Vancouver program provides ‘window of opportunity’ to addiction treatment
VANCOUVER — A Vancouver emergency department has become the first in Canada to give overdose patients take-away packs of medication aimed at warding off withdrawal symptoms and getting them into treatment to prevent deaths from tainted opioids.
Dr. Andrew Kestler, a co-lead of the program at St. Paul’s Hospital, said patients get a three-day supply of Suboxone and easy-to-understand instructions from a nurse before they’re discharged.
The idea is to prevent barriers to treatment because many patients are unable to get a prescription filled at a pharmacy after they leave the hospital, Kestler said Wednesday, adding severe physical and emotional withdrawal symptoms can make it impossible for people to seek help.
“We know that of people who have died of an overdose in British Columbia, over 50 per cent of those had visited an emergency department in the last year before their death,” he said.
Five women and three men have so far been given the medication in the emergency department, Kestler said.
“We’re hoping to translate our experience at St. Paul’s to the rest of the province and the rest of the country.”
Patients from the hospital can also access a clinic in the same building so they can be connected with services in the community before being followed up by an overdose outreach team that can link them to a doctor.
The two-year pilot project will be evaluated by the BC Centre on Substance Use in the province, which has the highest number of overdose deaths in Canada.
Mark Haggerty, a peer support worker at the Rapid Access Addiction Clinic at St. Paul’s, said he beat an addiction to alcohol and cocaine and understands there’s a small window of opportunity to get people into treatment, often after they’ve had a wake-up call from an overdose.
“If they have the opportunity to get on Suboxone right away that will help. If they have to wait 10 hours to come to a clinic or just to wait to get treatment a lot of things can happen. A lot of things can happen in a couple of hours, when people get another fix.”
Drug users often fear getting treatment because they face stigma as “low-life addicts,” even from medical staff, though that’s been slowly changing as addiction has become better understood, Haggerty said.
Dr. Keith Ahamad, the other co-lead of the program, said the overdose crisis demands a change in emergency-room culture in order to save lives and handing people a prescription is the wrong approach.
“Many places don’t even do that, which is kind of shocking,” said Ahamad, who is also a researcher with the BC Centre on Substance Use.
“We’re in the midle of a public health emergency and it really needs to be all hands on deck. If there were any other health emergency like this emergency departments really would be the beacon of where to get care. They’re open 24/7 and they’re staffed with all sorts of health-care professionals,” he said.
“The culture around addiction treatment in the health-care system for decades has really been one of ignore. And if we do anything the onus is on the patient to try and navigate a system and find care somewhere and maybe we give them a number to call and they’re told on a certain day within a few weeks they can maybe make an appointment somewhere.”
— Follow @CamilleBains1 on Twitter.
Camille Bains, The Canadian Press
Senate report recommends Canada develop targeted suicide prevention strategies
Senators sit in Senate of Canada Building in Ottawa, on Wednesday, Sept. 23, 2020. A Senate report released today says that if Canadian governments at all levels targeted their suicide prevention strategies towards men and Indigenous people, who die most by suicide, the landscape of the issue can transform. THE CANADIAN PRESS/Justin Tang
By Fakiha Baig
A Senate report released Thursday says Canada can make major strides in suicide prevention if all levels of government develop strategies tailored towards men and Indigenous people, the groups facing the highest suicide rates.
The Senate Committee on Social Affairs, Science and Technology also says the Federal Framework for Suicide Prevention Act has done little to bring down the rate of suicides across Canada since it was adopted in 2016 because it does not prioritize evidence-based interventions for suicide prevention and does a poor job at tracking the issue.
Sen. Patrick Brazeau, a member of the Algonquin community of Kitigan Zibi and a committee member, says he pushed for a study of suicide in Canada after he tried to take his own life twice almost a decade ago.
“I was hurting,” the senator says in the report.
“Some people have lost cherished ones to this and just can’t handle it, but for those who can handle it, it is very important they share their voices and stories … There are many people having problems in Canada today.”
The report found that men account for 75 per cent of suicides in Canada. Indigenous leaders told the committee that “Inuit experience suicide at roughly 6 to 25 times the national rates, depending upon region and also demographics.”
The report said men die more by suicide because “men choose more lethal means of suicide, like firearms.”
Brazeau says Canada needs to conduct a gender-based analysis of the programs available because the report has found there are more prevention efforts available for women than for men.
