Injection sites can prevent deaths, not overdoses

Injection sites can prevent deaths, not overdoses

Not many people who moved to the Comox Valley for its small-town feel, access to recreational opportunities or the lively arts scene imagined heroin addicts injecting themselves in public places or one person dying almost every month from an opioid overdose.

But these things are happening here.

The Chambers of Commerce and elected officials don’t want to draw undue attention to this grim reality, but it has become too big to ignore.

More than 150 people died from opioid overdoses on Vancouver Island last year. Although more people died in the larger centres of Victoria and Nanaimo, the North Island (including the Valley) had the highest rate of increase — up 156 percent over last year — in overdoses. Ten people died from overdoses over the past 12 months in the Comox Valley.

And Island Health believes the overdose statistics are actually worse, and that many overdoes go unreported. And heroin kills more people than official death certificates indicate. That’s because heroin metabolizes as morphine, so toxicology reports in overdose cases often list morphine or an opiate as the cause of death.

Opioid deaths have increased sharply because most street heroin today contains fentanyl, which is up to 100 times more powerful than heroin. Just a speck of fentanyl the size of a few grains of salt can kill a 113-kilogram (250-pound) person.

Island Health Medical Health Officer Charmaine Enns told the Courtenay City Council this week that her agency hopes to reduce the Valley’s overdose death rate by opening a safe injection site where trained personnel could administer rescue breathing or Naloxone, a drug that can reverse an opioid overdose.

But these sites are misnamed and give the public a false impression. Island Health staff cannot prevent someone from overdosing, which occurs nano-moments after the drug is injected. They can only prevent the overdosed person from dying.

Enns said the supervised injection site at the offices of Island Health or some other provincial agency will allow staff to interact with users and offer mental health counselling and other services. That’s a good thing, and so is giving people a chance to live another day and get their life back on track.

But there are potential downsides.

To keep people suffering from addiction coming back to the clinics, Island Health staff might have to offer users less addictive drugs, such as methadone, and potentially dispense stronger drugs. If that does occur, the public may have a strong reaction.

The sites also put staff at risk because even a small amount of fentanyl is deadly if it’s absorbed through the skin or inhaled when airborne. Fentanyl’s potency has already harmed first responders from New Jersey to Vancouver.

The public should know what safeguards are in place to prevent this from happening here.

City of Courtenay firefighters have agreed to voluntarily respond immediately to serious medical calls, which includes overdoses. But they will only do so if they are equipped with Naloxone nasal spray, supplied by either the province for free or if the City Council agrees to purchase it.

They will not, in other words, participate in using needles to inject Naloxone, sometimes known by its commercial name, Narcan. To do that increases the chance of contacting fentanyl or needle injuries.

The extent of the heroin addiction problem has been partially hidden because today’s users are often middle-income, white, and no longer habitues of the gritty alleys of urban areas. The use of heroin and other opioids has moved into suburbs and small towns.

Island Health reports that overdose occurrences are widespread across the entire Comox Valley.

All over the province and across North America, people hooked on prescription painkillers find heroin easier to acquire and less expensive. If that wasn’t alarming enough, heroin use has become popular among school-aged teens. U.S. studies show that 3 percent of high school students are using heroin today.

The province was right to declare a public health emergency over the opioid problem. But whether the ministry’s plan just treats symptoms, or provides a lasting solution remains to be seen.

Even though safe injection sites raise troubling questions about enabling addiction rather than treating it, doing nothing is not an option when so many deaths can be prevented.

At the very least, we can learn from this effort, change course based on what is learned, and, at the same time, start thinking a whole lot harder about what it would take to prevent people from becoming addicted in the first place.

Is the genuine apology a forgotten or endangered species?

Is the genuine apology a forgotten or endangered species?

When civility in modern public discourse declines, it attempts to drag other forms of decent human interaction into the murky abyss of lost social conventions.

The genuine apology, for example, teeters dangerously close to collateral damage. In the Trump world, you never apologize. You just don’t “talk about it anymore.” In the new lexicon, “I’m sorry” are dirty words.

Have you offended the parents of a war hero, an honest judge or a whole race of people? Just announce that sometimes you say the wrong things, which you regret, but don’t be specific.

If you’re an Olympic swimmer who committed a crime in a foreign country and then committed other crimes and told lies to cover it up, obfuscate your apology with sad-sack whining about your personal trauma. Forget the part about pointing a loaded gun at less-privileged third-world people.

But don’t forget when an apology is required.

For example, after 35 years of shirking its legal obligations and moral duty to carry out the terms of Mack Laing’s Last Will, which it accepted along with valuable waterfront property, his personal possessions and his money, the Town of Comox has never officially apologized for its breach of trust.

I’m sure that Laing’s family in Manitoba and Oregon would appreciate the gesture.

