Bring drug overdose plan to B.C. interior

To reduce drug overdose deaths, Vancouver Coastal Health authority plans to track patients to make sure they are taking their prescribed opioids.

image: IFL Science

I may seem odd that lives can be saved by making sure that patients take one opioid (Methadone) so that they don’t die from another (fentanyl). But that’s what statistics show. If patients stay on Methadone they’re more likely to be alive a year later.

It’s the first program of its kind in Canada and the latest effort to turn the tide on the opioid crisis that is projected to kill 1,500 British Columbians (Globe and Mail, Sept. 15, 2017). That’s up from 914 in 2016.

The problem is that patients have hectic lifestyles that make daily prescriptions difficult to take. As a result, only one-third are still on Methadone after a year. Laura Shaver, board member of the B.C. Association for People on Methadone, supports the plan:

“I would think it would be a great idea for many people that are, you know, a little bit unstable, for them to have a bit of a push behind them. With a bit of support, things could be a lot different.”

Rolando Barrios, assistant director at the Vancouver Coastal Health, sets his goal at 95 per cent Methadone compliance:

“We may not achieve that, but think about doubling the 30 per cent to 60 per cent . . . and the impact that would have.”

Tracking Methadone patients is labour intensive. The unregimented lifestyles of drug addicts make it difficult for them to make daily appointments. Starting this month, 20 teams, each comprising of three health professionals, will check on 3,000 patients to make sure they are taking their drugs.

Pharmacists will alert the teams if patients have not taken their daily dose. The team will then phone or visit the patient to check up. Participation in the program is voluntary: the teams are not policing patients.

The plan is modeled on the highly successful program to stop HIV/AIDS launched in 2010. It actively sought untreated HIV-positive people and followed up with an antiretroviral therapy. As a result, the transmission of AIDS was reduced by 96 per cent.

“With HIV,” says Dr. Barrios, “we used to wait until people had low immune systems before they started treatment . . . and then science came in and said we need to treat them earlier and faster. We learned that we needed to be aggressive.”

If the plan is so good for Vancouver, why isn’t it being applied throughout the province? Vancouver’s drug deaths may make news but the problem is worse in B.C.’s interior on a per capita basis.

Kamloops is bad -40 people died of drug overdoses in 2016- but Kelowna is worse. Kelowna led all Canada in per capita opioid poisoning hospitalizations. Vancouver was 16th. Kamloops didn’t make the top twenty but the program is needed here.

The Interior Health Authority needs to match the efforts of Vancouver Coastal Health. Users of prescription opioids need to be monitored. Only by reaching out will the death rate be brought down.

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By the time the trekkers got to Kamloops

In April of 1935 they left their miserable camps and made their way to Vancouver. The camps had been set up in the middle of nowhere. Young men worked in the military-run camps for 20 cents a day under deplorable conditions in dead-end jobs with no end in sight.

Canada’s History Magazine

The camps were designed to harsh. Prime Minister Bennett had reluctantly set them up as a concession to the unemployed victims of the Great Depression. He was opposed to anything that looked like a handout, including even the appalling camps. He told a labour delegation in 1930: “Never will I or any government of which I am part put a premium on idles or put our people on the dole (Canada’s History magazine, August-September, 2016).”

The camps didn’t have to be that way, says historian Bill Waiser of the University of Saskatchewan. “In contrast to the American Civil Conservation Corps, a popular federal work-for-relief program across the border, the make-work projects and isolating conditions of the Canadian relief camps aggravated the gloom of the men who were in them.”

About fifteen hundred desperate men arrived in Vancouver and were warmly received. Huge public rallies and parades were held. On Mother’s Day in Stanley Park, three hundred women circled the men in the shape of a heart.

As is typical, provincial and federal governments wrangled over who was responsible for the men. Finally the men decided to take matters into their own hands and trek to Ottawa aboard boxcars. About one thousand left Vancouver in June of 1935. Governments made no attempt to stop them –convinced that the trekker’s tenacity would dissolve in the cold trip through the mountains.

