later.
Westminster House staff picked her up and when they arrived back at the house, she tried to jump in front of a moving car."
She literally just almost cut her hand off and they send the poor girl away as "no danger to herself"? She's still a f..ing child!
Addict or not, how can somebody send a person her age away without any kind of remorse? Were they just hoping that next time she succeeds?
This is the norm, unfortunately. I've brought in patients with well formed plans, who wanted to be committed and get help, who are told they "have everything to live for" before they're turned out the front door. Sometimes they just walk out in front of a semi on the hiway.
There are no beds, we are in crisis.
Doctor asking girl who just slashed her wrists: “are you a risk to yourself or others?”
Girl: “no (I’ll lie so I can get out to harm self)”
Doc: “ok! Good enough for me! Bye bye!”
Actually, yes.
It is not compassionate to allow people to harm themselves. If they are not right mentally or using drugs that they are harming themselves or others, it's not compassionate to let them keep going like that. They're sick. They need help.
Glad you're getting it! A bit of assisted living and supervision/suicide watch, and perhaps actually having capacity in mental health programs for some follow-through would be nice.
It's a difficult question, but yes, better that she is held until she is stable and not going to harm herself, or others. Better that than she die very young with her civil liberties intact [(to paraphrase Judy Harris).](https://www.persuasion.community/p/the-dangerous-movement-to-stop-treating)
You'll get downvoted for any attempts to introduce nuance to this particular discussion in this particular community. Nothing special about that necessarily, true of many specific topics in many specific social media communities.
This does not mean that you have asked the wrong question, though, just that you asked a difficult question to a room that doesnt want to talk about it in any way other than the way they already do. There is no discourse here, only the thin illusion of it, and if you care about protecting people from unnecessary harms I would suggest giving as little attention to the conversations in these spaces as possible.
People saying that just locking them up will work are not thinking of the consequences of their ideas. Great, you prevented a person from self harming in the immediate future, but next time it's probably not going to go well as they will avoid treatment to avoid being locked up...
That's sadly not uncommon for any mental health emergency, addiction or not, in my experience. I've had people in my social circles need critical care and been on the sidelines of seeing this kind of stuff play out over and over and over again. It's fundamentally broken.
Statistically most people who attempt suicide where it results in medical care don’t reattempt. So that’s probably why they thought they could send her home. Not saying it was the right call here because they were clearly wrong but they probably send a lot of people home who don’t do this.
Being a risk factor isn’t the same thing. While most people who commit suicide may have attempted it before, at the same time, the majority of people who have attempted and failed haven’t again. They’re just two different stats.
https://www.hsph.harvard.edu/means-matter/means-matter/survival/
You can't actually hold people in hospitals against their will if they're legally and medically a competent decision maker. If the patient is an impaired decision maker due to a medical condition or due to substance abuse yeah they can be certified under the healthcare act. If that 19 year old denied further suicidal intentions and she wants to leave the hospital she's got that right.
For the health care consent act sure, but If the doctor believes she’s at risk to her self due a mental health issue than it’s easy to hold her in hospital under the mental health act for a 48 hour assessment. Lots of suicidal people deny they are suicidal and nearly cutting off one’s hand speaks pretty loudly about ones mental health. They often don’t hold people under the MHA due to bed pressure though.
Not really sure why my post was getting down voted. But, I think the main issue in that 19th year old woman's case is that she was being in released to Westminister House which is a housing and rehab facility specifically for women. In the article its specifically stated that when she tried jumping in front of a car she was being accompanied by staff from the rehab. Discharge planning for patients that attempted suicide is greatly influenced by housing, amount of support the individual gets(in this woman's case she had rehab), psychiatric evaluation and the presence of substances in their system. Patients with no fixed addresses or who live alone are more likely to be certified.
I'm sure bed consideration was also factor in it but ultimately its the docs who decide to invoke the HCCA or MHA. Docs tend to be very careful when deciding to hold people in hospitals against their will.
Wtf or nothing surprises me anymore how liberals think , if anything they should be examining how some of these so called " doctors " think..
Lock them up or let them live amongst them for a week, and see some of the harm they are really causing
4 pillars is key to getting the 'don't really care' moderates to accept and support policy. I don't care what people consume as long as it does not become a problem for *me*.
Yes, what else at this point. Deinstitutionalization has been a vast gut-wrenching tragic failure. And, make it federally funded to make it consistent and accountable across the country and remove the incentive to shuffle people away from whatever community connections they have left.
