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Primary Care Network offers ideas to help you tolerate uncertainty

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Primary Care Network offers ideas to help you tolerate uncertainty.

TOLERATING UNCERTAINTY

When we are anxious, we tend to over-estimate the danger, and the odds, of bad things happening, and we under-estimate our ability to cope if or when those bad things happen.

Even if the odds are really small that a bad thing will happen, that tiny chance is enough to really upset us. We call it “intolerance of uncertainty”. We might think things like “I just can’t cope with not knowing”, “I have to be 100% certain”, “uncertain events are almost always bad”, so “I must prepare for each uncertain event”.

The thoughts make us feel anxious, so we try to reduce the uncertainty by worrying about it – by planning and preparing for the possible negative future event. However, although we think worry helps us feel better and helps us feel more in control, it doesn’t reduce the risk of the possible negative event happening. Sometimes we even think it would be better if the bad thing happened right now, because that would be better than living with the uncertainty.

We might try to increase certainty by planning and preparing for each worst case scenario, by seeking reassurance from others, by checking and looking things up on the internet, by avoiding certain things, putting things off or making excuses, or we might try to keep busy so that we don’t think about the uncertain future. However, worrying doesn’t affect the future outcome, we cannot prevent all bad things from happening and life remains uncertain. By worrying about what MIGHT happen, how does that affect us right now? Worrying seems like the best thing to do, but it only makes us feel worse and makes us less able to cope with real life.

We can deal with uncertainty in two main ways. We can challenge our need for certainty by looking at the advantages and disadvantages of needing to be certain and how it affects us. We can explore other areas of our lives in which we do tolerate uncertainty, or look at how other people deal with uncertainty, such as friends or characters in television programmes.

The other way is to learn to tolerate uncertainty – to reduce our need for certainty. And we can do this, using the acronym: APPLE

Tolerating Uncertainty with APPLE:

A for AWARE – Notice the need for certainty as it comes up in your mind

P for PAUSE – Don’t react as you normally do. Don’t react at all. Just pause, and breathe

P for PULL BACK – Tell yourself this is just the worry talking, and this apparent need for certainty is not helpful and not necessary

L for LET GO – let go of the thought or feeling about needing certainty. Tell yourself it is only a thought or feeling. Don’t believe everything you think! Thoughts are not statements of fact. They will pass. You don’t have to respond to them. You might imagine them floating away in a bubble or cloud.

E for EXPLORE – you can explore the present moment, because right now, in this moment, we are ok. Notice your breathing, and the sensations of breathing. Notice the ground beneath you, look around you and notice what you see, what you hear, what you can touch, what you can smell. Right now. Then shift your focus of attention to something else – maybe carry on what you were doing before you noticed the worrying thought, or do something else – mindfully, with your full attention.

(C.2015 Carol Vivyan – used with permission)

Read more stories on Todayville.

Red Deer Primary Care Network (RDPCN) is a partnership between Family Doctors and Alberta Health Services. Health professionals such as psychologists, social workers, nurses and pharmacists work in clinics alongside family doctors. In addition, programs and groups are offered at the RDPCN central location. This improves access to care, health promotion, chronic disease management and coordination of care. RDPCN is proud of the patient care offered, the effective programs it has designed and the work it does with partners in health care and the community. www.reddeerpcn.com

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Community

SPARC Red Deer – Caring Adult Nominations open now!

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Red Deer community let’s give a round of applause to the incredible adults shaping the future of our kids. Whether they’re a coach, neighbour, teacher, mentor, instructor, or someone special, we want to know about them!

Tell us the inspiring story of how your nominee is helping kids grow up great. We will honour the first 100 local nominees for their outstanding contributions to youth development. It’s time to highlight those who consistently go above and beyond!

To nominate, visit Events (sparcreddeer.ca)

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Addictions

‘Harm Reduction’ is killing B.C.’s addicts. There’s got to be a better way

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From the Frontier Centre for Public Policy

By Susan Martinuk 

B.C. recently decriminalized the possession of small amounts of illicit drugs. The resulting explosion of addicts using drugs in public spaces, including parks and playgrounds, recently led the province’s NDP government to attempt to backtrack on this policy

Since 2016, more than 40,000 Canadians have died from opioid drug overdoses — almost as many as died during the Second World War.
Governments, health care professionals and addiction experts all acknowledge that widespread use of opioids has created a public health crisis in Canada. Yet they agree on virtually nothing else about this crisis, including its causes, possible remedies and whether addicts should be regarded as passive victims or accountable moral agents.

