Pubdate: Fri, 03 Mar 2017
Source: Ottawa Citizen (CN ON)
Copyright: 2017 Postmedia Network Inc.
Contact:  http://www.ottawacitizen.com/
Details: http://www.mapinc.org/media/326
Author: Kelly Egan
Page: A2

NO SIMPLE SOLUTIONS IN THE OPIOID CRISIS

One thing is becoming clear about the city's opioid crisis: Nobody has
any easy answers.

As a consequence, we're madly off in all directions, clinging to false
hope, such as:

All we need is more youth treatment centres.

Not really. The terrifying thing about the two latest high-profile
deaths is that we're likely not dealing with addicts, or even
addiction. These were, evidently, young people experimenting with
drugs, or only occasional users of pills.

How do 100 or 1,000 more treatment beds help a Teslin Russell, the
promising 18-year-old who tragically died of an overdose Dec. 31,
apparently the victim of "one bad pill"? There is no evidence,
according to the account from her parents, of a pattern of drug use,
let alone addiction.

And this is what makes fentanyl, in particular, so worrisome. Kids
don't become alcoholics with one drink, but they can die after one
pill, 100 times more potent than heroin.

Similarly, was Chloe Kotval, who died at age 14 on Feb. 14, a
candidate for a residential centre, or the victim of youthful
misjudgment and terrible luck?

Also, the snap response - "throw them in treatment" - sounds great in
theory but, in practice, doesn't work. The user has to be ready for
help. So often, they aren't. So often, they have to wait. So often,
they relapse.

The Dave Smith Youth Treatment Centre has 24 beds, programs that run
45 to 90 days, and wait times that are weeks, if not months. Executive
director Mike Beauchesne calls the whole sector "chronically
underfunded" and says the number of addicts actually asking for help
is as low as 10 per cent. So yes, more beds, but beds aren't the whole
solution.

"There's no quick fix," agreed Marion Wright, executive director of
Rideauwood Addiction and Family Services. "The only piece that's
really changed is that things have gone from bad to deadly very quickly."

It's a terrible problem from China we can stop at the border or the
dealer's den.

Not really. On the whole, Canada is awash in legally prescribed
opioids, one of the highest prescription rates in the world. Should we
be surprised that lethal, counterfeit pills can so easily knit their
way into the existing fabric of pharmaceuticals that fill suburban
medicine cabinets?

This, says Beauchesne, is how the problem manifests itself at the 
doorstep of Dave Smith: "(We've seen) the gradual increase in the number 
of kids reporting using opioids from their own prescription cabinets, 
their parents' cabinets or of their peers."

Indeed, opioid pain relievers are used by roughly 15 per cent of the
population (even higher among seniors), down from 22 per cent in 2008.
The Centre for Addiction and Mental Health in Toronto reported that 37
per cent of those seeking help were hooked on opioids from physician
prescriptions. At Dave Smith, 31 per cent of clients (aged 13 to 21)
reported at least weekly opioid use.

And underground? Internet-ordered ingredients, basement cooks,
quantities so small they evade detection at borders. We shouldn't
count on the "war on drugs" to keep bootleg opioids off the streets.
When did it ever work? Naloxone is the answer. Not really. Obviously,
it's a critical tool for first responders and anyone who is a regular
drug user and in danger of an overdose. But can we realistically
expect there would be so much of the antidote available, at all the
right times and places, to save anyone in danger? (We don't even have
naloxone in high schools.)

And what of young people who aren't overdosing? Is not the greater
worry for the legion of young people spending their days wasted? The
schools are the problem. Not true. Wright says counsellors from
Rideauwood spend at least 14 hours a week in every English high school
in Ottawa, a program stitched together with those exiting the Dave
Smith centre. This on top of whatever awareness is spread through the
regular curriculum and guidance systems.

Just this week, Wright and others in the addictions sector spoke to
roughly 100 principals at a city-wide meeting. The goal is for a
co-ordinated message from those third parties regularly in the
classroom: Rideauwood, Ottawa police, Ottawa public health.

She believes early intervention at the school level, more peer-to-peer
help, the right parenting, and constant messaging and education are
our best hopes at battling the crisis. She attended a meeting in
Kanata this week where many parties, politicians and agency heads
turned up to offer support to parents worried about the unknowns or
themselves in the centre of an addictions storm.

"It must have been extremely unsatisfying for parents," she said. Why?
Did we not have all the experts in one place?

"Because they didn't get any answers."
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MAP posted-by: Matt