The problem isn’t just that the apology has fallen out of vogue. People seem to have forgotten how to do it properly. Lesson number one: atonement isn’t about you.

After a well-known actor recently made some anti-gay statements, he said, “This is heartbreaking for me.” As a corporate CEO acknowledged environmental wrong-doing, he said, “There’s no one who wants this over more than I do. I would like my life back.”

Confronted with the past collective sins of the town, in respect to Mack Laing’s Last Will and trust, Mayor Paul Ives has said, “That was then, this is now.” And went on to justify tearing down what Heritage B.C. considers a significant landmark.

A genuine apology doesn’t hedge. It doesn’t include modifiers that dilute personal responsibility. It doesn’t impose limits on accountability or suggest a partial defense by casting some measure of blame on those offended. It promises to do better.

Canadians are good apologizers. We’ve apologized to Chinese Canadians for a 19th Century head tax; to Japanese Canadians for stealing their property and imprisoning them in internment camps; to Inuit peoples for relocating them to a harsh place without survival assistance; and, for turning away nearly 400 Sikh migrants on the vessel, Komagata Maru over a century ago, knowing they faced certain death.

And we do apologize right.

Prime Minister Justin Trudeau, addressing the abuse of Indigenous Canadians in the residential school systems, he said, “Our goal, as we move forward together, is clear: It is to lift this burden from your shoulders, from those of your families and communities … It is to accept fully our responsibilities, and our failings, as a government and as a country.”

A genuine apology is often uttered to relieve a person or an organization of its guilt and shame. But the refusal to apologize attempts to mask any feeling of guilt or shame that might make the person or organization look weak or vulnerable.

Most everyone has said or done something they regret. But in the absence of any reparation, these things can hover over our sense of well-being like storm clouds. A simple, heartfelt apology can clear the air.

So, let’s not be like Trump. Let’s not apologize for apologizing, where contrition is appropriate. Let’s embrace moments of introspection that manifest in words that heal and move us forward.

Social Studies 2.6.2017

America’s fast-food president likes it clean

Seventy-year-old U.S. President Donald Trump loves fast food. Big Macs. Buckets of KFC. Slices of pizza. And he hates exercise, which he doesn’t do often. America’s Fast-Food president isn’t setting a good example in the fight against childhood obesity and early onset diabetes.

Why does he eat so much fast food? In his own words:

“I’m a very clean person. I like cleanliness, and I think you’re better off going there (McDonald’s) than maybe someplace that you have no idea where the food’s coming from. It’s a certain standard,” he said.

Useless facts about electric cars B.C. will pay you to drive

The B.C. provincial government this week announced a $40 million investment to encourage people to drive electric cars. In addition, residents can save up to $11,000 if they trade their old car for an electric one.

The province’s Clean Energy Vehicles for B.C. program offers up to $5,000 for an electric vehicle purchase, and the non-profit B.C. Scrap-It offers and additional $6,000 dollars towards electric vehicles purchases. Vehicles priced above $77,000 are not eligible for purchase incentives.

Here are some electric car facts:

• The first cars ever made by Oldsmobile and Studebaker were electric.
• Electric cars outsold gas models by 10-to-1 in the 1890s.
• The world’s first automotive dealerships sold electric cars.
• Self-starters were introduced in electric cars 20 years before gas vehicles.
• The very first speeding ticket was given to the driver of an electric car.

Sarah Palin coming to Canada? We say (big gulp) No betcha!

There’s a rumor that President Trump might appoint the weird and absolutely nuts Sarah Palin as the U.S. ambassador to Canada. Aside from the fact that this makes many people want to throw up, she doesn’t speak Canadian or any of our other official languages.

Ottawa Citizen columnist Andrew Cohen wrote, “In Canada, Palin would have to learn to speak one of our official languages. She would have to live in a land of naïfs who favour immigrants, gay marriage, the United Nations and NATO.”

Let’s take a big gulp ourselves, and hope this is fake news, or an early April Fools joke.

Cumberland celebrates its heritage, while Comox destroys theirs

Heritage Week in British Columbia starts next Monday and runs through Sunday, Feb. 13 to Feb. 19. The Village of Cumberland will celebrate its history starting at 10 a.m. on Saturday, February 18th, with the 13th annual Heritage Faire at the Cumberland Recreation Institute Hall. The Faire revives the spirit of a folk festival in the 1950s focused on the diverse heritage of Cumberlanders.

The Town of Comox, on the other hand, doesn’t have any heritage events planned that we know about. They just have anti-heritage events. Like the Town Council’s recent unanimous decision to beg the B.C. Supreme Court to release the town from the obligations it agreed to 35 years ago in accepting famous naturalist Hamilton Mack Laing’s property, house and money.

