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Small communities grapple with ‘huge challenge’ of opioid crisis

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OTTAWA — In the small town of Arnprior, nestled into the Ottawa Valley, at least five suspected opioid overdoses in the span of week prompted police to issue a public warning.
Access to extremely dangerous opioids is not limited to larger cities, …


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  • OTTAWA — In the small town of Arnprior, nestled into the Ottawa Valley, at least five suspected opioid overdoses in the span of week prompted police to issue a public warning.

    Access to extremely dangerous opioids is not limited to larger cities, said the Renfrew detachment of the Ontario Provincial Police, and the drugs have “infiltrated every corner of our province in some form or another.”

    “When you are purchasing drugs illegally, you actually don’t know exactly what is in those drugs,” said OPP Const. Tina Hunt, a community safety officer with the detachment. “Even though you think you’re buying one drug, it could be laced with another type of drug.”

    The problem plaguing Arnprior — a town of 9,000 — is shared by small communities across Canada, according to 2017 data presented late last year by the Canadian Institute for Health Information (CIHI), indicating they in fact have hospitalization rates for opioid poisonings more than double those in Canada’s largest cities.

    In its public release, Renfrew OPP also warned of something known as “purp” or purple heroin, typically a combination of heroin and its more-potent cousins fentanyl or carfentanil.

    Fentanyl is 40 times more powerful than heroin and carfentanil (which was developed as a veterinary painkiller for very large animals) is 100 times stronger than fentanyl, figures that illuminate the challenges of tackling what experts say is increasingly a toxic drug supply.

    The synthetic opioids are comparatively easy to manufacture and transport. They can be cut with fillers and sold as heroin or pressed into pills that can be indistinguishable from pharmaceuticals that come from legitimate manufacturers. But a tiny excess in the dose can be deadly.

    The data from CIHI indicated that although hospitalization rates for overdoses varied across the provinces and territories, communities of 50,000 to 100,000 people saw some of the highest rates of opioid poisonings. 

    Brantford, Ont., had an opioid-poisoning hospitalization rate more than 3.5 times the Ontario average. Kelowna, B.C. had one of the highest rates of opioid-poisoning hospitalizations in Canada in 2017. Each has about 100,000 people.

    Helen Jennens, who lives in Kelowna and lost both her sons, Rian and Tyler, to opioids, said Monday that resources in her community have been improving but said appropriate supports were not in place in her family’s darkest hours.

    Larger communities offer more places for people to go to find help, she said. “There’s more outreach centres; the access to help is just better.”

    Both Rian and Tyler had become addicted to opioids after being prescribed painkillers for injuries.

    Donald MacPherson, the director of the Canadian Drug Policy Coalition, said Monday that smaller communities are “incredibly underserved” by some basic types of programs such as harm-reduction services, adding that reduced capacity, funding issues and higher costs create challenges outside urban centres. The group promotes more liberal drug policies, arguing that the war on drugs does more harm than good.

    There has been an effort in British Columbia to create community action teams to try to address the need for more on-the-ground services, MacPherson said, noting an enormous problem remains “because the drug market doesn’t discriminate.”

    “It exists everywhere, from the smallest places to the largest places,” he said. “I think in many places they are left behind … The rural-urban divide when it comes to the basics of life-saving services is immense.”

    Canada’s Rural Economic Development Minister Bernadette Jordan has witnessed some of the impacts in her own community.

    Jordan, who represents the Nova Scotia riding of South Shore-St. Margaret’s, said anyone who think the opioid crisis is an urban issue is wrong.

    “We are seeing it right across the country, in small communities, in rural communities,” she said in a recent roundtable interview with The Canadian Press. “It is a huge, huge challenge; there is no question.”

    She said she has discussed the issue with the health minister.

    “This isn’t just happening in Vancouver, in Toronto, in Montreal,” she said. This is happening right across the country.”

    In a statement, a spokesperson for Health Minister Ginette Petitpas Taylor pointed to commitments the Liberals made in their most recent budget.

    It proposed additional funding of $30.5 million over 5 years, beginning in 2019-20, with $1 million a year committed after that, for targeted measures to address persistent gaps in harm reduction and treatment.

    “We will continue to do all we can to save lives, because this crisis continues to be one of the most serious public-health issues in Canada’s recent history,” said Petitpas Taylor’s press secretary Thierry Belair.

    MacPerson said the federal government could accelerate rural innovation in overdose prevention and harm-reduction.

    “I think there should be a rural strategy developed that the federal government could fund and co-fund maybe with the provinces,” he said.

    “This epidemic is presenting a huge challenge and if one good thing comes out of this disaster, is that we begin to do things differently. So the opportunity is to seize that moment and really be serious about changing the way we operate.”

