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Category: Overdose

  • Training Drug Users and Bystanders to Treat Overdose Saves Lives

    Training Drug Users and Bystanders to Treat Overdose Saves Lives

    Drug overdose is a growing public health crisis that now kills more adults per year in the United States than motor vehicle accidents. In cars, seatbelts and airbags save lives. When it comes to opioid overdose a safe and non-abusable medicine called naloxone can restore breathing and avert death. Pragmatic doctors and health officials want anyone who uses opioids like heroin—and anyone likely to be around during an overdose—to have access to this life-saving drug, and know how to use it.

    In Massachusetts, researchers led by Dr. Alexander Walley at the Boston University Medical Center set out to discover the results of a state-supported overdose education and naloxone distribution program on deaths from overdose. We sat down with Dr. Walley to discuss the findings.

    What did your research find?

    This study demonstrates that overdose education and naloxone distribution is an effective public health intervention to address the growing overdose epidemic. We found that communities that received overdose education and naloxone reported significantly fewer deaths than communities that received no training. We also observed that the higher the cumulative rate of program implementation, the greater the reduction in death rates. In other words, the more people at risk or in contact with people at risk for overdose who were given naloxone, and trained to prevent, recognize and respond to an overdose, the lower the overdose death rates.

    Why are overdose education and naloxone delivery programs like these so important?

    Since the beginning of the Massachusetts overdose education and naloxone delivery programs, there have been more than 1,700 overdose rescues using naloxone. While we do not know how many of these people may have died if they had not received naloxone, it is likely that many of them would have. These rescues have inspired many us to maintain hope that all overdose deaths can be prevented.

    People who have recently stopped using opioids—whether because of jail time or treatment—are at increased risk of overdose, and we’ve heard inspiring stories of overdose reversals in these cases. While opioid addiction is a treatable disease, it is a chronic disease where relapse is unfortunately part of the natural history. Preventing overdose allows people to continue their progress towards recovery, and may enable them to seek out other lifesaving services.

    What barriers stand in the way of implementing programs like this in other parts of the United States?

    I’ll start first by listing features of the program in Massachusetts that contributed to its success and would support broader implementation: one is the use of a nasal delivery device for naloxone, allowing naloxone to be administered through the nose, instead of by injection. The other is a standing order issued by the health department that permits non-medical personnel to deliver overdose education and distribute naloxone. Without this order, a doctor would need to be present each time naloxone is given out. To date, there are still large parts of the country with no access to a lifesaving naloxone distribution program; though this program locator tool can help you find out if there is one near you.

    The two main barriers to the expansion of these initiatives are that insurance companies do not cover the nasal delivery device that allows naloxone to be administered through the nose, and prescribers (doctors, nurse practitioners and physicians’ assistants) are not yet adequately educated on prescribing naloxone. We’ve created a website, prescribetoprevent.org, to help facilitate naloxone prescribing.

    What message would you send to officials in countries like Russia and China where the death toll from drug overdoses continues to climb?

    Preventing needless deaths from opioid overdose is a bridge issue – it’s a cause that people from different perspectives on treatment and harm reduction can agree and work together on. It can be a starting point from which we can work together in addressing the harms associated with drug use.

    What happens now?

    We keep implementing and evaluating this program and ones like it. In Massachusetts, overdose education and naloxone have been delivered to heroin users, prescription opioid users, patients in emergency departments, and the people who are most likely to respond to an overdose including: people who are incarcerated, family members, social service providers, police officers, and firefighters. It is important to determine how these programs should be tailored to different populations to maximize their reach, effectiveness and sustainability. That’s what we’re working on now.

    This blog post was originally published on the Open Society Foundations website.
  • SALOME Participants Need An Exit Strategy

    SALOME Participants Need An Exit Strategy

    The SALOME study (Study to Assess Longer-term Opioid Medication Effectiveness), is a clinical trial being conducted in Vancouver, BC. The study compares the effectiveness of six months of injectable diacetylmorphine  (heroin) with six months of injectable hydromorphone (Dilaudid, a licensed medication) and the effects of switching from injectable to oral heroin or Dilaudid.

