Fentanyl crisis in Calgary: Vice documentary

[Itse]

Originally Posted by Street Pharmacist

It's not obfuscation. I was responding to Thor suggesting you could just buy it and there were no repercussions. It's still not legal.

While technically not a criminal offence, the point is there's still a punishment for possession

Okay, granted you're right, but it's not really a very helpful comment for the discussion.

Personally I think the most relevant part of the Portuguese solution isn't so much the individual laws, it's the general approach. They're approaching it as a health issue.

For example, Portugal moved drug policy issues from the Justice Department to the Ministry of Health. It doesn't mean that all the related law enforcement just went away, but it's a major shift in thinking, and I think both sensible and morally the right approach.

[peter12]

Originally Posted by Itse

Okay, granted you're right, but it's not really a very helpful comment for the discussion.

Personally I think the most relevant part of the Portuguese solution isn't so much the individual laws, it's the general approach. They're approaching it as a health issue.

For example, Portugal moved drug policy issues from the Justice Department to the Ministry of Health. It doesn't mean that all the related law enforcement just went away, but it's a major shift in thinking, and I think both sensible and morally the right approach.

So while they approach it as a health issue, it is, and will always remain to be a moral issue about the existential purpose of human beings.

[afc wimbledon]

Originally Posted by Senator Clay Davis

East Hastings is also way better than it used to be, back when it had the highest concentration of HIV/AIDS outside of sub-Saharan Africa. It's nowhere near as much of a hole as it was say 10-15 years ago.

Much of it is moving to Surrey, the Whalley Newton corridor is now the new East Hastings.

[peter12]

Originally Posted by afc wimbledon

Much of it is moving to Surrey, the Whalley Newton corridor is now the new East Hastings.

The West End has needle bins now, as well. The problem dispersed. There are probably more addicts here than ever.

[afc wimbledon]

Originally Posted by peter12

Yes, gentrification.

Partly but also partly technology, cell phones and Craigslist has made the downtown east side unneccersary, it used to be the only place you could find dealers and hookers openly working the streets, now you call them and they drive to your door.

[Street Pharmacist]

Originally Posted by Itse

Okay, granted you're right, but it's not really a very helpful comment for the discussion.

Personally I think the most relevant part of the Portuguese solution isn't so much the individual laws, it's the general approach. They're approaching it as a health issue.

For example, Portugal moved drug policy issues from the Justice Department to the Ministry of Health. It doesn't mean that all the related law enforcement just went away, but it's a major shift in thinking, and I think both sensible and morally the right approach.

I think it's an extremely helpful point.

There's a chasm of difference between allowing something to whoever wants it and keeping selling illegal and punishing possession.

[afc wimbledon]

I'm not sure it's particularly helpful to look at homogenous European populations that are reasonably middle class, Portugal Switzerland, Sweden to assess policy that we are going to try and apply to Canada, there is no equivalent to the depths of despair our native population lives in there.
Addiction is heavily influenced by cultural social and economic factors, our society is nothing like Portugal or Holland, the UK comes closer.

[Street Pharmacist]

Originally Posted by afc wimbledon

Actually you can, and people do die from withdrawal, granted there are other underlying health issues, the physical shock to the body can cause death in someone elderly or weakened by other illness.
It doesn't happen if the withdrawal is monitored in hospital as the doctors will taper the doses down but it happens in jail every now and then where they are less sympathetic.

Nobody dies from withdrawal. The only recorded deaths are from anaesthesia assisted detox. Opiate withdrawal is agonizing, but calling it potentially deadly is silly. Any death from opiate withdrawal (even in jail) you can find there are accompanying withdrawals from benzodiazepines, alcohol or methamphetamine.

The point if saying this is not that people should just quit. The reason this is important is two fold

1) when in treatment programs such as methadone maintenance we regularly err on the side of caution when faced with a supply dilemma "I lost my carry", or "I'm leaving for Vancouver Friday and need carries to take with me". My response when I cannot discuss with their physician is to deny because when choosing between potential diversion and withdrawal, I will choose withdrawal as it's less likely to lead to bad outcomes.

2) No one should be afraid to use narcan. Narcan causes complete and almost instantaneous withdrawal. No one will die from this

[peter12]

Originally Posted by afc wimbledon

I'm not sure it's particularly helpful to look at homogenous European populations that are reasonably middle class, Portugal Switzerland, Sweden to assess policy that we are going to try and apply to Canada, there is no equivalent to the depths of despair our native population lives in there.
Addiction is heavily influenced by cultural social and economic factors, our society is nothing like Portugal or Holland, the UK comes closer.

People take drugs because they want to take them, but also because people, who should have the sense to stigmatize drug use, stand by, either helplessly or because of a misguided relativity. Certainly, brain damage, child abuse, psychological and sexual trauma all make an individual more likely to take drugs, but a lot of it boils down to cultural permissiveness, particularly due to the breakdown of the family.

There was a young girl I worked with who was the daughter of a chief, spoiled, wealthy, intelligent, and someone who insisted to spoil her genetic lottery winnings on parties, drugs, and illicit random sex.

One day she disappeared from a job site, and the next day, I had to release her from our employment. We were on friendly terms, and she understood that this was just business. I asked her where she had been, and she told me that she was bored, found some guys with drugs, got into their cars, and went to another reserve.