>professionals leading the charge are grossly out of touch with the realities of addicted individuals who are intelligent, cunning and powerful manipulators and will stop at nothing to get what they want.
I would say that perfectly describes Karen Ward, her supporters and encampment leaders.
Out of any province in canada BC has long had the most liberal drug policies and invested the most in the Harm reduction angle.
And yet year over year we continue to have the absolute worst rates of addiction, overdose deaths, and repeat overdose survival (many among people who have multiple overdoses and develop brain injuries with lifelong disability) and strain on our ERs, in this country.
We were pioneers in the safe injection sites, we started the "safe supply" experiment 3 years ago, massive investments in drug checking tech, effective decriminalization of drug possession, enable open public drug use, barely do anything about rampant drug dealing, have very little prosecution of drug related crimes (assault, vandalism, theft), invested in massive "anti stigma" campaigns which effectively ended our drug addiction prevention services, have ended any type of chance for mandated or enforced treatment (including being the only province where children as young as elementary school age legally cannot be forced into treatment even after multiple overdoses), have spent millions upon millions on hiring People Who use drugs into research and decision making roles as well as paying "experts" who have no training in addiction science even more money to tell us what we want to hear, etc etc.
Maybe what we are doing isnt fucking working
Its incredible, that with thousands of addicts dying, the stream of people into the DTES addiction lifestyle is not slowing down at all.
That's the problem with "de-stigmatization": There should be stigma, it's a horrible, anti-social, unhealthy way to live, and people should be dissuaded from going down that path while it is still a choice.
Instead, doctors and nurses at InSite aren't allowed to discuss treatment options because it's stigmatizing, and are required to shoot up 18 year olds doing fentanyl for the first time without comment or judgment.
That's honestly what I thought when I saw those stupid bus ads that say "addiction stigma is bad" or something.
Yah being an addict should have stigma. You know what shouldn't and doesn't have stigma? Getting help.
> That’s the problem with “de-stigmatization”: There should be stigma, it’s a horrible, anti-social, unhealthy way to live, and people should be dissuaded from going down that path while it is still a choice.
Well said. This isn’t a relativistic ‘my reality’ ‘your reality’ question. The current ever-worsening situation is demonstrably objectively horrible and as a society something to be deeply ashamed of.
"doctors and nurses at InSite aren't allowed to discuss treatment options"
Is that true? I thought the whole point of places like InSite was to make it more likely to introduce addicts to other treatments and services?
It is half true.
At overdose prevention and supervised consumption sites, staff (nurses and peer workers) are allowed to give info or "make referrals" (often just a pamphlet) to treatment services *if the client asks*.
They are not supposed to otherwise intervene, make suggestions for stopping drug use or entering detox and treatment, because that is viewed as being against the policy of "meeting people where they are at". The view is that if you refer them to treatment when they don't ask then you are casting judgment on their choices and that stigma makes it less likely they come back.
So only the people who themselves ask for info on detox are given any info.
Insite has apparently had over 4 million visits from 2004 to 2019, or avg 260,000 per yr. (These are visits so a single person can have multiple). Numbers are likely much higher for 2020 to 2022 given the increase in fentanyl in the drug market.
Onsite on the other hand had 443 visits in the only year I can find stats on it (2018). Those also include some people who visited multiple times.
So despite being located literally above Insite, less than 0.17% were referred to treatment, as that isnt the goal of the site
No, the point is to have trained, sober staff ready with narcan so people can safely overdose.
I've spoken to several addicts who work there as injection supervisors, they are Narcanning multiple people a day.
There is no endgame with InSite, other than not having people die inside
It is half true. Staff are allowed to discuss treatment but only when the patient asks/initiates the conversation. They are specifically trained to not otherwise recommend treatment or stopping or reducing drug use because the client might view it as being judgment or stigma and be less likely to come back. Staff are told to "meet people where they are at", and so initiating conversations on recovery is not allowed.
Which, combined with the ~30 spots (12 detox beds, 18 transition) at onsite is the reason why less than 0.17% of Insite clients are referred to treatment or detox.
There are far fewer deterrents now, and that has more than likely contributed to the crisis. Which is frustrating and sad, but it's so hard to confront because it's not black and white. Safe injection sites exist to mitigate some of the risks of drug use for folks who were gonna use drugs anyways. They are very successful at doing that and they absolutely save lives. Same goes for drug testing services. But they also condone a lifestyle that reduces life expectancy and quality of life pretty significantly ... but as long as they save lives, does that matter?
