Poilievre repeats misinformation about B.C.’s safe drug supply

I just watched Conservative leader Poilievre’s tacky video set in front of a tent city in Vancouver. For dramatic effect, his video is interspersed with drive-by shots of street people. Grainy effects, except when Poilievre speaks, are added to provide a supposed gritty vérité.

image: The Hill Times

He makes sweeping statements in which he claims these people in the background are hooked on drugs. And some probably are.

But it’s more likely they are homeless because they have no homes: they can’t afford to buy and the rents are outrageous.

Rather than exploit the homeless as props for his populist rant, he could explain just who the homeless are. Rather than characterizing them as drug users, he could tell the truth but that wouldn’t suit his sensationalized video. The fact is that Vancouver’s homeless are overrepresented by indigenous Canadians and racial minorities.

The sad reality is that the homeless are victims of racial discrimination.

Despite accounting for only 2.5 per cent of Vancouver’s population, Indigenous people make up one-third of all those experiencing homelessness.

He could point out that Blacks and Latin Americans are disproportionately represented among the Vancouver’s homeless population.

But no, Poilievre prefers to ignore the racial and Indigenous discrimination represented by the tent city in his seedy video. He exploits those already discriminated by further tarring them all as drug addicts.

Poilievre spouts more populist drivel when he claims and that the “tax funded” safe supply of drugs is a failed experiment.

The opposite is true.

Prescribing drug addicts a safe supply of drugs saves tax dollars. The drugs are far cheaper than the cost of policing and to our health care system of treating addicts who overdose.

In fact, no one has died from a drug overdose at a safe consumption site. The BC Coroners Service looked into illicit drug toxicity deaths between 2012 and 2022 and found that no one had died of an overdose at a supervised consumption site. They said there was “no indication” they were contributing to the rise in narcotic-related fatalities. In fact, 56 per cent of overdose deaths in B.C. this year happened in private residences.

The safe supply of drugs to addicts saves lives because it lowers the rates of overdose and reduces in the use of fentanyl and other street drugs. It reduces the cost to the taxpayer of health care for addicts through reduced hospital admissions and emergency room visits. It improves connections to care and treatment for people who have not had support services in the past. The safe supply of drugs reduces police costs by decreasing criminal activity.

Poilievre adds to his misinformation but saying that injection sites are also to blame. B.C.’s safe injection sites do not use “tax paid drugs.” Users bring their own drugs and staff stand by in case of a bad reaction.

B.C. is leading the country in fighting the stupid laws that led to the problem in the first place.

Starting in January, 2023, adults in B.C. will not be arrested or charged for the possession of up to 2.5 grams of opioids (including heroin, morphine, and fentanyl), cocaine (including crack and powder cocaine), methamphetamine (meth) and MDMA (ecstasy).

Drug abuse is a medical issue. Shame on Poilievre for exploiting the homeless and spreading misinformation.

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Doctors beware: this opioid is not listed

Doctors rely on Canada’s Controlled Drugs and Substances Act as a guide in prescribing drugs. Tramadol is not listed there but that could change soon.

image: Tramadol dropshipper

Tramadol is a sneaky drug, as Dr. David Juurlink discovered when a patient with a shoulder injury was prescribed tramadol. On the positive side, tramadol relieved the shoulder pain. Then problems starting showing up says Dr. Juurlink:

“The first sign of trouble arose three months later. His shoulder pain gone, the patient assumed he no longer needed tramadol. He was wrong. Shortly after stopping it, he developed debilitating insomnia, shakes and back pain – something he’d never experienced before. Irritable, exhausted and functioning poorly at work, he soon found the solution: All he needed to do was keep taking tramadol, and these problems went away (Globe and Mail, November 27, 2017).”

There are two outcomes of being hooked on drugs. One is a physically dependence, such as exhibited by the above patient. The other is addiction in which a patient’s health deteriorates and their behaviour is transformed –what we usually think of as addiction. This patient needed the drug for no other reason than to avoid the debilitating effects of not taking the drug.

The reasons why tramadol is not listed are complex. First, the way that it affects patients depends on their genetics. Tramadol acts as if it were two drugs. It relieves pain using the same mechanism as aspirin does but for some with a particular enzyme, it converts to an opioid. Only 6 per cent of Caucasians have the enzyme, whereas 30 per cent of those of East African or Middle Eastern decent will experience opioid conversion.

Tailor-made drugs, specific to a patient’s genetics, hold future promise. That would allow doctors would know in advance whether a patient has the enzyme or not. For now doctors roll the dice in prescribing tramadol.

Second, when Health Canada last reviewed tramadol in 2007, during the era of the Harper government, a libertarian regime affected policy. Manufacturers of tramadol lobbied Health Canada directly and indirectly to keep the drug off the list. Manufacturers peddled the “dual mechanism of action” of tramadol without disclosing just what that meant. Indirect lobbying came in form of financial support to at least one patient advocacy group who wanted to keep the drug freely available.

The Holy Grail of pain-killers would be one as effective as opioids without the side effect of addiction. Researchers have been looking or more than a century. The German drug company, Bayer, marketed a cough suppressant derived from morphine under the trademark Heroin in 1895. It was marketed as being non-addictive.

More recently, OxyContin was marketed as a pain-relief drug “without unacceptable side effects.” Doctors believed that they were prescribing a safe drug but OxyContin proved otherwise. Patients who took it for pain relief got hooked and when prescriptions ran out, they went to the streets in search of substitutes.

Under the Trudeau government, Health Canada is considering placement of tramadol under the Controlled Drugs and Substances Act –where it belongs. Whether it is listed or not will be a test of a government’s resolve to put the health of Canadians above commercial interests.