By the time the trekkers got to Kamloops they were cold, hungry and dispirited. Unlike Vancouver, no warm reception awaited them. Nothing had been done to prepare for their arrival: Mayor W. J. Moffatt and the chief of police flatly refused requests for help.

Kamloops had problems of its own with hordes of desperate, unemployed men in formal camps and informal “hobo jungles” says Mary Balf, former curator of the Kamloops Museum, in her book Kamloops 1914-1945. In one case, on May 1, 1931, men flocked into the city to complain about the poor conditions in these camps. Police closed the bridge from North Kamloops to limit the numbers.

“The work camps continued rather haphazardly until the summer of 1936,” says Balf, “but never really worked well. . . frequently they were so badly managed that even the promised wages were not forthcoming.”

After 300 men joined the trekkers from Kamloops, they were revitalized. As word of the trekkers spread, they were soon regarded as folk heroes. Washtubs of stew awaited them when they arrived in Golden in June. Calgary citizens were struck by the youthful innocence of the men.

More men joined the trek in Alberta but not my father. He was in a camp in Jasper at the time building the national park. He never told me about the camp conditions in Jasper. Perhaps he preferred to forget the depression and the stigma of unemployment. Perhaps, like some of the projects in the U.S., the building of parks gave purpose to his work.

As the popularity of the heroic trekkers grew, the federal government began to worry that they might actually get to Ottawa. By the time they got to Regina, the feds decided they would go no further. On Dominion Day in 1935, Regina police and RCMP raided a rally attended by thousands of trekkers and supporters. A riot ensued with hundreds of injuries and two deaths.

The trek ended but not without a cost to the feds. In October of 1935, Bennett’s government was defeated. A year later the camps were closed down.

Stephen Harper’s gift to Canada

It’s not what he intended but former Prime Minister Harper has emboldened Canada’s Supreme Court and strengthened the Charter of Rights and Freedoms.

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Harper set out to remake Canada in his own image; a conservative unlike any Canada has seen before. Certainly not like the Progressive Conservative party that his amalgamation consumed; one based the libertarian principles Harper learned from his American professors at the University of Calgary.

Harper considered the Charter, introduced in by Pierre Trudeau in 1982, to be an artifice. But to Harper’s chagrin, the legacy of his nemesis has been strengthened.

It’s not for lack of trying. Harper tried to subvert the Charter by passing contrary laws.  Looking to emulate the U.S. system of making political appointments, he tried to stack the Supreme Court to support his subversion. That backfired as the judges he had appointed struck down laws he had passed, such as those on mandatory jail terms or illegal drugs.

Another approach was to kill of the Charter by a thousand cuts. In changing the law incrementally, he imaged that lots of small increments would add up to big change. Sean Fine, justice reporter for the Globe and Mail explains:

“On murder, he took away the ‘faint-hope clause’ that allowed for parole after 15 years instead of 25. Then he permitted the 25-year waiting period for a parole hearing to be added up in cases of multiple murders – 25 years on each murder. And then he promised life in prison with no parole for especially brutal murders.”

Harper tried to shut down the safe-injection clinic in Vancouver, Insite, where drug users could inject heroin with a nurse present, The Supreme Court ruled that shutting the clinic would severely harm, perhaps kill, drug addicts.

The Supreme Court ruling had the unintended consequence of making it harder for the Harper government to limit the rights of the vulnerable. Undeterred, Harper pressed ahead with prostitution laws, which the court unanimously ruled against decreeing that the laws endangered prostitutes.

More consequences of this legacy played out when the city of Abbotsford attempted to keep homeless people from sleeping in parks by spreading chicken manure.

“B.C. Supreme Court Chief Justice Christopher Hinkson, a Harper appointee, ruled for the homeless and against the city. Government should not cause physical or psychological harm to a vulnerable population, he said, citing the Insite ruling.”

Ghosts of a strengthened Supreme Court and the Charter brought in by Pierre Trudeau will haunt the son. Rulings have reduced the ability of all governments to impinge on rights.

