Break the Needle 2

Break the Needle 2

Yet another insightful article from Break the Needle.

We are thankfully not at this stage yet, but the efforts of our politicians and the trajectory they have put in place lead to some inevitability that we will as they push the failed ‘Harm Minimisation’ approach they have embraced – ‘Safer Supply’ will be the inevitable next step after safe injecting facilities and pill testing interventions that promote drug use.

 The Canadian experience highlights the failure to recognise or accept that early

intervention is the only process that can reverse this trend from ruining lives.

…CAA comment.

………………………………….

 

Leading addiction doctor warns of Canada’s ‘safer supply’ disaster

 

Addiction physician Dr. Sharon Koivu has seen the effects of safer supply programs in her clinical practice and personal life — and is sounding the alarm

Having worked on the front lines of Ontario’s opioid crisis, she views these programs as a catastrophic failure.

In an extended interview, Koivu explained the unintended consequences of these programs, which offer free tablets of hydromorphone — an opioid about as strong as heroin – to vulnerable patients with a history of addiction. While advocates of safer supply claim it mitigates the use of more dangerous illicit substances, there is evidence that most users divert — that is, sell or trade — their hydromorphone to acquire stronger substances.

Safer supply was first piloted in London, Ont., in 2016, before being widely expanded across Canada in 2020 with the help of generous federal grants. While the program looked good on paper, Koivu, who provides comprehensive addiction consultation services at a London-based hospital, saw a different reality: her patients were destabilising, relapsing and fatally overdosing because of safer supply.

Koivu says that “one hundred percent” of her colleagues working in addiction medicine have noticed safer supply diversion. Some patients have told her they have been threatened with violence if they do not procure and divert these drugs. She estimates that, because of safer supply, tens of thousands of diverted hydromorphone pills — also known as “Dilaudid,” “dillies” or “D8s” — are flooding into Canadian streets every day.

For context, just two or three of these pills, if snorted, are enough to induce an overdose in a new user.

This influx has caused the drug’s street price to crash by as much as 95 per cent. While 8-milligram hydromorphone pills used to sell for $20 each several years ago, they can now be bought for as little as a dollar or two. These rock-bottom prices have ignited a new wave of addictions and relapses, and lured opioid-naive individuals into experimenting with what is essentially pharmaceutical heroin.

Koivu estimates that 80 per cent of her opioid-using patients now take diverted hydromorphone.

“The biggest harm is that we’ve turned on the tap and we’ve made everything cheap, which is leading to a large increase in the number of people becoming addicted and suffering,” she said.

“It is the most serious issue that I’ve seen in my lifetime.”

Safer supply programs seem to regularly overprescribe opioids without considering patients’ actual needs, Koivu says. Patients have come into her hospital with prescriptions that provide 40 eight-milligram hydromorphone pills a day, even though they can only tolerate 10 pills.

‘That attraction is horrific’

Throughout the first few decades of Koivu’s career, almost “everyone” in her patient pool developed addictions due to childhood traumas or from mishandling opioids prescribed for chronic pain.

Since the advent of safer supply, the origins of new opioid addictions have shifted toward social or recreational exposure. Concerningly, this exposure often occurs in patients’ adolescent years.

“I’m seeing an increase in youth becoming addicted,” said Koivu, who has had patients as young as 15 tell her their addictions began through diverted hydromorphone.

“Almost everyone I see who’s started since 2018 started recreationally. It started as something that was at a party. It’s now a recreational drug at the youth level.”

Parents often seem completely unaware of the problem. Some have told Koivu they overheard their children discussing the availability of “D8s” at their high schools, only to later realise — when it was too late — they were referring to opioids.

“You can’t walk into your house with a six-pack of beer. If you’re smoking weed, people can smell it. But you can walk into your house with a lot of [tablets] in your pocket. So, it’s cheap, really easy to hide, and is even called ‘safe’ by the government. I think that attraction is horrific.”

“Our youth are dying at a higher rate … and we have a lot more hydromorphone found in [their bodies] at the time of death.”

While safer supply programs claim to make communities safer, Koivu’s lived experiences suggest the opposite. She used to reside in London’s Old East Village, where the city’s first safer supply program opened in 2016, but moved away after watching her neighbourhood deteriorate from widespread crime, overdoses and drug trafficking.

“I moved there to support a supervised injection site,” said Koivu. “Then I watched that community drastically change when safer supply was implemented. … I would go for walks and directly see diversion taking place. Homelessness is very complicated, but this has absolutely fuelled it in ways that are unconscionable.”

