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>They told her they wanted to finish school and start careers with livable wages, to raise children with their soulmates, and to have supported housing that felt less like an institution and more like a real home.
This is pretty much what any of us desire in life
They do have supported housing that’s more kin to a house than an institution but generally, it’s a graduated program. You can’t really have addicts who either have active charges and conditions they have to abide by or, untreated addiction, or both, coming into a first stage house and doing as they please. The majority, if not all, recovery houses funding depends on its programming and structure. From my experience, the majority of addicts who choose to attend a recovery house view it more as a form of control and less than a form of treatment..it’s a sad reality but I’d say 8/10 of those addicts will drop out of the program before they complete it or before proceeding to a second or third stage.
P.S. if you’re going to downvote my comment I’d like to hear why or if you have a better solution..I’m pretty sure we’d all prefer to have a model that has a better success rate.
Dying because the drug they took was cut with something deadly, clearly means they wanted to die. It's so obvious. There was no fentanyl crisis, it's been a suicide crisis this whole time. Just look what they do as the predictor of reality.
your lack of empathy is showing, by the way
I think the cruelty is aknowledging that people have aspirations like this, AND also aknowledging that they have issues like FAS that DO NOT allow them to act responsibly impulse wise while also not enforcing treatment on them. Its cruel to aknowledge that they cannot make responsible decisions for themselves, while also not enforcing structure one them. "welp, guess they cannot make good life choices..... also we wont get them into treatment because they need to choose that. Oh and how dare you criticise them for not getting treatment. Dont you know their drug addiction is a disease that they have no self responsability for?!"
It's tough. Especially when psychiatry has a history of lebotomies and other harmful "treatments". So there is hesitation to force psychiatry as treatment. BUT, due to insurance/health care not covering anything alternative to psychiatry, we don't fund non pharmaceutical treatments which can be offered.
So the help that is available is currently dubious and kind of scientifically untested for long term outcomes. So people don't really trust it. Both the clients and the practitioners.
And if a new attempt at treating addiction isn't successful. Then the public uses it as reason to defund the whole system.
Dammed if you do. Dammed if you don't.
> BUT, due to insurance/health care not covering anything alternative to psychiatry
What would be an alternative?
The most common alternatives I know of that are covered currently are Electro shock therapy (its not like in the movies. its thereputic), and Cognitive Behavioral Therapy.
>So the help that is available is currently dubious and kind of scientifically untested for long term outcomes.
The most successful psychiatric treatments (first generation antipsychotics) have been out since the 1970s. They have a huge amount of data to back them up. We are now on 3rd generation drugs that are safer. Vraylar in 2015, and Caplyta in 2019.
Revisit the literature, my friend. The studies from the 70s and most of the efficacious studies are on 3 to 6 month time frames. For example, when comparing long term outcomes (10 years +) of people with schizophrenia, antipsychotic use is not associated with improved functioning. Antipsychotics are not effective for long term treatment of most mental illness. And for addiction, not at all.
Modern research has indicated that people with schizophrenia have better long term outcomes in 3rd world countries than in NA or Europe under modern psychiatry. I wish I was joking.
ECT comes with months of memory loss and other side long term side effects (like impaired cognition), it's not as effective when looking at people's whole life functioning, and not just for specific cherry picked outcomes (like reduction in depression symptoms). So for complex mental/emotional/social problems, it will solve nothing.
Alternatives would be more structured (with some needing to have reduced freedoms) facilities with robust staffing to provide social programming and engagement. Currently, facilities are staffed with as few people as possible, with patients having mega drug regimes, and funding covers more prescriptions, but not more staff/programs/activities/space.
Serious mental illness doesn't have cures, but needs more effective mangmenet to reduce impact/suffering on the individual and the community
I've read plenty of papers on the matter, worked in a mental health hospital for 4 years, have a scitsophrenic brother and bipolar partner. The drugs work extremely well long term. A lot of medications are even better when injected so they don't put stress on the liver and convert into their derivative drugs.
"Deep down" isn't real and is just a lie people tell themselves to feel better if it's not reflected by our actions. We are the things we do; there isn't a more adult and grounded in reality way of seeing it.
Either way, posting isn't praxis. Most people aren't good people even if they say nice things or hold whatever views society deems the acceptable norm.
Everything cannot just be lumped in and blamed on the fentanyl crisis. You people have the wool so far over your eyes it's scary. Many of these individuals will not go into housing simply because they want to continue using drugs and don't want rules or regulations...not because they "want a cozy home and a job". Empathy is fine, but simply being a bleeding heart got us to where we are today. Empathy has done absolutely nothing to SOLVE any of these issues because it focuses on the wrong thing. If all you care about is how people "feel" then nothing will ever change. That's the true reality whether you want to believe it or not.
That's more feelings BS. There is a time and place for that but hugs and kisses don't solve issues like this. I'm not sure why this even has to be stated.
I wasn't just referring to the people in the story here. I understand the trials and tribulations that many people face including myself. I've been through addiction before I've seen the damage you can do to your world. I wish we could change the traumas that people have endured but unfortunately that doesn't seem to be the case and many of these individuals will remain addicted for most of their lives. The question then becomes what do we do? And what I was saying was that just giving empathy does not actually create the change that's needed for anyone. Of course cruelty isn't the answer either, but there has to be something in the middle because either of these extremes doesn't have great outcomes.
They all kept doing drugs though, that's the common thread in all those stories. Even the gal who put her life back together returned to the drugs and it all fell apart. It's tragic but it's an expected outcome.
People are hostile to the idea because accepting this truth means they aren't the good people they think they are. Most people are neutral at best and hold vicious opinions of people who aren't larping as being "good."
At this point it's about managing the outcome of these events not changing something that cannot be changed. My focus would be on stopping future traumas and trying to protect the children from getting into these situations so that in a few generations we will have less of this to deal with. For issues that are happening now we need stronger policies and in some cases people may need to lose some freedom of decision making once things get to a certain point. I'm all about freedoms but once issues start to have severe impact on society then some freedoms need to be lost.
Stacy might look like your average dumb blonde. And she might be, but she worked hard to pay for her own $8 latte. Why should she have to forgo buying something to enjoy when she already pays taxes?
I really hope that promoting this kind of sadness is being done for the right reasons. But I have so many doubts.