In spite of pleas from Heritage B.C. — the sponsor of Heritage Week — the Town of Comox wants to tear down Laing’s house, Shakesides, and use his money for other purposes.

Social Studies 1.30.2017

Proud of Washington state for first to sue Trump

I am so proud of my friend and Governor of Washington State, Jay Inslee, for denouncing President Trump travel ban on Muslims from certain countries. And for Washington State Attorney General Bob Ferguson for leading the nation in suing the Trump Administration over its actions against immigrants. And my birth-state of Minnesota joined the suit two days later.

A federal judge ruled in favor of the lawsuits and people from the affected countries can now apply for entry to the U.S.

“Judge Robart’s decision, effective immediately … puts a halt to President Trump’s unconstitutional and unlawful executive order,” Ferguson said. “The law is a powerful thing — it has the ability to hold everybody accountable to it, and that includes the president of the United States.”

I’m proud to have been publisher (and editor of our editorial page) of The Olympian, the only major daily newspaper in Washington state that endorsed Inslee for governor when he first ran in 2012. We also endorsed Ferguson. Both turned out to be excellent choices.

(The Olympian Editorial Board in December 2014, from left community members Jill Severn and Larry Jefferson, Gov. Jay Inslee, Publisher George Le Masurier, columnist John Dodge and state house reporter Brad Shannon}

Who’s at fault: drivers or cyclists for crashes?

Who’s at fault: drivers or cyclists for crashes?

Provincial Court Judge Peter Doherty handed down a fair decision in the case of Timothy Prad of Bowser, the motorist who struck and killed a bicyclist, Paul Bally of Fanny Bay, on the Old Island Highway about a year ago.

The judge found the motorist honestly thought he had hit a deer and had not left the scene to avoid arrest.

But in the court of public opinion, deciding whether cyclists or motorists generally bear more responsibility when the two collide would more likely result in a hung jury.

People who regularly ride bicycles believe motorists have the greater responsibility because they’re driving multi-ton vehicles at higher rates of speed. And there will be an equal number of motorists who blame cyclists who often act as if the rules of the road don’t apply to them.

Either side could count multiple research studies to support their point of view, which is why I like the 2012 report on cycling deaths in Ontario by the province’s chief coroner. The study reviewed the circumstances of 129 deaths resulting from collisions between cyclists and motor vehicles.

The report states, “In 71 percent of deaths (91 of 129), some modifiable action on the part of the cyclist was identified which contributed to the fatal collision. The three most common contributory cyclist actions identified were inattention (30 cases; 23 percent), failure to yield right of way (24 cases; 19 percent) and disregarding traffic signals (10 cases; 8 percent).”

The report also states, “In 62 percent of cases (64 of 104) in which the cyclist collided with a vehicle (defined as a motor vehicle, streetcar or train), one or more modifiable actions on the part of the driver were identified which were felt to have contributed to the death … The three most common contributory driver actions were speeding (31; 30 percent), driver inattention (29; 28 percent) and failure to yield (20; 19 percent).”

Those percentages don’t appear to add up because the chief coroner found that in almost half of the cases both the cyclist and the driver contributed to the accident.

In other words, the chief coroner found that 100 percent of the fatalities were preventable if both drivers and cyclists had exhibited more due care and attention.

Every day that I travel around the Comox Valley, I see cyclists blow through stop signs, often without even slowing down. I see cyclists with ear buds. I encounter cyclists riding abreast of each other on rural roads (a violation of the rules for cyclists under Section 183.2(d) of the Motor Vehicle Act).

I have even seen a cyclist press the stop light button on Comox Avenue at the St. Joe’s General Hospital crosswalk and then ride across while cars piled up in both directions (183.2(b)).

But I’m also a cyclist, who, at the peak of my competitive period, often logged in excess of 150 miles a week on Comox Valley and Campbell River roadways.

A driver on Dove Creek Road once passed within inches of me, causing me to lose my balance and crash. And when I regrettably offered up a one-digit salute, he stopped and, in a fit of road rage, came back to assault me.

On another ride to Victoria, a large RV with super-wide side-view mirrors passed me through a construction zone in Nanaimo where the roadway narrowed. It was surreal. I felt a slap on my back and then I was airborne, out of my pedals, catapulted into a well-located patch of thick foliage.

In both cases there was no behavior I could have modified to avoid those accidents. They were 100 percent driver error, in my opinion.

Cycling is an important component of the Comox Valley lifestyle and a growing tourism attraction. It’s also important to encourage cycling as a physical activity that contributes to healthy lifestyles.

A regional task force comprising representatives from the cycling community, motorists, law enforcement, municipalities and the Ministry of Highways could make recommendations to mitigate the safety concerns of cycling and encourage more people to participate in a healthy and environmentally friendly activity.

Maybe it could also prevent another unnecessary and tragic loss of life.