Category "Canada"


Daphne Bramham: B.C. group’s call for legally regulated heroin sales is unfounded

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Desperate times call for desperate and often unfounded measures. And, that’s exactly what a new report from the B.C. Centre on Substance Use is proposing in response to the unabating opioid overdose crisis.

It wants government to immediately clear the way for “heroin compassion clubs.” These would be free-standing co-op stores staffed by health care providers selling untainted heroin — diacetylmorphine — to members at the same price or less than street heroin. It would be free to members who can’t afford it, even though the report acknowledges that the risk of street resale of prescription opioids is greatest when the drugs are free.

And that would all be possible, the report says, because of things like volume discounts and “other economies of scale.”

“It would be precisely measured and dispensed in known quantities and at relatively safe doses,” says the report that was released Thursday. The emphasis has been added.

The heroin would be in powdered form, rather than an injectable liquid, just like it is on the street except this would be untainted heroin, not heroin cut with caffeine to prevent overdoses or any other additives to bulk up the product.

Members would be able to buy a couple of days’ supply and take it home with them.

Membership would be low-barrier, a term that’s not defined in the report.

Applicants would be screened by staff members who are “health care providers,” although not necessarily addictions physicians.

The co-op’s board members would be people with “lived experience” — a.k.a. users and former addicts.

Evan Wood, the head of the B.C. Centre on Substance Abuse, says the proposal is unprecedented so there is no evidence that it would reduce overdose deaths or disrupt organized crime’s role in fentanyl, money laundering or housing affordability, which is what’s advertised on the report’s cover.

“To be fair, we are in an unprecedented situation with fentanyl and the prescription opioids overdose crisis,” Wood said. “We are in uncharted waters.”

The two main goals are keeping users alive and disrupting the evils of organized crime.

These are ambitious albeit inappropriate goals for an organization whose mandate is to “develop, help implement, and evaluate evidence-based approaches to substance use and addiction.”

Using heroin to treat users isn’t new. But every other trial or program has a treatment component whether they’re at Vancouver’s Crosstown Clinic, the PHS Community Services or in European countries.

In Europe, heroin is prescribed with the goal of stabilizing users to a point where they can get jobs, form relationships or switch to other (cheaper) opioid replacement therapies such as methadone or Suboxone. (The annual cost per patient in European prescription-heroin programs ranges from $19,000 in Switzerland to $30,000 in the Netherlands.)

But there’s nothing like this in Canada.

“I’m not aware of the existence of ‘heroin clubs’ anywhere else,” Jann Schumacher from the Swiss-based Ticino, an organization of addictions specialists, said in an email. “In Switzerland the heroin assisted therapy is strongly regulated and always under medical control.

“Our Swiss model (heroin assisted treatment) has strong evidence as a harm reduction method, in getting people into treatment and stabilizing their lives, and in reducing the illegal market.”

To qualify, Swiss patients must have at least two years of opioid dependence and at least two failed tries using other addictions treatment methods. They are only allowed to the drug in pill form and take it with them after being in the program for six months and only if it’s necessary to hold down a job.

Drug-related crime in Switzerland has decreased 90 per cent. But compassion clubs would have no effect on drug-related crimes because members would still have to find some way to buy the heroin.

As for disrupting organized crime, the report suggests that compassion clubs would be competing for sales, influencing both the demand and market for heroin.

“The establishment of a regulated and controlled supply of fentanyl-unadulterated heroin may increase demand for street heroin among persons who use street opioids and force organized crime groups to return to the provision of heroin as part of the illicit drug market,” the report says.

And since violence is criminals’ usual response to unwelcome competition, it seems likely that they will attempt to terrorize compassion clubs out of business.

What makes this proposal all the more absurd is that it is aimed only at British Columbia. Surely, low-barrier access to pure heroin would be a magnet to every opioid user across the continent, let alone Canada.

British Columbia is already the epicentre of the overdose crisis just as it was ground zero for the cannabis legalization movement that began with compassion clubs dispensing so-called “medical marijuana,” which led to an explosion in unlicensed and unregulated pot shops.

It’s also where Canada’s harm-reduction model was birthed with free needles, supervised injection sites and readily available naloxone. But it was supposed to be part of a four-pronged strategy just as Switzerland’s is — a strategy that includes access to treatment and recovery as well as education aimed at dissuading drug use.

But since 2017, the $608 million spent by the B.C. government has gone almost exclusively to harm reduction. Yet, the number of overdose deaths is still rising.

It’s clearly not working and Canadians can’t help noticing now that 9,000 are dead including more than 4,000 in British Columbia. According to an Angus Reid poll released last week, 85 per cent of Canadians want mandatory treatment for opioid addiction. Forget legalization or free drugs, decriminalization was favoured by only 48 per cent.

Although the B.C. Centre on Substance Abuse is proposing a radical and untried solution, Wood dismissed mandatory treatment as an option because it’s unsupported by evidence.

As for decriminalization, Wood said, “The problem with it is that you still leave control of the market to organized crime. The user is not criminalized, but they still have to go to the black market.”

Yet, 20 years’ worth of evidence from Portugal show that paired with assertively promoting treatment and recovery, providing universal access to those programs and enforcing drug trafficking laws, decriminalization works.

There, it not only effectively brought an end to Portugal’s heroin overdose crisis, addiction and usage rates for all drugs including cigarettes and alcohol are now among the lowest in Europe.