Fuelled by the deadly manufactured opioid fentanyl, Canada’s national drug overdose rate stood at 19.3 people per 100,000 in 2022, a shockingly high number when compared to the European Union’s rate of just 1.8. But national statistics hide considerable geographic variation. British Columbia and Alberta together account for only a quarter of Canada’s population yet nearly half of all opioid deaths. B.C.’s 2022 death rate of 45.2/100,000 is more than double the national average, with Alberta close behind at 33.3/100,00.

In response to the drug crisis, Canada’s two western-most provinces have taken markedly divergent approaches, and in doing so have created a natural experiment with national implications.

B.C. has emphasized harm reduction, which seeks to eliminate the damaging effects of illicit drugs without actually removing them from the equation. The strategy focuses on creating access to clean drugs and includes such measures as “safe” injection sites, needle exchange programs, crack-pipe giveaways and even drug-dispensing vending machines. The approach goes so far as to distribute drugs like heroin and cocaine free of charge in the hope addicts will no longer be tempted by potentially tainted street drugs and may eventually seek help.

But safe-supply policies create many unexpected consequences. A National Post investigation found, for example, that government-supplied hydromorphone pills handed out to addicts in Vancouver are often re-sold on the street to other addicts. The sellers then use the money to purchase a street drug that provides a better high — namely, fentanyl.

Doubling down on safe supply, B.C. recently decriminalized the possession of small amounts of illicit drugs. The resulting explosion of addicts using drugs in public spaces, including parks and playgrounds, recently led the province’s NDP government to attempt to backtrack on this policy — though for now that effort has been stymied by the courts.

According to Vancouver city councillor Brian Montague, “The stats tell us that harm reduction isn’t working.” In an interview, he calls decriminalization “a disaster” and proposes a policy shift that recognizes the connection between mental illness and addiction. The province, he says, needs “massive numbers of beds in treatment facilities that deal with both addictions and long-term mental health problems (plus) access to free counselling and housing.”

In fact, Montague’s wish is coming true — one province east, in Alberta. Since the United Conservative Party was elected in 2019, Alberta has been transforming its drug addiction policy away from harm reduction and towards publicly-funded treatment and recovery efforts.

Instead of offering safe-injection sites and free drugs, Alberta is building a network of 10 therapeutic communities across the province where patients can stay for up to a year, receiving therapy and medical treatment and developing skills that will enable them to build a life outside the drug culture. All for free. The province’s first two new recovery centres opened last year in Lethbridge and Red Deer. There are currently over 29,000 addiction treatment spaces in the province.

This treatment-based strategy is in large part the work of Marshall Smith, current chief of staff to Alberta’s premier and a former addict himself, whose life story is a testament to the importance of treatment and recovery.

The sharply contrasting policies of B.C. and Alberta allow a comparison of what works and what doesn’t. A first, tentative report card on this natural experiment was produced last year in a study from Stanford University’s network on addiction policy (SNAP). Noting “a lack of policy innovation in B.C.,” where harm reduction has become the dominant policy approach, the report argues that in fact “Alberta is currently experiencing a reduction in key addiction-related harms.” But it concludes that “Canada overall, and B.C. in particular, is not yet showing the progress that the public and those impacted by drug addiction deserve.”

The report is admittedly an early analysis of these two contrasting approaches. Most of Alberta’s recovery homes are still under construction, and B.C.’s decriminalization policy is only a year old. And since the report was published, opioid death rates have inched higher in both provinces.

Still, the early returns do seem to favour Alberta’s approach. That should be regarded as good news. Society certainly has an obligation to try to help drug users. But that duty must involve more than offering addicts free drugs. Addicted people need treatment so they can kick their potentially deadly habit and go on to live healthy, meaningful lives. Dignity comes from a life of purpose and self-control, not a government-funded fix.

Susan Martinuk is a senior fellow at the Frontier Centre for Public Policy and author of the 2021 book Patients at Risk: Exposing Canada’s Health Care Crisis. A longer version of this article recently appeared at C2CJournal.ca.

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