    —Follow @kkirkup on Twitter

    Kristy Kirkup, The Canadian Press


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    Focus on traumatized boys critical to gender equality, new research shows

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    TORONTO — Boys in poor urban areas around the world are suffering even more than girls from violence, abuse and neglect, groundbreaking international research published on Monday suggests.
    The study in the Journal of Adolescent Health, along with …


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  • TORONTO — Boys in poor urban areas around the world are suffering even more than girls from violence, abuse and neglect, groundbreaking international research published on Monday suggests.

    The study in the Journal of Adolescent Health, along with similar new research, suggests an adequate focus on helping boys is critical to achieving gender equality in the longer term.

    “This is the first global study to investigate how a cluster of traumatic childhood experiences known as ACEs, or adverse childhood experiences, work together to cause specific health issues in early adolescence, with terrible life-long consequences,” Dr. Robert Blum, the lead researcher for the global early adolescent study, said in a statement. “While we found young girls often suffer significantly, contrary to common belief, boys reported even greater exposure to violence and neglect, which makes them more likely to be violent in return.”

    The study from Johns Hopkins Bloomberg School of Public Health looked at childhood traumas suffered by 1,284 adolescents aged 10 to 14 in more than a dozen low-income urban settings around the world such as the United States, China, the U.K., Egypt and Bolivia.

    Overall, 46 per cent of young adolescents reported experiencing violence, 38 per cent said they suffered emotional neglect and 29 per cent experienced physical neglect. Boys, however, were more likely to report being victims of physical neglect, sexual abuse and violence.

    While higher levels of trauma lead both boys and girls to engage in more violent behaviours, boys are more likely to become violent. Girls tend to show higher levels of depression.

    Separately, a new report to be released next month at an international conference in Vancouver concludes that focusing on boys is critical to achieving gender parity. The report from the Bellagio Working Group on Gender Equality — a global coalition of adolescent health experts — finds boys and men are frequently overlooked in the equality equation.

    “We cannot achieve a gender-equitable world by ignoring half of its occupants,” the report states. “It is crucial that boys and men be included in efforts to promote gender equality and empowerment.”

    For the past six years, a consortium of 15 countries led by the Bloomberg School of Public Health and World Health Organization has been working on the global early adolescent study. The aim is to understand how gender norms are formed in early adolescence and how they predispose young people to sexual and other health risks.

    Evidence gathered by the study indicates boys experience as much disadvantage as girls but are more likely to smoke, drink and suffer injury and death in the second decade of life than their female counterparts.

    The key to achieving gender equality over the next decade or so — as the United Nations aims to do — involves addressing conditions and stereotypes that are harmful to both girls and boys, the researchers say. They also say it’s crucial to intervene as early as age 10. The norm is now age 15.

    “Gender norms, attitudes and beliefs appear to solidify by age 15 or 16,” the working group says. “We must actively engage girls and boys at the onset of adolescence to increase total social inclusion and produce generational change.”

    Leena Augimeri, a child mental-health expert with the Child Development Institute in Toronto, agreed with the need to focus on boys as well as girls. At the same time, she said, the genders do require different approaches.

    “Boys are equally at risk,” said Augimeri, who was not involved in the studies. “When we look at the various issues that impact our children, we have to look at it from different perspectives and lenses and you can’t think there’s a one fit for all.”

     

    Colin Perkel, The Canadian Press


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    ‘Dignity and wisdom’: Chief justice praises Gascon after final high-court case

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    OTTAWA — Supreme Court Justice Clement Gascon received a standing ovation Thursday after hearing his final case on the high court.
    Gascon graciously thanked his family and colleagues, saying it is an immense privilege to be a judge.
    Last month, Gascon,…


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  • OTTAWA — Supreme Court Justice Clement Gascon received a standing ovation Thursday after hearing his final case on the high court.

    Gascon graciously thanked his family and colleagues, saying it is an immense privilege to be a judge.

    Last month, Gascon, 58, announced plans to retire for unspecified personal and family reasons.

    He said this week he has long struggled with anxiety and depression, and while he has generally been able to manage the illness, it recently led to a difficult episode.

    Gascon said he suffered a panic attack before he briefly went missing May 8. He profusely apologized for the uncharacteristic absence, citing the effects of his difficult career decision and a change in medication.

    In the crowded courtroom Thursday, Chief Justice Richard Wagner praised Gascon as an exceptional person.

    “Our esteemed colleague has served Canadians with dignity and wisdom,” Wagner said. “His commitment and friendship will be missed.”

    Justice Sheilah Martin shed tears.

    Gascon officially steps down Sept. 15 but will continue to have input into judgments flowing from cases he has heard, as long as they are released within six months of his retirement date.

    Judgments released after mid-March will note that Gascon had no input into the decision.

    “My work as a judge is far from complete,” he said. “I can assure you that I will continue.”

    The Canadian Press


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