Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Friday, April 12, 2024

Singing From a Different Hymnal

"Media Relations officers were asked to ensure that internal notifications were flagged and shared with provincial headquarters prior to things being issued so that additional notifications could be completed."
"No one has been restricted from addressing matters in their jurisdiction and pre-existing Media Relations protocols have not changed."
"[In fact, the guidance indicated that we] commit to be available to review and ensure timely feedback as it is not our intention on delaying communication efforts."
Staff Sgt.Kris Clark, senior media relations officer, Royal Canadian Mounted Police E Division statement

"Organized crime groups are actively involved in the redistribution of safe supply and prescription drugs."
"It might mean how we regulate our safe supply might need a sober second glance."
Cpl. Jennifer Cooper, RCMP Prince George detachment
The front of a pharmacy, with text reading 'Third Avenue IDA Pharmacy'.
RCMP have arrested a suspect who was accused of standing outside the IDA pharmacy in Prince George and trading illicit drugs for safe supply prescription pills. (Andrew Kurjata/CBC)

A leaked memo emerged where Mounties in British Columbia have been instructed to step carefully around "hot button issues", in the wake of RCMP in British Columbia continually reporting the phenomena of government-distributed "safer supply" opioids showing up in drug busts. "It is very clear we are in a pre-election time period and the topic of 'public safety' is very much an issue that governments and voters are discussing", the email of March 11 from HQ of E Division, B.C. branch of the RCMP reads.

Thus the 150 detachments in the province of the RCMP were instructed not to directly address such potentially controversial issues. Best practice henceforth would be rout enquiries from journalists and government communications staff through to central headquarters for response. Drug seizures and drug decriminalization to be considered on a list of "hot button issues". Controversies continue to erupt related to the province's commitment to "safer supply", at the same time that it has decriminalized simple possession of illicit drugs.

At the turn of the year, provincial RCMP detachments had reported seizures of black-market hydromorphone tablets initially distributed by the government of British Columbia ostensibly representing a safer supply. Consequentially, in northeastern B.C., RCMP with the Prince George division reported hydromorphone tablets seized, along with various street drugs like cocaine and methamphetamine and prescription drugs  such as painkiller and anti-convulsant gabapentin.
 
A police seizure showing money and drugs on a table.
Prince George RCMP seized prescription drugs, suspected methamphetamine and fentanyl and a small amount of cash from the suspect's residence after a 10-day surveillance operation. (Prince George RCMP)

Police in Campbell River on Vancouver Island, a month earlier reported seizure of 3,500 hydromorphone pills identifying them as having been diverted into the black market by "a well-organized drug trafficking operation". Reports that appeared to contradict the consistent claim of authorities in British Columbia that "diversion" did not present as a major problem; alternately that it wasn't occurring, to begin with.

British Columbia boasted becoming the world's first jurisdiction to launch the Safer Opioid Supply program in 2020, a plan to dispense prescribed recreational opioids, in the form of hydromorphone pills; an alternative to addicts relying on the "toxic illegal drug supply". Interviews with over a dozen addiction-medicine specialists in May 2023 by investigative journalist Adam Zivo, for the National Post, concluded that addicts routinely obtain safer supply, then turn around to provide it for cash to the black market.

The obvious result was that the "toxic illegal drug supply" was in fact being subsidized by the illegal funding resulting from reselling safer supply. The black market was flooded with inexpensive hydromorphone. A search of the  website reddit by Adam Zivo resulted in the appearance of dozens of posts boasting diverted "dillies" for sale. B.C. chief coroner Lisa Lapointe, herself an enthusiastic advocate for safer supply, publicly declared in June of 2023 that it was "not true" that diversion was taking place, but was the result of "increasingly polarized rhetoric that is not informed by evidence"
 
RCMP coincidentally in British Columbia promulgated an official statement authorized by its assistant commissioner that there "is currently no evidence to support a widespread diversion of safer supply drugs in the illicit market in B.C. or Canada", the very day the "hot button issues" memorandum had been sent out. "We've increased awareness to our police officers in order to better identify cases where safer supply drugs may be present within their investigations", the assistant commissioner clarified. 
 