    SALOME began active recruitment in December, 2011. Participants will be in the study for one year, followed by a 1-month transition period where they will be encouraged to, once again, take part in conventional treatments such as methadone maintenance, drug-free treatments, and detox programs (treatments that have proven to be ineffective for these participants).

    SALOME is a follow-up to the NAOMI study, which tested whether heroin-assisted treatment or methadone is more effective in improving the health of chronic and long-time opiate users. The repeated failure of treatment efforts for participants is in fact part of the criteria for selection of participants in SALOME, as was the case in NAOMI.

    Many of the first participants will be exiting the clinical trial now and over the next two months (February and March).

    Both studies provide an immense value not only to our scientific understanding of heroin dependence, but also to those individuals who have participated in the research. But as with NAOMI, the current study protocol of SALOME puts research participants at an increased risk by failing to have an adequate “exit strategy” in place for when research is complete.

    Each of the research participants has previously failed on methadone maintenance treatment and other conventional treatments before entering the study, yet if the study shows that they are benefiting from diacetylmorphine when the research is concluded, they will not be allowed to be maintained on the drug that is benefitting them. Instead, they will be returned to methadone or other conventional treatment options.

    This practice, as demonstrated in international research and through the accounts of participants in the NAOMI study, produces real harms to members of our community, and we cannot tolerate it being repeated during the SALOME study.

    Canada remains the only country conducting a prescription diacetylmorphine (heroin) trial that has failed to provide diacetylmorphine to the research participants at the end of the trial.

    We feel that research testing new methods of treatment for the harms of addiction is valuable, but must be conducted in ways that effectively address the continuing treatment and support for the individual participants in the research if the intervention proves successful.

    By not putting in place an adequate exit strategy, the study is putting marginalized and vulnerable people at risk.

    We request that Providence Health Care take immediate steps to provide ongoing diacetylmorphine treatment for participants concluding the SALOME study by applying for and supporting Special Access to diacetylmorphine, and begin planning for a pilot program for providing this treatment to the community at large.

    How you can help:

    On behalf of the NAOMI Patients Association (NPA), a community letter directed to Providence Health Care in support of heroin assisted therapy is circulating. The letter is available here.

    For more information please contact Susan Boyd, on behalf of NAOMI Patients Association at naomipatientsassociation@hotmail.com

    To learn more about the NPA click here.

  • Harm Reduction and the Public Good in Victoria, BC

    Harm Reduction and the Public Good in Victoria, BC

    It seems that in Canada, public meetings about harm reduction bring out the best and worst in people. This was certainly the case on Wednesday at a public meeting to discuss the inclusion of improved services in a local health unit on the edge of Victoria’s Fernwood neighbourhood.

    This location is already the site of Victoria’s Sobering Centre and its Medical Detox facility. The meeting was held at the initiation of the Vancouver Island Health Authority (VIHA) to discuss their plan to create two service hubs in Victoria for harm reduction services. As you may recall, Victoria was forced to close its only fixed site needle exchange in 2008 after controversy erupted over public congregation outside its doors. Since then, attempts to move this site to other locations have been met with vociferous public opposition despite an intentional shift away from having just one location to having over 20 options for accessing needles and supplies.

    Going in to the meeting, no one was happy. Clearly some thought the proposed services were too little and some though they were too much. Supporters of people who use drugs wondered about the inclusion of peers in the development and implementation of these services. But some area residents seemed palpably angry about VIHA’s new plan. The Health Authority took pains to argue that their latest proposal only adds new professional services to two locations already providing harm reduction supplies. But no matter how much reassurance representatives gave, some residents still angrily denounced the service.