Koivu characterises the evidentiary standards used by advocates of safer supply as “deeply problematic.” She says many of the studies supporting safer supply are qualitative — meaning they rely on interviews — and use anecdotal data from patients who have a vested interest in perpetuating the program.

While Koivu has been blowing the whistle on safer supply programs for years, her concerns largely went unnoticed until recently. She has faced years of harassment and denigration for her views.

“When I came to say I’m concerned about what I’m seeing: the infections, the suffering, the encampments … I was literally told that I was lying,” she said.

Last month, the London Police Service provided the National Post with data showing that annual hydromorphone seizures increased by 3,000 per cent after access to safer supply was significantly expanded in 2020. The newspaper has since raised questions about why this data was not released earlier and whether the police stonewalled attempts to investigate the issue.

Koivu considers herself a lifelong progressive and has historically supported the New Democratic Party. But she is concerned many left-leaning politicians have ignored criticism of safer supply. Many seemingly believe that opposition to it is inherently conservative.

“I went to a hearing in Ottawa of a standing committee to talk about addiction,” she said. “We had five minutes to give a talk and then two hours to answer questions, [but] I didn’t receive any questions from the NDP or the Liberals.”

Although Koivu believes safe supply can play a role in the continuum of care for opioid addiction, she says it must be executed in a meticulous manner that prevents diversion and emphasises pathways to recovery.

“It needs to be part of a comprehensive strategy to help people get their lives back. And right now, it’s not.”

Above all, it is Koivu’s experience as a mother that drives her to criticize safer supply. One of her sons struggled with opioid addiction as a young adult. Although he eventually recovered, the experience could have killed him.

“Had this program been around … my family could have been another statistic from an opioid death. That drives me. Because it’s very real, and it’s very personal.”

Break The Needle

Break The Needle

 This article gives an insight into the direction and traps in managing drug addiction.

 Canada has been the window to the future of the drug addiction problem in Australia. It has shown the world the contrasting outcome of pragmatic management as opposed to the id

We will bring you further articles authorised to be published by Break the Needle, giving a window into where the drug epidemic is headed and what works and what doesn’t. We would do well to note the Canadian experience.

We have our own conflicted approach, with one arm of the government expending vast resources trying to control the illicit drug trade and use, the Legal system and the Health system dealing with the consequences of use, while all the while the government is promoting and facilitating drug use, with the Drug Injecting Room and further promotion of safe drugs, the Pill Testing service.

Captured by the failed ‘Harm Minimisation’ fallacy, we can expect the next big thing will be an emphasis on ‘Safer Supply’. The toe is already in the door with Pill Testing.

 

Opioid seizures exploded by 3,000% in Ontario City after a “safer supply” experiment.

Doctors and journalists wondering why local police failed to disclose concerning statistics to the public sooner.

JUL 07, 2024

A London (Canada) police drug seizure in April included 9,298 Dilaudid eight-milligram tablets.

By Matthew Hannick

Nigel Stuckey saved more lives during the last five years of his policing career than the previous three decades combined. “Every time you go back to the street, it has a different flavour,” said Stuckey, a former sergeant with the London Police Service (LPS) who retired in 2022. “As a frontline police officer, you are constantly going to overdoses in the city. I’ve administered Narcan to multiple people, and this is just something that never existed before.”

Stuckey first noticed a dramatic increase in overdoses and drug-related crimes occurring throughout his city – London, Ontario – in 2019. While the reasons behind this increase were initially unclear, recent data released by the LPS suggest that “safer supply” programs may be contributing to the problem.

Safer supply programs aim to save lives by providing drug users with pharmaceutical-grade alternatives to the untested street supply. That typically means distributing hydromorphone, a heroin-strength opioid, as an alternative to illicit fentanyl. However, addiction experts say the program is having the opposite effect, as many people who are enrolled in safer supply programs are illegally selling or trading their prescribed hydromorphone on the black market, a practice known as “diversion.”

Harm reduction advocates claim that safer supply diversion is not a significant issue, but according to an investigation into London Police Services (LPS) seizure data by journalist Adam Zivo, the number of hydromorphone tablets seized in London increased by 3,000 per cent after access to safer supply was greatly expanded in 2020.

In 2019, the LPS seized fewer than 1,000 hydromorphone tablets. This number jumped significantly in 2020 and continued to rise afterwards, reaching 30,000 tablet seizures last year – an unprecedented amount. The London police estimate that last year’s record will be met or exceeded by the end of 2024.

Doctors have said that this is only representative of a small fraction of what is actually out there, and that just 3-4 of these pills, if snorted, are enough to induce an overdose in a new user.

Some people are wondering why this data wasn’t released months, if not years, earlier.