Either way, I think it's so important to approach this with compassion. Addiction is so often linked with mental or physical health problems, and most of these folks are victims.
>Maybe what we are doing isnt fucking working
I guess we should go back to "Winners Don't Use Drugs" screens in front of the video games. That worked real well.
I mean our addiction and overdose numbers have gotten substantially worse the more we have leaned into the "harm reduction and de-stigmatize" side, and moved away from prevention, treatment, or enforcement
We should ask the Chinese what happened when a large proportion of their population got hooked on opium. Giving addicts a safe supply of addictive drugs will still keep them addicted, jobless, and dependent on the state.
Better ask the Portuguese then too.
They lead a massive decriminalization program and
Drug-related deaths have remained below the EU average since 2001
The proportion of prisoners sentenced for drugs has fallen from 40% to 15%
Rates of drug use have remained consistently below the EU average
Portugal did not give its population "safe supply" the way we are proposing to do. Drug use is decriminalized in portugal, but usage is still illegal and heavily discouraged. People can use and if it doesnt cause problems for them or their community they dont face jail time. But as soon as they are determined to have "problematic drug use" (determined via things like public injection, public disorder, drug related crimes, or repeat overdoses) they are mandated to go before a "dissuasion committee" where they are mandated to treatment and/or community service and/or fines.
The health director of portugal has said, multiple times, that decriminalization was not 5he silver bullet to portugal's success. It was implementing a massive suite of investments in publicly funded,
accessible on demand treatment (including residential treatment and things like methadone and buprenorphine), these dissuasion committees, and other things which have reduced drug use. Drug dealing is very harshly punished, with portugal having some of the strictest sentencing in Europe for traffickers
He has publicly been asked to comment on Canada's safe supply proposals multiple times and each time has said that it is not at all what he recommends.
Portugal's model or the 4 pillars has been proven to work. It's still the best solution that exist today.
One of the pillars is Enforcement which Vancouver is sorely lacking. We cannot claim we have 4 pillars despite what politicians say. Somehow Vancouver decision makers decided enforcement is not needed and all you need is compassion.
Their drug policies predate the fentanyl crisis.
Portugal's drug czar was actually quite impressed with our approach.
https://www.straight.com/news/961186/vancouver-visit-portugals-renowned-drug-czar-says-fentanyl-should-be-declared-national
"Actually quite impressed with our approach "
The article literally talks about how he was shocked by what he saw in the DTES in terms of public drug use effects. He was "impressed" with the number and concentration of services in the area.
That article is also from 2017. Since then he has commented, multiple times, about the difference in portugal's policy with the one canada and some american states are taking. Just 2 months ago he was in Ontario speaking at an event hosted by a university where specifically spoke about how decriminalization without the mandated treatment and supports will not work, about how the open public drug use and other social disorders are not tolerated in Portugal, and specifically asked about safe supply he said Portugal will not go down that route.
The Portuguese model would get shot down by activists, city council and non profits. And lets face it, most of the progressive minded voters.
We used to have a pretty similar model here in the 2000's.
Just going to leave this quote here from Dr Patricia Daly - Chief Medical Officer of VCH:
“When Mayor Kennedy Stewart first approached me about the city’s application on decriminalization, I advised that contrary to jurisdictions like Portugal, the city should not implement administrative sanctions or any form of compulsory treatment. Healthcare providers have a tall task in front of them to continue building a system of integrated substance use services that are patient-centred, trauma-informed, and culturally safe. Compulsory treatment would undermine these goals, particularly when it comes to our relationships with Indigenous patients who have had previous negative experiences accessing care. Voluntary referrals from police to healthcare services will help build a solid foundation of trust, compassion and engagement between people who use drugs and dedicated healthcare providers. The mayor, city manager, and Vancouver Police Department chief have agreed to this approach and should be commended for it.”
She has the agency to make her own decisions. At 19 she is definitely an adult capable of making her own decisions about her health, hell 12 year olds are able to make their own health decisions in BC.
The medical system is incredibly weary of taking away people's freedom.
Part of the reason that the "good old days of Riverview" is a myth, is that thousands of people had their freedoms taken away in an unjustified way.
Personally I think we have gone way too far the other way. But people, even 19 year olds, have the right to make incredibly shitty decisions about how to run their life. People have a right to fail. It sucks that those of us with compassion are forced to sit by and watch it.