    Their language was pointed and painfully discriminatory – “those people”, “them” – meaning people who use drugs. Some neighbours worried about the safety of their children and some were afraid that violence, property theft and damage would escalate in their community. Even a Victoria Police’s Staff Sergeant Dave Bown challenged these speakers to rethink that one. These same neighbours were angry with VIHA for communicating their plans in the media despite an agreement to consult with neighbours.

    These days, community input into health care can be an afterthought and even VIHA representatives admitted last night that that they could have done a better job of getting feedback on the plans from residents. So the neighbours are probably angry for a reason. But still, the opposition to harm reduction reminded me that it’s easy to pit children’s safety against the needs of a scary “other”. It’s much harder to get down to work on making the community safe for all, including people who use drugs.

    These kinds of public meetings are taking place all over Canada as residents oppose proposed harm reduction or methadone services in their neighbourhoods. And media coverage often goes hand-in-hand with these events – conveying partial truths and giving angry voices the opportunity to parade out the worst of discriminatory attitudes toward people who use drugs.

    At the same time, I was heartened by some of last night’s speakers who invited their neighbours to help clean up used needles and offered examples of successful programs to educate children about harm reduction. Some neighbours repeatedly spoke about their fear of discarded needles until one resident of Fernwood, Andrea Langlois, stood up and reminded everyone that no one had ever contracted HIV from being poked by a inappropriately discarded syringe off the street. That turned the tide and other neighbours stepped forward to praise the plan and welcome the services. A couple of speakers even wondered if public use of drugs could be addressed with supervised consumption services. These weren’t people used to speaking the language of harm reduction but they seemed to get it – that the public safety and health of the whole community is enhanced by a full range of harm reduction services.

    One of the final speakers from the audience capped off the evening with a request that many of us could heed – stop sowing the seeds of fear and get to work on meeting the needs of all our citizens.

  • Cheap, Easy, and Lifesaving—Naloxone Treatment for Overdose

    Cheap, Easy, and Lifesaving—Naloxone Treatment for Overdose

    How much does it cost to save a life? That question got a clear and striking answer this week in the case of overdose from heroin in the United States. A study published in the Annals of Internal Medicine found that distribution of the overdose antidote naloxone—a safe, non-abusable, and inexpensive medicine—to one in five heroin users in the United States could prevent as many as 43,000 deaths. The cost of distribution would be equivalent to some of the cheapest, most effective, and most accepted medical interventions, like checking blood pressure at a doctor’s office.

    The study used mathematical modeling to assess whether giving out naloxone was “worth it”—that is, to determine how much naloxone distribution would cost per “quality-adjusted” year of life gained. This is the measure used by economists and policymakers to compare health interventions and decide which ones are affordable. The naloxone study also investigated assumptions that patient advocates would rather not acknowledge—like whether it would be cheaper to let illegal drug users die, or to put them in jail. Those are ugly questions, but ones that certainly run through the minds of opponents of health services for drug users worldwide. The answer was that naloxone saves lives with costs far below what health or prison systems pay. For example, screening for cancer with colonoscopy costs over $50,000 per quality adjusted life year gained in the United States, and screening for HIV costs around $40,000.

    Naloxone distribution saves lives for as little as $400.

    The other question, of course, is whose lives are deemed worth saving. Drug overdose now kills more adults a year in the United States than motor vehicle accidents, or deaths from choking or accidental falls. Most of us have seen safety messages related to driving, choking, or minding our step, but naloxone and other measures to prevent overdose remain unknown to many at risk. As noted in an editorial in the same journal, co-authored by officials from the National Institute on Drug Abuse and the FDA, making new and easy-to-use formulations of the medicine can help. However, action can be taken now to make the medicine available to heroin users—actions that will prevent thousands of needless deaths, and spare family and friends who may have to watch helplessly as their loved ones stop breathing.

    – Daniel Wolfe

    Daniel Wolfe is director of the International Harm Reduction Development Program at the Open Society Foundations. This blog post was originally published on the Open Society Foundations website.

