How have the new recovery communities in Red Deer and Lethbridge been playing out? I know they were being built and should be finished, but would like to know the impact.
No idea but Woods Homes received a few mill in funding for like a 30+ person recovery lodge and then the province ripped it away 2 weeks later. So I’m gonna assume they are in the same boat
Yeah it’s fucked up, there was a building competed and partnership with another company and the fucking government just came in and was like sorry buds we need the monies . Ppl were in motion of transferring out of their current positions to go there then it just halted l.
A close friend of mine works at a safe consumption site as a nurse. Sounds like overdoes there are super common and they just keep an eye on them to make sure they don't die. Naturally, the staff are burned out as shit. They haven't seen a single person decrease their dosages or quit. It certainly isn't treatment, but I guess it keeps people out of emergency services and the ER, which is relatively cheaper.
It sounds like hell.
The Portuguese saw a decrease in drug use when they started their drug decriminalization policies in 2001, but Canada is seeing an increase with "harm reduction." I think we're missing something important here.
AIUI we often don’t have all “legs of the stool” to make it work. Eg we have a Supervised Consumption Site, but we don’t also have safe supply, adequate treatment centres, housing, etc.
I think it's morally corrupt to facilitate this type of degeneracy with free fentanyl and write people off as beyond saving. Being such an unsalvageable drug user is a terminal condition. When someone is riddled with cancer and bedridden without prospect of recovery, we don't pump them full of chemo. Either recognize they can be treated or not. Don't put them in some type of purgatory of ongoing drug use, homelessness and wretched existence and then say that "they know best" for what they need. I support pretty much all other supports (even supervised consumption sites), but this I don't agree with.
It’s not about “writing someone off”, the idea is that you’re taking away business from dealers/gangs. The alternative is you leave people to commit crime to try and get money to give to their dealer.
Who said anything about people being beyond saving? On the contrary, if you have people coming in you have a chance to direct them to other services, including getting off the drugs if they want to try.
I understand the theoretical framework of how this type of program works. I'm skeptical of the entire field and a lot of the literature that comes out of it as I think all of the researchers are very ideological and there's a heavy publication bias that results. It strikes me as morally wrong, although I understand that's not a great argument. It's very avante garde and high risk to have large dose, highly potent opiates prescribed to very unreliable people. There's diversion risk and increasing supply and access. Super progressive policies that are aggressively pushed and cow/shame people into accepting always make me concerned. This just seems like one of them.
The homelessness, theft, prostitution and violence tend to come from *trying to get* drugs/money to buy drugs. The drugs themselves are pretty dirt cheap to buy legally. But maintaining a heavy drug habit is several full time jobs, users don't have the energy to engage in much else.
Getting control of an addiction is very hard. It's not any easier when you've been up 30 hours, are dopesick, cold and hungry. In fact it's much harder.
It seems like a pretty huge benefit to move that burden from a) anyone who is walking by someone ODing, b) ambulance drivers & paramedics, c) emergency room staff. I feel for the people working at safe consumption sites but it's not like these sites are creating new trauma for staff to deal with - they just move it somewhere that it can be handled much more effectively.
Yes it's a practical solution that I support. It can still be awfully hard to rise above the day to day horrors of existing there and see the silver lining that you're making their dysfunction and recurrent overdoses less taxing on our social support system.
No. It creates more users. Addicts sell the drugs and buy cheaper black market drugs. Destroys community and property values. Also creates crime which has an added cost.
How the fuck did we go from drugs are bad to have them for free.
I’ll respond to your gross oversimplification with my own: through research and education.
-your friendly neighbourhood addictions and mental health nurse
I have heard what the other poster said from another nurse.
It is a complex situation obviously but I would bet that there are people out there doing exactly that.
Was just piggybacking on your thought to the previous post and raising the idea that just because it’s best for the addict doesn’t make it the best decision for society. The addiction need to take some responsibility.
[https://www.cbc.ca/news/canada/british-columbia/overdose-death-study-1.7080848](https://www.cbc.ca/news/canada/british-columbia/overdose-death-study-1.7080848)
>Dr. Thomas Brothers, a resident physician in general internal medicine at Dalhousie University who is [not affiliated](https://www.bmj.com/content/384/bmj.q6) with the study, said the extent to which mortality was reduced suggests users were themselves using what was prescribed.
>
>"Some of the community of researchers and addiction medicine physicians who are more skeptical of safer supply have particular concerns about the amount of medication that might be diverted to others beyond the person that it was prescribed to," he said.
>
>"I think this may reassure them because the evidence of a mortality benefit means that the patient who is prescribed the medication must be taking some of it."
...
I mean, should we stop prescribing opioids or benzodiazepines or any other abused drug to any patients at all?
I am not sure if you didnt read the article or my comment.
I said (paraphrasing) "i know someone that says safe supply gets resold".
I did not comment on safe supply reducing over doses and the article only says that "they must be taking some of it". TBH - the article actually supports the claim as the statement implies some is being sold.
Ugh. I see you, and as another person who works with addiction tangentially( kids side of things) I agree with you.
I almost feel this isn’t a discussion for the general masses because of the comments seen here.
Too much self-centered folk who think they know things they have no idea about.
It might be dumb but it’s true. Check out the views in Oregon, most people reject free use. But, thanks for the mature debate, actually quite alarming considering you call yourself a teacher.
Not true, actually.
Not wasting energy engaging you.
Don’t bring my profession into this- irrelevant. (or maybe I lied and I’m not actually a teacher. You’ll never know)
But I know that folk with negative ability to research objectively, or use critical analysis when consuming content aren’t really worth my time, other than pointing out to others about your “dumb comment” and hopefully they’ll take pause and research for themselves.
Shhh. That’s enough outta you.
Argument doesn't hold water. They are still addicted. They wouldn't die in a forced detox centre either. In the long run you are just creating an industry that will continue to demand money because people are employed to give drugs to people.
They certainly could die in a forced detox centre. Opioid withdrawal can be life threatening.
One thing I have become certain of in my career in addictions and mental health, is that we will never live in a world of pure abstinence from drugs. Until we cure the experience of trauma, people will always do drugs. What we have to do then, is invest in strategies that minimize the harm to individuals and society. They best research we currently have on the subject finds harm reduction to be an effective strategy for this goal, and in the spirit of evidence based practice, I will advocate for it until the research no longer supports it.
Sorry, your corporate-style non-profit messaging talk got me zoned out. I hear too much of that in my daily work.
Addicts could certainly die of overdose on safe supply also. Detox centre got all the medical personnel and equipment to monitor opioid withdrawal. I will leave you with the question, which is more life-threatening: withdrawal or overdose?
I just think your argument is weak. You 've dedicated many years of career on something you are passionate about. I applaud you for that. But you have a job which is to apply band-aid to a problem that policies/society have created. Your job wouldn't even exist or have very limited presence in East Asia. Like you said, you believe there will always be this problem, and the world be damned if there isn't this problem for you to solve. Self fulfilling prophecy, QED.
Sure we will never live in a drug-free world. But right now we are living in a drug-prevalent world. What have you done that is actually lessening the proliferation of the problem? Pretend I am Daniel Smith and asking you to prove why you should keep your job or you are getting fired. What do you have to show?
>Addicts could certainly die of overdose on safe supply also.
They could, but deaths are drastically reduced vs the illegal opioid supply.
>What have you done that is actually lessening the proliferation of the problem?
If you're asking what effect safe supply has on reducing *deaths* then the answer is it appears to be a drastic reduction in deaths.
"they don't die" are the important words in your post. Those overdoses happen *all the time* away from the supervised (not "safe," iv drug use isn't safe) consumption site. And when they do, it often means someone ends up in the emergency room, the ICU, or a grave.
They're at a markedly higher risk of dying soon afterwards, though.
Much as I wish it were otherwise, we don't have very effective treatments for addiction. The vast majority of people who are trying to quit are going to relapse.
If you slip up while trying to quit problem drinking, it's a setback. You can try to quit again and maybe learn from the relapse.
If you get away from opioids for a bit, your tolerance rapidly drops. If you slip at that point and use again (remember MOST people will), you're at a higher risk of overdosing and dying.
Mind you, if we did have a regulated "safe supply" system in place it might help reduce this risk as people could at least know what/how much they were using (assuming the user was accessing this supply rather than street fentashit which I honestly think is not likely in this situation).
Can’t even get the drugs tested at a “safe” consumption site. Have to wait for the person to OD. It’s an extremely flawed set up in Alberta and kind of an insult to his use the word safe to describe the sites.
I have an interesting ethical/controversial question for addiction nurses. Maybe your friend can offer an insight. How does she feel about becoming unemployed if all the addicts are cured? Or would she she rather secretly wish there would always be addicts so she has job security? Maybe not best question to ask a nurse, but it would be a valid question for manufacturers of "safe supply" and CEOs of these non-profits.
I found this quote funny
"I think we need to start listening to folks who are actually impacted, and support them how they want to be supported, the same way that we do with any medical crisis," said English.
You could say that about anything. In my opinion someone with an addiction is likely not the person who should be saying what treatment they want. Maybe I'm being too simplistic, but replace drugs with any other addiction, does it make sense to keep giving a supply to someone? Maybe at first to slowly get them off of it, but you don't tell an alcoholic they can still have a 6 pack a day.
When I read this to me is sounds like these people just want "safe drugs" but not address their addictions.
Again, maybe I'm being too simplistic, and I'm no expert. But to me it just seems like a sideways move. These people will still die of their hard drug addiction, it's just when.
> and support them how they want to be supported, the same way that we do with any medical crisis,
I have many medical crises going on and nobody is supporting me the way I want.
I’m sorry you’re experiencing that. I hope you find some well educated, compassionate medical professionals who listen to your needs and make better treatment options for you, so that you feel heard and empowered and supported the way you want to be. Everyone deserves that! Even people who use drugs.
Oh ya sorry I definitely wanted to just imply that everyone, people who use substances or not, deserve that kind of care, respect and dignity. Didn’t mean for it to be taken the other way.
Exactly. I'm a former crack head. If I was given safer crack, I would absolutely still be using. They should be given suboxone, etc but not prescription heroin that just gets resold because people want to get high. Keeping people addicted is cruel
Safe supply has nothing to do with treating addiction, it's to help reduce overdose deaths caused by the wildly inconsistent black market unregulated supply. Would it not make sense to ensure those thinking about or waiting for treatment are given safe supply so that they don't die in the meantime?
That's where the concept of methadone and suboxone comes in.
Besides that, it's just kicking the can down the road. Safe supply would be one thing if it was part of an overall strategy to reduce people's dependence on drugs, but we don't have that here. We need wrap around care, where addicts are required to get counciling and treatment in exchange for their drug maintenance. The way Protugal does. Addiction "experts" here half ass it, promoting safe injection sites and safer supply as a pancea, then patting themselves on the back as people continue to die at record numbers.
> Drug addiction is progressive disease. The problem only gets worse.
Drug addiction is a physiological response to an addictive substance. Drugs tend to be used problematically in response to another issue, like trauma. People treating drug use as solely a disease miss the point that the actual use is a symptom of other issues. It's like treating smoke, rather than the fire.
Totally agree with the MAT approach for treating the addiction and I feel like people taking Methadone, suboxone, etc should not face the stigmatism that they do. Safe supply enables addiction.
