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B.C. overdose prevention sites should be template for others: report

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VANCOUVER — It was a day Heather Hobbs recalls vividly: the staff at AIDS Vancouver Island had pulled another overdose victim from the washroom, his body was blue from a lack of oxygen.

The man was revived and they closed the office in Victoria to allow staff to regroup. At the same time, in an alley just a half a block away, another of their clients was dying from an overdose.

Hobbs said she remembers seeing the man leave the facility as they began cleaning up from the overdose. His death was the tipping point for the implementation of an overdose prevention site at their facility, even though they weren’t yet legal, she said.

“I feel like it’s possible, had we not had to have closed, that he would still be alive. So it’s those moments that stick with me and really drive it home that these spaces are essential in terms of keeping people alive,” said Hobbs, who is the manager of harm reduction services for AIDS Vancouver Island.

In April 2016, the B.C. government declared a public health emergency in the overdose crisis, allowing for the unprecedented implementation of the prevention facilities. Within weeks, 20 sites had mushroomed around the province.

A new study by researchers at the Canadian Institute for Substance Use Research concludes the rapid implementation of the sites should be used as a template for other governments to save lives.

The study says the quick response of the provincial government and community groups is an “international example of an alternative to the lengthy and cumbersome sanctioning processes for (supervised consumption sites.)”

The report, published this month in the International Journal of Drug Policy, says other government demands for public consultations and an intensive application process “are highly questionable in the context of legal drug poisonings and evidence-based alternatives such as (overdose prevention sites.)”

Health Canada approves the supervised consumption sites, which require an exemption from federal drug laws, while the overdose prevention sites in B.C. are sanctioned under the provincial health minister’s declaration of a public health emergency.

Bruce Wallace, co-author of the report, a scientist at the institute and an associate professor at the University of Victoria, said the study demonstrates how unnecessary the approval process is elsewhere.

“Our research is showing that the benefits of being able to have overdose prevention sites at so many different locations and really integrated with housing, health and social support is a model to go for, rather than going back to the federal processes, which are more onerous to set up and more limited in scope.”

The BC Coroners Service said 991 people died of illicit drug overdoses in 2016, 1,486 died the next year and 1,510 were killed by illicit drugs in 2018. The dramatic rise in deaths coincides with emergence of the powerful opioid fentanyl, which the coroner says is responsible for the majority of illicit drug deaths.

Canada’s Public Health Agency said last week that 3,286 people died of apparent opioid-related deaths between January and September last year.

The report draws on interviews from staff at three of the prevention sites in Victoria to determine their impact.

Wallace said he’s frustrated that other jurisdictions in Canada aren’t adopting the same innovate practices to save lives, especially because they’ve been warned that dangerous opioids are moving into their provinces. 

“So to have that level of warning of the potential harm and not act, it’s really tragic that people would not take these lessons and adopt them as fast as they can in other jurisdictions.”

The Ontario government announced in late March that while 15 overdose prevention sites had been approved, six others would close, including three in Toronto.

Judy Darcy, B.C.’s mental health and addictions minister, said there are about 40 overdose prevention sites across B.C. with over one million visits. Thousands of overdoses have been reversed and there have been no deaths at the sites, she added. 

Darcy said it’s estimated the government’s actions, including the prevention sites, take-home naloxone kits and other prevention measures, have saved about 4,700 lives.

She said the prevention sites are a critical tool that also connect visitors to other supports, such as housing or treatment. But the stigma remains, Darcy said, and that is the next barrier to knock down.

“For too long we have treated mental health, mental illness as a sign of weakness and addiction as a character failure and as a sign of moral failure,” she said. “These centres don’t judge people. They’re there to save lives, they’re there to connect people to the social supports they need.”

Terri Theodore, The Canadian Press

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RCMP seeks names of potential victims of coerced sterilization, Lucki says

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OTTAWA — The RCMP is seeking the names of potential victims of coerced sterilization procedures and wants lawyers to help in the process, RCMP Commissioner Brenda Lucki said Tuesday.

In testimony before the House of Commons health committee, Lucki said the RCMP is willing to meet with victims, adding it would be helpful if lawyers could talk to complainants about coming forward.

“The lawyers … if they were to speak with those victims and provide them the options of coming to the police, we would absolutely sit down with each and every victim that they had to look at it from a criminal point of view,” she said.

“Obviously they are not going to release their names without their consent as well. But … if we were to have those conversations, and possibly we could convince victims to come forward through the lawyers, that would be one avenue that we could explore.”

MPs asked Lucki to testify as part of a study about ongoing concerns from predominantly Indigenous women who allege they were coerced or forced into tubal ligation procedures during childbirth.

Her testimony also followed a letter sent this spring by NDP health critic Don Davies who asked the RCMP to conduct an investigation of serious and credible allegations that have been brought forward.

Lucki told Davies in a March letter that the force would work with commanding officers in each province and territory as well as other police agencies to see if any complaints have been reported.

“To date, we have no allegations that are on file for forced or coerced sterilization that were found to be reported to the RCMP directly,” Lucki said Tuesday. She said the RCMP takes all criminal allegations very seriously and that the force has reached out to the Canadian Association of Chiefs of Police to raise awareness.

The issue has been the subject of much public scrutiny, particularly in the past two years.