  • The Missing Link in Overdose Prevention

    The Missing Link in Overdose Prevention

    Long-established medical practice supports prescribing pre-loaded syringes of epinephrine to people having severe, life-threatening allergic reactions to allergens such as bee stings, nuts and shellfish. Patients, including children, are taught how to use them and carry them with them at all times in order to administer the drug without delay when they have a reaction. It “buys time” to allow the person to get to emergency medical care for monitoring and further treatment if needed. Epinephrine is considered an emergency drug and in most circumstances is administered by trained medical personnel in health care settings. However, the risk of death from a severe allergic reaction, when seconds count, outweighs the risks associated with dispensing the drug for unsupervised use by lay people in the community.

    For about thirty years, the harm reduction approach has been advocated by some in Canada as a means of promoting health and preventing needless injury and death among people who use drugs. It accepts that, whatever one’s beliefs about drug use and the people who use drugs, at any given time some people will use drugs unsafely. It holds that preventing unnecessary morbidity and mortality is best accomplished by a continuum of strategies which include educating drug users about the drugs they use, the risks involved, ways to mediate those risks, and the availability of supports to reduce or cease risky use.

    For example, research from Australia has shown that needle exchange programs prevented 32,000 HIV infections and almost 100,000 Hepatitis C infections in the first decade of the 21st century, saving over AU$1 billion – which represents a five-fold return on investment.  Despite decades of robust evidence supporting the efficacy of harm reduction, in general health care providers have been “slow adopters” of harm reduction strategies.

    In September 2010, the College of Physicians and Surgeons of Ontario (CPSO) described widespread addiction to strong painkillers, known as opiates, as a “public health crisis” in Ontario. Earlier this year, a potent long acting opiate known as OxyContin was removed from the Canadian market and replaced with a new formulation called OxyNeo, which is made with a time release coating which is more difficult to bypass, making it less accessible to people using it without a prescription. This has resulted in fewer people using the drug, but not fewer people addicted to opiates.

    Research from the United States shows that many former Oxycontin users turned to more readily accessible opiates such as fentanyl and heroin after Oxycontin was taken off the market there.Reports from police and addiction workers suggest the same is now happening here in Canada. One of the problems with this is that people have had to change from opiates with a precisely known strength to others with variable potency. The risk of overdose has increased as a result. Recognizing this, Ontario Health Minister Deb Matthews announced in April 2012 that her government was increasing resources to address opiate addiction, including distribution of “emergency overdose kits across the province.”

    Similar to the way in which we provide emergency epinephrine to people with life-threatening allergic reactions, distributing a drug called naloxone, which reverses opiate overdoses, has been saving the lives of people who have overdosed on opiates since 1995 in the UK and Germany. There are 150 such programs in 19 American states but so far only Toronto and Ottawa have naloxone distribution programs up and running in Ontario, eight months after the health minister’s announced support of the strategy.

    Naloxone distribution involves providing opiate users with education on overdose prevention, first aid, CPR, as well as naloxone administration in an overdose situation, which “buys time” to get someone to emergency care. The OHRDP received Ministry of Health funding to create a detailed guidance document, which they have compiled building on the work of the Toronto and Ottawa pioneers. It is replete with supporting documentation, current statistics, training manuals, sample protocols and medical directives (required legally to prescribe and dispense this medication to lay people). The naloxone has been purchased and is ready to be used by trained lay people.

    Few health care providers would argue that the opiate addiction crisis has gone away. Small communities are dealing with issues like heroin which they have never seen before. What is different in small communities is that the people using substances are much more dispersed and invisible (for more information, see “Below the Radar”). While it may be reasonable in large cities to focus overdose prevention in places where there are high concentrations of drug users, small towns need a more widespread system of interventions because the people affected are not to be found in a few highly visible areas.