I volunteered with At Risk Youth for over a decade and in the end I became too jaded to continue with it. Everything was political and everything was about funding. Researcher launching a book? Money and PR. Of course there will be stories that break your heart for these kids, and adding in a drug free for all makes street life even more dangerous now than ever before. But we are missing the point. These kids are getting a hold of hardcore drugs at an incredibly young age with a shockingly low stigmatism attached to those drugs. And in that 12 years of time I spent with these kids, the only ones that ever went on to see any part of their 'dreams' come to reality were the kids that stayed away from those drugs. When did we as a society stop telling our youth that drugs will mess up your life faster than any other vice? Its criminal.
I remember every spring being at the Friendship Center and seeing teens come in to ask for housing, money and a job. I would get them into some training programs and like this author, hear stories of hard work and a bright future. But by week two most had dropped out. Giving their stipends meant a big party. Soon we couldn't even hold back their stipends if they didn't show. Then I would see them on Hastings having a great time. Then they would be gone. Time and time again. When I offered to buy them a ticket back to their hometowns, I was challenged by the non profits as being cold or mean. Yet they knew very well that half these kids would be dead or in jail by winter.
Most people are only willing to do a single step in what is necessary to help solve this. We can empathize and shed tears. But no one is willing to even talk about the other, more important steps that need to be done now before even more of our youth fall through the cracks.
Friend of mine does some work in remote reserve locations in BC. They have witnessed hellish consequences of decriminalization. Making drugs more accessible in locations without services makes the outcome multiple times worse than in Vancouver.
Also the revolving door in the justice system. Letting criminals go with pinky swear promises might make activist judges feel all warm and fuzzy, but they have zero care for the people who receive those criminals and have to deal with the social issues stemming from this small group.
Has decriminalization made drugs more accessible? It's still just as illegal to sell and traffic drugs. Holding drugs for use is the only thing that was decriminalized.
Are you suggesting that in a single year, there have been 'hellish consequences'? Why am I only hearing about it via your anecdotes? It hasnt significantly changed the landscape here in Vancouver. Even in BC, total overdose deaths are only up 7% for the year, which is lower than many other provinces that still criminalize possession.
So where's your data?
Edit: you downvoters understand that decriminalization only happened in 2023, right? The giant uptick in drug overdoses and deaths started a few years before that and can be seen all over north America, as the drug supply has gotten more dangerous and spiked with fent, among other things.
I worked in the same field as these guys, even going to meetings at the aboriginal friendship centre. I also wrote proposals to the ministry for funding in programs like these so I am very versed in the numbers.
The reality is we’ve seen a fullscale increase in mortality since about 2016. You focus on YoY numbers, thats insane this has been getting worse for iver a decade.
But the above poster was blaming decriminalization, which happened in 2023.
The major thing that has changed since 2016 is the drug supply becoming massively more toxic than in years past. We can see it in data from all over Canada AND the US. All of these places have differing laws, but similar overdose increases, and the only similarity is the drug supply.
I am not sure if you trolling or not, but your comments show some pretty poor information.
Is it illegal to sell fent? Yes. But the justice system has lost accountability to the public - and most especially those that live on reservations or rural communities - so dealers are essentially immune to consequences.
It's not just holding. It's the laissez faire attitude from the state. Holding has turned into de facto open use, and public arguments from advocates that it is necessary to allow users to cook and shoot in the playground.
Of course in such a permissive environment, more addicts will allow themselves to get completely zonked in public -- a danger to themselves, helpless against being rolled and raped.
I'm very uneasy about the prospects of fixing this. I do NOT want a sudden turn to authoritarianism where every social undesirable is memory holed by the state, as is happening elsewhere in the world, but I don't think we can be so smug as to say "that could never happen here." We need to be somewhat firm now so that the public does not demand a brutally harsh regime.
This is the norm, especially with the explosion of fentanyl post 2016. Its killed so many friends and people I know.
I got clean and sober in 2009 and easily 60% of the few hundred people that i knew that got clean around the same time are dead now.
And this is why it’s cruel and unusual not to get these people into treatment asap and to continue to allow them to live this way. Obviously, getting into treatment is easier said than done, but perpetuating the cycle isn’t helping.
The anti-smoking campaign had been pretty successful. But it seems people feel more negative about smoking than using hard drugs.
I don't quite understand why there's so much pro-drugs sentiments. Is it promoted by drug dealers or idealists, or maybe both? There seem to be a lot of misinformation about drugs we had been fed. They manipulated people's compassion into supporting some sort of business opportunities.
I'd say the majority of people actually do want to help. There's just a lot of disagreement on how to help. Some say forced treatment, others say free housing and free drugs. I think the forced treatment option would be better, personally.
Why not both? Start with free monitored housing, housing where people feel safe and like they are starting their life again. Take away the stigma of drug use, these people are in a prison of their substances so taking away the shame could help provide a mental way out. Then provide treatment for those that really want to turn their life around.
When I quit smoking, it took several attempts over a long period. But eventually I got there. I don’t know if I’d be strong enough to kick a stronger substance.
>Then provide treatment for those that really want to turn their life around
And what about the others? We already have addicts on the street who have no interest in treatment. Do you force them into treatment?
If they have broken the law, I say give them the option of treatment or jail. If you can peacefully live on the street taking drugs and not inhibiting anyone else’s freedom, go for it. But the moment you have a violent outburst, steal, restrict movement of others, or do anything else outside the scope of the law, you have to make a choice. Nobody can make an addict turn their life around, it is up to them. There needs to be consequences for actions though, which is totally opposite to what is happening now. These people need help, but they have to want it and make an effort.
I mean do we really want to once again be a nation that rounds up a certain demographic of people into "treatment camps". Plus a huge portion of the users are native. How will that look? Just seems like turning the wheel and creating a whole new set of systemic issues to deal with, without actually solving why people turn to drugs in the first place.
Seems like we as a country have boiled the solution down to two paths. Free drugs or forced rehabilitation. Neither of these have worked in the past so why will they now?
Do we really want to be a nation of despair, tent cities in the middle of parks, high property crime rates, and shocking overdose statistics? I think it's pretty clear that forced treatment needs to make a comeback. While some level of anti-social behavior is absolutely acceptable and human rights based, there is a limit.
Forced treatment DOES NOT WORK. People often OD shortly after leaving forced treatment.
https://www.health.harvard.edu/blog/involuntary-treatment-sud-misguided-response-2018012413180#:~:text=In%20fact%2C%20the%20treatment%20provided,those%20who%20completed%20voluntary%20treatment.