https://i.cbc.ca/1.6831678.1683159536!/cumulusImage/httpImage/image.jpg_gen/derivatives/16x9_780/overdose-statue.jpg
A statue commemorating people who have died of drug overdoses is pictured at Seaforth Peace Park in Vancouver on in April 2022. B.C implemented a safer supply program in 2020 in an attempt to address the toxic drug crisis in the province. (Ben Nelms/CBC)
"Someone comes out of a pharmacy with their prescribed safe supply, and is met head on with a drug dealer offering them illicit drugs in exchange for those drugs to be then distributed into the community."
"It's pretty evident this is exactly how this problem has become a problem in British Columbia."
Elenore Sturko, ex-RCMP officer, currently B.C. United opposition critic for mental health and addiction

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Saturday, May 13, 2023

The Great Compassionate Progress in Safe Injection Sites

"Patients who diverted [hydromorphone given to addicts at Safe Injection Sites entering the street market for sale to enable the sellers to afford the more potent and desirable fentanyl] were able to have an increase in their standard of living."
"What I saw at the very beginning was absolutely that. But as fentanyl became more available in the community, I've seen more and more people divert to get fentanyl."
Dr. Sharon Koivu, addiction physician, London Health Sciences Centre

"[Diversion is an issue; high opioid tolerance among fentanyl users was a] top challenge."
"[Safer supply program staff said] Even maximal doses of [hydromorphone] have little effect except withdrawal management."
"This leads people to continue to use street fentanyl, as [hydromorphone does] not approximate the effect they get from fentanyl."
Health Canada report findings from safer supply pilot projects
A needle outside of The Hamilton Clinic.
 
Compassionate progressives want to believe that by providing drug users with government-funded substitutes for what is often potentially tainted illicit substances, people can be saved from overdosing with ultra-potent street drugs such as fentanyl and even worse, carfentanil. Unfortunately theory doesn't match human idiosyncracies leading people to value brief and fleeting mood changes brought by psychotropics, an excess of which could usher them out of this world.
 
An opioid crisis in Canada has been responsible for the death of over 35,000 people since 2016. The safer supply drugs distributed through government-funded programs are frequently left unconsumed by the recipients who choose to sell them on the black market at irresistible prices which then goes on to fund the procurement of fentanyl, preferred by the recipients of the 'safer' drugs. The black market resale is formally referred to as 'diversion'. The result of this situation is that across Canada communities are being flooded with cheap opioids.
 
With little incentive to switch to hydromorphone, fentanyl addicts sell their safer supply at bargain prices to buy their substance of choice.
Fentanyl addicts sell their safer supply at bargain prices
Hydromorphone, the primary opioid dispensed at such supply sites has dropped in price significantly in cities that operate safer supply programs. Addiction physicians are being informed by drug users that diverted hydromorphone leaves these cities to enter other markets where opioids are less accessible, to sell for higher prices. This has attracted the attention and invited the presence of gangs and drug dealers.

A 2017 study published in Psychopharmacology  establishes that hydromorphone produces "similar subjective and physiological effects as heroin", but is "more potent than heroin", while another 1990 study published in The Journal of the International Association for the Study of Pain estimated hydromorphone is in fact, five times stronger than heroin.

Relating to the increases in availability and affordability of hydromorphone as a black market drug, there have been negative consequences where physicians report a new wave of opioid addictions pronounced among youth. Addiction physicians also report that many patients once thriving in recovery now relapsing as patients, either abandon treatment to enroll in safer supply programs or are drawn to return into addiction by the abundance and cheap cost of hydromorphone on the streets.

Drug users looking for a quicker rush often crush hydromorphone tablets meant for oral consumption in favour of injecting them intravenously, leading to excruciating, disfiguring infections where paralysis has resulted for some patients. The Canadian government saw virtue in investing almost $80 million in 28 safer supply projects. According to Dr. Koivu of the London Health Sciences Centre, fentanyl was not seen widely in London in 2016, then over ensuing years spread and with it came the abuse of safer supply programs.

The typical 8-milligram tablet of hydromorphone delivers four times the dose generally used in hospital settings, yet it is still not as powerful as fentanyl. Since users prefer to sell their government-provided hydromorphone pills in favour of using the sale funds to supply themselves with fentanyl, the safer supply program, whose primary benefits include mitigation of fentanyl use, is actually in reality, subsidizing fentanyl usage.

A nurse at the Crosstown Clinic, a supervised injection site in Vancouver, British Columbia, handed out a syringe of medical-grade heroin to a patient in May.
Credit...Jackie Dives for The New York Times

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