    For example, Peterborough ranks seventh highest in the province for opioid related deaths.  Peterborough Police Chief Murray Rodd has warned that “already we are seeing an increase in heroin and fentanyl in our city,” which he is concerned will lead to “even more overdoses in the coming months”.  A network of Peterborough agencies is poised to roll out an evidence-based overdose prevention program, which includes naloxone training – the first for an Ontario county which includes many rural communities where 911 response times are longer than is common in large cities.  Supported by the local Medical Officer of Health, the police service and EMS, it will only reach the people it needs to if local health care providers get behind the initiative. One hopes that they will do so without delay, as the project will undoubtedly save lives and provide a model for other small and rural communities.

    One of the reasons we study epidemiology (what is causing injury and death) is to use that information to plan programs which will prevent unnecessary injuries and deaths. Health providers have an obligation to understand evidence based interventions available around opioid addiction and to use them to reduce deaths. Some may ask “is this really needed?” but when overdose death rates are so well documented, the answer is obvious. Saving even one person from a needless overdose death should be considered important. She is someone’s daughter, maybe someone’s mom. While the needs of opiate users may not resonate with health care providers in the same way as the needs of people severely allergic to bee stings, when we have an evidence-proven lifesaving intervention, we are obligated to offer it widely and without delay.

    -Kathy Hardill

    Kathy Hardill is a Primary Care Nurse Practitioner at a clinic which includes patients whose health is made vulnerable through homelessness, poverty and other risk factors. This blog post was originally published on HealthyDebate.ca
  • The Drug War in Your Passport

    The Drug War in Your Passport

    On October 18th, 1929, the Judicial Committee of the Privy Council in England, the highest court in Canada at the time, made a landmark decision that would forever change the role of women in Canadian politics. It repealed a previous ruling by the Supreme Court and made official women’s status as “persons” in Canada, which meant that from that point on, women were eligible to become members of the senate.

    The individual largely responsible for this ruling was the trailblazing women’s rights activist Emily Murphy, who three years prior became the British Empire’s first female magistrate. Along with four other women, who came to be known as “the famous five”, Murphy campaigned for this crucial shift in the meaning of the word “person”.

    Murphy’s legacy is alive and well today, with statues and art depicting her campaign located across the country. And now, according to a recent announcement, she will also be appearing in the pages of the new Canadian passports, alongside Terry Fox.

    But Murphy has another, lesser-known legacy. She is, perhaps more than any one individual, responsible for the criminalization of cannabis in Canada and the beginning of this country’s 90-year war on pot.

    From 1920 to 1922, Murphy wrote a series of articles for Maclean’s magazine, which would later be collected in her book “The Black Candle”. These writings, which amounted to an explicitly racist, anti-immigrant diatribe, were aimed at “educating” the Canadian public as to the dangers of drug use and drug trafficking.

    Informed by her experience as a magistrate in Alberta and a tour of Vancouver’s Chinatown, Murphy surmised that drug addiction was “a scourge so dreadful in its effects that it threatens the very foundations of civilization.”

    In “The Black Candle” she argued that substances such as cannabis, opium and cocaine were being trafficked throughout the country as part of a vast conspiracy aimed at corrupting the “purity” of the white race and the destruction of Anglo-Saxon communities.

    Of cannabis users she wrote:

    “The addict loses all sense of moral responsibility. Addicts to this drug, while under its influence, are immune to pain, and could be severely injured without having any realization of their condition. While in this condition they become raving maniacs and are liable to kill or indulge in any form of violence to other persons, using the most savage methods of cruelty without, as said before, any sense of moral responsibility.”

    Capitalizing on the anti-Chinese sentiment in Vancouver at the time, she successfully elevated and expanded upon the moral panic associated with opium to the national level and helped persuade the Canadian government to enact stricter drug laws.

    In 1921, An Act to Amend the Opium and Narcotic Drug Act increased maximum sentences for trafficking and possession from one year to seven years. And in 1923, informed by Murphy’s argument and “evidence”, the Canadian government became the first western country to ban cannabis.