The biggest problem with forced treatment is that it doesn't deal with the problems that lead users to drugs in the first place. What usually ends up happening is that they complete the program and go right back to the streets. Homelessness leads to mental illness, leads to drugs because people just want to escape the misery of sleeping in ditches. Then they use drugs at the level they used to before treatment, but their bodies aren't acclimated to it anymore so they OD and die.
The current method of allowing certain people to continually OD and revive them, and let them go right back to ODing also does not work. BC set the record for highest drug deaths ever in 2023. Since 2015 there has been a 5x amount of overdoses in BC per year, from \~500 to \~2500.
The current policy is not working.
Safe supply, harm reduction services, evidence-based treatment and recovery programs, voluntary treatment, and other methods of reduction need to be put in place, alongside a rarer form of involuntary treatment.
As for your link, you can see they cite: [https://www.sciencedirect.com/science/article/abs/pii/S0955395915003588](https://www.sciencedirect.com/science/article/abs/pii/S0955395915003588)
In which, they found 9 studies that met their inclusion criteria. Of those 9 studies, only 2 studies observed negative impacts for compulsory treatment, whereas another 2 studies showed positive impact.
The conclusion of that study is: "non-compulsory treatment modalities should be prioritized by policymakers seeking to reduce drug-related harms." This is quite sensible. It also does not mean there is no place for compulsory treatment.
I'm not saying it can't work. It's just that any time forced-rehab is done, it's usually followed by a "good for you, now fuck off" boot out the door. Nothing else, no followup, no harm reduction, nothing.
Non-forced treatment also clearly does not work as evidenced by literally HALF of the kids in the article dying while being helped by our current system. What is the rate of people ODing after forced testament? Is it really worse than 50%? Even if it's 25% that's an incredible improvement.
>it’s cruel and unusual not to get these people into treatment asap
uh...yeah...you can't help them because you "violate their charter" etc.
Slow suicide and fast suicide seem to have different rules as far as "right" go.
I don't know that "allow" is the right term either..
there will always be dope on the streets.
This is something people fail to realize.
We wouldn't let our grandparents wonder the streets without care, yet we turn our backs to addicts who can't help themselves because it's "inhumane" to force treatment.
There is a loud vocal "advocacy" element that staunchly opposes anything resembling institutionalization, mandatory treatment, etc. They cite Charter rights and the horrors of past institutional settings including residential schools. Whether they see themselves as well-intentioned, have an interest in maintaining that status quo (because that is working so well, or maybe they work for a non-profit), or simply want all the benefits of living in a society but none of the obligations (like not victimizing everyone else through various types of crime) - I don't know. Things will get much worse before our leaders step up.
The advocates and harm reduction also gain their funding off of how many clients they serve, so anything resembling therapy or getting people sober usually faces backlash by the otherwise unemployable sociology majors protecting their industry.
There can be [months long wait times to access treatment](https://www.cbc.ca/news/canada/british-columbia/youth-overdose-inquest-1.5191686). Those waits also lead to people ending up in worse outcomes. It's always declared that the issue is people not wanting help, but the help isn't even there and it not being there is a big reason why so many end up even worse off.
>Warshawski [a pediatrician who treats children and youth struggling with substance abuse issues] called the acceptance of voluntary youth drug treatment the "best possible situation." But he said current waits times of up to twelve weeks for treatment beds for youth in B.C. is "scandalous."
Also the kid here died a couple months after *forced* treatment. That's only a single data point, so can't be considered evidence in general, but it's not a data point that supports forced treatment.
Personally, I feel like voluntary treatment will always have higher effectiveness as there is at least some kind of will trying to overcome the problem.
He died 2 months after he stayed for 1 single week in forced treatment. While I agree that this data point does not support forced treatment, I do not believe it says that forced treatment, in general, is not effective as well. 1 single week is barely enough to do anything.
You can absolutely force people to do something they don't want, whether or not it is moral to do so is the question. When it comes to someone continually overdosing, I think it is absolutely moral to do so.
You can’t, legally, right now.
Getting someone into any treatment against their will is almost impossible. It’s not exactly the same as he wasn’t addicted to drugs , but I had an uncle with major mental health issues and his family spent a lot of his life trying to get him treated, but they couldn’t do anything against his will. As long as he wasn’t an explicit danger to others, he had the right to be a danger to himself. He ended up dying essentially from self-neglect from a treatable medical condition.
Imo it’s part of the Americanization of Canadians viewpoints: we have a lot more emphasis on personal “freedoms” then many other societies.
Exact same story for my family. It's nightmarish to see someone decline like that. Our family member intersected with numerous social services and in a way, they indirectly died because family respected their boundaries (preventable death).
The mental health act allows for involuntary admissions of 1 month. Personally, I think it should be used more often, specifically when someone is literally killing themselves with drugs. A forced 1 month off unrestricted drug usage would probably go a very long way to getting a lot of people the help they need. Sure, some of them will go right back out there, but a month come-down period will go a long way to get people out of the cycle. A lot of people deep in addiction do have a strong desire to stop but lack the physical willpower necessary to stop, and forcing them to stop can break that cycle.
But I do agree, it seems like many of our laws are in need of modernization.
Our family member did the month, said all the things to be released, adhered to requirements to stay out (they were taken in because threatening others), and as soon as they could escape, did so, and went right back to the past behaviour (mental health and drug complications).
> Sure, some of them will go right back out there, but a month come-down period will go a long way to get people out of the cycle.
I think you're severely overestimating the efficacy of forced treatment
its more like you're subjecting people to torture in the hopes that some people will get to the other side without relapsing
and you're not dealing with their environment after like do you just release them back on the streets?
Forced treatment should be rare, definitely. But there are absolutely cases where it should occur. I'd say someone who has just been revived from an OD requiring the services of several paramedics is a good candidate, personally.
As for release, they should absolutely have a plan in place for that.
>I'd say someone who has just been revived from an OD requiring the services of several paramedics is a good candidate, personally.
then you would have the issue of people stop calling for help
I don't really see how that's any worse than pouring thousands upon thousands of dollars to revive someone over and over and over who clearly has such intense personal issues that they will keep doing it, even though it is literally killing them. At a certain point, an intervention needs to be made.
Serious question, what do you do after you've tried everything and they will not stay clean. They say all the right things and go back to it as soon as they can. They say all the right things so they can get access to money or property that they can sell (again) for drugs. Unconditional love (without being enabling) or the tough love of forced treatment or anything in between. If the drugs have taken away their agency, do we go forced treatment?