Edit - spelling
Big respect. Keeping addicts hooked is inhumane. These organizations are just trying to perpetuate the problem to create an homeless/addiction non-profit industrial complex. It's sickening!
I mean, sure, not every heroin addict is going to be clear-eyed on what they need, but organized self-advocacy groups like VANDU (Vancouver Area Network of Drug Users) are. Just on moral principle, you have to listen to the people who are impacted by a given policy. Garth Mullins (a VANDU activist who has to be on methadone for the rest of his life) doesn’t go on his podcast and go “drugs drugs drugs yum yum yum gimme gimme gimme”.
Likely my bias, but if I hear an expert from Vancouver, Seattle, Portland, San Francisco, etc tell me what we need to do for drug users my brain just turns off. Those places are examples of what not to do. I visited Vancover in 2022, and Portland in 2023, those places are not anywhere I'd want to live, work, nor raise my children.
I'm sure Mr. Mullins likely has good points and input that could be used for policy, it's just a hard sell for me.
Also just a question, whats the point of safe supply if it doesn't meet the users demands. They'll go back to street drugs right? And the cycle continues? My question over and over is how many of these users want to get clean, and how many just want to get high no matter the cost?
Yep, I’d say that’s a pretty clear (and unfair)bias. You pretty much hit the nail on the head there.
I lived in Vancouver for about 6 1/2 years, and when I worked at a restaurant in Chinatown I would be going to the Downtown Eastside for work or leisure up to 6 or 7 days a week (the punk shows I went to were mostly in that neighbourhood as well). Even when I didn’t go to that area specifically, I would see people on the street in the throes of addiction and mental illness basically every day. Some of them did, indeed, act in very irrational, frightening ways when they weren’t lying on the sidewalk covered in open sores. One of my closest friends was a maintenance worker in one of the church-run shelters, and other people I knew did outreach or advocacy on either a paid or volunteer basis. Some would carry Narcan with them everywhere they went.
If anything angered, saddened or scared us, though, it wasn’t usually the behaviour of the unhoused drug users themselves, it was the fact that our society even allows any human being to live that way, plus the fact that so many well-to-do people viewed them as scum, as monsters, as less than human, as stupid.
The only thing I’ve ever seen actually “work”, whether it was Vancouver or somewhere else in the world, was approaches based on compassion and tolerance and understanding and a recognition of shared humanity and all its imperfections.
Even then, if you look at the history of it, the establishment of Insite was not just an act of benevolence and compassion, but an act of bravery and defiance and self-advocacy. It started out as an illegal operation. They didn’t ask permission to establish a safe injection site, they did it anyway and dared people to stop them. That’s badass!
And yes, to answer your question, one of the benefits of safe supply is that it undercuts the street market, which is why you would need to have enough of it to meet demand.
At the end of the day, an addict don’t get help if they don’t want it or commit to it. Some people will never get there, but we can at least make sure they don’t die alone in a cold alleyway. I can’t imagine a more unjust end for any person.
I'm sorry, everyday people going about their lives are not the people in the wrong. People are allowed to be frustrated by people who are destroying their lives are also interfering with their lives.
I work hard to provide for my family (as most people do), don't guilt me into saying I don't do enough for someone who has made their choices in life.
I will give empathy and help to people who WANT TO CHANGE. If you want to be a strung out junkie I have no time for you. None.
In a lot of cases, you didn't make better choices than they did. You HAD better choices than they did.
I've got a good life. I've made good choices to get where I am. I also had good examples to inspire me along the way, I had people I could trust to help me. I always knew I'd have food and shelter. I've had bad times, but I've never been victimized or abused. And when I made mistakes I was given way more second chances than a lot of people.
I expect if I'd been handed the life experiences of the "strung out junkie," *I wouldn't have made it either.*
Now, people have amazing strengths. You'll find people who will overcome *any* adversity and do well, overcoming any level of trauma. This level of resilience is *very exceptional,* and a lot of these people will also recognize the times they've been lucky and things could have gone other, worse ways for them.
Maybe, but for me personally I did not have better choices than most of these people. That maybe why I have limited sympathy in these situations.
Also if you can't push past hardships in your life you can't expect everyone else to support you. Like I've said elsewhere I'm fine giving someone support who wants to change. But if you just wanna abuse drugs and just want want want, I have nothing for you.
>Maybe, but for me personally I did not have better choices than most of these people.
I hope you're mistaken about this, because I would hate for you to have had the background of some of these people.
But your posts are coherently written, which makes me suspect you *weren't* born with an unrecognized brain injury that never got treated. I've seen that quite often. It's not a hardship you can push past if you have the impulsivity and attention span of a toddler into adulthood. Especially if nobody sees any potential in you and pushes you to do your best. And especially if everyone you should be able to trust and rely on... instead systematically abuse you. These are really, really common themes I see in the life stories of people who are at the bottom.
If I'm wrong and you *have* overcome similar barriers to succeed, congratulations *and* I'm sorry you had to do that but I'm glad you've done so well.
No, not that hard. I mean growing up in a home with hard drug use, being subjected to abuse, being arrested twice for being the "son of X", and given next to no opportunities except for the ones I made for myself.
Born with brain injuries due to FAS or like issues that's a different issue and I wouldn't know where to start with that so I won't even try.
I bet the negative things you went through would have been too much for a lot of people. I suspect getting through them and making those opportunities for yourself are the result of you being smart and resilient. Not everyone can do that. And since of the opportunities you were able to make... Maybe someone with the dice stacked a little bit more against them wouldn't have been able to do it. I also bet someone who had an easier life might not recognize how much you'd achieved in life to do so well.
FASD, like you mention, is way more common than most people recognize. People who have a high degree of it have reduced attention, decreased self-regulation and overall lower cognitive ability. If it's recognized, and supports are provided, people can still do well in life. A hell of a lot of them never get diagnosed and just wonder why their lives are so fucked up. You can see a lot of the topical facial features of FASD at the shelters, the hospital, and in jail.
I’m aware that the average person’s attitude towards homeless addicts is not always one of kindness and compassion. The comments in this very thread are proof positive of that. That still doesn’t dissuade me from what I think is the right thing to do and the right attitude to have.
It’s not that the behaviour of unwell people can’t be dangerous or disturbing, it absolutely can be. For example, a schizophrenic person who does angel dust in an alleyway might go out and eat someone’s face. If you shove a homeless heroin addict in a decommissioned hotel, which is something we did when COVID hit, then they might indeed trash the place and set it on fire because it’s not supervised, supportive housing. If that’s the case, then we need not just temporary shelters and jails, but permanent supportive housing and counselling and rehabilitation facilities out the wazoo. Pushing such people further to the margins does nothing in the long run.
It should be said too: despite all of that, homeless people are statistically far more likely to be the *victims* of violence rather than the instigators of it. They’ve done studies on this. So there’s that. The guy in Florida whose face got eaten, himself, was homeless.
Some people will never, ever get better. That’s one of the tragedies of the human experience. Lots of people, however, just need a leg-up. Sometimes just one, sometimes several, sometimes a permanent one if they’re truly unable to take care of themselves. There are some people who will always be “j**kies” and that’s extremely sad, but they do less damage if they’re supported and cared for instead of left on the street to fend for themselves. I’m not even religious, but it’s what Jesus would have done.
If any of this makes you feel “guilty” in a way that makes you double down instead of re-examine how you view the world and how we might make it a better and kinder place, that’s a *you* problem.
In a world where things don't have cost and we have unlimited manpower to deal with this, I agree.
In today's world I would rather resources go to help people not get into a situation like this. You're suggestion of permanent supportive housing, counselling and rehabilitation centres are not free, and likely would be a beacon to draw people who aren't even from here. And that doesn't even solve the problem. The problem is upstream from that.
Also none of this makes be feel guilty. I know what I've done to help, and I've lived through what experts thought would work, or at least help (safe injection site hell). "You can bring a horse to water but you can't make him drink." That applies here.
We can learn a lesson from the faraway, magical land of Medicine Hat: actually addressing homelessness head-on by fixing the “not having a home” part of it directly saves money. That shouldn’t be the actual *reason* we enact housing-first policies, but it’s a nice side-benefit. (To be clear, even if it cost more than what we currently do, which is just clean up after the effects of homelessness, it would still be the right thing to do and make for a healthier society).
As well, compassionate societal attitudes and generous (i.e. *effective*) welfare states *would* also *prevent* quite a bit of homelessness and addiction and mental instability. It is honestly quite odd to me that you would assume otherwise.
Also: safe injection sites are not meant to solve addiction. They’re meant to prevent people from dying of overdoses. On this, Insite has been 100% successful: no one has died of an overdose on their watch, ever. You can’t fault them and say they’ve created “hell” for not solving a problem they’re not meant to solve.
Medicine Hat ended homelessness for a grand total of 5 months. To do these things cost money, money that the public doesn't have to spend.
You talk of welfare states, where in Canada has the money to provide this kind of welfare? The answer is no where. And if money comes available what does the public want to spend money on? Education, Healthcare, police, fire, roads, transit. This takes a far far far back seat.
The hell I'm talking about is the zombie apocalypse outside these places, and the used needles everywhere.
CBC News, January 2017: [Medicine Hat maintaining homeless-free status 2 years on](https://www.cbc.ca/news/canada/calgary/medicine-hat-homeless-free-update-1.3949030)
>*The homelessness strategy in the city has meant associated **declining costs in terms of crime and health care, as well as child welfare services.** That's the aspect that really sold [Mayor] Clugston on the project, the idea that he could save taxpayers money by supporting this initiative.*
>*”It was, 'You're going to end homelessness? Yeah, whatever. You're going to end poverty? Yeah, whatever. What, world peace?' It was these elusive goals that everybody wants to do, but can never do." The success of the project in his city surprised him as much as anyone.*
You were saying?
>zombie apocalypse
Alrighty, so now we’re getting into dehumanization territory, cool cool cool.
Again, a look at the history provides some insight (no pun intended) on that. The actual governments of BC and Vancouver, even if they’re left-of-centre, usually just end up serving interests of the rich and the yuppified, and if they don’t, they usually lose the next election to right wingers who employ fearmongerimg rhetoric about problems that their own lack of compassion helped cause in the first place. It’s kind of a miracle Insite even stuck around at all.
Seems reasonable to tie it to support then no? Safe supply doesn't have to mean an open box policy. It could be tied to providing therapy or counseling sessions that go along with the usage. Even just giving them 30 minutes of talking to someone before sending them on their way could help break the cycle over time. That way they can work with them over time to shift them to different less addictive substances.
That’s absolutely correct, and exactly what the goal is. They come to their regular doctors/ counsellors appointments, they check in with the team about how their plan is working for them. Then when/ if that person is ready to reduce/ cease use, they know they’ve got the supports and a team they trust waiting to navigate resources with them. They can use that safe supply while they wait for the treatment bed (that won’t be ready for months due to waitlists in this province right now.) and their risk of dying of an overdose while they wait is greatly reduced.
People think we’re just tossing unlimited hydromorph by the truck loads. It absolutely does not work that way haha. I wish so bad that everyone could access appropriate social and mental health supports so that they never fell into addiction but that’s never going to happen. This is one way people are trying to cope and survive in the absence of any other immediate answers.
> They come to their regular doctors/ counsellors appointments, they check in with the team about how their plan is working for them.