    It is a strange and tragic irony that Murphy, who used a contrived drug scare to attack immigrants, should after all these years appear in Canada’s new passport; a document that is meant to enshrine and protect the rights of all Canadian citizens, new or old.

  • Qu’est-ce que la naloxone?

    Qu’est-ce que la naloxone?

    La naloxone est un composé chimique sécuritaire et très efficace qui inverse les effets des opiacés comme l’héroïne. Depuis 40 ans, elle est utilisée dans des milieux cliniques comme traitement d’urgence contre les surdoses d’opiacés. Aux É.-U. et en Europe, les programmes « Take Home Naloxone » ont été associés à des réductions de jusqu’à 34 % des décès liés aux drogues[1]. L’utilisation de la naloxone au Canada est autorisée depuis plus de 40 ans, et elle figure à la Liste modèle de l’OMS des médicaments essentiels. La naloxone ne peut faire l’objet d’abus – en l’absence de narcotiques, elle ne présente essentiellement aucune activité pharmacologique. La naloxone ne fonctionne qu’avec les drogues de la famille des opiacés/opioïdes – elle n’est pas efficace pour les surdoses d’autres drogues comme la cocaïne.

    Comment la naloxone peut-elle réduire le nombre de décès liés aux drogues?

    La naloxone peut jouer un rôle majeur dans la prévention des décès – surtout si elle peut être administrée à une personne en surdose aussi tôt que possible. Afin de maximiser l’effet de la naloxone sur les décès liés aux drogues, il faut que la naloxone soit disponible sur les lieux de la surdose avant l’arrivée de l’aide spécialisée. Ce qui veut dire que la naloxone doit être disponible pour les membres de la communauté, aux fins d’utilisation d’urgence. Les programmes « Take Home Naloxone » ont été liés à des réductions de jusqu’à 34 % des décès liés aux drogues[2].

    L’accès à la naloxone varie autour du monde, notamment les doses à apporter (take-home) pour les personnes qui utilisent des drogues illicites en Europe, en Australie, de même qu’à Edmonton et Toronto. L’Écosse a instauré une National Patient Group Directive en août 2010 pour faciliter le développement de programmes de naloxone pour apporter. Les Patient Group Directives (PGD) permettent que la naloxone soit prescrite par des infirmières et des pharmaciens compétents. En Écosse, chaque personne libérée d’une prison et à risque de surdose reçoit une formation et une trousse de naloxone[3]. La naloxone est en vente libre à Turin, en Italie. Il y a plus de 180 programmes réussis de naloxone pour apporter aux États-Unis, comme le Project Lazarus de Caroline du Nord, qui a contribué à distribuer de la naloxone aux personnes qui sont à risque à cause des opiacés prescrits[4].

    Au Canada, la naloxone est contrôlée à titre de médicament sur ordonnance (MSO) en vertu de l’annexe F du Règlement de la Loi sur les aliments et drogues. Elle est prescrite par les médecins à des patients désignés nommément seulement, qui sont jugés à risque d’une surdose d’opiacés. La disponibilité de la naloxone est également soumise à la législation provinciale régissant les pharmacies ainsi qu’aux organisations professionnelles comme les collèges provinciaux de médecins et chirurgiens.

    La recherche a constaté que la disponibilité de la naloxone n’augmente pas l’utilisation des opioïdes. Des programmes ont remarqué que former des gens à administrer un médicament qui sauve des vies est une expérience qui change une vie.

     

     


    [1] Scottish Drugs Forum. Take-home Naloxone: Reducing Drug Deaths. À l’adresse :www.sdf.org.uk/index.php/download_file/view/132/108/

    [2] Buxton, et al., 2012; Scottish Drugs Forum.