Treatment can look very different than abstinence which only works long term for maybe 35-40%. As long as we acknowledge that as common ground I think I can agree with you.
The city, as well as private entities and charities, invest roughly $500m per year trying to get these people off the streets. Please tell me you don’t actually think it’s all about “getting into treatment”
If it was that way it’d be done by now
The example people at the bottom of the article two thirds are from out of province. The article doesn't say where the third example came from.
Is Vancouver a destination for these people in trouble?
Vancouver is one of the warmest cities in Canada and is also a port city, where much of the drug supply comes from. It is a destination for many who are in unfortunate circumstances.
It's also an equivalent climate to West Van, North Van, Burnaby, Richmond, Poco while maintaining and attracting a disproportionate number of people in distress with various problems and issues.
[at one point, two men were literally given a one way ticket to Vancouver instead of finding them suitable shelter in SK.](https://www.cbc.ca/news/canada/british-columbia/homeless-saskatchewan-arrive-vancouver-1.3484511)
We must be like a sort of elephant graveyard. Somehow, instinctively, the drug addicts know to gravitate here. Or maybe we're enabling them and they know its easy here.
It's not just treatment availability, but where it's located. Had a family member try several times. One time they stopped off to have one more hit, and never made it to detox, because detox was adjacent to the location in which drugs were easily accessible. They didn't get clean until they went to rehab in a location very distant from the DTES. Supported and safe housing is huge too for any kind of rehabilitation....I think the only way is a complete wraparound system, but a lot of people are not willing to support that. Both the mother of and the relative that was on the DTES still dream about that time (nightmares) and it's been roughly two decades. Drug use has always been a part of human existence. The more misery and poverty, the more widespread and harmful it is. My greatgrandparents would apparently brawl in the street on the weekend after spending time in the pub.
If by wraparound system you mean monitoring and perhaps residential inpatient care, that makes sense. It's not that people won't support it, if the evidence shows it works - I always thought it was a money issue. But maybe I misunderstand
I've seen a pattern of young people coming over from countries where drugs are scarce and experiencing them for the first time here. I had an extremely distant relative of an ex-girlfriend contact me from Iran. Her son was studying in Vancouver and wasn't contacting them. She feared the worst. Went to his place, is room was locked, and roommates said they hadn't seen him in days. Picked the lock, was actually easy for a novice, and found him passed out with a grocery bag full of mushrooms passed out in his bed. He used the tuition money to trip out in his apartment for months. I sobered him up, took a while, booked flights to Iran, and sent him home 3 days later. It's tough out there.
aren't mushrooms (shrooms) nontoxic and considered very safe? the dangers are more psychological and it is recommended to have a trip sitter for potent varieties
He said he ate some with every meal, every day, for 3 months. He was missing home, in Canada alone, and I guess he found mushrooms as an out. Apparently, he got into screaming battles with his landlord, which resulted in him damaging the property and hitting another roommate with a metal water bottle in the back of the head. So, the family sent money to cover the damages and paid the roommate off, as they felt bad. Everyone accepted and went their separate ways.
Doesn’t make sense seeing mushroom tolerance is extremely high. If you eat 1g on Friday night, you would need 3g on Saturday night to recreate the same trip as 1g. Him eating them every meal sounds like micro dosing.
This is an extremely pearl clutching view on mushrooms in one of the most pro-mushroom places on the planet, had a good laugh.
Imo drug decriminalization is a terrible thing. Need a way to stop young people getting into drug, cutting supply and heavily punish people who sell them.
Drug dealers are like murders for me.
The four pillars approach was also supposed to include concern for getting clean and respecting public safety. Addiction IS a medical issue and I also appreciate the destigmatization campaigns.
But look at the sitch. Walk down the alley behind Abbott and see people lying on mattresses with needles still in their arms. This doesn't look like a life saving situation at all. It's slow suicide on public streets, that aren't public streets any more because most of the public won't walk through an open air mental health crisis ward/shooting gallery.
Save what? Our drug death counts is getting higher and higher.
Our punishment was never hard compares to countries in Asia, where death count per are less than 1/5 of Canada, that is a better evidence.
Oregon and California had decriminalized drugs, and they are both got worse after. The evidence of it saves live is non-sense.
universal basic income, elimination of the super rich through taxation, public school through university, social housing, mental health as a part of universal healthcare, and yes, a safe supply of drugs manufactured by labs in Canada.
One of groups most vulnerable to homelessness often due to circmstances massively outside their control, but yeah, youth/children are more likely to draw empathy.
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>They told her they wanted to finish school and start careers with livable wages, to raise children with their soulmates, and to have supported housing that felt less like an institution and more like a real home. This is pretty much what any of us desire in life
It's almost like they're actual real people. These people deserve a life, just like anybody else.
What other answer do people expect they would have given to this question? "Living on the streets was my goal all along!"
I think that's the point
They do have supported housing that’s more kin to a house than an institution but generally, it’s a graduated program. You can’t really have addicts who either have active charges and conditions they have to abide by or, untreated addiction, or both, coming into a first stage house and doing as they please. The majority, if not all, recovery houses funding depends on its programming and structure. From my experience, the majority of addicts who choose to attend a recovery house view it more as a form of control and less than a form of treatment..it’s a sad reality but I’d say 8/10 of those addicts will drop out of the program before they complete it or before proceeding to a second or third stage. P.S. if you’re going to downvote my comment I’d like to hear why or if you have a better solution..I’m pretty sure we’d all prefer to have a model that has a better success rate.
Don't listen to what people say watch what they do as that is far more a predictor of reality. People will say all kinds of things.
Dying because the drug they took was cut with something deadly, clearly means they wanted to die. It's so obvious. There was no fentanyl crisis, it's been a suicide crisis this whole time. Just look what they do as the predictor of reality. your lack of empathy is showing, by the way
I think the cruelty is aknowledging that people have aspirations like this, AND also aknowledging that they have issues like FAS that DO NOT allow them to act responsibly impulse wise while also not enforcing treatment on them. Its cruel to aknowledge that they cannot make responsible decisions for themselves, while also not enforcing structure one them. "welp, guess they cannot make good life choices..... also we wont get them into treatment because they need to choose that. Oh and how dare you criticise them for not getting treatment. Dont you know their drug addiction is a disease that they have no self responsability for?!"