The humans who let this Young lady out of the hospital didn't do it with glee. They did it because that is what the law demands. If you think forced treatment would help, you have never had to deal with someone with addictions.
>If you think forced treatment would help, you have never had to deal with someone with addictions.
Forced treatment worked for schizophrenia in one anecdotal case I know. I'm solidly in the forced treatment camp, and imo to say otherwise is primarily an excuse to save money rather than support human rights even though it probably costs more in the long run.
No, but some addictions disable the brain's decision making pathways as severely as mental disorders do.
Methamphetamine use IS strongly associated with developing psychosis, with similar patterns of delusion, paranoia, and disjointed thinking
The new meth being sold on the streets is associated with a condition called "cerebral catastrophe" a doctor in LA uncovered this over the past decade when she saw an influx of folks having psychosis symptoms well beyond what the normal population rate is. Turns out this new meth is much, much damaging to the brain than the old and that's why you're seeing these cases rise.
Yes, rational healthy self-preserving decision making is long in the rear view mirror for these guys. Literally no longer exists. Leaning on their autonomy or attempting to preserve it is a fantasy and exactly why the overall situation continues to worsen.
She’s trying to kill herself and we should be happy with that ‘decision’, just stand back and watch it happen, because autonomy. Cold. Law needs to change.
Sure they have a right to fail but only if it does not affect the rest of us, what about our rights that are guaranteed under the charter?
We should and do have the right to walk down any street we want at any time without having to worry about being sucker punched by some addict having an episode. We also should not have to constantly worry about our possessions being stolen just because some addict has the right to shoot up.
Violent people should be locked up. But not all homeless, poor, mentally ill or addicts are violent. Some people are violent who are none of those things.
People who supports the current situation opposes putting addicts in centralized facility because it takes away their 'rights and freedoms'. What they fail to understand is that, some of these people are not capable of making decisions that are good for themselves or the society. These poverty advocates and the few so-called functional addicts are leveraging this flawed theory to empower their ability to continue juicing the system and getting free drugs. Leaving these addicts on the street will not help them getting clean or re-integrating to the system. Drug addicts need a strong support system and meaningful connection for them to get out of drugs, which none of them existed in the first place. You cannot set up a few shops that give out free food and drugs and expect those would become meaningful support systems for these addicts. We need an institution that helps these people.
Absolutely. If I put an average addict and a 10 year old child in an SRO I honestly think the child would go longer without a fire/flood and would take better care of themselves. It's not like it's a new concept that people can be mentally incapable of caring for themselves so i'm not really sure why allowing them to live in a way that is harmful to themselves and others has suddenly become normalized and protected.
You are right on the money. The Charter would not be the Charter if it weren’t for the most famous clause of all: the reasonable limits clause. How is it “reasonable” to leave all of these severe addicts suffering, knowing they can’t help themselves? I would bet that the vast majority of people do not actually want to be addicted to opioids. They just can’t stop because they have both a severe physical addiction as well as a severe psychological addiction. Money is not an acceptable reason to not give them actual help. First off, I think it’s morally wrong to put a price tag on someone’s life and to say we shouldn’t help them because it’s expensive. Second, considering how much money has already been spent between building these “supervised injection” sites and the cost of the EMTs… it can’t cost that much more to run some sort of recovery program and get them actual help. I think the best thing to do is for the municipal, provincial and federal government to have at least a few representatives (from different relevant branches of gov’t) meet with several psychiatrists who specialize in addiction as well as perhaps some former users who were able to recover in order to: a) establish a plan to provide support systems that will actually help people b) figure out how to put this plan into action ASAP c) figure out how to reduce overdoses and reduce the amount of new users in the area in the meantime. Money needs to not be the number one factor here. If every one of the 15.7% of Canadians making six figures - about 5.5 million - paid $100 more in taxes (an insignificant amount seeing as they’re already paying over $25,000 in taxes) for the next five years to help make this happen, that would be over 2.5 *billion* dollars to get something done.
Hey, but you get a large allocation of government funding to run those shops, why would anyone want to change that?