[email protected]

Twitter: @bramham_daphne


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Nova Scotia says it won’t appeal accessibility ruling by human rights board – Halifax

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The province says it won’t appeal a Nova Scotia human rights ruling that it discriminated against people in wheelchairs by failing to enforce a regulation requiring restaurants to have accessible bathrooms.

The independent board of inquiry said in a decision released in September that the province did not regulate food safety provisions on accessible washrooms in restaurants with patios.

READ: ‘Accessible washrooms should include everyone’: N.S. human rights inquiry begins

Chairwoman Gail Gatchalian ordered the Environment Department to interpret, administer and enforce the regulations as they appear.

The Justice Department says it will fast track an action plan to ensure the human rights decision is implemented in a timely fashion.

WATCH: Nova Scotia’s Accessibility Advisory Board holds inaugural meeting in Halifax

It will be developed in collaboration with the disability community and the restaurant industry.

The department says its effort will be supported by the newly established Accessibility Directorate and the Nova Scotia Accessibility Advisory Board.

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‘Accessible washrooms should include everyone’: N.S. human rights inquiry begins – Halifax

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Imagine only being able to go to a limited number of food establishments because the majority of them don’t have restrooms you’re able to access. Those living with physical disabilities in Nova Scotia say that is their ongoing reality.

Four people are now fighting the provincial government to address accessible bathrooms in a human rights inquiry.

“We have under a public health law, a requirement that every licensed food establishment has washrooms for the public that are convenient and those aren’t administered in any way that takes into account accessibility and our point of view is the public includes everybody, includes people who use wheelchairs for mobility and a convenient washroom for them is one that is accessible,” David Fraser said, the lawyer who’s representing the case on behalf of the complainants.

READ MORE: Nova Scotia Human Rights Commission to hold inquiry into restaurant washroom access

Fraser says the start of the inquiry is the latest stage in what’s been a “long process.”

He says his clients originally went to the Human Rights Commission to register a complaint about the way the province enforces accessible washrooms in the realm of public health. The commission rejected their complaint.

Fraser then took on the case pro-bono and the matter went before the Nova Scotia Supreme Court, where a court order was issued to accept the complaint.

That was last year, and since then the commission has appointed a tribunal to hear the matter.

The inquiry is being overseen by Gail Gatchalian, a human rights and labour law lawyer. Gatchalian has also granted intervenor status to the Restaurant Association of Nova Scotia, meaning they have the right to participate and provide comment on any legal issues being considered throughout the proceedings.

Fraser says the public-health law and regulations requiring accessible restrooms are in place, but how the government interprets them are key.

“Right now as we understand it, the government interprets the regulation in such a way that the public is the ‘average’ public and ‘convenient’ is only seen as a matter of, ‘Does the location of the washroom compromise food safety?’ And in our view, accessibility to the washroom actually has a big impact on that,” Fraser said.

One of the complaints is from Gus Reed, who wrote to the municipality when accessible patios were being considered, asking to consider the lack of accessible washrooms.

“I didn’t receive a response to that and in my own way, I pursued that by trying to speak with the minister of the environment,” he said.

Reed said he did have a meeting with the Department of Environment but that it was “inconclusive,” leading him to file a human rights complaint.

Reed ultimately wants the government to view inaccessibility to washrooms as a food-safety issue because if people with physical disabilities can’t wash their hands, it could impact the health safety of the restaurant as a whole.

Fraser reinforces that point by referencing an outbreak of Norovirus that occurred in a Halifax restaurant.

“Somebody came for a cruise ship and they transmitted Norovirus — a whole bunch of people on the staff got sick and hand hygiene is the number one thing that deals with those issues,” Fraser said.

The Department of Environment says regulations state that washrooms be in a convenient location, and the government recognizes the importance of accessibility.

“The province is working to address issues of accessibility through the Accessibility Act, with the goal of being accessible by 2030,” the department said in a statement to Global News.

The inquiry will run over the next several days.

© 2018 Global News, a division of Corus Entertainment Inc.

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Justice orders N.S. Human Rights Commission to accept accessibility complaint – Halifax

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The Nova Scotia Human Rights Commission (HRC) has to accept a complaint by a group alleging systemic discrimination by the province in how it enforces regulations regarding washroom accessibility.

READ MORE: Wheelchair users ask court to force human rights commission to hear their complaint

The commission rejected the complaint twice last year and referred it to an ombudsman.

In a written decision dated March 28, Justice Frank Edwards said the decisions made by two human rights officers dealing with the initial complaint were “unreasonable.”

One argument made in court from the commission involved the number of requests it gets.

“Counsel for the Commission argues that the HRC would be overwhelmed if every inquiry had to be treated as a complaint. I am not impressed with that argument,” said Edwards.

He also said that the HRC has to inquire into complaints, per the Human Rights Act [PDF].

David Fraser, who represented the six applicants on a pro bono basis, said the group didn’t take issue with specific restaurants but, rather, how the relevant government departments would waive the requirement for an accessible bathroom in a number of instances.

“So when a restaurant builds a patio, they have to make that patio accessible, but they don’t have to provide an accessible washroom,” he said on Wednesday.

Paul Vienneau, an applicant who uses a wheelchair, said it’s important for him to be able to wash his hands before eating at a restaurant.

“I carry an unnamed hand cleaner with me constantly, which is not a legit answer to this problem,” he said.

A spokesperson for the HRC said that no one was available for an interview on Wednesday, but a statement was provided.

“While the Commission will accept direction of the court to process this particular complaint, the Commission will be appealing the Court’s interpretation of the Human Rights Act,” it read.

© 2017 Global News, a division of Corus Entertainment Inc.

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