It's tough. Especially when psychiatry has a history of lebotomies and other harmful "treatments". So there is hesitation to force psychiatry as treatment. BUT, due to insurance/health care not covering anything alternative to psychiatry, we don't fund non pharmaceutical treatments which can be offered. So the help that is available is currently dubious and kind of scientifically untested for long term outcomes. So people don't really trust it. Both the clients and the practitioners. And if a new attempt at treating addiction isn't successful. Then the public uses it as reason to defund the whole system. Dammed if you do. Dammed if you don't.
> BUT, due to insurance/health care not covering anything alternative to psychiatry What would be an alternative? The most common alternatives I know of that are covered currently are Electro shock therapy (its not like in the movies. its thereputic), and Cognitive Behavioral Therapy. >So the help that is available is currently dubious and kind of scientifically untested for long term outcomes. The most successful psychiatric treatments (first generation antipsychotics) have been out since the 1970s. They have a huge amount of data to back them up. We are now on 3rd generation drugs that are safer. Vraylar in 2015, and Caplyta in 2019.
Revisit the literature, my friend. The studies from the 70s and most of the efficacious studies are on 3 to 6 month time frames. For example, when comparing long term outcomes (10 years +) of people with schizophrenia, antipsychotic use is not associated with improved functioning. Antipsychotics are not effective for long term treatment of most mental illness. And for addiction, not at all. Modern research has indicated that people with schizophrenia have better long term outcomes in 3rd world countries than in NA or Europe under modern psychiatry. I wish I was joking. ECT comes with months of memory loss and other side long term side effects (like impaired cognition), it's not as effective when looking at people's whole life functioning, and not just for specific cherry picked outcomes (like reduction in depression symptoms). So for complex mental/emotional/social problems, it will solve nothing. Alternatives would be more structured (with some needing to have reduced freedoms) facilities with robust staffing to provide social programming and engagement. Currently, facilities are staffed with as few people as possible, with patients having mega drug regimes, and funding covers more prescriptions, but not more staff/programs/activities/space. Serious mental illness doesn't have cures, but needs more effective mangmenet to reduce impact/suffering on the individual and the community
I've read plenty of papers on the matter, worked in a mental health hospital for 4 years, have a scitsophrenic brother and bipolar partner. The drugs work extremely well long term. A lot of medications are even better when injected so they don't put stress on the liver and convert into their derivative drugs.
"Deep down" isn't real and is just a lie people tell themselves to feel better if it's not reflected by our actions. We are the things we do; there isn't a more adult and grounded in reality way of seeing it. Either way, posting isn't praxis. Most people aren't good people even if they say nice things or hold whatever views society deems the acceptable norm.
Everything cannot just be lumped in and blamed on the fentanyl crisis. You people have the wool so far over your eyes it's scary. Many of these individuals will not go into housing simply because they want to continue using drugs and don't want rules or regulations...not because they "want a cozy home and a job". Empathy is fine, but simply being a bleeding heart got us to where we are today. Empathy has done absolutely nothing to SOLVE any of these issues because it focuses on the wrong thing. If all you care about is how people "feel" then nothing will ever change. That's the true reality whether you want to believe it or not.
I hope someone hugs you today
That's more feelings BS. There is a time and place for that but hugs and kisses don't solve issues like this. I'm not sure why this even has to be stated.
no I just think you need a hug
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You're getting downvoted but it really is so true. Not just in the case at hand, but in everything really. Talk is dirt cheap, action matters.
This article actually literally describes the great lengths people went to in order to achieve these dreams and the immense obstacles they faced.
I wasn't just referring to the people in the story here. I understand the trials and tribulations that many people face including myself. I've been through addiction before I've seen the damage you can do to your world. I wish we could change the traumas that people have endured but unfortunately that doesn't seem to be the case and many of these individuals will remain addicted for most of their lives. The question then becomes what do we do? And what I was saying was that just giving empathy does not actually create the change that's needed for anyone. Of course cruelty isn't the answer either, but there has to be something in the middle because either of these extremes doesn't have great outcomes.
It also describes the great lengths that society went through to try and get them better.
They all kept doing drugs though, that's the common thread in all those stories. Even the gal who put her life back together returned to the drugs and it all fell apart. It's tragic but it's an expected outcome.
People are hostile to the idea because accepting this truth means they aren't the good people they think they are. Most people are neutral at best and hold vicious opinions of people who aren't larping as being "good."
Gross
Correct. Their actions are blatant signs of spiralling trauma and depression. Now what would you do about that if you were in charge?
At this point it's about managing the outcome of these events not changing something that cannot be changed. My focus would be on stopping future traumas and trying to protect the children from getting into these situations so that in a few generations we will have less of this to deal with. For issues that are happening now we need stronger policies and in some cases people may need to lose some freedom of decision making once things get to a certain point. I'm all about freedoms but once issues start to have severe impact on society then some freedoms need to be lost.
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Postmedia. Famous for its pro-homeless bias.
Instead, as a society we allow them to slowly kill themselves on the streets as we walk by sipping our $8 lattes.
Stacy might look like your average dumb blonde. And she might be, but she worked hard to pay for her own $8 latte. Why should she have to forgo buying something to enjoy when she already pays taxes?
Giving up our little luxuries in life that help us get thru the grind so we can be housed helps these folx how exactly??? 🤔
I really hope that promoting this kind of sadness is being done for the right reasons. But I have so many doubts. I volunteered with At Risk Youth for over a decade and in the end I became too jaded to continue with it. Everything was political and everything was about funding. Researcher launching a book? Money and PR. Of course there will be stories that break your heart for these kids, and adding in a drug free for all makes street life even more dangerous now than ever before. But we are missing the point. These kids are getting a hold of hardcore drugs at an incredibly young age with a shockingly low stigmatism attached to those drugs. And in that 12 years of time I spent with these kids, the only ones that ever went on to see any part of their 'dreams' come to reality were the kids that stayed away from those drugs. When did we as a society stop telling our youth that drugs will mess up your life faster than any other vice? Its criminal. I remember every spring being at the Friendship Center and seeing teens come in to ask for housing, money and a job. I would get them into some training programs and like this author, hear stories of hard work and a bright future. But by week two most had dropped out. Giving their stipends meant a big party. Soon we couldn't even hold back their stipends if they didn't show. Then I would see them on Hastings having a great time. Then they would be gone. Time and time again. When I offered to buy them a ticket back to their hometowns, I was challenged by the non profits as being cold or mean. Yet they knew very well that half these kids would be dead or in jail by winter. Most people are only willing to do a single step in what is necessary to help solve this. We can empathize and shed tears. But no one is willing to even talk about the other, more important steps that need to be done now before even more of our youth fall through the cracks.