Dr. Sharon Koivu, a London-based addiction physician, was among the first to recognize the harms of safer supply and has been warning the public about widespread diversion for years. Based on her clinical experiences, she believes that diverted safer supply hydromorphone is causing new addictions and falling into the hands of youth.

When Koivu tried to speak out against safer supply and call attention to diversion and an overall lack of program transparency, she was bullied and told that the suffering she was witnessing didn’t exist. This harassment was so severe that her mental health deteriorated and she worried about whether her career had been irreversibly damaged – yet the London police had quietly possessed data showing that she was right all along.

“It’s become an ideological thing,” she said. “People seem to have doubled down on the information they have. They don’t want to hear from someone who has information and concerns that don’t align with their, I’m going to say, ideology – because it’s not science.”

News of skyrocketing hydromorphone seizures might have remained hidden from the public had it not been for a major bust earlier this year.

On April 12, the London police announced a drug seizure which included 9,298 hydromorphone eight-milligram tablets. When Zivo inquired into this seizure, he received no answers to his questions for almost two months. He says that he was “stonewalled” and that the police seemed unwilling to release key data until it became impossible for them not to.

Zivo found it particularly concerning that the 2019-2023 hydromorphone seizure data was not released earlier. “Journalists and addiction physicians have been trying to raise the alarm about this issue for years,” he said, “but have been called liars, grifters and fearmongers, despite the fact that data validating their concerns existed and was held by the London Police Service.”

Stuckey, who now works as a documentary filmmaker covering London’s homelessness, addiction and mental health crisis, had a similar experience when he queried the LPS about the 9,290 hydromorphone pills seized this April.

Despite multiple requests for information about a possible connection to safer supply, the police service did not get back to him. He expressed frustration at the police’s unresponsiveness and worried that a lack of government transparency is endangering both the general public and law enforcement officers.

“Members of the London Police Service are being put in harm’s way dealing with organized crime and firearms to take drugs off the street, which were provided by the federal government. It’s absolute lunacy that we are paying one branch of government to rid a problem that was created by another branch of government,” said Stuckey.

It would be deeply concerning if the LPS knowingly withheld data pertaining to safer supply diversion. Not only has the failure to publish such data hindered informed public debate and policy development, it has also compromised the safety of the very communities which police are tasked with protecting.

According to Zivo, safer supply programs have benefitted from the silence of powerful institutions like the LPS. He said that, as there seems to be significant institutional resistance to acknowledging the community harms of safer supply, then more attention and trust should be given to local grassroots-level addiction medicine practitioners “who are bravely testifying to what they are seeing in their clinics.”

However, Dr. Koivu thinks that “the tide is turning” and that more people are beginning to understand the harms of safer supply

“I think it’s unfortunate that this data wasn’t made available sooner, when it was relevant to the funding of these programs and the changes we’re seeing in the city. The police need to be accountable for that. I really don’t understand their rationale for not addressing this” she said. “They hung me out to dry while knowing that what I was saying was accurate. If the police are afraid to come forward, no wonder physicians are afraid to come forward, too.”

Harm reduction, palliative care for drug addicts.

Harm reduction, palliative care for drug addicts.

This article by American Holland  Marshall is reproduced with permission and gives an insight into the future of the issues Victoria will face if the current Drug strategies are exploited and developed.

The question we pose is who is pushing and funding all these strategies?

The one sector that has the most to gain is the Drug industry, not the users. An industry that kills its customers by dramatically reducing their life expectancy so recruiting(normalisation of drugs) is paramount for their operations.-Editor 

HARM REDUCTION IS LONG-TERM PALLIATIVE CARE FOR DRUG ADDICTS.

Harm reduction is based on reducing the likelihood that people will be seriously hurt or die when they do dangerous things. That is why we have laws that require drivers to obey speed limits, motorcyclists must wear helmets and construction workers must wear safety shoes.

Harm reduction doesn’t stop accidents; they make them less dangerous.

In health care, harm reduction started with programs to prevent sexually transmitted diseases by distributing condoms and lubricants. These services expanded with the arrival of the HIV/Aids epidemic and it then included the goal to reduce hepatitis C among heroin users.

Harm reduction industry goals

1.) Increase the number of drug supply facilities & supervised consumption sites.
2.) Make drug use accepted as a normal practice.
3.) Defund the police & have drug use considered solely a medical issue.
4.) Safe Supply. This is when addicts receive government-funded drugs.

Modern times

We now live in more radical times. Harm reduction advocates now focus on social justice and bodily autonomy. People have the right to make decisions about their own bodies, without coercion from anyone.

The harm reduction model doesn’t try to discourage addictions; it seeks to make drug use safer and more accepted.