Brazeau says this could be because, historically, men have also been taught to hide their emotions which makes taking care of their mental well-being more difficult.
“(We think) men are strong, men are supposed to be tough, and men don’t have to get help, and they’ll sort it out on their own,” Brazeau said. “I’m living proof that’s not the case.”
The report said various evidence-based approaches can reduce suicide among the overrepresented groups, including “means restrictions.”
“Means restriction aims to make the most common and lethal methods of suicide more difficult to access” the report says, recommending Canada limit gun ownership and strengthen border surveillance on firearms trafficking.
The reports states multiple factors, including the effects of colonialism, have hurt Indigenous well-being and the 2016 framework needs to acknowledge this.
“Realities differ quite a bit from First Nations, to Métis, to Inuit and; from urban Indigenous peoples to those on reserves, or in rural areas,” the report says.
“Witnesses emphasized the importance of providing accessible care and intervention to all Indigenous peoples, whether they live in urban, rural, or remote environments.”
It also emphasized programming for suicide prevention should involve Indigenous care.
The Senate report says primary care physicians can also greatly benefit from suicide prevention efforts.
The federal Minister of Mental Health and Addictions Carolyn Bennett has told the Senate “the College of Family Physicians is currently planning to extend the two-year residency to three years to accommodate additional training in mental health, addictions and pain,” the report says.
Bennett did not immediately respond to a request for comment on the report but the Senate says the minister has informed the committee work is being done to update the 2016 framework.
The report also calls for Canada to create a national suicide data collection system that is consistent from province to territory and urged the existing 2016 framework to formally acknowledge the disproportionately high suicide rates among Indigenous people, as well as men and boys.
Brazeau says the Senate’s next step is to discuss the report with the federal government, which will then prepare a response to its findings.
“It’s important that future governments take those recommendations and focus on the target populations,” Brazeau said.
If you or someone you know is thinking about suicide, support is available 24/7 by calling Talk Suicide Canada (1-833-456-4566) or, for residents of Quebec, 1 866 APPELLE (1-866-277-3553).
This report by The Canadian Press was first published June 8, 2023.
WHO’s Global Digital Health Certification Network
From the youtube channel of Dr. John Campbell
With notes from the World Health Organization website, Dr. John Campbell explains the WHO’s Global Digital Health Certification Network. To see the WHO’s press release click here or scroll below the video where it is attached.
Press release from the World Health Organization
The European Commission and WHO launch landmark digital health initiative to strengthen global health security
The World Health Organization (WHO) and European Commission have announced today the launch of a landmark digital health partnership.
In June 2023, WHO will take up the European Union (EU) system of digital COVID-19 certification to establish a global system that will help facilitate global mobility and protect citizens across the world from on-going and future health threats, including pandemics. This is the first building block of the WHO Global Digital Health Certification Network (GDHCN) that will develop a wide range of digital products to deliver better health for all.
“Building on the EU’s highly successful digital certification network, WHO aims to offer all WHO Member States access to an open-source digital health tool, which is based on the principles of equity, innovation, transparency and data protection and privacy,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “New digital health products in development aim to help people everywhere receive quality health services quickly and more effectively”.
Based on the EU Global Health Strategy and WHO Global strategy on digital health, the initiative follows the 30 November 2022 agreement between Commissioner Kyriakides and Dr Tedros to enhance strategic cooperation on global health issues. This further bolsters a robust multilateral system with WHO at its core, powered by a strong EU.
“This partnership is an important step for the digital action plan of the EU Global Health Strategy. By using European best practices we contribute to digital health standards and interoperability globally—to the benefit of those most in need. It is also a powerful example of how alignment between the EU and the WHO can deliver better health for all, in the EU and across the world. As the directing and coordinating authority on international health work, there is no better partner than the WHO to advance the work we started at the EU and further develop global digital health solutions,” said Stella Kyriakides, Commissioner for Health and Food Safety.
This partnership will include close collaboration in the development, management and implementation of the WHO GDHCN system, benefitting from the European Commission’s ample technical expertise in the field. A first step is to ensure that the current EU digital certificates continue to function effectively.
“With 80 countries and territories connected to the EU Digital COVID-19 Certificate, the EU has set a global standard. The EU certificate has not only been an important tool in our fight against the pandemic, but has also facilitated international travel and tourism. I am pleased that the WHO will build on the privacy-preserving principles and cutting-edge technology of the EU certificate to create a global tool against future pandemics,” added Thierry Breton, Commissioner for Internal Market.