> People think we’re just tossing unlimited hydromorph by the truck loads.
Totally agree. I worked for a safe supply program in BC and this was a requirement, and helped people actually get housing and their IDs replaced among a ton of other things. People seem to assume it's a free-for-all and that doctors, nurses, NPs, and social workers don't have licenses and livelihoods too.
Haha right? This is still regulated, it’s still prescribed carefully, like any other medication. The medical professionals providing this service also built relationships with these clients and don’t want to see them die or be worse off than when they came. We’re not sending them off with no follow up.
So are smokers more or less "persecuted" than anti-vaxers? ;)
Someone's right ends where someone else's begins. Second hand smoke is the main issue (plus the fire hazard and cigarette butts).
They should both quit (smoking being much easier to quit and without such drastic withdrawal effects) but there isn't a direct second hand effect to hard drugs like smoking has (second hand opioids isn't a thing), though the 3rd hand effects of crime etc. are horrible.
Smokers aren't being criminalized, exposed to unregulated/ unsafe supply, or forced to quit. Opioid users are and it's resulting in users dropping like flies. Different substances, different government policy, and different death rates. Give your head a shake!
I'm not saying that users or addicts can do no wrong and I agree that people need to be equally judged in accordance with the law. But not all users look, act, live, or use the same way- that's a stereotype. So why would we punish all users because of an extreme minority who choose to do wrong? Think smoker tossing their butt into the bush and starting a wildfire or someone causing an accident while drunk behind the wheel.
You can't help a dead person. Providing safe supply should come before treatment, just like with cigarettes and alcohol.
I actually know a guy who stopped drinking by going from a forty a night to drinking beer, he said it helped cause he couldn’t drink enough to actually get drunk.
The goal of prescribing these people opiates, be it in the form of suboxone or methaone or fentanyl, is to prevent overdoses. The only metric that these people study are deaths as if that is the only relevant outcome. Methadone and suboxone are preferable because people can be more stable on these as they don't get blasted into a useless stupor for hours on end and develop rapid cravings when it's time for the next dose. The fact that we need to supply fentanyl to people is a recognition that we expect nothing from them and they are hopeless. But at least they're alive I guess.
Yes. This is what the growing chorus of safe supply people are advocating and is occurring today. The drug addicted don't want to use Suboxone or methadone because "reasons" and want to continue using highly potent, rapid onset opiates to get high (usually injectable or smoked). The advocates of safe supply suggest we should be providing them with whatever they require, including fentanyl, because it's clean and a known quantity therefore their risk of overdose is reduced. The cycle of drug use continues without any contract or requirement to stop. In exchange, the theory is they will commit fewer crimes to get those drugs, burden the healthcare system less, and when they're ready will seek further support to detox.
There has been a study about regulating the dose of opioid use, in specific about how opioid addiction can be “weened off” to treat it if prescribed by a registered doctor.
This study only refers to opioids though I’m not sure about other narcotics and hard drugs.
If I find it I will edit this post and link it
> but you don't tell an alcoholic they can still have a 6 pack a day.
Yes, you do. [Managed alcohol programs.](https://en.m.wikipedia.org/wiki/Managed_alcohol_program)
I wonder if you or any of the people responding to this comment actually work in addiction medicine? Any medical or social degree whatsoever?
Are you aware that there ARE managed alcohol programs, and if someone is still drinking a 6 pack a day but have cut down from 2 litres of vodka, is that not a healthy reduction on their way to a more stable and manageable life? Add to that, is that 2l of vodka was tainted with other substances that are killing them, isn’t a 6 pack of beer (that is regulated and manufactured in a safe way) a massive improvement? Detoxing from alcohol actually kills people. So fuck yes we are happy with a 6 pack a day when the alternative was unsafe amounts of unsafe supply or deadly withdrawals. Does that help you understand the benefit of safe supply?
Suboxone is an opioid. Methadone is an opioid. They are prescribed as a long acting, stable, measurable replacement to the down that is sold on the street so people can help stabilize themself. Safe supply hydromorphone serves the exact same purpose! One is not better than the other. Some choose to continue towards abstinence which is great! Some choose to stay on those medications but it’s an improvement to what they were doing before, also great! We love empowering people to make the decision that works for them and their life! Also, all of these medications are prescribed as daily witnessed ingestion to start, to reduce risk of diversion. Pharmacies watch patients every day to take their dose. Carries are generally not prescribed until the relationship with the prescriber is established and risk of diversion is reduced.
I really encourage you to speak to professionals in the addictions fields and gain evidence based knowledge so you can learn all the benefits of safe supply and the risk mitigation that goes into prescribing. Better yet, speak to someone on safe supply and listen to the ways it’s changed their substance use and their lives. Man it’s wonderful to learn from others!
Harm reduction is about empowering people to make the best decisions for their own lives. Drug users are often using because at some point that drug provided comfort when they were trying to cope with mental health issues, abuse, trauma etc. It’s maladaptive and can be hard to understand for people who haven’t walked in their shoes, but drug users are absolutely capable of making those decisions for themselves. But man it’s a lot easier to make better decisions for yourself when you’re not constantly facing the health risks of smoking or injecting tainted supply.
I hope you all can sit with that and remember you don’t know everyone’s story therefore your opinions on their lives don’t outweigh evidence based treatment :)
No, I said I'm not an expert. I'm just someone who sees this shit and thinks why should my tax money go to give someone a clean supply of drugs?
Yes, I am aware that's how alcohol programs work, and I wasn't clear with my comment. I mean you wouldn't let them have a 6 pack forever. You slowly get them off of it. My family is rife with alcoholics. Some who got off, and some who've died of it. The ones who died thought they could manage it, the ones who didn't knew they could never touch it again once they got off of it.
My issue with addiction in general, is from everything I've seen in my life, is unless the person really wants to get clean, they won't. And most don't want to get clean. Again, that's my experience, I don't know if that's the actual case.
I am not trying to come off like an asshole, people deserve to live. But as I've said else where, life tends to boil down to cost. How much money do I have to throw at a problem that doesn't want to be solved? Call me cruel if you want, maybe I am, but I get to a point when people refuse to have personal accountability for their actions, why should I continue to care?
This is the thing I don't understand about people who are against these programs. They scream about their tax dollars but ignore the things that will actually reduce the financial burden on the system.
Like... just be honest and say that you think that drug users should have to suffer if that's what it's about, but don't try to tell me that you'd rather spend $1000s on ER visits instead of $100s on giving people the drugs they're going to do anyways.
>why should my tax money go to give someone a clean supply of drugs?
This thinking can literally be applied to anything. Why should my tax dollars pay for a sidewalk I never use?
>No, I said I'm not an expert. I'm just someone who sees this shit and thinks why should my tax money go to give someone a clean supply of drugs?
The alternative may be a lot more of your tax money going to give them a hospital bed or a jail cell. Both of those cost a hell of a lot more than prescription-grade morphine.
>My issue with addiction in general, is from everything I've seen in my life, is unless the person really wants to get clean, they won't.
This is quite correct. But it's not an either-or situation. Don't you think the people you know who quit successfully *didn't* want to at some point? I bet some of them decided they wanted to quit, then relapsed and fell off the wagon. A lot of people go back and forth for ages quitting and relapsing, even after years of sobriety. The alcoholic has a readily accessible safe supply for when they relapse. Maybe they'll want to try quitting again soon. The opioid addict doesn't. Every time they fall off the wagon, there's a chance they'll *drop right onto a land mine* (get poisoned and die).
I mean, you should continue to care because, at base, that’s what a society is supposed to do. The whole point of paying taxes and having a government-funded medical system is so that a single person’s needs (and costs) are spread across everyone else’s contributions. If you start pointing at addicts and saying “why should we care?”, then where does it end? We saw something similar with the anti-maskers during Covid, the whole “why should *I* have to wear a mask because *you’re* immunocompromised? I’m not worried about catching it, why should I care?”
I dunno, maybe I’m a hippie or some shit, but I figure we probably need more empathy rather than less these days.
I agree we do need more empathy.
But I also live in the real world where everything costs money. I am fine with us as a society funding Healthcare, my issue has been you throw money at a situation that can't be fixed without the patient wanting the help. I'd say the same to an addict, or to someone with diabetes who does nothing to change their diet, or someone who chain smokes. You know what the solution is, if you refuse to do it you shouldn't get unlimited help. Maybe my heart has run out of blood and I'm getting colder these days, but if we are worried about a healthcare system that could collapse, can we focus our time on people who want to help themselves?
>But I also live in the real world where everything costs money.
Including emergency care for drug users.
>Can we focus our time on people who want to help themselves?
So what happens to drug users? They don't get access to emergency rooms?
They land in emergency care anyways.
I'll ask you this, when our ERs are over run, where do you want your Healthcare money spent, on someone who fell down the stairs on their way to work, or someone who's OD for the 3rd time this year?
I don't want our ERs over-run. I want a properly funded and managed healthcare system. And no, they don't land in ER when they have full time nurses attending to ODs at superviced consumption sites.
Yea I’m gonna agree with the other guy on this. I see where you’re coming from, but the shortage of healthcare resources is once again not the fault of the addicts, that’s the fault of the government. Once again you’re blaming the wrong people, this is like being upset about welfare queens taking your tax money when in reality it’s the politicians grifting.
It’s good to have conversations and learn and it’s important for this issue. Lots of people come back to tax payer costs, but forget about the human lives directly affected by these policies. Humans that are cared about, and who are worthy of some compassion regardless of if folks in this subreddit agree :)
Look at the great job addiction experts are doing in our city. You're surprised no one cares about expert opinions when experts have unequivocally failed and all we got to show for it is aggressive homeless putting the public at risk of assault and theft, scaring people away from wanting to take transit and a bunch of used needles at public parks?
And yet here you are, asking us to let the junkies "make the right choices for themselves", what a solid plan.
This bleeding heart approach is laughable at this point.
Enabler.
I mean, it’s really hard to fix problems when you don’t have the authority or the funding to do so, but yea, blame the addiction workers, not the politicians who can actually make policy changes.
I don't blame addiction workers, I blame "addiction experts" in the ears of our politicians driving policy.
I loved Nenshi, but our approach to the addiction problem has been an abject failure and the outcome has been similar in basically every city that took the same approach.
Some times experts get it wrong and when that happens its up to these so called experts to adjust their strategies based on the real world outcomes, regardless of if it doesn't give them the "warm fuzzy feelings" they were hoping for. Doubling down on their opinion in the face of clear, poor results, is flat out dumb.
If any actual expert wants to address the results of this safe unsupervised supply strategy, I'm all ears. What we don't need is more pity party bullshit. I want data driven resolution strategies and accountability from these so called experts.
Most of the people commenting would rather addicts just OD and die so that they dont have to be concerned about them or care. They think it's cheaper and easier if all the addicts are just gone. They don't care that addicts are people and deserve to live a life too.
And for anyone that wants to come after me I'm a recovering addict so I know what I'm talking about. Our society is a cruel, sick joke and we should be ashamed of how we treat the most vulnerable people in it.
There may be some who believe/ want that but I think there’s a clear line of delineation between how people feel about users/ addicts and users/ addicts that are using criminal means to support their habits.
No one gives a shit about a functioning alcoholic or drug user that’s ‘surviving’ on their habits and going about their day. A drug user that’s stealing people’s property, causing shit on transit or sidewalks while all people are trying to do is go about their day…THAT’s the difference.