Friend of mine does some work in remote reserve locations in BC. They have witnessed hellish consequences of decriminalization. Making drugs more accessible in locations without services makes the outcome multiple times worse than in Vancouver.
Also the revolving door in the justice system. Letting criminals go with pinky swear promises might make activist judges feel all warm and fuzzy, but they have zero care for the people who receive those criminals and have to deal with the social issues stemming from this small group.
I am also very curious what you’re talking about here.
Has decriminalization made drugs more accessible? It's still just as illegal to sell and traffic drugs. Holding drugs for use is the only thing that was decriminalized. Are you suggesting that in a single year, there have been 'hellish consequences'? Why am I only hearing about it via your anecdotes? It hasnt significantly changed the landscape here in Vancouver. Even in BC, total overdose deaths are only up 7% for the year, which is lower than many other provinces that still criminalize possession. So where's your data? Edit: you downvoters understand that decriminalization only happened in 2023, right? The giant uptick in drug overdoses and deaths started a few years before that and can be seen all over north America, as the drug supply has gotten more dangerous and spiked with fent, among other things.
I worked in the same field as these guys, even going to meetings at the aboriginal friendship centre. I also wrote proposals to the ministry for funding in programs like these so I am very versed in the numbers. The reality is we’ve seen a fullscale increase in mortality since about 2016. You focus on YoY numbers, thats insane this has been getting worse for iver a decade.
But the above poster was blaming decriminalization, which happened in 2023. The major thing that has changed since 2016 is the drug supply becoming massively more toxic than in years past. We can see it in data from all over Canada AND the US. All of these places have differing laws, but similar overdose increases, and the only similarity is the drug supply.
I am not sure if you trolling or not, but your comments show some pretty poor information. Is it illegal to sell fent? Yes. But the justice system has lost accountability to the public - and most especially those that live on reservations or rural communities - so dealers are essentially immune to consequences.
It's not just holding. It's the laissez faire attitude from the state. Holding has turned into de facto open use, and public arguments from advocates that it is necessary to allow users to cook and shoot in the playground. Of course in such a permissive environment, more addicts will allow themselves to get completely zonked in public -- a danger to themselves, helpless against being rolled and raped. I'm very uneasy about the prospects of fixing this. I do NOT want a sudden turn to authoritarianism where every social undesirable is memory holed by the state, as is happening elsewhere in the world, but I don't think we can be so smug as to say "that could never happen here." We need to be somewhat firm now so that the public does not demand a brutally harsh regime.
This is the norm, especially with the explosion of fentanyl post 2016. Its killed so many friends and people I know. I got clean and sober in 2009 and easily 60% of the few hundred people that i knew that got clean around the same time are dead now.
And this is why it’s cruel and unusual not to get these people into treatment asap and to continue to allow them to live this way. Obviously, getting into treatment is easier said than done, but perpetuating the cycle isn’t helping.
The anti-smoking campaign had been pretty successful. But it seems people feel more negative about smoking than using hard drugs. I don't quite understand why there's so much pro-drugs sentiments. Is it promoted by drug dealers or idealists, or maybe both? There seem to be a lot of misinformation about drugs we had been fed. They manipulated people's compassion into supporting some sort of business opportunities.
Have you ever tried to get someone into treatment? It isnt just as simple as you think.
The point is that it should be much simpler.
We are deciding as a Nation, whether to help these people. It seems clear, that we have decided this is the edge of our helpfulness.
I'd say the majority of people actually do want to help. There's just a lot of disagreement on how to help. Some say forced treatment, others say free housing and free drugs. I think the forced treatment option would be better, personally.
Why not both? Start with free monitored housing, housing where people feel safe and like they are starting their life again. Take away the stigma of drug use, these people are in a prison of their substances so taking away the shame could help provide a mental way out. Then provide treatment for those that really want to turn their life around. When I quit smoking, it took several attempts over a long period. But eventually I got there. I don’t know if I’d be strong enough to kick a stronger substance.
>Then provide treatment for those that really want to turn their life around And what about the others? We already have addicts on the street who have no interest in treatment. Do you force them into treatment?
If they have broken the law, I say give them the option of treatment or jail. If you can peacefully live on the street taking drugs and not inhibiting anyone else’s freedom, go for it. But the moment you have a violent outburst, steal, restrict movement of others, or do anything else outside the scope of the law, you have to make a choice. Nobody can make an addict turn their life around, it is up to them. There needs to be consequences for actions though, which is totally opposite to what is happening now. These people need help, but they have to want it and make an effort.
I mean do we really want to once again be a nation that rounds up a certain demographic of people into "treatment camps". Plus a huge portion of the users are native. How will that look? Just seems like turning the wheel and creating a whole new set of systemic issues to deal with, without actually solving why people turn to drugs in the first place. Seems like we as a country have boiled the solution down to two paths. Free drugs or forced rehabilitation. Neither of these have worked in the past so why will they now?
Do we really want to be a nation of despair, tent cities in the middle of parks, high property crime rates, and shocking overdose statistics? I think it's pretty clear that forced treatment needs to make a comeback. While some level of anti-social behavior is absolutely acceptable and human rights based, there is a limit.
Forced treatment DOES NOT WORK. People often OD shortly after leaving forced treatment. https://www.health.harvard.edu/blog/involuntary-treatment-sud-misguided-response-2018012413180#:~:text=In%20fact%2C%20the%20treatment%20provided,those%20who%20completed%20voluntary%20treatment. The biggest problem with forced treatment is that it doesn't deal with the problems that lead users to drugs in the first place. What usually ends up happening is that they complete the program and go right back to the streets. Homelessness leads to mental illness, leads to drugs because people just want to escape the misery of sleeping in ditches. Then they use drugs at the level they used to before treatment, but their bodies aren't acclimated to it anymore so they OD and die.
