Pubdate: Fri, 23 Dec 2016
Source: Globe and Mail (Canada)
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Gary Mason
Page: A13

THE COLD TRUTH BEHIND B.C.'S OVERDOSE EPIDEMIC

When tucking into your holiday feast this weekend, spare a thought for
those unable to enjoy such comforts.

First responders come to mind, especially in Metro Vancouver, which is
in the grip of an epidemic of drug overdoses. According to the most
recent statistics, 755 people have died so far in 2016, a 70-per-cent
increase over this time last year.

If you are shocked by this news, you are excused. For some reason,
this public-health calamity has failed to galvanize the country's
attention, certainly not like the great SARS panic of 2003 did. It was
top of the news - and the federal government's political agenda - for
months.

SARS claimed the lives of 44 people in Canada. That many are dying of
overdoses in a single week in British Columbia.

The province may have more than 900 overdose deaths by year's end, at
the rate things are going. The 128 people who died in November was the
highest monthly total all year, which is pretty discouraging given
that the provincial health officer declared a public emergency over
the crisis last spring.

Certainly, government authorities at all levels deserve some of the
blame for this mess; the response has not been the swiftest. But the
trail of human destruction caused by newer strains of opioids such as
fentanyl also caught local health agencies off guard. A mad scramble
is in progress to find ways to prevent more deaths.

If you consider that last week, 13 people in the province died of drug
overdoses in a single day, including nine in Vancouver, you would say
the response so far has been an unqualified disaster. If, on the other
hand, you consider how high the death toll might have been without
some of the measures introduced - broader access to resuscitation
drugs such as naloxone, mobile medical units and more
supervised-injection sites - you would charitably say the plan has
done at least some good.

So far, however, efforts have been almost wholly reactive. At some
point, the province and Ottawa will have to address underlying issues
and seek longer-term solutions, which is even more complex and
politically fraught.

Some are drawing a line between what we are witnessing in British
Columbia with the province's decision a few years ago to make it
harder to access prescription painkillers such as Oxy Contin. Users
will go in search of alternatives, including to the street if
necessary, which has its own perils. However, that does not explain
why the problem is so acute in British Columbia; governments across
the country, including Ontario, have also delisted these types of narcotics.

This scourge is taking the lives of the troubled and dispossessed of
Vancouver's Downtown Eastside as you might expect, and also members of
the middle and professional class. It does not have a common,
recognizable face, which, in some ways, makes it more difficult to
tackle.

Any examination of possible remedies always leads to a conversation in
which few are comfortable partaking.

One part of it is acknowledging that treatment is simply not an option
for many people. Some will be drug users for the rest of their lives,
regardless of the amount of intervention. If you accept this, then the
best way to keep them alive is to ensure they have access to drugs
that do not kill them.

The other aspect of this discussion few want to broach concerns
decriminalization. It is the solution almost every public-health
expert in the field recommends, and yet it is the one most unpalatable
to governments and the public at large.

The example most often cited by those in favour of this route is
Portugal, which decriminalized, and regulated, all hard drugs such as
heroin and cocaine 15 years ago. In the interim, it has had a
significant decline in overdoses, use and disease. Still, some insist
on a more hardline approach: Throw anyone linked to drugs in prison,
the longer the better.

While that might make some feel better, the so-called war on drugs has
been demonstrated not to work, no matter where it has been waged.

The fact is, an ugly stigma around illicit drugs remains. If you use
them you are somehow less of a person, if you die from them, you
deserve less of our sympathy. We are witnessing that cold truth
playing out now. And it is not anything of which we should feel proud.
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MAP posted-by: Matt