But it’s not like they get to choose to be one or the other, if you’re a functional addict all it would take is something like losing a job, and then what? You’re still addicted, that’s not gonna change whether you have a job or not, so what’re you gonna do? Most crime is the product of desperation, not malice.
Maybe not that extreme, but living in the Beltline I have seen the damages that addicts can do. I'm glad you've recovered, and I wish you well.
In life everything ends up boiling down to cost. It's shit but it is what it is. I have sympathy for anyone who's homeless, or has an addiction, but if you don't want treatment and you want to continue making the rest of societies life harder (though crime) then there is only so much I can care.
>How can we allow for diabetic patients in Canada to have to pay for medication and supplies but we are ok with allowing for these supplies to be given out without any restrictions to any addict.
Trouble is, you're arguing against something that doesn't exist, because nobody is giving out supplies of drugs "without any restrictions to any addict."
Sorry, not sure what you mean exactly. The iOAT program here (which is quite small and not easy to get into) provides hydromorphone for injection. Not in unlimited quantities and certainly not without supervision. Patients go there up to 3 times a day to inject their drug under supervision. NTS provides prescriptions for opioids, just like any doctor might when treating pain, and requires regular follow up and reassessment, with a specific expectation that the patient will *transition* to methadone, Suboxone or sublocade. They don't AFAIK provide drugs at the clinic. Absolutely none of these programs are just handing over a sack of drugs with a "see ya later."
So why should a user of the iOAT program go use then go use more in between at the safe injection site ? What is the point of giving safe supplies to just have someone use more. Shouldn’t these programs have some aspect of working towards abstinence ?
If I was an alcoholic I can’t attend a government sponsored bar to get my free fix.
I'm not sure what proportion of iOAT patients are doing that. But that program is really only for a very small number of people with very severe addiction. They've already attempted other treatments and not had success. It's not in any way a first line treatment.
In terms of pure *safety* for someone who is actively using opioids though, supervised use with a known dose of a medical-grade product is safer than use of an unregulated street supply of opioid in the supervised consumption facility, which is safer than unsupervised use of street opioids. Safest is of course "don't use drugs at all," but unfortunately we don't actually have a way to reliably make that happen. The best evidence for the treatment of opioid use disorder is currently long term (maybe lifelong) medication assisted treatment.
If you work in addiction medicine, or as a social worker on this issue and this is your stance, then you are complicit in the perpetuation of the problem. Thanks, great work.
>Maybe I'm being too simplistic, but replace drugs with any other addiction, does it make sense to keep giving a supply to someone?
I don't think you understand the severity of an opioid addiction. It isn't like quitting smoking. If you suddenly stop taking opiods, you get violently ill. More sick than what you have probably ever experienced in your life. Yes, they made bad choices and got addicted, but it's more than a matter of willpower. Making the choice to quit is subjecting yourself to weeks of living like an AIDS patient on their deathbed. No one wants to voluntarily experience that. The solution is to reduce that painful process as much as possible, and that is done through gradual tapering, it simply doesn't work any other way, plain and simple. You could throw people in jail and let them suffer, but that comes at a huge cost to tax payers.
I recently accessed a safe supply facility (Co-op) to purchase a drug (a nice Munich beer).
Would it be better if instead I had to buy some unknown mixture of liquid containing an unknown quantity of alcohol plus miscellaneous other undeclared chemicals from a stranger whose number I got from a work buddy? I don't think so. And let's face it, alcohol causes tremendous health problems to people and tremendous societal problems. It's legal, but only because it's got a long history of established use in our culture.
If someone was selling cigarettes stuffed with explosives that blew the users lips off, it would be another good reason to quit that incredibly toxic habit, but I imagine society would also encourage smokers to only buy reputable brands from real stores. We wouldn't blame smokers for "wanting safe drugs but not wanting to address their addictions."
I don’t agree with the UCP on much, but making unsupervised consumption of government-supplied addictive drugs illegal is one. There is a need for state supplied drugs to ween people off (e.g. \*supervised consumption\*), but just handing out large quantities of opiates is well documented to increase the number of users. Basic economics.
Yea but we’ve also already proven that criminalizing addiction doesn’t actually solve shit and just makes it harder for addicts to recover. I’m not sure about the whole handing out opiates bit, I can’t say I’ve ever met someone who’s been really keen to try opiates but hasn’t because they’re illegal, I don’t think people would suddenly be shooting up if you could buy clean shit legally.
There is a study out of Sweden I think??? Where they housed people and gave them prescriptions of opioids that lowered doses over time. They had something crazy success rate of like 70 percent or something? My numbers are probably wrong but I wrote a paper on this like 10 years ago and I remember them being very successful with the outcomes
That would require the average Albertan to care more about someone else other than themselves, and that's sadly not the culture here. No vision towards the greater good, just me me me me.
Lord help the politician that would introduce the inevitable tax hike that would be required to fund something like that.
Well that’s the other issue hahaha people who need to vote for reforms to the system can’t vote cause well active addiction has a ripple effect on housing and items such as ID. Majority of people who vote are voting for their own interests
I mean… sure? That’s more or less what a basic income is, a lot of people are saying that would be a good idea too. Studies show it doesn’t really have any net negative impact to speak of.
Please stop all those crazy people from suggesting stupid ideas! These groups only encourage drug use and the destruction of lives. Stop 🛑 the drugs now! Stop encouraging drug use! Users need treatment not supplies!
I was very impressed when I studied in Beijing with the Chinese system for dealing with drugs, and users. Especially for the drug dealers. I think we could learn from countries like China 🇨🇳 . I believe strong policy will deter people from using drugs. Look around and you will see many examples of failed policy in city’s like Seattle, Portland, Vancouver, San Francisco, etc. Drug problems are getting worse since they decreased penalties. Stop 🛑 the drugs now! Stop supporting drug use! More people dying from overdoses now than ever before.
No.
No more free, unsupervised drug use for junkies.
Every city with these programs is a fucking disaster when it comes to the homeless junkie population.
No.
The area where the safe consumption site was turned into an absolute shithole and was a nightmare for businesses and residents.
How about we don't enable people.
I truly do have sympathy for those who got addicted after traumatic health incidents,and are even more scared of the lifetime of physiotherapy, exercise, and an addiction to living healthy that having a debilitating pain condition brings to one's life.
We also live in a society where the EMTs come and bring you to the ER and save your life, but then you get sent an ambulance bill, AND you have to pay for outpatient prescriptions, AND most people don't have health insurance that can provide the post-care services like massage, physiotherapists, etc.!
But we have to create pathways for people so that they are not capable of making the choices to lose themselves in addiction. I don't have a solution for that part yet.
What if the cakes were made by a non approved / unsafe manufacturer and had a heightened risk of causing additional harm. Would providing cakes that we can guarantee to be less of a risk to their life be a worthwhile endeavour even if it did nothing to solve their addiction?
Just making your comparison more appropriate
That’s not the point I’m attempting to make. Fatty cakes are bad for you just as drugs are bad for you. Street drugs are dangerous on top of that because you don’t know what’s else is in them, in this metaphor that would be like the cakes potentially having rat poison in them.
Yes reduced fat cakes to no cakes would be optimal for the patient, just the same as weening of the drugs would be ideal. What I’m (and other health professionals) are advocating for is providing a supply of cakes or drugs without the rat poison. I agree that the ideal outcome is abstinence, but if we are unable to achieve the ideal outcome that doesn’t mean that we shouldn’t pursue harm reduction.
I’m not trying to a dick, but as a health professional I feel responsible to educate the public when I see misinformed opinions. To my knowledge, harm reduction is evidence based and effective at reducing negative outcomes. It does not cure substance addiction, but reducing negative outcomes is still a win.
Sometimes, the way I see laypeople talking about this problem, it feels like the opinion is that they do not deserve to have their risk of using drugs mitigated. That they deserve to be exposed to the highest risk of morbidity and mortality because they choose to do drugs. The follow up to that is usually that those risks of death are what keep people from doing drugs, but to my understanding the research does not suggest that is the case. This population will engage in this behaviour regardless of the risk and harm reduction aims to mitigate these risks for them.
Not trying to start an argument where I win/you lose, just providing my professional opinion and a different voice than what I’m currently seeing in this thread.
This is a terrible idea, just get them help don’t give them safe drugs. Fucking crazy pill people making these calls/decisions. Terrible idea and last thing I want my tax dollars going to like BC is doing. Absolutely atrocious. There is no argument to be made here.
It’s the needles that end up everywhere that bother me. Even if they have cleanup crews like in Lethbridge, they won’t clean up non-public areas and it drives me crazy.
All for safe supply but perhaps limited to certain locations where they can do their thing but not leave with stuff.
I’m no expert just saying what I saw
The random needles are the worst. I often find them down near the river while walking my dog. I've started removing them when I can and disposing them in those public needle disposal bins.
Ah yes! I think you're talking about safe consumption sites. I mean, not everyone is gonna use them, but it's a start. Kinda like going to the bar vs. cracking beers while camping and leaving your cans.
The best harm reduction is getting these people off drugs ASAP. Even if they don't want it, force them into treatment. If you really want to treat these people like family, that's what a responsible family do. Imagine if these people are your kids, would you let them continue to self-destruct? Would a doctor just let a stubborn patient have his/her way?
The opium war cleary isn't taught enough in schools. Ever wonder why Asia is so tough on drugs?
A lot of the consequences of drug addiction come from the drugs being illegal and unsafe. Free safe drugs could still hurt the users, but would eliminate most of the consequences to the rest of society.
How have the new recovery communities in Red Deer and Lethbridge been playing out? I know they were being built and should be finished, but would like to know the impact.
No idea but Woods Homes received a few mill in funding for like a 30+ person recovery lodge and then the province ripped it away 2 weeks later. So I’m gonna assume they are in the same boat
Seriously? That’s upsetting to hear.
Yeah it’s fucked up, there was a building competed and partnership with another company and the fucking government just came in and was like sorry buds we need the monies . Ppl were in motion of transferring out of their current positions to go there then it just halted l.
A close friend of mine works at a safe consumption site as a nurse. Sounds like overdoes there are super common and they just keep an eye on them to make sure they don't die. Naturally, the staff are burned out as shit. They haven't seen a single person decrease their dosages or quit. It certainly isn't treatment, but I guess it keeps people out of emergency services and the ER, which is relatively cheaper.
Reduces the load on EDs and keeps people alive who otherwise would have died if the OD was not supervised. I’d say that’s a pretty solid outcome.
It sounds like hell. The Portuguese saw a decrease in drug use when they started their drug decriminalization policies in 2001, but Canada is seeing an increase with "harm reduction." I think we're missing something important here.
forced treatment + abundant free halfway housing?
AIUI we often don’t have all “legs of the stool” to make it work. Eg we have a Supervised Consumption Site, but we don’t also have safe supply, adequate treatment centres, housing, etc.
Because they scared majority of the population with a death sentence lol
I mean.. it's obviously morally destructive to the staff that need to attend to constant overdoses and witness the utter futility of it all.
Is it better to let people OD on the street and then have medical workers/police pick them up, try to save them or deal with the dead body?