In 2017, the Saskatchewan Health Region issued a public apology after complaints from Indigenous women, and a proposed class-action lawsuit was launched naming as defendants the Saskatoon Health Authority, the provincial and federal governments, and a handful of medical professionals.

Dr. Judith Bartlett, a Metis physician who co-authored the external review, told the committee on Tuesday that Indigenous women interviewed for the report often felt invisible, profiled and powerless.

She also said she does not believe women will come forward to the RCMP because there is “no safety there for them.” Those interviewed for the report were granted anonymity, she said, noting they often felt much better having been able to express the harm done to them.

Much more research is needed to understand the scope of the problem because any time an individual is asked to make a decision when they’re not in the state of mind to weigh pros and cons constitutes coercion, Bartlett said.

Dr. Jennifer Blake, chief executive of the Society of Obstetricians and Gynaecologists of Canada, told MPs that obtaining consent for tubal ligations at the time of delivery should be avoided at all costs. She also noted that when she first learned of allegations a forced sterilizations, she thought it was in reference to a historical issue.

Last Tuesday, lawyer Alisa Lombard, a partner with the firm Semaganis Worme Lombard, told the health committee she represents a client, referred to as D.D.S., was sterilized without proper and informed consent in December 2018 at a Moose Jaw, Sask., hospital

That same month, the United Nations Committee Against Torture urged Canada to act to address the issue of coerced sterilization, setting a one-year deadline to report back on progress.

In response, Health Minister Ginette Petitpas Taylor and Jane Philpott, then Indigenous services minister, sent a letter to provinces and territories proposing a working group of officials to discuss the concerns.

Health Canada said Tuesday the group has had “productive discussions” about the scope and purpose of the federal-provincial-territorial plan to “advance cultural safety and humility in the health system.” As a first step, officials decided Health Canada would take the lead on “an environmental scan of cultural safety initiatives and practices across Canada,” the agency said in a statement.

—Follow @kkirkup on Twitter

Kristy Kirkup, The Canadian Press

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Blair says more gun-control action needed, signals no new steps before election

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OTTAWA — Crime Reduction Minister Bill Blair says more must be done to address gun violence, but he’s also signalling that no new measures will be taken before the fall election.

Steps could — and should — be taken to prevent the theft, illegal diversion and cross-border smuggling of handguns, Blair said Tuesday. 

As he entered a cabinet meeting, Blair emphasized the importance of secure storage of firearms to prevent them from being stolen and ending up in the wrong hands.

The government is also open to working with municipalities to allow them to decide exactly where, or even if, firearms can be stored within their boundaries, he said.

However, the parliamentary sitting is expected to conclude shortly and the government is scrambling to tie up loose ends before the summer recess and an election campaign likely to begin in September.  

“Some of this would require regulatory and legislative change,” Blair said. “And I think it’s important not only to do the right thing, but to take the time to do it right.”

Prime Minister Justin Trudeau asked Blair last August to study the possibility of a ban on handguns and assault-style rifles after a shooting spree in Toronto.

A recently released summary of a federal consultation said Canadians were divided on the idea.

Still, Blair’s office said late last month that no options had been ruled out to clamp down on guns “designed to hunt people” as it weighed new options. Rumours of a federal ban on the popular AR-15 semi-automatic rifle began to circulate.

While Blair reiterated Tuesday there are firearms the government considers “so dangerous that there really is no place in a safe and civil society for them,” he made no firm commitment to ban or buy back such guns from owners.

Blair stressed a need to ensure secure storage, prevent people from buying firearms on behalf of criminals and deter smuggling of weapons into Canada from the United States, which he called “the largest handgun arsenal in the world.”

“There are a number of very effective measures that I believe that we can and must take to create a safer environment.”

Allowing municipalities to enact additional restrictions on handguns would not only be “wholly inadequate,” it would also be inefficient, said Heidi Rathjen, co-ordinator of PolySeSouvient, which wants an overhaul of the gun classification system with the ultimate aim of banning weapons specifically designed to kill people.

“All one has to do is consider the glaring disaster resulting from a patchwork of state and local gun laws south of the border,” she said Tuesday.

“And one has to ask: why would stricter controls on handguns be justified in cities and not in rural areas? It seems more like the Liberals chose not to deal with the highly politicized issue of banning handguns and instead decided to pass the buck to municipalities.”

The law already requires safe storage of firearms, but there has been a “significant increase” in the theft of large numbers of handguns from homes and retailers, with the guns ending up on the street in the wrong hands, Blair said.

He acknowledged there are responsible handgun owners who obey all the rules. “We may ask them to undertake additional measures to secure their weapons to make sure that they’re not vulnerable to being stolen.”

Public Safety Canada says 24 firearms were stolen from a shop in Prince Albert, Sask., by snipping one cable, raising concerns that the after-hours commercial storage regulations could be insufficient.

Some businesses “may not be fully compliant” with existing regulations, say department notes released through the Access to Information Act. However, chief firearms officers “indicate this is infrequent and businesses come into compliance quickly when non-compliance is identified.”

The RCMP says some businesses go beyond minimum requirements through measures including shatterproof glass in display cases, video-monitoring systems and alarms, safes bolted to the floor, deadbolt locks and solid doors instead of hollow ones for storage rooms.

— Follow @JimBronskill on Twitter

Jim Bronskill , The Canadian Press


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