Solitary confinement in federal prisons is being challenged based on the Insite ruling. If Justin Trudeau’s new Minister of Justice, Ms. Wilson-Raybould, attempts to defend the status quo, she could find herself taking a position on basic Charter rights similar to that taken by the Harper government.

“The result could be a supreme irony: Unless she moves quickly – on refugee health cuts, on mandatory jail sentences that fall most heavily on aboriginal peoples, on a spate of laws that reduce judges’ discretion – the Trudeau government will find that its justice-department lawyers are in court defending Harper-era policies whose goal was to remove perceived liberal bias from the justice system.”

  After many cuts, Liberals go on spending spree with Games 

Premier Campbell’s conversion to big spender is quite     remarkable.  Before the Olympics, the premier was all for    cutting spending — schools, hospitals, courthouses, shelters for women and youths at risk, campgrounds, Pharmacare, avalanche warning, and just about anything he could.  Winning the Olympic bid for Vancouver has changed his mind.

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Now the premier can’t spend money fast enough.  Campbell will bankroll the biggest spectacle in the world in 2010. His government will hire thousands of workers over a seven year period to build convention centers, roads, rapid transit and games facilities.  The B.C. Liberals will become a bigger employer than the left-leaning government they replaced.

The premier’s conversion is remarkable because up until now Campbell has led us to believe that governments don’t create jobs.  The role of the government, he has told us over and over,  is to get out of the way of the free enterprise system.   By reducing environmental regulations and lowering wages for workers, we were led to believe that big business would create prosperity that would be only rivaled by our province’s natural beauty.

At least, that was what he thought until the glory of Olympic Games illuminated the new way — spend, spend, spend.  Now he is a believer in big government projects and will spend his way into the hearts of British Columbians and the world.

Or, more correctly, the premier will spend our tax dollars on a huge sports spectacle.  Never mind that we would rather spend our money on more sensible things, like human resources.  Campbell has forgotten that B.C.’s biggest resource is its people and the wisest expenditure is on health, education, clean air and water, safety, and helping the less fortunate to their feet.

Campbell’s gamble is that he will recover our tax dollars through revenue from ticket sales, TV rights, and corporate sponsorship.  It’s not a sure thing.

“The Province of British Columbia, as the sole guarantor of the Games, is assuming all the financial burden of what is, clearly, a risky business venture,” says a report from the Canadian Centre for Policy Alternatives.   “The 2010 Games will not ‘pay for themselves,'” says the report.  In fact, Olympic games usually lose money or worse, because of bad accounting, no one is ever quite sure.

UCC economist Jim Seldon has seen it all before and cost overruns are common. “I’ve looked at both the studies prepared by the provincial government and the one by the CCPA — plus a lot of other benefit-cost and economic impact studies for ‘events’ of various sorts over the years,” Seldon told me.  Cost recovery is unlikely.

But Seldon thinks that the CCPA study could have done a better job in the study of benefits.  Instead of looking at the costs, look at the value received through the expenditure of our tax dollars.  That could have been tested by a question: “Would you be willing to pay $10 a year more in taxes for the next ten years to have the Olympics come to BC.”

If taxpayers are willing to pay more taxes for the Olympics, then it’s not a cost but a benefit.  “The idea is pretty simple:  if you are willing to pay $10 for something rather than go without it, then that item logically must be worth at least $10 to you and maybe more,” according to Seldon. So, even if we are a bit short in recovering our investment the money may be well spent.  Or not.

And what about all the thousands of construction jobs in created by the Olympic games.  In fact, jobs are created by almost any government project.  It doesn’t matter if it’s building Olympic stadiums, highways, hydro dams, fast ferries, or just digging holes in the ground.

The real question is not whether jobs are created but rather, what are the lasting benefits of those jobs?  Will the pride of hosting a world-class event and attracting world’s attention for a few weeks be worthwhile?

Time will tell if Campbell’s gamble will be a lasting legacy and the money well spent.  Will it be as durable as former Premier W.A.C. Bennett’s hydro dams and a public electrical utility?  Or will it be more like Premier Glen Clarke’s failed dream of B.C. as a world class ship-building province?