Stigma

The message is addicts should not feel ashamed about using drugs. Drug addicts have been part of our society for centuries and they will continue to be with us.

Stigma must be eliminated. Drug addiction should be seen as just another craving like drinking coffee, eating chocolate or drinking alcohol. The drug addiction activists state that drug addicts are part of our society and they will continue to de so.
After all, Sherlock Holmes regularly smoked opium.

In a nutshell, this means addicts have the right to use drugs free of judgment or intervention.

Controlling the message

To help get their message across, the activists are constantly changing their language to hide what is actually happening to the addicts. The words:
• shooting galleries has been renamed Supervised Injection Sites.
• crack houses has been renamed Supervised Consumption Sites.
• addicts has been renamed People Who Use Drugs (PWUD)
• vagrants has been renamed homeless and then, persons without housing.
• shoplifting, muggings & thefts have been renamed survival crimes.
• squatting in parks or sidewalks has been renamed sheltering in place.
• police has been renamed strangers with guns.

I could go on and on but you get the idea.

Harm Reduction services

Health officials and the NGOs understand that powerful illegal drugs are killing addicts. In an attempt to prevent the transmission of blood borne and bacterial infections due to drug use, they give addicts:
• all the paraphernalia necessary to consume drugs.
• syringes for the addicts that inject drugs.
• crack pipes.
• smoking & snorting kits.
• condoms & lubricants for safer sex. (For love or for money)
• information on how to safely do drugs.
• snacks & bottles of water
• pet food
• information on what social services are available in the community.
• information on drug treatment facilities.
• Naloxone kits.

These sterile supplies do help reduce the transmission of blood borne and bacterial infections.

The drug supply centres do not want to upset the addicts, so they soft pedal advice on treatment centres and normally will discuss them only when asked.

Who are the experts?

Social justice warriors insist that drug addicts and ex-drug addicts are the experts that the politicians should be listening to for advice when they enact drug addiction policies and laws.
“People with lived and living experience in drug use are the experts that have proposed solutions to the drug poisoning crisis and have for decades.”

Harm Reduction costs

It is expensive for society to casually accept drug addictions as a new normal.

The taxpayers are paying for absolutely everything. Billions are spent on welfare and disability cheques, temporary shelters, hotel and motel rooms, all of the drug paraphernalia and the Narcon kits.

Transit services face increases in security and cleaning costs. The homeless don’t pay fares. Buses, street cars, subways and transit terminals are becoming mobile drug dens and homeless shelters. No wonder ridership is down.

Municipalities have to pay to clean up all the human waste and garbage that the addicts discard in the parks, alleyways and sidewalks. Police, fire services, ambulance services and emergency departments require large increases in their budgets.

Businesses have to pay for increased shoplifting losses, security guards, cameras, graffiti removal and protective fencing. Downtowns do not feel safe so the retail stores lose customers and some have had to close.

According to Statistics Canada, the homeless support sector saw a 60.7% increase in workers between 2016 and 2021. Guess who’s paying for that?

Harm reduction encourages drug use

Giving away free drug paraphernalia, supporting addicts living on the streets, demanding that drug use should be stigma free and even declaring that using drugs while partying is okay does nothing to stop people from experimenting with drugs.

‘Safer snorting kits’ handed out at British Columbia US high school after drug presentation

Students received kits containing information about “safer snorting” including a picture of a straw hovering above a line of white powder. Included in the kit were tubes for snorting and cards for making lines to snort.

The kit includes straws and wallet-sized cards for cutting powdered drugs into snortable lines — as well as a booklet on ‘staying safe when you’re snorting’including a pic

“Have condoms and lube with you. You may want to have sex while high,” reads one tip. Another advises the drug user to decorate their snorting equipment. “Adding a personal touch to your snorting equipment will help you better recognize your own when using with others,” it reads.

The booklet also notes the wide variety of drugs that can be consumed via snorting, from cocaine to crystal meth; fentanyl and ketamine.

Is this their mission Statement?

“I know it can be a little controversial, but one of the key tenets of harm reduction
that I see is that we want to be able to facilitate and champion autonomy of people
who use drugs.”

—Amber Tejada, Hepatitis Education Project

Addiction isn’t freedom, and “respecting people’s right” to die from it isn’t enlightened or compassionate. Harm Reduction should be named Harm Facilitation or Harm Prolongment. The people harm reduction supposedly saves keep using drugs and have a very short life expectancy.

Three years. Life expectancy of a feral cat.
Three years. Life expectancy of a person addicted to fentanyl.

Assisting someone with severe mental illness to use illicit drugs is nearly criminal negligence.