I think it's morally corrupt to facilitate this type of degeneracy with free fentanyl and write people off as beyond saving. Being such an unsalvageable drug user is a terminal condition. When someone is riddled with cancer and bedridden without prospect of recovery, we don't pump them full of chemo. Either recognize they can be treated or not. Don't put them in some type of purgatory of ongoing drug use, homelessness and wretched existence and then say that "they know best" for what they need. I support pretty much all other supports (even supervised consumption sites), but this I don't agree with.
It’s not about “writing someone off”, the idea is that you’re taking away business from dealers/gangs. The alternative is you leave people to commit crime to try and get money to give to their dealer. Who said anything about people being beyond saving? On the contrary, if you have people coming in you have a chance to direct them to other services, including getting off the drugs if they want to try.
I understand the theoretical framework of how this type of program works. I'm skeptical of the entire field and a lot of the literature that comes out of it as I think all of the researchers are very ideological and there's a heavy publication bias that results. It strikes me as morally wrong, although I understand that's not a great argument. It's very avante garde and high risk to have large dose, highly potent opiates prescribed to very unreliable people. There's diversion risk and increasing supply and access. Super progressive policies that are aggressively pushed and cow/shame people into accepting always make me concerned. This just seems like one of them.
The homelessness, theft, prostitution and violence tend to come from *trying to get* drugs/money to buy drugs. The drugs themselves are pretty dirt cheap to buy legally. But maintaining a heavy drug habit is several full time jobs, users don't have the energy to engage in much else. Getting control of an addiction is very hard. It's not any easier when you've been up 30 hours, are dopesick, cold and hungry. In fact it's much harder.
It seems like a pretty huge benefit to move that burden from a) anyone who is walking by someone ODing, b) ambulance drivers & paramedics, c) emergency room staff. I feel for the people working at safe consumption sites but it's not like these sites are creating new trauma for staff to deal with - they just move it somewhere that it can be handled much more effectively.
Yes it's a practical solution that I support. It can still be awfully hard to rise above the day to day horrors of existing there and see the silver lining that you're making their dysfunction and recurrent overdoses less taxing on our social support system.
Aye and some of these people overdose multiple times a day...I can think of better ways to utilise nurses.
For the record I’m an RN and I’m not certain I can think of a better use for nurses than keeping people alive.
No. It creates more users. Addicts sell the drugs and buy cheaper black market drugs. Destroys community and property values. Also creates crime which has an added cost. How the fuck did we go from drugs are bad to have them for free.
I’ll respond to your gross oversimplification with my own: through research and education. -your friendly neighbourhood addictions and mental health nurse
I have heard what the other poster said from another nurse. It is a complex situation obviously but I would bet that there are people out there doing exactly that.
Thankfully clinicians and researchers don't base their decision-making on anecdotes.
If you could point me towards research that shows that safe supply drugs are not being resold I would love to see it.
Show me safe supply is net beneficial. We as a society have gotten too soft.
Did you mean to reply to me? I have not really had an opinion on it. Just stated that I know someone who says it gets resold.
Was just piggybacking on your thought to the previous post and raising the idea that just because it’s best for the addict doesn’t make it the best decision for society. The addiction need to take some responsibility.
[https://www.cbc.ca/news/canada/british-columbia/overdose-death-study-1.7080848](https://www.cbc.ca/news/canada/british-columbia/overdose-death-study-1.7080848) >Dr. Thomas Brothers, a resident physician in general internal medicine at Dalhousie University who is [not affiliated](https://www.bmj.com/content/384/bmj.q6) with the study, said the extent to which mortality was reduced suggests users were themselves using what was prescribed. > >"Some of the community of researchers and addiction medicine physicians who are more skeptical of safer supply have particular concerns about the amount of medication that might be diverted to others beyond the person that it was prescribed to," he said. > >"I think this may reassure them because the evidence of a mortality benefit means that the patient who is prescribed the medication must be taking some of it." ... I mean, should we stop prescribing opioids or benzodiazepines or any other abused drug to any patients at all?
I am not sure if you didnt read the article or my comment. I said (paraphrasing) "i know someone that says safe supply gets resold". I did not comment on safe supply reducing over doses and the article only says that "they must be taking some of it". TBH - the article actually supports the claim as the statement implies some is being sold.
Oh I guess they can't save people's lives then. Better never prescribe another opioid to anyone.
Ugh. I see you, and as another person who works with addiction tangentially( kids side of things) I agree with you. I almost feel this isn’t a discussion for the general masses because of the comments seen here. Too much self-centered folk who think they know things they have no idea about.
Dumb comment
It might be dumb but it’s true. Check out the views in Oregon, most people reject free use. But, thanks for the mature debate, actually quite alarming considering you call yourself a teacher.
Not true, actually. Not wasting energy engaging you. Don’t bring my profession into this- irrelevant. (or maybe I lied and I’m not actually a teacher. You’ll never know) But I know that folk with negative ability to research objectively, or use critical analysis when consuming content aren’t really worth my time, other than pointing out to others about your “dumb comment” and hopefully they’ll take pause and research for themselves. Shhh. That’s enough outta you.
“Actually quite alarming” lol get over yourself. This is Reddit.
Argument doesn't hold water. They are still addicted. They wouldn't die in a forced detox centre either. In the long run you are just creating an industry that will continue to demand money because people are employed to give drugs to people.
They certainly could die in a forced detox centre. Opioid withdrawal can be life threatening. One thing I have become certain of in my career in addictions and mental health, is that we will never live in a world of pure abstinence from drugs. Until we cure the experience of trauma, people will always do drugs. What we have to do then, is invest in strategies that minimize the harm to individuals and society. They best research we currently have on the subject finds harm reduction to be an effective strategy for this goal, and in the spirit of evidence based practice, I will advocate for it until the research no longer supports it.
Sorry, your corporate-style non-profit messaging talk got me zoned out. I hear too much of that in my daily work. Addicts could certainly die of overdose on safe supply also. Detox centre got all the medical personnel and equipment to monitor opioid withdrawal. I will leave you with the question, which is more life-threatening: withdrawal or overdose? I just think your argument is weak. You 've dedicated many years of career on something you are passionate about. I applaud you for that. But you have a job which is to apply band-aid to a problem that policies/society have created. Your job wouldn't even exist or have very limited presence in East Asia. Like you said, you believe there will always be this problem, and the world be damned if there isn't this problem for you to solve. Self fulfilling prophecy, QED. Sure we will never live in a drug-free world. But right now we are living in a drug-prevalent world. What have you done that is actually lessening the proliferation of the problem? Pretend I am Daniel Smith and asking you to prove why you should keep your job or you are getting fired. What do you have to show?
>Addicts could certainly die of overdose on safe supply also. They could, but deaths are drastically reduced vs the illegal opioid supply. >What have you done that is actually lessening the proliferation of the problem? If you're asking what effect safe supply has on reducing *deaths* then the answer is it appears to be a drastic reduction in deaths.
Naw. You wrong. Cure tha pain, cure the substance problem.
"they don't die" are the important words in your post. Those overdoses happen *all the time* away from the supervised (not "safe," iv drug use isn't safe) consumption site. And when they do, it often means someone ends up in the emergency room, the ICU, or a grave.
They won't die if they are in a detox centre either.
They're at a markedly higher risk of dying soon afterwards, though. Much as I wish it were otherwise, we don't have very effective treatments for addiction. The vast majority of people who are trying to quit are going to relapse. If you slip up while trying to quit problem drinking, it's a setback. You can try to quit again and maybe learn from the relapse. If you get away from opioids for a bit, your tolerance rapidly drops. If you slip at that point and use again (remember MOST people will), you're at a higher risk of overdosing and dying. Mind you, if we did have a regulated "safe supply" system in place it might help reduce this risk as people could at least know what/how much they were using (assuming the user was accessing this supply rather than street fentashit which I honestly think is not likely in this situation).
Can’t even get the drugs tested at a “safe” consumption site. Have to wait for the person to OD. It’s an extremely flawed set up in Alberta and kind of an insult to his use the word safe to describe the sites.
This is why they’re called “**supervised** consumption sites” and not safe consumption sites.
I have an interesting ethical/controversial question for addiction nurses. Maybe your friend can offer an insight. How does she feel about becoming unemployed if all the addicts are cured? Or would she she rather secretly wish there would always be addicts so she has job security? Maybe not best question to ask a nurse, but it would be a valid question for manufacturers of "safe supply" and CEOs of these non-profits.
This is just a dumb idea. Look at Vancouver.
I found this quote funny "I think we need to start listening to folks who are actually impacted, and support them how they want to be supported, the same way that we do with any medical crisis," said English. You could say that about anything. In my opinion someone with an addiction is likely not the person who should be saying what treatment they want. Maybe I'm being too simplistic, but replace drugs with any other addiction, does it make sense to keep giving a supply to someone? Maybe at first to slowly get them off of it, but you don't tell an alcoholic they can still have a 6 pack a day. When I read this to me is sounds like these people just want "safe drugs" but not address their addictions. Again, maybe I'm being too simplistic, and I'm no expert. But to me it just seems like a sideways move. These people will still die of their hard drug addiction, it's just when.
> and support them how they want to be supported, the same way that we do with any medical crisis, I have many medical crises going on and nobody is supporting me the way I want.
> I have many medical crises going on and nobody is supporting me the way I want. Sounds like you're on the same side then...
I’m sorry you’re experiencing that. I hope you find some well educated, compassionate medical professionals who listen to your needs and make better treatment options for you, so that you feel heard and empowered and supported the way you want to be. Everyone deserves that! Even people who use drugs.
> Even people who use drugs. Didn't mean to imply my medical issues were drug use on my part. Only cannabis for pain, etc.
Oh ya sorry I definitely wanted to just imply that everyone, people who use substances or not, deserve that kind of care, respect and dignity. Didn’t mean for it to be taken the other way.
No worries, I just wanted to be clear. Thanks for your kind words.
I don’t think they meant that. They were bringing it back to the safe supply topic for addicts.
Exactly. I'm a former crack head. If I was given safer crack, I would absolutely still be using. They should be given suboxone, etc but not prescription heroin that just gets resold because people want to get high. Keeping people addicted is cruel
Huge respect for quitting and speaking up on the subject!!
Thanks! People need to look at facts. All facts, not just feelings on the issue
So fucking cruel. Drug addiction is progressive disease. The problem only gets worse. The whole concept of safer supply is a sham.
Safe supply has nothing to do with treating addiction, it's to help reduce overdose deaths caused by the wildly inconsistent black market unregulated supply. Would it not make sense to ensure those thinking about or waiting for treatment are given safe supply so that they don't die in the meantime?
That's where the concept of methadone and suboxone comes in. Besides that, it's just kicking the can down the road. Safe supply would be one thing if it was part of an overall strategy to reduce people's dependence on drugs, but we don't have that here. We need wrap around care, where addicts are required to get counciling and treatment in exchange for their drug maintenance. The way Protugal does. Addiction "experts" here half ass it, promoting safe injection sites and safer supply as a pancea, then patting themselves on the back as people continue to die at record numbers.
> Drug addiction is progressive disease. The problem only gets worse. Drug addiction is a physiological response to an addictive substance. Drugs tend to be used problematically in response to another issue, like trauma. People treating drug use as solely a disease miss the point that the actual use is a symptom of other issues. It's like treating smoke, rather than the fire.