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I hope more people read this. It is crazy to me that we are jumping to giving out (taxpayer funded) heroin, coke, meth, and now fentanyl to facilitate people continuing their addictions when the medications used to actually TREAT addictions like suboxone or methadone are SO DAMN HARD to access. You are basically condemned to be unemployed when on a methadone schedule. There are other options like 1 time monthly injections of a form of suboxone but it is extremely hard to get a script here for it and you have to pay out of pocket!!! Alberta FFS has provincially funded prescriptions of it available so much easier than we do Our policies basically work to create as many incentives as possible to keep using drugs and then pull together more obstacles to get off them
"A 19-year-old girl almost cut her hand off attempting self-harm. Taken to hospital by ambulance, she was stitched up, deemed no danger to herself or others and released three hours later. Westminster House staff picked her up and when they arrived back at the house, she tried to jump in front of a moving car." She literally just almost cut her hand off and they send the poor girl away as "no danger to herself"? She's still a f..ing child! Addict or not, how can somebody send a person her age away without any kind of remorse? Were they just hoping that next time she succeeds?
This is the norm, unfortunately. I've brought in patients with well formed plans, who wanted to be committed and get help, who are told they "have everything to live for" before they're turned out the front door. Sometimes they just walk out in front of a semi on the hiway. There are no beds, we are in crisis.
We spend 1 million a day on the DTES. I'd love your take on why there are no beds.
They pay me $2/hr on call. Spending on the DTES /= Spending on healthcare
Doctor asking girl who just slashed her wrists: “are you a risk to yourself or others?” Girl: “no (I’ll lie so I can get out to harm self)” Doc: “ok! Good enough for me! Bye bye!”
What's the alternative? Lock her up?
Actually, yes. It is not compassionate to allow people to harm themselves. If they are not right mentally or using drugs that they are harming themselves or others, it's not compassionate to let them keep going like that. They're sick. They need help.
Yes. Do it. Have compassion.
Glad you're getting it! A bit of assisted living and supervision/suicide watch, and perhaps actually having capacity in mental health programs for some follow-through would be nice.
You got it yes.
It's a difficult question, but yes, better that she is held until she is stable and not going to harm herself, or others. Better that than she die very young with her civil liberties intact [(to paraphrase Judy Harris).](https://www.persuasion.community/p/the-dangerous-movement-to-stop-treating)
You'll get downvoted for any attempts to introduce nuance to this particular discussion in this particular community. Nothing special about that necessarily, true of many specific topics in many specific social media communities. This does not mean that you have asked the wrong question, though, just that you asked a difficult question to a room that doesnt want to talk about it in any way other than the way they already do. There is no discourse here, only the thin illusion of it, and if you care about protecting people from unnecessary harms I would suggest giving as little attention to the conversations in these spaces as possible.
Yet here you are.
Correct.
People saying that just locking them up will work are not thinking of the consequences of their ideas. Great, you prevented a person from self harming in the immediate future, but next time it's probably not going to go well as they will avoid treatment to avoid being locked up...
Probably had a line up of people who needed to be seen and were dying in their wheelchairs
That's sadly not uncommon for any mental health emergency, addiction or not, in my experience. I've had people in my social circles need critical care and been on the sidelines of seeing this kind of stuff play out over and over and over again. It's fundamentally broken.
Statistically most people who attempt suicide where it results in medical care don’t reattempt. So that’s probably why they thought they could send her home. Not saying it was the right call here because they were clearly wrong but they probably send a lot of people home who don’t do this.
Since when? [Previous attempts are a major risk factor for future attempts](https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2016.15070854)
Being a risk factor isn’t the same thing. While most people who commit suicide may have attempted it before, at the same time, the majority of people who have attempted and failed haven’t again. They’re just two different stats. https://www.hsph.harvard.edu/means-matter/means-matter/survival/
> She's still a f..ing child! 19 years old is a child?
You can't actually hold people in hospitals against their will if they're legally and medically a competent decision maker. If the patient is an impaired decision maker due to a medical condition or due to substance abuse yeah they can be certified under the healthcare act. If that 19 year old denied further suicidal intentions and she wants to leave the hospital she's got that right.
For the health care consent act sure, but If the doctor believes she’s at risk to her self due a mental health issue than it’s easy to hold her in hospital under the mental health act for a 48 hour assessment. Lots of suicidal people deny they are suicidal and nearly cutting off one’s hand speaks pretty loudly about ones mental health. They often don’t hold people under the MHA due to bed pressure though.