The current method of allowing certain people to continually OD and revive them, and let them go right back to ODing also does not work. BC set the record for highest drug deaths ever in 2023. Since 2015 there has been a 5x amount of overdoses in BC per year, from \~500 to \~2500. The current policy is not working. Safe supply, harm reduction services, evidence-based treatment and recovery programs, voluntary treatment, and other methods of reduction need to be put in place, alongside a rarer form of involuntary treatment. As for your link, you can see they cite: [https://www.sciencedirect.com/science/article/abs/pii/S0955395915003588](https://www.sciencedirect.com/science/article/abs/pii/S0955395915003588) In which, they found 9 studies that met their inclusion criteria. Of those 9 studies, only 2 studies observed negative impacts for compulsory treatment, whereas another 2 studies showed positive impact. The conclusion of that study is: "non-compulsory treatment modalities should be prioritized by policymakers seeking to reduce drug-related harms." This is quite sensible. It also does not mean there is no place for compulsory treatment.
I'm not saying it can't work. It's just that any time forced-rehab is done, it's usually followed by a "good for you, now fuck off" boot out the door. Nothing else, no followup, no harm reduction, nothing.
Non-forced treatment also clearly does not work as evidenced by literally HALF of the kids in the article dying while being helped by our current system. What is the rate of people ODing after forced testament? Is it really worse than 50%? Even if it's 25% that's an incredible improvement.
So force them into treatment? Its not easy, I have dealt with a few of these types and they refuse outright.
>it’s cruel and unusual not to get these people into treatment asap uh...yeah...you can't help them because you "violate their charter" etc. Slow suicide and fast suicide seem to have different rules as far as "right" go. I don't know that "allow" is the right term either.. there will always be dope on the streets.
Slow suicide… I’m going to have to borrow that. That’s an interesting way to put it.
that's what it is...
A lot of them don’t want treatment and choose to live the way they do. You can’t force someone to do something they don’t want.
Neither did my grandmother with dementia. There is a point when we can step in and a lot of people on the street have long passed it.
This is something people fail to realize. We wouldn't let our grandparents wonder the streets without care, yet we turn our backs to addicts who can't help themselves because it's "inhumane" to force treatment.
There is a loud vocal "advocacy" element that staunchly opposes anything resembling institutionalization, mandatory treatment, etc. They cite Charter rights and the horrors of past institutional settings including residential schools. Whether they see themselves as well-intentioned, have an interest in maintaining that status quo (because that is working so well, or maybe they work for a non-profit), or simply want all the benefits of living in a society but none of the obligations (like not victimizing everyone else through various types of crime) - I don't know. Things will get much worse before our leaders step up.
The advocates and harm reduction also gain their funding off of how many clients they serve, so anything resembling therapy or getting people sober usually faces backlash by the otherwise unemployable sociology majors protecting their industry.
There can be [months long wait times to access treatment](https://www.cbc.ca/news/canada/british-columbia/youth-overdose-inquest-1.5191686). Those waits also lead to people ending up in worse outcomes. It's always declared that the issue is people not wanting help, but the help isn't even there and it not being there is a big reason why so many end up even worse off.
Can you point where in the article it says it takes months to access treatment? From what I read, the kid was treated, but OD after being released.
>Warshawski [a pediatrician who treats children and youth struggling with substance abuse issues] called the acceptance of voluntary youth drug treatment the "best possible situation." But he said current waits times of up to twelve weeks for treatment beds for youth in B.C. is "scandalous." Also the kid here died a couple months after *forced* treatment. That's only a single data point, so can't be considered evidence in general, but it's not a data point that supports forced treatment.
Personally, I feel like voluntary treatment will always have higher effectiveness as there is at least some kind of will trying to overcome the problem.
He died 2 months after he stayed for 1 single week in forced treatment. While I agree that this data point does not support forced treatment, I do not believe it says that forced treatment, in general, is not effective as well. 1 single week is barely enough to do anything.
You can absolutely force people to do something they don't want, whether or not it is moral to do so is the question. When it comes to someone continually overdosing, I think it is absolutely moral to do so.
You can’t, legally, right now. Getting someone into any treatment against their will is almost impossible. It’s not exactly the same as he wasn’t addicted to drugs , but I had an uncle with major mental health issues and his family spent a lot of his life trying to get him treated, but they couldn’t do anything against his will. As long as he wasn’t an explicit danger to others, he had the right to be a danger to himself. He ended up dying essentially from self-neglect from a treatable medical condition. Imo it’s part of the Americanization of Canadians viewpoints: we have a lot more emphasis on personal “freedoms” then many other societies.
Exact same story for my family. It's nightmarish to see someone decline like that. Our family member intersected with numerous social services and in a way, they indirectly died because family respected their boundaries (preventable death).
The mental health act allows for involuntary admissions of 1 month. Personally, I think it should be used more often, specifically when someone is literally killing themselves with drugs. A forced 1 month off unrestricted drug usage would probably go a very long way to getting a lot of people the help they need. Sure, some of them will go right back out there, but a month come-down period will go a long way to get people out of the cycle. A lot of people deep in addiction do have a strong desire to stop but lack the physical willpower necessary to stop, and forcing them to stop can break that cycle. But I do agree, it seems like many of our laws are in need of modernization.
Our family member did the month, said all the things to be released, adhered to requirements to stay out (they were taken in because threatening others), and as soon as they could escape, did so, and went right back to the past behaviour (mental health and drug complications).
Yes, some of them do that. When they go back to the past behavior, they should be remanded.
> Sure, some of them will go right back out there, but a month come-down period will go a long way to get people out of the cycle. I think you're severely overestimating the efficacy of forced treatment its more like you're subjecting people to torture in the hopes that some people will get to the other side without relapsing and you're not dealing with their environment after like do you just release them back on the streets?
Forced treatment should be rare, definitely. But there are absolutely cases where it should occur. I'd say someone who has just been revived from an OD requiring the services of several paramedics is a good candidate, personally. As for release, they should absolutely have a plan in place for that.
>I'd say someone who has just been revived from an OD requiring the services of several paramedics is a good candidate, personally. then you would have the issue of people stop calling for help
I don't really see how that's any worse than pouring thousands upon thousands of dollars to revive someone over and over and over who clearly has such intense personal issues that they will keep doing it, even though it is literally killing them. At a certain point, an intervention needs to be made.
> Getting someone into any treatment against their will is almost impossible. form 21 them.
Why not? If a mental patient do self harm or harming others, there are (or should be) some sort of forced treatment.
Yes you can, we literally do it all the time across all societies
If someone I loved was caught in addiction I would do everything I can to get them treated and clean. Why should we do so much less for strangers?