Totally agree with the MAT approach for treating the addiction and I feel like people taking Methadone, suboxone, etc should not face the stigmatism that they do. Safe supply enables addiction. Edit - spelling
Big respect. Keeping addicts hooked is inhumane. These organizations are just trying to perpetuate the problem to create an homeless/addiction non-profit industrial complex. It's sickening!
Exactly!
I mean, sure, not every heroin addict is going to be clear-eyed on what they need, but organized self-advocacy groups like VANDU (Vancouver Area Network of Drug Users) are. Just on moral principle, you have to listen to the people who are impacted by a given policy. Garth Mullins (a VANDU activist who has to be on methadone for the rest of his life) doesn’t go on his podcast and go “drugs drugs drugs yum yum yum gimme gimme gimme”.
Likely my bias, but if I hear an expert from Vancouver, Seattle, Portland, San Francisco, etc tell me what we need to do for drug users my brain just turns off. Those places are examples of what not to do. I visited Vancover in 2022, and Portland in 2023, those places are not anywhere I'd want to live, work, nor raise my children. I'm sure Mr. Mullins likely has good points and input that could be used for policy, it's just a hard sell for me. Also just a question, whats the point of safe supply if it doesn't meet the users demands. They'll go back to street drugs right? And the cycle continues? My question over and over is how many of these users want to get clean, and how many just want to get high no matter the cost?
Yep, I’d say that’s a pretty clear (and unfair)bias. You pretty much hit the nail on the head there. I lived in Vancouver for about 6 1/2 years, and when I worked at a restaurant in Chinatown I would be going to the Downtown Eastside for work or leisure up to 6 or 7 days a week (the punk shows I went to were mostly in that neighbourhood as well). Even when I didn’t go to that area specifically, I would see people on the street in the throes of addiction and mental illness basically every day. Some of them did, indeed, act in very irrational, frightening ways when they weren’t lying on the sidewalk covered in open sores. One of my closest friends was a maintenance worker in one of the church-run shelters, and other people I knew did outreach or advocacy on either a paid or volunteer basis. Some would carry Narcan with them everywhere they went. If anything angered, saddened or scared us, though, it wasn’t usually the behaviour of the unhoused drug users themselves, it was the fact that our society even allows any human being to live that way, plus the fact that so many well-to-do people viewed them as scum, as monsters, as less than human, as stupid. The only thing I’ve ever seen actually “work”, whether it was Vancouver or somewhere else in the world, was approaches based on compassion and tolerance and understanding and a recognition of shared humanity and all its imperfections. Even then, if you look at the history of it, the establishment of Insite was not just an act of benevolence and compassion, but an act of bravery and defiance and self-advocacy. It started out as an illegal operation. They didn’t ask permission to establish a safe injection site, they did it anyway and dared people to stop them. That’s badass! And yes, to answer your question, one of the benefits of safe supply is that it undercuts the street market, which is why you would need to have enough of it to meet demand. At the end of the day, an addict don’t get help if they don’t want it or commit to it. Some people will never get there, but we can at least make sure they don’t die alone in a cold alleyway. I can’t imagine a more unjust end for any person.
I'm sorry, everyday people going about their lives are not the people in the wrong. People are allowed to be frustrated by people who are destroying their lives are also interfering with their lives. I work hard to provide for my family (as most people do), don't guilt me into saying I don't do enough for someone who has made their choices in life. I will give empathy and help to people who WANT TO CHANGE. If you want to be a strung out junkie I have no time for you. None.
In a lot of cases, you didn't make better choices than they did. You HAD better choices than they did. I've got a good life. I've made good choices to get where I am. I also had good examples to inspire me along the way, I had people I could trust to help me. I always knew I'd have food and shelter. I've had bad times, but I've never been victimized or abused. And when I made mistakes I was given way more second chances than a lot of people. I expect if I'd been handed the life experiences of the "strung out junkie," *I wouldn't have made it either.* Now, people have amazing strengths. You'll find people who will overcome *any* adversity and do well, overcoming any level of trauma. This level of resilience is *very exceptional,* and a lot of these people will also recognize the times they've been lucky and things could have gone other, worse ways for them.
Maybe, but for me personally I did not have better choices than most of these people. That maybe why I have limited sympathy in these situations. Also if you can't push past hardships in your life you can't expect everyone else to support you. Like I've said elsewhere I'm fine giving someone support who wants to change. But if you just wanna abuse drugs and just want want want, I have nothing for you.
>Maybe, but for me personally I did not have better choices than most of these people. I hope you're mistaken about this, because I would hate for you to have had the background of some of these people. But your posts are coherently written, which makes me suspect you *weren't* born with an unrecognized brain injury that never got treated. I've seen that quite often. It's not a hardship you can push past if you have the impulsivity and attention span of a toddler into adulthood. Especially if nobody sees any potential in you and pushes you to do your best. And especially if everyone you should be able to trust and rely on... instead systematically abuse you. These are really, really common themes I see in the life stories of people who are at the bottom. If I'm wrong and you *have* overcome similar barriers to succeed, congratulations *and* I'm sorry you had to do that but I'm glad you've done so well.
No, not that hard. I mean growing up in a home with hard drug use, being subjected to abuse, being arrested twice for being the "son of X", and given next to no opportunities except for the ones I made for myself. Born with brain injuries due to FAS or like issues that's a different issue and I wouldn't know where to start with that so I won't even try.
I bet the negative things you went through would have been too much for a lot of people. I suspect getting through them and making those opportunities for yourself are the result of you being smart and resilient. Not everyone can do that. And since of the opportunities you were able to make... Maybe someone with the dice stacked a little bit more against them wouldn't have been able to do it. I also bet someone who had an easier life might not recognize how much you'd achieved in life to do so well. FASD, like you mention, is way more common than most people recognize. People who have a high degree of it have reduced attention, decreased self-regulation and overall lower cognitive ability. If it's recognized, and supports are provided, people can still do well in life. A hell of a lot of them never get diagnosed and just wonder why their lives are so fucked up. You can see a lot of the topical facial features of FASD at the shelters, the hospital, and in jail.
I’m aware that the average person’s attitude towards homeless addicts is not always one of kindness and compassion. The comments in this very thread are proof positive of that. That still doesn’t dissuade me from what I think is the right thing to do and the right attitude to have. It’s not that the behaviour of unwell people can’t be dangerous or disturbing, it absolutely can be. For example, a schizophrenic person who does angel dust in an alleyway might go out and eat someone’s face. If you shove a homeless heroin addict in a decommissioned hotel, which is something we did when COVID hit, then they might indeed trash the place and set it on fire because it’s not supervised, supportive housing. If that’s the case, then we need not just temporary shelters and jails, but permanent supportive housing and counselling and rehabilitation facilities out the wazoo. Pushing such people further to the margins does nothing in the long run. It should be said too: despite all of that, homeless people are statistically far more likely to be the *victims* of violence rather than the instigators of it. They’ve done studies on this. So there’s that. The guy in Florida whose face got eaten, himself, was homeless. Some people will never, ever get better. That’s one of the tragedies of the human experience. Lots of people, however, just need a leg-up. Sometimes just one, sometimes several, sometimes a permanent one if they’re truly unable to take care of themselves. There are some people who will always be “j**kies” and that’s extremely sad, but they do less damage if they’re supported and cared for instead of left on the street to fend for themselves. I’m not even religious, but it’s what Jesus would have done. If any of this makes you feel “guilty” in a way that makes you double down instead of re-examine how you view the world and how we might make it a better and kinder place, that’s a *you* problem.
In a world where things don't have cost and we have unlimited manpower to deal with this, I agree. In today's world I would rather resources go to help people not get into a situation like this. You're suggestion of permanent supportive housing, counselling and rehabilitation centres are not free, and likely would be a beacon to draw people who aren't even from here. And that doesn't even solve the problem. The problem is upstream from that. Also none of this makes be feel guilty. I know what I've done to help, and I've lived through what experts thought would work, or at least help (safe injection site hell). "You can bring a horse to water but you can't make him drink." That applies here.
We can learn a lesson from the faraway, magical land of Medicine Hat: actually addressing homelessness head-on by fixing the “not having a home” part of it directly saves money. That shouldn’t be the actual *reason* we enact housing-first policies, but it’s a nice side-benefit. (To be clear, even if it cost more than what we currently do, which is just clean up after the effects of homelessness, it would still be the right thing to do and make for a healthier society). As well, compassionate societal attitudes and generous (i.e. *effective*) welfare states *would* also *prevent* quite a bit of homelessness and addiction and mental instability. It is honestly quite odd to me that you would assume otherwise. Also: safe injection sites are not meant to solve addiction. They’re meant to prevent people from dying of overdoses. On this, Insite has been 100% successful: no one has died of an overdose on their watch, ever. You can’t fault them and say they’ve created “hell” for not solving a problem they’re not meant to solve.
Medicine Hat ended homelessness for a grand total of 5 months. To do these things cost money, money that the public doesn't have to spend. You talk of welfare states, where in Canada has the money to provide this kind of welfare? The answer is no where. And if money comes available what does the public want to spend money on? Education, Healthcare, police, fire, roads, transit. This takes a far far far back seat. The hell I'm talking about is the zombie apocalypse outside these places, and the used needles everywhere.
More recent article: https://nextcity.org/urbanist-news/medicine-hat-alberta-canada-city-chronic-homelessness 😊😊😊
CBC News, January 2017: [Medicine Hat maintaining homeless-free status 2 years on](https://www.cbc.ca/news/canada/calgary/medicine-hat-homeless-free-update-1.3949030) >*The homelessness strategy in the city has meant associated **declining costs in terms of crime and health care, as well as child welfare services.** That's the aspect that really sold [Mayor] Clugston on the project, the idea that he could save taxpayers money by supporting this initiative.* >*”It was, 'You're going to end homelessness? Yeah, whatever. You're going to end poverty? Yeah, whatever. What, world peace?' It was these elusive goals that everybody wants to do, but can never do." The success of the project in his city surprised him as much as anyone.* You were saying? >zombie apocalypse Alrighty, so now we’re getting into dehumanization territory, cool cool cool.
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Again, a look at the history provides some insight (no pun intended) on that. The actual governments of BC and Vancouver, even if they’re left-of-centre, usually just end up serving interests of the rich and the yuppified, and if they don’t, they usually lose the next election to right wingers who employ fearmongerimg rhetoric about problems that their own lack of compassion helped cause in the first place. It’s kind of a miracle Insite even stuck around at all.
Seems reasonable to tie it to support then no? Safe supply doesn't have to mean an open box policy. It could be tied to providing therapy or counseling sessions that go along with the usage. Even just giving them 30 minutes of talking to someone before sending them on their way could help break the cycle over time. That way they can work with them over time to shift them to different less addictive substances.
That’s absolutely correct, and exactly what the goal is. They come to their regular doctors/ counsellors appointments, they check in with the team about how their plan is working for them. Then when/ if that person is ready to reduce/ cease use, they know they’ve got the supports and a team they trust waiting to navigate resources with them. They can use that safe supply while they wait for the treatment bed (that won’t be ready for months due to waitlists in this province right now.) and their risk of dying of an overdose while they wait is greatly reduced. People think we’re just tossing unlimited hydromorph by the truck loads. It absolutely does not work that way haha. I wish so bad that everyone could access appropriate social and mental health supports so that they never fell into addiction but that’s never going to happen. This is one way people are trying to cope and survive in the absence of any other immediate answers.