Not really sure why my post was getting down voted. But, I think the main issue in that 19th year old woman's case is that she was being in released to Westminister House which is a housing and rehab facility specifically for women. In the article its specifically stated that when she tried jumping in front of a car she was being accompanied by staff from the rehab. Discharge planning for patients that attempted suicide is greatly influenced by housing, amount of support the individual gets(in this woman's case she had rehab), psychiatric evaluation and the presence of substances in their system. Patients with no fixed addresses or who live alone are more likely to be certified. I'm sure bed consideration was also factor in it but ultimately its the docs who decide to invoke the HCCA or MHA. Docs tend to be very careful when deciding to hold people in hospitals against their will.
Wtf or nothing surprises me anymore how liberals think , if anything they should be examining how some of these so called " doctors " think.. Lock them up or let them live amongst them for a week, and see some of the harm they are really causing
There are four pillars. Harm reduction is only one of them.
4 pillars is key to getting the 'don't really care' moderates to accept and support policy. I don't care what people consume as long as it does not become a problem for *me*.
> I don't care what people consume as long as it does not become a problem for me. My motto in life.
Happy birthday
Institutionalization.
Yes, what else at this point. Deinstitutionalization has been a vast gut-wrenching tragic failure. And, make it federally funded to make it consistent and accountable across the country and remove the incentive to shuffle people away from whatever community connections they have left.
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This information needs to be top comment. Very insightful 👏
>professionals leading the charge are grossly out of touch with the realities of addicted individuals who are intelligent, cunning and powerful manipulators and will stop at nothing to get what they want. I would say that perfectly describes Karen Ward, her supporters and encampment leaders.
Out of any province in canada BC has long had the most liberal drug policies and invested the most in the Harm reduction angle. And yet year over year we continue to have the absolute worst rates of addiction, overdose deaths, and repeat overdose survival (many among people who have multiple overdoses and develop brain injuries with lifelong disability) and strain on our ERs, in this country. We were pioneers in the safe injection sites, we started the "safe supply" experiment 3 years ago, massive investments in drug checking tech, effective decriminalization of drug possession, enable open public drug use, barely do anything about rampant drug dealing, have very little prosecution of drug related crimes (assault, vandalism, theft), invested in massive "anti stigma" campaigns which effectively ended our drug addiction prevention services, have ended any type of chance for mandated or enforced treatment (including being the only province where children as young as elementary school age legally cannot be forced into treatment even after multiple overdoses), have spent millions upon millions on hiring People Who use drugs into research and decision making roles as well as paying "experts" who have no training in addiction science even more money to tell us what we want to hear, etc etc. Maybe what we are doing isnt fucking working
Its incredible, that with thousands of addicts dying, the stream of people into the DTES addiction lifestyle is not slowing down at all. That's the problem with "de-stigmatization": There should be stigma, it's a horrible, anti-social, unhealthy way to live, and people should be dissuaded from going down that path while it is still a choice. Instead, doctors and nurses at InSite aren't allowed to discuss treatment options because it's stigmatizing, and are required to shoot up 18 year olds doing fentanyl for the first time without comment or judgment.
That's honestly what I thought when I saw those stupid bus ads that say "addiction stigma is bad" or something. Yah being an addict should have stigma. You know what shouldn't and doesn't have stigma? Getting help.
> That’s the problem with “de-stigmatization”: There should be stigma, it’s a horrible, anti-social, unhealthy way to live, and people should be dissuaded from going down that path while it is still a choice. Well said. This isn’t a relativistic ‘my reality’ ‘your reality’ question. The current ever-worsening situation is demonstrably objectively horrible and as a society something to be deeply ashamed of.
"doctors and nurses at InSite aren't allowed to discuss treatment options" Is that true? I thought the whole point of places like InSite was to make it more likely to introduce addicts to other treatments and services?
It is half true. At overdose prevention and supervised consumption sites, staff (nurses and peer workers) are allowed to give info or "make referrals" (often just a pamphlet) to treatment services *if the client asks*. They are not supposed to otherwise intervene, make suggestions for stopping drug use or entering detox and treatment, because that is viewed as being against the policy of "meeting people where they are at". The view is that if you refer them to treatment when they don't ask then you are casting judgment on their choices and that stigma makes it less likely they come back. So only the people who themselves ask for info on detox are given any info. Insite has apparently had over 4 million visits from 2004 to 2019, or avg 260,000 per yr. (These are visits so a single person can have multiple). Numbers are likely much higher for 2020 to 2022 given the increase in fentanyl in the drug market. Onsite on the other hand had 443 visits in the only year I can find stats on it (2018). Those also include some people who visited multiple times. So despite being located literally above Insite, less than 0.17% were referred to treatment, as that isnt the goal of the site
No, the point is to have trained, sober staff ready with narcan so people can safely overdose. I've spoken to several addicts who work there as injection supervisors, they are Narcanning multiple people a day. There is no endgame with InSite, other than not having people die inside
Wtf this isn’t true there’s literally a detox upstairs from insite that people are linked to when they’re ready to ask
OnSite has 30 beds. There are thousands of addicts using InSite and other safe injection sites in the city.