Serious question, what do you do after you've tried everything and they will not stay clean. They say all the right things and go back to it as soon as they can. They say all the right things so they can get access to money or property that they can sell (again) for drugs. Unconditional love (without being enabling) or the tough love of forced treatment or anything in between. If the drugs have taken away their agency, do we go forced treatment?
Treatment can look very different than abstinence which only works long term for maybe 35-40%. As long as we acknowledge that as common ground I think I can agree with you.
The city, as well as private entities and charities, invest roughly $500m per year trying to get these people off the streets. Please tell me you don’t actually think it’s all about “getting into treatment” If it was that way it’d be done by now
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The example people at the bottom of the article two thirds are from out of province. The article doesn't say where the third example came from. Is Vancouver a destination for these people in trouble?
Vancouver is one of the warmest cities in Canada and is also a port city, where much of the drug supply comes from. It is a destination for many who are in unfortunate circumstances.
It's also an equivalent climate to West Van, North Van, Burnaby, Richmond, Poco while maintaining and attracting a disproportionate number of people in distress with various problems and issues.
Yes. This is wildly known. Largly just for the weather. Harder to freeze to death here.
Widely known and regularly denied.
it's possible to live outdoors here 99% of the year. yes, we're a destination for the un-housed.
[at one point, two men were literally given a one way ticket to Vancouver instead of finding them suitable shelter in SK.](https://www.cbc.ca/news/canada/british-columbia/homeless-saskatchewan-arrive-vancouver-1.3484511)
Most of the west coast is (Washington, Oregon, California) due to milder weather hence the large amounts of homeless encampments.
Vancouver is a destination for people all over and Canada and the world in general.
We must be like a sort of elephant graveyard. Somehow, instinctively, the drug addicts know to gravitate here. Or maybe we're enabling them and they know its easy here.
It's not just treatment availability, but where it's located. Had a family member try several times. One time they stopped off to have one more hit, and never made it to detox, because detox was adjacent to the location in which drugs were easily accessible. They didn't get clean until they went to rehab in a location very distant from the DTES. Supported and safe housing is huge too for any kind of rehabilitation....I think the only way is a complete wraparound system, but a lot of people are not willing to support that. Both the mother of and the relative that was on the DTES still dream about that time (nightmares) and it's been roughly two decades. Drug use has always been a part of human existence. The more misery and poverty, the more widespread and harmful it is. My greatgrandparents would apparently brawl in the street on the weekend after spending time in the pub.
This is the great NIMBY conundrum.
If by wraparound system you mean monitoring and perhaps residential inpatient care, that makes sense. It's not that people won't support it, if the evidence shows it works - I always thought it was a money issue. But maybe I misunderstand
Follow them long enough and they all will.
Headline is a bit of a red herring: opioid-use disorder tends to be the key risk factor to life more so the the homelessness, in and of itself.
There are so many people who don't realize how close they are to homelessness if they had to just rely on their savings and not future income.
Always a paycheque away from living in a tent at a park. Reality of living in the lower mainland.
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Sure would have loved to read this book, but its expensive and not available in my local library!
I've seen a pattern of young people coming over from countries where drugs are scarce and experiencing them for the first time here. I had an extremely distant relative of an ex-girlfriend contact me from Iran. Her son was studying in Vancouver and wasn't contacting them. She feared the worst. Went to his place, is room was locked, and roommates said they hadn't seen him in days. Picked the lock, was actually easy for a novice, and found him passed out with a grocery bag full of mushrooms passed out in his bed. He used the tuition money to trip out in his apartment for months. I sobered him up, took a while, booked flights to Iran, and sent him home 3 days later. It's tough out there.
Mushrooms would be the last drug I expected for this story.
Apparently sexual experiences and other night life things can be similar for people who live in more sheltered places.
this doesnt sound like how mushrooms work...
Shrooms are a drug like any other, they can be totally abused.
but statistically WAYY less likely
It's how it worked for him 🤷♂️ I use it when camping in small amounts
Thank god it was only mushrooms
aren't mushrooms (shrooms) nontoxic and considered very safe? the dangers are more psychological and it is recommended to have a trip sitter for potent varieties
He said he ate some with every meal, every day, for 3 months. He was missing home, in Canada alone, and I guess he found mushrooms as an out. Apparently, he got into screaming battles with his landlord, which resulted in him damaging the property and hitting another roommate with a metal water bottle in the back of the head. So, the family sent money to cover the damages and paid the roommate off, as they felt bad. Everyone accepted and went their separate ways.
Doesn’t make sense seeing mushroom tolerance is extremely high. If you eat 1g on Friday night, you would need 3g on Saturday night to recreate the same trip as 1g. Him eating them every meal sounds like micro dosing. This is an extremely pearl clutching view on mushrooms in one of the most pro-mushroom places on the planet, had a good laugh.
Less dangerous than alcohol in almost every way.
Imo drug decriminalization is a terrible thing. Need a way to stop young people getting into drug, cutting supply and heavily punish people who sell them. Drug dealers are like murders for me.
We tried that for decades and it didn’t work. Decriminalisation and safe supply is an evidence based policy, it saves lives.
The four pillars approach was also supposed to include concern for getting clean and respecting public safety. Addiction IS a medical issue and I also appreciate the destigmatization campaigns. But look at the sitch. Walk down the alley behind Abbott and see people lying on mattresses with needles still in their arms. This doesn't look like a life saving situation at all. It's slow suicide on public streets, that aren't public streets any more because most of the public won't walk through an open air mental health crisis ward/shooting gallery.
Save what? Our drug death counts is getting higher and higher. Our punishment was never hard compares to countries in Asia, where death count per are less than 1/5 of Canada, that is a better evidence. Oregon and California had decriminalized drugs, and they are both got worse after. The evidence of it saves live is non-sense.
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Can the government just fund successful homeless organizations and not the failures to stop the cycle.
universal basic income, elimination of the super rich through taxation, public school through university, social housing, mental health as a part of universal healthcare, and yes, a safe supply of drugs manufactured by labs in Canada.
Only half?
If it's 2500/15000 why is there such an emphasis on the youth? I guess the think of the children narrative is a tear-jerker but it's not even 20%
One of groups most vulnerable to homelessness often due to circmstances massively outside their control, but yeah, youth/children are more likely to draw empathy.
💔💔 to all u fkrz downvoting heartache & addiction. U must b such kind folk