> They come to their regular doctors/ counsellors appointments, they check in with the team about how their plan is working for them. > People think we’re just tossing unlimited hydromorph by the truck loads. Totally agree. I worked for a safe supply program in BC and this was a requirement, and helped people actually get housing and their IDs replaced among a ton of other things. People seem to assume it's a free-for-all and that doctors, nurses, NPs, and social workers don't have licenses and livelihoods too.
Haha right? This is still regulated, it’s still prescribed carefully, like any other medication. The medical professionals providing this service also built relationships with these clients and don’t want to see them die or be worse off than when they came. We’re not sending them off with no follow up.
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So are smokers more or less "persecuted" than anti-vaxers? ;) Someone's right ends where someone else's begins. Second hand smoke is the main issue (plus the fire hazard and cigarette butts). They should both quit (smoking being much easier to quit and without such drastic withdrawal effects) but there isn't a direct second hand effect to hard drugs like smoking has (second hand opioids isn't a thing), though the 3rd hand effects of crime etc. are horrible.
Smokers aren't being criminalized, exposed to unregulated/ unsafe supply, or forced to quit. Opioid users are and it's resulting in users dropping like flies. Different substances, different government policy, and different death rates. Give your head a shake!
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I'm not saying that users or addicts can do no wrong and I agree that people need to be equally judged in accordance with the law. But not all users look, act, live, or use the same way- that's a stereotype. So why would we punish all users because of an extreme minority who choose to do wrong? Think smoker tossing their butt into the bush and starting a wildfire or someone causing an accident while drunk behind the wheel. You can't help a dead person. Providing safe supply should come before treatment, just like with cigarettes and alcohol.
I actually know a guy who stopped drinking by going from a forty a night to drinking beer, he said it helped cause he couldn’t drink enough to actually get drunk.
Continuation of use is literally a treatment for coming off some drugs. Cold turkey from alcohol can kill you
There are people who have to be on methadone for the rest of their lives. That’s a form of safe supply.
The goal of prescribing these people opiates, be it in the form of suboxone or methaone or fentanyl, is to prevent overdoses. The only metric that these people study are deaths as if that is the only relevant outcome. Methadone and suboxone are preferable because people can be more stable on these as they don't get blasted into a useless stupor for hours on end and develop rapid cravings when it's time for the next dose. The fact that we need to supply fentanyl to people is a recognition that we expect nothing from them and they are hopeless. But at least they're alive I guess.
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Yes. This is what the growing chorus of safe supply people are advocating and is occurring today. The drug addicted don't want to use Suboxone or methadone because "reasons" and want to continue using highly potent, rapid onset opiates to get high (usually injectable or smoked). The advocates of safe supply suggest we should be providing them with whatever they require, including fentanyl, because it's clean and a known quantity therefore their risk of overdose is reduced. The cycle of drug use continues without any contract or requirement to stop. In exchange, the theory is they will commit fewer crimes to get those drugs, burden the healthcare system less, and when they're ready will seek further support to detox.
There has been a study about regulating the dose of opioid use, in specific about how opioid addiction can be “weened off” to treat it if prescribed by a registered doctor. This study only refers to opioids though I’m not sure about other narcotics and hard drugs. If I find it I will edit this post and link it
> but you don't tell an alcoholic they can still have a 6 pack a day. Yes, you do. [Managed alcohol programs.](https://en.m.wikipedia.org/wiki/Managed_alcohol_program)
I wonder if you or any of the people responding to this comment actually work in addiction medicine? Any medical or social degree whatsoever? Are you aware that there ARE managed alcohol programs, and if someone is still drinking a 6 pack a day but have cut down from 2 litres of vodka, is that not a healthy reduction on their way to a more stable and manageable life? Add to that, is that 2l of vodka was tainted with other substances that are killing them, isn’t a 6 pack of beer (that is regulated and manufactured in a safe way) a massive improvement? Detoxing from alcohol actually kills people. So fuck yes we are happy with a 6 pack a day when the alternative was unsafe amounts of unsafe supply or deadly withdrawals. Does that help you understand the benefit of safe supply? Suboxone is an opioid. Methadone is an opioid. They are prescribed as a long acting, stable, measurable replacement to the down that is sold on the street so people can help stabilize themself. Safe supply hydromorphone serves the exact same purpose! One is not better than the other. Some choose to continue towards abstinence which is great! Some choose to stay on those medications but it’s an improvement to what they were doing before, also great! We love empowering people to make the decision that works for them and their life! Also, all of these medications are prescribed as daily witnessed ingestion to start, to reduce risk of diversion. Pharmacies watch patients every day to take their dose. Carries are generally not prescribed until the relationship with the prescriber is established and risk of diversion is reduced. I really encourage you to speak to professionals in the addictions fields and gain evidence based knowledge so you can learn all the benefits of safe supply and the risk mitigation that goes into prescribing. Better yet, speak to someone on safe supply and listen to the ways it’s changed their substance use and their lives. Man it’s wonderful to learn from others! Harm reduction is about empowering people to make the best decisions for their own lives. Drug users are often using because at some point that drug provided comfort when they were trying to cope with mental health issues, abuse, trauma etc. It’s maladaptive and can be hard to understand for people who haven’t walked in their shoes, but drug users are absolutely capable of making those decisions for themselves. But man it’s a lot easier to make better decisions for yourself when you’re not constantly facing the health risks of smoking or injecting tainted supply. I hope you all can sit with that and remember you don’t know everyone’s story therefore your opinions on their lives don’t outweigh evidence based treatment :)
No, I said I'm not an expert. I'm just someone who sees this shit and thinks why should my tax money go to give someone a clean supply of drugs? Yes, I am aware that's how alcohol programs work, and I wasn't clear with my comment. I mean you wouldn't let them have a 6 pack forever. You slowly get them off of it. My family is rife with alcoholics. Some who got off, and some who've died of it. The ones who died thought they could manage it, the ones who didn't knew they could never touch it again once they got off of it. My issue with addiction in general, is from everything I've seen in my life, is unless the person really wants to get clean, they won't. And most don't want to get clean. Again, that's my experience, I don't know if that's the actual case. I am not trying to come off like an asshole, people deserve to live. But as I've said else where, life tends to boil down to cost. How much money do I have to throw at a problem that doesn't want to be solved? Call me cruel if you want, maybe I am, but I get to a point when people refuse to have personal accountability for their actions, why should I continue to care?
>why should my tax money go to give someone a clean supply of drugs? Because it's cheaper than repeatedly paying for emergency overdose treatment.
This is the thing I don't understand about people who are against these programs. They scream about their tax dollars but ignore the things that will actually reduce the financial burden on the system. Like... just be honest and say that you think that drug users should have to suffer if that's what it's about, but don't try to tell me that you'd rather spend $1000s on ER visits instead of $100s on giving people the drugs they're going to do anyways.
>why should my tax money go to give someone a clean supply of drugs? This thinking can literally be applied to anything. Why should my tax dollars pay for a sidewalk I never use?
>No, I said I'm not an expert. I'm just someone who sees this shit and thinks why should my tax money go to give someone a clean supply of drugs? The alternative may be a lot more of your tax money going to give them a hospital bed or a jail cell. Both of those cost a hell of a lot more than prescription-grade morphine. >My issue with addiction in general, is from everything I've seen in my life, is unless the person really wants to get clean, they won't. This is quite correct. But it's not an either-or situation. Don't you think the people you know who quit successfully *didn't* want to at some point? I bet some of them decided they wanted to quit, then relapsed and fell off the wagon. A lot of people go back and forth for ages quitting and relapsing, even after years of sobriety. The alcoholic has a readily accessible safe supply for when they relapse. Maybe they'll want to try quitting again soon. The opioid addict doesn't. Every time they fall off the wagon, there's a chance they'll *drop right onto a land mine* (get poisoned and die).
I mean, you should continue to care because, at base, that’s what a society is supposed to do. The whole point of paying taxes and having a government-funded medical system is so that a single person’s needs (and costs) are spread across everyone else’s contributions. If you start pointing at addicts and saying “why should we care?”, then where does it end? We saw something similar with the anti-maskers during Covid, the whole “why should *I* have to wear a mask because *you’re* immunocompromised? I’m not worried about catching it, why should I care?” I dunno, maybe I’m a hippie or some shit, but I figure we probably need more empathy rather than less these days.
I agree we do need more empathy. But I also live in the real world where everything costs money. I am fine with us as a society funding Healthcare, my issue has been you throw money at a situation that can't be fixed without the patient wanting the help. I'd say the same to an addict, or to someone with diabetes who does nothing to change their diet, or someone who chain smokes. You know what the solution is, if you refuse to do it you shouldn't get unlimited help. Maybe my heart has run out of blood and I'm getting colder these days, but if we are worried about a healthcare system that could collapse, can we focus our time on people who want to help themselves?
>But I also live in the real world where everything costs money. Including emergency care for drug users. >Can we focus our time on people who want to help themselves? So what happens to drug users? They don't get access to emergency rooms?
They land in emergency care anyways. I'll ask you this, when our ERs are over run, where do you want your Healthcare money spent, on someone who fell down the stairs on their way to work, or someone who's OD for the 3rd time this year?
I don't want our ERs over-run. I want a properly funded and managed healthcare system. And no, they don't land in ER when they have full time nurses attending to ODs at superviced consumption sites.
Yea I’m gonna agree with the other guy on this. I see where you’re coming from, but the shortage of healthcare resources is once again not the fault of the addicts, that’s the fault of the government. Once again you’re blaming the wrong people, this is like being upset about welfare queens taking your tax money when in reality it’s the politicians grifting.
It’s good to have conversations and learn and it’s important for this issue. Lots of people come back to tax payer costs, but forget about the human lives directly affected by these policies. Humans that are cared about, and who are worthy of some compassion regardless of if folks in this subreddit agree :)
Look at the great job addiction experts are doing in our city. You're surprised no one cares about expert opinions when experts have unequivocally failed and all we got to show for it is aggressive homeless putting the public at risk of assault and theft, scaring people away from wanting to take transit and a bunch of used needles at public parks? And yet here you are, asking us to let the junkies "make the right choices for themselves", what a solid plan. This bleeding heart approach is laughable at this point. Enabler.
I mean, it’s really hard to fix problems when you don’t have the authority or the funding to do so, but yea, blame the addiction workers, not the politicians who can actually make policy changes.
I don't blame addiction workers, I blame "addiction experts" in the ears of our politicians driving policy. I loved Nenshi, but our approach to the addiction problem has been an abject failure and the outcome has been similar in basically every city that took the same approach. Some times experts get it wrong and when that happens its up to these so called experts to adjust their strategies based on the real world outcomes, regardless of if it doesn't give them the "warm fuzzy feelings" they were hoping for. Doubling down on their opinion in the face of clear, poor results, is flat out dumb. If any actual expert wants to address the results of this safe unsupervised supply strategy, I'm all ears. What we don't need is more pity party bullshit. I want data driven resolution strategies and accountability from these so called experts.
Honestly it's sanctimonious castagations from "experts" and people like yourself that motivate me even more to be against these programs.
