Pubdate: Mon, 25 May 2015
Source: Toronto Star (CN ON)
Copyright: 2015 The Toronto Star
Contact:  http://www.thestar.com/
Details: http://www.mapinc.org/media/456
Author: Joe Fiorito
Page: GT2

A DISPATCH FROM THE FIELD OF HARM REDUCTION

Recently I chewed khat, a leaf with properties conducive to 
sociability; and on a couple of occasions I ate cannabis chocolate.

I neither brag nor complain, I merely think we ought to normalize 
khat, find a reliable way to measure the potency of cannabis, in any 
and all forms, so that those who use it can make informed judgments.

As you might guess from the above, I am also a supporter of harm 
reduction, and so I went to an information meeting awhile back to 
learn a little bit about the problems of drug overdose.

The presentation was made by four people who are prominent in the 
harm reduction movement, one of them a woman who is now on methadone 
after years of using heroin.

In the audience were perhaps 40 people who work, in some way, with 
those who use drugs. We were asked a question off the top: Had anyone 
in the audience ever had an overdose? A couple of hands went up.

Then, a more specific question: how many in the audience have ever 
had a hangover? Many more hands were raised to the tune of nervous 
laughter; the chuckles turned to chagrin when it was pointed out that 
a hangover is the result of an overdose of alcohol.

So there. And then things got really serious, and here are some 
things I learned: We have a crisis on our hands. In Toronto, in 2010, 
there were 106 deaths attributed to the misuse of opioids; 26 of 
these deaths involved heroin; 17 deaths involved the painkiller 
fentanyl; and there were 30 deaths in which oxycodone played a part. 
All those numbers are significantly higher than they were in 2002. 
Now hear this: There were, in Toronto, more accidental deaths caused 
by drugs than there are deaths in car accidents, and yet car 
accidents are prominent in the news, and overdoses are not.

Do we value some lives more than others? And do you still wonder why 
some people are cynical about the media?

Someone in the seminar asked why drug deaths are rising if harm 
reduction works? It's a good question with a complicated answer. 
There may be more users who don't know what they're doing. There are 
certainly all sorts of new drugs on the street, some of which are 
tainted and some of which are quite powerful. There's also more to it 
than that. Some people return to drugs after a long absence, perhaps 
a spell in prison, only to find that their drug of choice is more 
powerful than it was when they quit.

And some drug users are quite inventive. For example, there are those 
who will extract the fentanyl from used dermal patches, and add it to 
their heroin; thing is, fentanyl is powerful in and of itself, but it 
is also unevenly distributed in the patches, so that a user may not 
know how much he or she is getting. Inventive, yes. Dangerous, 
utterly. An aside: there are some places in the world where used 
fentanyl patches can be turned in, much the same way as used needles 
can be turned in; this practice should be widespread.

Things may get worse before they get better: someone in the gathering 
observed that her old neighbour, who had been taking an opioid 
medication, forgot that she had done so and took more. The ambulance 
came for her, as it does a couple of times a year.

We're all getting older; brr.

We were then given a short course in the symptoms of various kinds of 
overdose, and what to do, but these were not the most interesting 
things I learned. This was:

There are all sorts of new drugs popping up on the street, and 
sometimes they are dirty or profoundly powerful and it takes some 
time for information and cautions to circulate.

At the moment, for example, there is some particularly nasty crack 
cocaine in circulation.

How do people learn about these things? The hard way, early on.

There is a website - ReportBadDrugsTO.ca - but it's really just a 
survey and requires one to fill out a detailed form, and you don't go 
there to learn about bad drugs, you go there to report them. I offer 
no comment. I do have a question: Shouldn't there be an app for that?
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MAP posted-by: Jay Bergstrom