    [3] National Services Scotland. 2012. National Naloxone Programme Scotland Monitoring Report – Naloxone Kits Issued in 2011/12. À l’adresse : http://naloxone.org.uk/index.php/allresearch/99-reseach14

    [4] Dasgupta, N. et al. 2008. « Project Lazarus: Overdose Prevention and Responsible Pain Management ». North Carolina Board of Medicine: Forum, p. 8. À l’adresse :www.ncmedboard.org/images/uploads/publications_uploads/no108.pdf

  • Rapport du directeur

    Rapport du directeur

    Les trois derniers mois ont foisonné d’activités comme nous établissons davantage notre présence comme CCPD et formons des liens avec des organisations et des personnes du pays et du monde entier. Il se produit véritablement quelque chose de grand, et un élan se dirige vers de nouvelles approches innovatrices pour aborder les problèmes de drogues.

    En février, j’ai été invité à prendre la parole à un congrès international, à Mexico,Drogas : Un balance a un siglo de su prohibición, organisé par le groupe de prévention du crime Mexico Unido Contra la Delincuencia. Le forum a effectué un examen exhaustif des solutions de rechange possibles aux conséquences désastreuses de la guerre aux drogues du gouvernement mexicain. Des conférenciers sont venus du monde entier pour faire part de leurs innovations, de leurs changements législatifs et de leurs pratiques qui ont donné aux politiques des drogues une approche de santé publique et les ont éloignées du modèle de justice pénale raté.

    Intégration de l’injection supervisée dans les services de santé et la communauté : un échange de connaissances national

    En avril, la CCPD a organisé un forum sur les services d’injection supervisée en partenariat avec le centre du Dr Peter de Vancouver et Cactus Montréal, à titre de réunion connexe du congrès de l’Association canadienne de recherche sur le VIH, à Montréal. Le congrès avait lieu à la magnifique Bibliothèque et Archives nationales du Québec. C’était une occasion pour les organisations de partager leurs expériences et de vérifier l’état actuel des discussions dans leurs localités. La CCPD travaille avec un certain nombre d’organisations à faire avancer ces discussions tandis que différentes localités cherchent à mettre en œuvre ces services.

    Rencontre de la stratégie nord-américaine sur les drogues – San Francisco, 12 et 13 avril

    Dans le cadre du travail international de la CCPD, nous avons été l’hôte d’une rencontre conjointement avec la Drug Policy Alliance des États-Unis et CUPHID de Mexico afin d’explorer le développement d’un dialogue coordonné nord-américain à propos des politiques sur les drogues. La rencontre de San Francisco a été la première séance préliminaire dans le but de vérifier comment nous pouvons collaborer à proposer des solutions de rechange aux politiques sur les drogues actuelles en Amérique du Nord. Tentant de raffermir ses liens sur le continent, la CCPD recherche présentement des alliés canadiens intéressés à soutenir ses travaux au Mexique.

    Visite dans les Maritimes

    Conformément à notre projet de constituer une coalition nationale, j’ai visité le Canada atlantique en mai. J’ai assisté à des activités et des rencontres à Halifax, à Saint-Jean Nouveau-Brunswick et à Charlottetown. Le Réseau atlantique de recherche sur la réduction des méfaits a invité la CCPD à prendre part à sa séance publique – Les gens et les politiques : comment les politiques sur les drogues influencent-elles la santé de nos communautés? En outre, une séance d’un jour avec des prestataires de services et des chercheurs examinait aussi comment mieux intégrer les services de réduction des méfaits dans le contexte des refuges et des salles d’urgence.

    À Saint-Jean NB, AIDS Saint John, l’institut des études urbaines et communautaires de l’Université du Nouveau-Brunswick et la CCPD ont co-organisé une activité, Les drogues et la ville, qui présentait une discussion d’experts en politiques sur les drogues avec Tim Christie, directeur de l’éthique, région sanitaire de Saint-Jean et Bill Reid, chef du service de police de Saint-Jean.

    À Charlottetown, j’ai rencontré des parents inquiets de l’absence de traitements pour les jeunes dans l’île, qui sont intéressés à organiser un « mouvement des toxicomanies » provincial afin de stimuler la discussion, de partager des expériences et de faire participer le gouvernement provincial au dialogue sur l’amélioration des services pour les personnes aux prises avec des problèmes de drogue.

