Despite criminal prohibition and the prospect of becoming ill or even dying, people still do drugs. So we are faced with a wrenching dilemma: Do we, as a society, take over and regulate the supply and quality of drugs or do we leave these issues to the forces of an unbridled market operating in a dark underworld?
The War on Drugs has been a failure, and soon enough using drugs will shift from a criminal to a public health issue. But what if we paid people not to engage in harmful consumption? If we rewarded them for stopping damaging use? Couldn't the savings in all manner of costs greatly outweigh the comparatively small expense of any incentive?
I had a good friend of mine become a drug addict. Crack specifically. I never imagined he'd be using it in a million years, but life has a funny way of showing you that anything is possible. He was a natural born hustler. He sold dope at school, at parties and pretty much wherever he could make a buck.
Think of pain as being your "harm alarm," a signal that is designed to get your attention, to motivate you to escape whatever is causing it. After all, pain -- potential harm -- could mean injury or even death. In this way, pain serves a useful purpose because it is functions to keep you safe and alive. But what about chronic pain?
Moby describes this time in his life as "celebratory in the face of squalor" and on many levels that sentiment chimes through each chapter. Providing a private glimpse into his sexual escapades, celebrity encounters, struggles with sobriety and downright shenanigans, the book candidly and often comically details the party before the storm.
Canadians might be surprised to learn that many health and social services widely available in the community are not available in most of Canada's correctional facilities -- this needs to change. We are missing a critical window of opportunity to reframe the period of incarceration as a time to help people improve their health and well-being before returning to our communities.
If you experience withdrawal symptoms, this does not meant that you cannot get off opioids. Withdrawal symptoms mean that your opioid level was dropped too quickly and your body was surprised by the lack of medication. The key is to work with your body to successfully taper your opioids -- by making small changes slowly over time.
Critics have begun pointing the finger at the medical system and its prescribers -- well-meaning doctors and specialists who've been giving too many patients excessively powerful opioid medications to deal with modest pain. But we can dig deeper and look at the relationship between medical education and pharmaceutical company influence as a significant contributing factor.
A 65-year-old man notices he's feeling more tired lately. He's gaining weight and losing muscle. He can't get as many erections, and generally feels foggy and unwell. His family doctor takes some blood tests and rules out thyroid problems, high cholesterol and blood sugar issues. The only finding is low testosterone -- but that's a normal part of aging, right?
If Canada is to implement national pharmacare, surely we want to know more about the drugs we'll be paying for. To this end, we must tackle a pre-existing challenge: we must open up the evidence our drug regulator houses concerning drug safety and effectiveness. For decades Health Canada has kept that information confidential at the behest of drug manufacturers. This practice limits the ongoing evaluation of a drug's safety and effectiveness and, in turn, provincial and territorial governments' decision-making about which drugs to pay for, not to mention physicians and patients who make decisions about which drugs to prescribe and take.
Despite recent headlines, Canadian rates of suicide and attempted suicide have remained largely unchanged over the last several decades. What has changed is that we've seen increasing rates of suicide in the Canadian military recently, after stable rates for decades. The problem of suicide is not limited to the military in Canada; indigenous populations, especially in northern remote communities, have high rates of suicide. We need a unified approach across provincial and federal sectors to reduce suicides in the military, among veterans and civilians.
Using non-beneficial medications or failing to offer comfort medications to chronically ill patients is potentially harmful, time-consuming and simply bad medical care. Unnecessary or unwarranted medical interventions, including medications, are also costly to the healthcare system. It's time to embrace new ways of thinking.
Since 2009, Health Canada has taken the position that e-cigarettes containing nicotine are illegal. But out on the streets, Health Canada is simply being ignored. There's a brisk trade in vaping supplies including nicotine. Much of the new legislation might be found unconstitutional if challenged in the courts. Nicotine addicts who still use tobacco as a delivery method are suffering harm to their health that now appears to be quite unnecessary.
Today, doctors' offices are inundated with people who have been harmed more than helped by these drugs. Thousands more are dead. And yet the marketing continues, with pain specialists and advocacy groups opposing moves to curtail opioid prescription, their efforts financed by the very companies that make these drugs.
You will know well from history that real change won't happen by providing more federal money with unconditional transfers.Real change will require helping provinces to shift the focus of our health system away from those who are relatively well resourced to new areas of care, such as essential pharmaceuticals and homecare.