A global WHO system building on EU legacy
One of the key elements in the European Union’s work against the COVID-19 pandemic has been digital COVID-19 certificates. To facilitate free movement within its borders, the EU swiftly established interoperable COVID-19 certificates (entitled ‘EU Digital COVID-19 Certificate’ or ‘EU DCC’). Based on open-source technologies and standards it allowed also for the connection of non-EU countries that issue certificates according to EU DCC specifications, becoming the most widely used solution around the world.
From the onset of the pandemic, WHO engaged with all WHO Regions to define overall guidelines for such certificates. To help strengthen global health preparedness in the face of growing health threats, WHO is establishing a global digital health certification network which builds upon the solid foundations of the EU DCC framework, principles and open technologies. With this collaboration, WHO will facilitate this process globally under its own structure with the aim to allow the world to benefit from convergence of digital certificates. This includes standard-setting and validation of digital signatures to prevent fraud. In doing so, WHO will not have access to any underlying personal data, which would continue to be the exclusive domain of governments.
The first building block of the global WHO system becomes operational in June 2023 and aims to be progressively developed in the coming months.
A long-term digital partnership to deliver better health for all
To facilitate the uptake of the EU DCC by WHO and contribute to its operation and further development, WHO and the European Commission have agreed to partner in digital health.
This partnership will work to technically develop the WHO system with a staged approach to cover additional use cases, which may include, for example, the digitisation of the International Certificate of Vaccination or Prophylaxis. Expanding such digital solutions will be essential to deliver better health for citizens across the globe.
This cooperation is based on the shared values and principles of transparency and openness, inclusiveness, accountability, data protection and privacy, security, scalability at a global level, and equity. The WHO and the European Commission will work together to encourage maximum global uptake and participation. Particular attention will be paid to equitable opportunities for the participation by those most in need: low and middle-income countries.
Dr. John Campbell’s Presentation notes:
WHO’s Global Digital Health Certification Network https://www.who.int/initiatives/globa…
WHO has established the Global Digital Health Certification Network (GDHCN). Open-source platform, built on robust & transparent standards, that establishes the first building block of digital public health infrastructure, for developing a wide range of digital products, for strengthening pandemic preparedness
Background Member States used digital COVID-19 test and vaccine certificates As the directing and coordinating authority on international health work, at the onset of the pandemic, WHO engaged with all WHO Regions to define overall guidance for such certificates and published the Digital Documentation of COVID-19 Certificates
https://www.who.int/publications/i/it… https://www.who.int/publications/i/it… there is a recognition of an existing gap, and continued need for a global mechanism, that can support bilateral verification of the provenance of health documents
The GDHCN may include Digitisation of the International Certificate of Vaccination or Prophylaxis, verification of prescriptions across borders
International Patient Summary Verification of vaccination certificates within and across borders Certification of public health professionals (through WHO Academy) Expanding such digital solutions will be essential to deliver better health for people across the globe.
The GDHCN has been designed to be interoperable with other existing regional networks EU-WHO digital partnership https://www.who.int/news/item/05-06-2… • LIVE: WHO and @EU… https://commission.europa.eu/strategy… WHO and the European Commission have agreed to partner in digital health.
This partnership will work to technically develop the WHO system with a staged approach to cover additional use cases, In June 2023, WHO will take up the European Union (EU) system of digital COVID-19 certification to establish a global system, that will help facilitate global mobility
This is the first building block of the WHO Global Digital Health Certification Network (GDHCN)
Dr Tedros Adhanom Ghebreyesus WHO aims to offer all WHO Member States access, On the principles of equity, innovation, transparency and data protection and privacy Stella Kyriakides, Commissioner for Health and Food Safety
This partnership is an important step for the digital action plan of the EU Global Health Strategy, we contribute to digital health standards and interoperability globally
Thierry Breton, Commissioner for Internal Market The EU certificate … has also facilitated international travel and tourism I am pleased that the WHO will build on …. cutting-edge technology … to create a global tool against future pandemics
One of the key elements in the European Union’s work against the COVID-19 pandemic has been digital COVID-19 certificates. WHO will facilitate this process globally under its own structure … allow the world to benefit from convergence of digital certificates. Expanding such digital solutions will be essential to deliver better health for citizens across the globe.
The WHO and the European Commission will work together to encourage maximum global uptake and participation.
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