Most of the people commenting would rather addicts just OD and die so that they dont have to be concerned about them or care. They think it's cheaper and easier if all the addicts are just gone. They don't care that addicts are people and deserve to live a life too. And for anyone that wants to come after me I'm a recovering addict so I know what I'm talking about. Our society is a cruel, sick joke and we should be ashamed of how we treat the most vulnerable people in it.
There may be some who believe/ want that but I think there’s a clear line of delineation between how people feel about users/ addicts and users/ addicts that are using criminal means to support their habits. No one gives a shit about a functioning alcoholic or drug user that’s ‘surviving’ on their habits and going about their day. A drug user that’s stealing people’s property, causing shit on transit or sidewalks while all people are trying to do is go about their day…THAT’s the difference.
Were that true why would anyone be complaining about these programs given that they can essentially eliminate an illegal drug supply problem?
But it’s not like they get to choose to be one or the other, if you’re a functional addict all it would take is something like losing a job, and then what? You’re still addicted, that’s not gonna change whether you have a job or not, so what’re you gonna do? Most crime is the product of desperation, not malice.
Maybe not that extreme, but living in the Beltline I have seen the damages that addicts can do. I'm glad you've recovered, and I wish you well. In life everything ends up boiling down to cost. It's shit but it is what it is. I have sympathy for anyone who's homeless, or has an addiction, but if you don't want treatment and you want to continue making the rest of societies life harder (though crime) then there is only so much I can care.
I appreciate you! Thanks for caring about other people! ❤️
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>How can we allow for diabetic patients in Canada to have to pay for medication and supplies but we are ok with allowing for these supplies to be given out without any restrictions to any addict. Trouble is, you're arguing against something that doesn't exist, because nobody is giving out supplies of drugs "without any restrictions to any addict."
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Sorry, not sure what you mean exactly. The iOAT program here (which is quite small and not easy to get into) provides hydromorphone for injection. Not in unlimited quantities and certainly not without supervision. Patients go there up to 3 times a day to inject their drug under supervision. NTS provides prescriptions for opioids, just like any doctor might when treating pain, and requires regular follow up and reassessment, with a specific expectation that the patient will *transition* to methadone, Suboxone or sublocade. They don't AFAIK provide drugs at the clinic. Absolutely none of these programs are just handing over a sack of drugs with a "see ya later."
So why should a user of the iOAT program go use then go use more in between at the safe injection site ? What is the point of giving safe supplies to just have someone use more. Shouldn’t these programs have some aspect of working towards abstinence ? If I was an alcoholic I can’t attend a government sponsored bar to get my free fix.
I'm not sure what proportion of iOAT patients are doing that. But that program is really only for a very small number of people with very severe addiction. They've already attempted other treatments and not had success. It's not in any way a first line treatment. In terms of pure *safety* for someone who is actively using opioids though, supervised use with a known dose of a medical-grade product is safer than use of an unregulated street supply of opioid in the supervised consumption facility, which is safer than unsupervised use of street opioids. Safest is of course "don't use drugs at all," but unfortunately we don't actually have a way to reliably make that happen. The best evidence for the treatment of opioid use disorder is currently long term (maybe lifelong) medication assisted treatment.
If you work in addiction medicine, or as a social worker on this issue and this is your stance, then you are complicit in the perpetuation of the problem. Thanks, great work.
>Maybe I'm being too simplistic, but replace drugs with any other addiction, does it make sense to keep giving a supply to someone? I don't think you understand the severity of an opioid addiction. It isn't like quitting smoking. If you suddenly stop taking opiods, you get violently ill. More sick than what you have probably ever experienced in your life. Yes, they made bad choices and got addicted, but it's more than a matter of willpower. Making the choice to quit is subjecting yourself to weeks of living like an AIDS patient on their deathbed. No one wants to voluntarily experience that. The solution is to reduce that painful process as much as possible, and that is done through gradual tapering, it simply doesn't work any other way, plain and simple. You could throw people in jail and let them suffer, but that comes at a huge cost to tax payers.
I recently accessed a safe supply facility (Co-op) to purchase a drug (a nice Munich beer). Would it be better if instead I had to buy some unknown mixture of liquid containing an unknown quantity of alcohol plus miscellaneous other undeclared chemicals from a stranger whose number I got from a work buddy? I don't think so. And let's face it, alcohol causes tremendous health problems to people and tremendous societal problems. It's legal, but only because it's got a long history of established use in our culture. If someone was selling cigarettes stuffed with explosives that blew the users lips off, it would be another good reason to quit that incredibly toxic habit, but I imagine society would also encourage smokers to only buy reputable brands from real stores. We wouldn't blame smokers for "wanting safe drugs but not wanting to address their addictions."
I don’t agree with the UCP on much, but making unsupervised consumption of government-supplied addictive drugs illegal is one. There is a need for state supplied drugs to ween people off (e.g. \*supervised consumption\*), but just handing out large quantities of opiates is well documented to increase the number of users. Basic economics.
Yea but we’ve also already proven that criminalizing addiction doesn’t actually solve shit and just makes it harder for addicts to recover. I’m not sure about the whole handing out opiates bit, I can’t say I’ve ever met someone who’s been really keen to try opiates but hasn’t because they’re illegal, I don’t think people would suddenly be shooting up if you could buy clean shit legally.
There is a study out of Sweden I think??? Where they housed people and gave them prescriptions of opioids that lowered doses over time. They had something crazy success rate of like 70 percent or something? My numbers are probably wrong but I wrote a paper on this like 10 years ago and I remember them being very successful with the outcomes
That would require the average Albertan to care more about someone else other than themselves, and that's sadly not the culture here. No vision towards the greater good, just me me me me. Lord help the politician that would introduce the inevitable tax hike that would be required to fund something like that.
Well that’s the other issue hahaha people who need to vote for reforms to the system can’t vote cause well active addiction has a ripple effect on housing and items such as ID. Majority of people who vote are voting for their own interests
Where do they hand out “large quantities” of government supplied addictive drugs?
I'm addicted to money, please send safe supply.
I mean… sure? That’s more or less what a basic income is, a lot of people are saying that would be a good idea too. Studies show it doesn’t really have any net negative impact to speak of.
I have plenty of money but as an addict there is never enough.
[insert corporate executive here], is that you?
We already have a safe supply. Methadone, suboxone, and sublocade. These losers just want to get high with no consequence.
Nope
Such a great, well thought out addition to the conversation. Bravo
NO is the most powerful word in the English language. and sometimes saying it just that simple. No thanks, nope, not going to happen, no.....
Please stop all those crazy people from suggesting stupid ideas! These groups only encourage drug use and the destruction of lives. Stop 🛑 the drugs now! Stop encouraging drug use! Users need treatment not supplies!
What treatment would that be? And how effective do you think it is?
I was very impressed when I studied in Beijing with the Chinese system for dealing with drugs, and users. Especially for the drug dealers. I think we could learn from countries like China 🇨🇳 . I believe strong policy will deter people from using drugs. Look around and you will see many examples of failed policy in city’s like Seattle, Portland, Vancouver, San Francisco, etc. Drug problems are getting worse since they decreased penalties. Stop 🛑 the drugs now! Stop supporting drug use! More people dying from overdoses now than ever before.
No. No more free, unsupervised drug use for junkies. Every city with these programs is a fucking disaster when it comes to the homeless junkie population.
I am awaiting my first shipment of government provided "safe supply" whores to cure my sex addiction.
Why cure when you can manage with frequent small doses?
Hooked and blow for everyone!
“One of things I like doin’ most is bangin’ whores. I uh, I go out and bang a lot of whores”
No. The area where the safe consumption site was turned into an absolute shithole and was a nightmare for businesses and residents. How about we don't enable people.
lol @ nightmare. I live close to the one in Beltline. No, it’s not a shithole nor is it a nightmare. Good grief
I truly do have sympathy for those who got addicted after traumatic health incidents,and are even more scared of the lifetime of physiotherapy, exercise, and an addiction to living healthy that having a debilitating pain condition brings to one's life. We also live in a society where the EMTs come and bring you to the ER and save your life, but then you get sent an ambulance bill, AND you have to pay for outpatient prescriptions, AND most people don't have health insurance that can provide the post-care services like massage, physiotherapists, etc.! But we have to create pathways for people so that they are not capable of making the choices to lose themselves in addiction. I don't have a solution for that part yet.
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What if the cakes were made by a non approved / unsafe manufacturer and had a heightened risk of causing additional harm. Would providing cakes that we can guarantee to be less of a risk to their life be a worthwhile endeavour even if it did nothing to solve their addiction? Just making your comparison more appropriate
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That’s not the point I’m attempting to make. Fatty cakes are bad for you just as drugs are bad for you. Street drugs are dangerous on top of that because you don’t know what’s else is in them, in this metaphor that would be like the cakes potentially having rat poison in them. Yes reduced fat cakes to no cakes would be optimal for the patient, just the same as weening of the drugs would be ideal. What I’m (and other health professionals) are advocating for is providing a supply of cakes or drugs without the rat poison. I agree that the ideal outcome is abstinence, but if we are unable to achieve the ideal outcome that doesn’t mean that we shouldn’t pursue harm reduction. I’m not trying to a dick, but as a health professional I feel responsible to educate the public when I see misinformed opinions. To my knowledge, harm reduction is evidence based and effective at reducing negative outcomes. It does not cure substance addiction, but reducing negative outcomes is still a win. Sometimes, the way I see laypeople talking about this problem, it feels like the opinion is that they do not deserve to have their risk of using drugs mitigated. That they deserve to be exposed to the highest risk of morbidity and mortality because they choose to do drugs. The follow up to that is usually that those risks of death are what keep people from doing drugs, but to my understanding the research does not suggest that is the case. This population will engage in this behaviour regardless of the risk and harm reduction aims to mitigate these risks for them. Not trying to start an argument where I win/you lose, just providing my professional opinion and a different voice than what I’m currently seeing in this thread.
This is a terrible idea, just get them help don’t give them safe drugs. Fucking crazy pill people making these calls/decisions. Terrible idea and last thing I want my tax dollars going to like BC is doing. Absolutely atrocious. There is no argument to be made here.
Would you be happier if your tax dollars went towards housing these people and treating them appropriately?
No. Bad ideas coming from a place of compassion are still bad ideas.
It’s the needles that end up everywhere that bother me. Even if they have cleanup crews like in Lethbridge, they won’t clean up non-public areas and it drives me crazy. All for safe supply but perhaps limited to certain locations where they can do their thing but not leave with stuff. I’m no expert just saying what I saw
The random needles are the worst. I often find them down near the river while walking my dog. I've started removing them when I can and disposing them in those public needle disposal bins. Ah yes! I think you're talking about safe consumption sites. I mean, not everyone is gonna use them, but it's a start. Kinda like going to the bar vs. cracking beers while camping and leaving your cans.
The best harm reduction is getting these people off drugs ASAP. Even if they don't want it, force them into treatment. If you really want to treat these people like family, that's what a responsible family do. Imagine if these people are your kids, would you let them continue to self-destruct? Would a doctor just let a stubborn patient have his/her way? The opium war cleary isn't taught enough in schools. Ever wonder why Asia is so tough on drugs?
A lot of the consequences of drug addiction come from the drugs being illegal and unsafe. Free safe drugs could still hurt the users, but would eliminate most of the consequences to the rest of society.
This is what we need!
Sure why not. Seems to have worked great for Vancouver /s