    Stratégie municipale sur les drogues de Thunder Bay

    Le 24 mai, Canadian Students for Sensible Drug Policy et la stratégie sur les drogues de Thunder Bay ont organisé l’activité Pot, Pills and Parties, qui portait sur l’effet du projet de loi C-10 sur les jeunes gens et comprenait une présentation de la CCPD :Changer le cadre : une nouvelle approche des politiques sur les drogues au Canada.

    En joignant les gens à travers le pays, la CCPD trouve de nouvelles façons innovatrices de consolider et de constituer sa coalition afin d’améliorer l’approche du Canada relativement aux problèmes des drogues. Nous continuerons de mobiliser les Canadiens et de travailler à cette fin à l’échelle internationale.

    Photo Credits:
    Mexico – Steve Rolles
    Montréal – Caroline Mousseau
    San Fransisco – CC Flickr evoo73
    Halifax – Wooden Shoe Photography

  • NAOMI Research Survivors: Experiences and Recommendations

    NAOMI Research Survivors: Experiences and Recommendations

    On March 31st, 2012 the NAOMI Patients Association (NPA) will celebrate the completion of their first research report, NAOMI Research Survivors: Experiences and Recommendations. To mark the occasion, they are having an open house on Saturday, March 31st at noon at the Vancouver Area Network of Drug Users (VANDU), 380 East Hastings Street, in the Downtown Eastside (DTES) of Vancouver, BC where they will be sharing their report and celebrating their achievement. All are welcome and snacks and copies of the report will be available.

    The Background

    Dave Murray
    Dave Murray

    In January 2011, Dave Murray organized a group of former participants from the North American Opiate Medication Initiative (NAOMI) heroin-assisted treatment clinical trial in the Downtown Eastside of Vancouver, now known as the NAOMI Patients Association (NPA).

    The NPA is an independent group that meets every Saturday at the Vancouver Area Network of Drug Users (VANDU) offices. The NPA has reached out to all former NAOMI participants in the heroin stream of the clinical trial and offers support, education, and advocacy to its members. Although attendance at weekly meetings varies, the highest attendance at a meeting was 44 members. On average, 15 members gather each week.

    The NPA is also associated with the British Columbia Association of People On Methadone (BCAPOM).

    Mission of the NPA

    The mission of the NPA is stated as:
    We are a unique group of former NAOMI research participants dedicated to:

    • Support for each other;
    • Advocacy;
    • Educating peers and the public;
    • Personal and political empowerment;
    • Advising future studies (heroin and other drugs) and permanent programs;
    • Improvements in consent and ethics;
    • The right to a stable life and to improvement in quality of life.

    The NPA’s goal is to see alternative and permanent public treatments and programs implemented in Canada, including heroin assistance programs.

    The Research

    In March of 2011 the NPA decided to undertake their own research project focused on their experiences as NAOMI research participants. They met with me, Susan Boyd, a drug policy researcher and activist, and decided to work together to conduct focus groups, brainstorming sessions, and writing workshops with NPA members. The NPA adopted the words below to further guide their own research project. They are written by long-time DTES activist Sandy Cameron who passed away last year, from his poem, Telling Stories.

    Telling Stories
    We need to tell our own stories.
    If we don’t tell our stories,
    people with power
    will tell our stories for us.
    It is from this place that the NPA began their own research, to tell their own story in their own words.

    NPA Research Findings

    Five primary themes emerged from the research:

    • Beneficial outcomes of being a participant in NAOMI,
    • Problematic outcomes of being a participant in NAOMI,
    • Ethics and Consent,
    • Creative writing/Everyday life, and
    • Recommendations for other research projects and programs.

    The NPA’s report, NAOMI Research Survivors: Experiences and Recommendations, expands on these themes and much more. The full report is available here.