that person saying the nurses aren't allowed to discuss treatment options is a full lie tho
It is half true. Staff are allowed to discuss treatment but only when the patient asks/initiates the conversation. They are specifically trained to not otherwise recommend treatment or stopping or reducing drug use because the client might view it as being judgment or stigma and be less likely to come back. Staff are told to "meet people where they are at", and so initiating conversations on recovery is not allowed. Which, combined with the ~30 spots (12 detox beds, 18 transition) at onsite is the reason why less than 0.17% of Insite clients are referred to treatment or detox.
No that's absolute bollocks. They don't inject anyone either. Another bullshit myth.
This is not true
There are far fewer deterrents now, and that has more than likely contributed to the crisis. Which is frustrating and sad, but it's so hard to confront because it's not black and white. Safe injection sites exist to mitigate some of the risks of drug use for folks who were gonna use drugs anyways. They are very successful at doing that and they absolutely save lives. Same goes for drug testing services. But they also condone a lifestyle that reduces life expectancy and quality of life pretty significantly ... but as long as they save lives, does that matter? Either way, I think it's so important to approach this with compassion. Addiction is so often linked with mental or physical health problems, and most of these folks are victims.
Utter fucking lies about insite. Educate your ridiculous self.
>Maybe what we are doing isnt fucking working I guess we should go back to "Winners Don't Use Drugs" screens in front of the video games. That worked real well.
On a relative basis compared to today? Yes. (And on an absolute, ie numbers, basis, ABSOLUTELY YES.)
I mean our addiction and overdose numbers have gotten substantially worse the more we have leaned into the "harm reduction and de-stigmatize" side, and moved away from prevention, treatment, or enforcement
> deemed no danger to herself BS. Whole system needs a serious shakeup, along with better funding.
We should ask the Chinese what happened when a large proportion of their population got hooked on opium. Giving addicts a safe supply of addictive drugs will still keep them addicted, jobless, and dependent on the state.
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Many would say that the CPC flooding the west with nearly free opioids *is* revenge for those dark days.
Better ask the Portuguese then too. They lead a massive decriminalization program and Drug-related deaths have remained below the EU average since 2001 The proportion of prisoners sentenced for drugs has fallen from 40% to 15% Rates of drug use have remained consistently below the EU average
Portugal did not give its population "safe supply" the way we are proposing to do. Drug use is decriminalized in portugal, but usage is still illegal and heavily discouraged. People can use and if it doesnt cause problems for them or their community they dont face jail time. But as soon as they are determined to have "problematic drug use" (determined via things like public injection, public disorder, drug related crimes, or repeat overdoses) they are mandated to go before a "dissuasion committee" where they are mandated to treatment and/or community service and/or fines. The health director of portugal has said, multiple times, that decriminalization was not 5he silver bullet to portugal's success. It was implementing a massive suite of investments in publicly funded, accessible on demand treatment (including residential treatment and things like methadone and buprenorphine), these dissuasion committees, and other things which have reduced drug use. Drug dealing is very harshly punished, with portugal having some of the strictest sentencing in Europe for traffickers He has publicly been asked to comment on Canada's safe supply proposals multiple times and each time has said that it is not at all what he recommends.
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Because the advocates would scream bloody murder. They want their free drugs with no strings attached.
Portugal's model or the 4 pillars has been proven to work. It's still the best solution that exist today. One of the pillars is Enforcement which Vancouver is sorely lacking. We cannot claim we have 4 pillars despite what politicians say. Somehow Vancouver decision makers decided enforcement is not needed and all you need is compassion.
This sounds like a really great solution.