 Chretien’s attitude towards legitimate protest is not acceptable

The findings of Ted Hughes’ inquiry into the 1997 APEC demonstrations in Vancouver were anticlimactic.   Canadians had decided long ago that the Government of Canada was involved in the suppression of demonstrators’ constitutional rights.

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These APEC demonstrations were pre-Seattle.  They were the kind of peaceful protest that citizens of most democratic countries take for granted.  Demonstrators held up signs and sat passively in the road.

The Government of Canada saw things differently.  “There was concern about vandalism. This was the very place where the meeting was going to take place. And therefore, the host, the Government of Canada decided that it wanted to secure the site,” says Ivan Whitehall, government lawyer.

Whitehall confuses the 1997 APEC meeting with later confrontations between anarchists and police such as those in Seattle and Quebec, where the Government set up their media focus props — the provocative fence in Quebec city and armoured police in their Darth Vader costumes.  Then they waited for the inevitable clash with anarchists.

It’s preferable for the Government to stage conflicts with protestors  because then they don’t have to deal with their legitimate concerns.  And with the concerns of most Canadians according to a recent poll. Those concerns can be dismissed by Chretien, as he recently did with Quebec delegates from civil society,  as “blah, blah, blah.”

The role of the Prime Minister Chretien in directing attacks in 1997 against the peaceful APEC demonstrators was not fully explored by Hughes.  The truth is still out there, according to Alliance MP Jim Abbott.  “There are filing cabinets full of documents that show involvement of Chretien in the affair,” he says.  But Hughes’ commission did not have the mandate to look at them.

There is evidence that involves Prime Minister Chretien.    First there is the scrawled police memo that said “PM wants tenters out”.  “I did not talk to the police myself” said Prime Minister Chretien (September 1998).  Maybe not.  And maybe ex-US President Clinton was technically telling the truth when he said “I did not have sex with that Lewinski woman”.

But the most compelling evidence of the Prime Minster’s APEC came from one of Chretien’s own cabinet minsters, Andy Scott.   Scott, the former Solicitor General, was sitting on a plane in 1998 and talking to his friend — loud enough for fellow passenger NDP MP Dick Proctor to  overhear it all.

Scott told his friend “Hughie may be the guy who takes the fall for this.”  Scott was referring to Sgt. Hugh Stewart, who was captured on video dousing demonstrators with pepper spray.  The video was played on television news dozens of times.

At first Solicitor General Scott couldn’t seem to remember a thing about the conversation. When a reporter asked   “You never heard of Sgt. Stewart?”, Scott replied “No I don’t. No. (Oct. 5 1998 CBC transcripts).

When Scott’s friend agreed with Dick Proctor, Scott had sudden recall. But not soon enough for him to be saved from being sacked by his boss, Prime Minister Chretien.

Sgt. Stewart gained the nickname “Sgt Pepper” by the demonstrators.  In the spirit of things, Prime minister Chretien made light of the incident.  He called pepper “something I put on my steak” and in the House of Commons said that maybe the police should have used baseball bats instead of pepper spray (October 19, 1998).  Ha ha, that’s a good one, Jean.

When the Prime Minister was questioned about the seemingly callous remark, he went from the frying pan to the fire.  Chretien replied “I don’t know. You know, use water cannon? I don’t know”.

Jim Abbott was not amused. “Doesn’t he realize that the reference to baseball bats yesterday and then trying to placate people by talking about water cannons today is totally unacceptable, completely offensive to Canadians,” he said.

Chretien’s attitude towards legitimate protest is not acceptable.  He is more concerned with protecting the rights of corporations and foreign leaders of dubious distinction than Canadians.   His comments turned out to be prophetic in the escalated violence at Quebec.

Was the Prime Minister involved in the embarrassing debacle of fortress Quebec, where water cannons and batons were used on citizens?  I don’t think Canadians will have to wait for another inquiry to decide.