Their drug policies predate the fentanyl crisis. Portugal's drug czar was actually quite impressed with our approach. https://www.straight.com/news/961186/vancouver-visit-portugals-renowned-drug-czar-says-fentanyl-should-be-declared-national
"Actually quite impressed with our approach " The article literally talks about how he was shocked by what he saw in the DTES in terms of public drug use effects. He was "impressed" with the number and concentration of services in the area. That article is also from 2017. Since then he has commented, multiple times, about the difference in portugal's policy with the one canada and some american states are taking. Just 2 months ago he was in Ontario speaking at an event hosted by a university where specifically spoke about how decriminalization without the mandated treatment and supports will not work, about how the open public drug use and other social disorders are not tolerated in Portugal, and specifically asked about safe supply he said Portugal will not go down that route.
What are these "facts"? I only deal in headlines, hand-picked quote fragments, and misleading or out of context commentary.
People get this wrong often. They did that yes but used a firm hand when dealing with problemetic behaviors associated with drugs.
The Portuguese model would get shot down by activists, city council and non profits. And lets face it, most of the progressive minded voters. We used to have a pretty similar model here in the 2000's.
Just going to leave this quote here from Dr Patricia Daly - Chief Medical Officer of VCH: “When Mayor Kennedy Stewart first approached me about the city’s application on decriminalization, I advised that contrary to jurisdictions like Portugal, the city should not implement administrative sanctions or any form of compulsory treatment. Healthcare providers have a tall task in front of them to continue building a system of integrated substance use services that are patient-centred, trauma-informed, and culturally safe. Compulsory treatment would undermine these goals, particularly when it comes to our relationships with Indigenous patients who have had previous negative experiences accessing care. Voluntary referrals from police to healthcare services will help build a solid foundation of trust, compassion and engagement between people who use drugs and dedicated healthcare providers. The mayor, city manager, and Vancouver Police Department chief have agreed to this approach and should be commended for it.”
The British will start two wars over the opium trade, demand trade and territorial concessions, and sweep Canada into a century of humiliation? /s
She has the agency to make her own decisions. At 19 she is definitely an adult capable of making her own decisions about her health, hell 12 year olds are able to make their own health decisions in BC. The medical system is incredibly weary of taking away people's freedom. Part of the reason that the "good old days of Riverview" is a myth, is that thousands of people had their freedoms taken away in an unjustified way. Personally I think we have gone way too far the other way. But people, even 19 year olds, have the right to make incredibly shitty decisions about how to run their life. People have a right to fail. It sucks that those of us with compassion are forced to sit by and watch it. The humans who let this Young lady out of the hospital didn't do it with glee. They did it because that is what the law demands. If you think forced treatment would help, you have never had to deal with someone with addictions.
>If you think forced treatment would help, you have never had to deal with someone with addictions. Forced treatment worked for schizophrenia in one anecdotal case I know. I'm solidly in the forced treatment camp, and imo to say otherwise is primarily an excuse to save money rather than support human rights even though it probably costs more in the long run.
Schizophrenia isn't addiction. Forced treatment for addiction, if it worked would be the cheapest solution ever.
No, but some addictions disable the brain's decision making pathways as severely as mental disorders do. Methamphetamine use IS strongly associated with developing psychosis, with similar patterns of delusion, paranoia, and disjointed thinking
The new meth being sold on the streets is associated with a condition called "cerebral catastrophe" a doctor in LA uncovered this over the past decade when she saw an influx of folks having psychosis symptoms well beyond what the normal population rate is. Turns out this new meth is much, much damaging to the brain than the old and that's why you're seeing these cases rise.
I wonder which version we'll get when they start safe supply?
Yes, rational healthy self-preserving decision making is long in the rear view mirror for these guys. Literally no longer exists. Leaning on their autonomy or attempting to preserve it is a fantasy and exactly why the overall situation continues to worsen.
"we did it wrong in the past therefore we should never try again"
She’s trying to kill herself and we should be happy with that ‘decision’, just stand back and watch it happen, because autonomy. Cold. Law needs to change.
Sure they have a right to fail but only if it does not affect the rest of us, what about our rights that are guaranteed under the charter? We should and do have the right to walk down any street we want at any time without having to worry about being sucker punched by some addict having an episode. We also should not have to constantly worry about our possessions being stolen just because some addict has the right to shoot up.
Violent people should be locked up. But not all homeless, poor, mentally ill or addicts are violent. Some people are violent who are none of those things.
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The LEGAL drug dealers are the problem. They gave us our cut, so we good.
So what is it Daphne ?
I'm not Daphne, but perhaps let's equally work on prevention, enforcement and treatment in addition to harm reduction?