I asked her what was so special about this particular reserve. She replied, "All reserves are the same, no matter where you go."

There are many indigenous people who choose to leave. There are many indigenous people, particularly the old, who choose to stay, and provide some semblance of social stability. It is the old who now take care of their grandchildren, while their own children waste their lives away on drugs and alcohol.

Witnessing these situations, day after day, for three years, and spending so much time laughing and learning from indigenous people, is why I will always view drug use as a moral problem with serious health, social, and economic side effects.

[Itse]

Originally Posted by Street Pharmacist

Legalization and routine sales is a pipe dream IMO. No longer can we monitor prescription opiate abuse then and that scares the living bejesus out of me. These drugs are already legal with tight controls that certainly could be improved, but it's quite scary to think of my patients being able to just go get some whenever they want

This is a case where I hope more people would know how alcohol sale used to work in Finland post-prohibition.

Essentially the weapon of choice for cutting down alcohol use was bureaucracy and crap service.

Legally anybody could buy anything they wanted, as long as they were old enough. In practice you could only buy from government controlled stores, which had crap selections and professionally stuck-up "cashiers" looking down at you no matter what.

The stores were deliberately unpleasant-looking, had no advertisements and the products were at first not even openly displayed, so you had to know what you were buying and ask for it. And no smiling here buddy, are you drunk? We don't sell to drunk people. And why are you buying that many bottles at a time? Do you have an alcohol problem? Perhaps we should send a social service worker to your place.

It was really effective in cutting down people's alcohol use. Still easier and safer than buying illegal alcohol, but often too much hassle for people to bother. It also quite clearly lacked the atmosphere of "this is how a fun night starts".

I think this general idea would work for drugs.

[peter12]

Originally Posted by Itse

This is a case where I hope more people would know how alcohol sale used to work in Finland post-prohibition.

Essentially the weapon of choice for cutting down alcohol use was bureaucracy and crap service.

Legally anybody could buy anything they wanted, as long as they were old enough. In practice you could only buy from government controlled stores, which had crap selections and professionally stuck-up "cashiers" looking down at you no matter what.

The stores were deliberately unpleasant-looking, had no advertisements and the products were at first not even openly displayed, so you had to know what you were buying and ask for it. And no smiling here buddy, are you drunk? We don't sell to drunk people. And why are you buying that many bottles at a time? Do you have an alcohol problem? Perhaps we should send a social service worker to your place.

It was really effective in cutting down people's alcohol use. Still easier and safer than buying illegal alcohol, but often too much hassle for people to bother. It also quite clearly lacked the atmosphere of "this is how a fun night starts".

I think this general idea would work for drugs.

This is so strange.

[calculoso]

Originally Posted by Bandwagon In Flames

Care to quote some studies on that? I recall some studies in the Netherlands which found the opposite to be true among local residents.

No studies, just common sense. If availability and/or ease of procurement goes up, so will consumption.

In Alberta, Alcohol consumption went up after alcohol stores were privatized and there became one on every block instead of one in every quadrant of the city (exaggeration for effect).

(EDIT: Picture isn't posting right - http://imgur.com/HNN1qWJ )


Red box added by me. Original graph Source:
http://www.aglc.ca/pdf/social_respon...l_Strategy.pdf

FIGURE 4: Trends in per capita alcohol consumption for Albertans and Canadians aged
15 and older, 1988 to 2005.3

1993: At the time of privatization, there were 208 retail liquor stores with 2,200 different products available.
1994: The last ALCB government run liquor store is closed on March 5.
Source:
http://aglc.ca/liquor/liquorhistoryandfacts.asp


Now, what happens when we increase the availability of Pot and whatnot through legalization? Naturally, some will decrease, as it is no longer the "Cool way to rebel against authority", but others will go to the liquor store and pick up a 6-pack of beer and a couple joints on a more regular basis.

I couldn't care less about what the documentary stated about OD rates (etc). This has nothing to do with what I'm saying.

[Itse]

Originally Posted by peter12

This is so strange.

The work of evil geniuses for sure. (Joking aside, it was a very different time.)

The general idea however is showing the vast amount of options between "drug shop on every corner" and "The War on Drugs".

[Zarley]

Originally Posted by calculoso

No studies, just common sense. If availability and/or ease of procurement goes up, so will consumption.

In Alberta, Alcohol consumption went up after alcohol stores were privatized and there became one on every block instead of one in every quadrant of the city (exaggeration for effect).

Alcohol consumption per-capita increased after privatization, but likely due to other factors:

- The chart you posted shows that consumption was higher in the 1980s during the ALCB monopoly then it is today. This shows that consumption levels are influenced by other factors and that privatization has a limited impact. I know that I don't drink less when I'm in BC because of their government run liquor stores.

- What is more likely is that demographic factors have resulted in increased consumption in Alberta. After a decade of slow growth in the 1990s, Alberta experienced an influx of working age people in the 2000s who are also in prime drinking age.

[RougeUnderoos]

Originally Posted by Itse

This is a case where I hope more people would know how alcohol sale used to work in Finland post-prohibition.

Essentially the weapon of choice for cutting down alcohol use was bureaucracy and crap service.

Legally anybody could buy anything they wanted, as long as they were old enough. In practice you could only buy from government controlled stores, which had crap selections and professionally stuck-up "cashiers" looking down at you no matter what.

The stores were deliberately unpleasant-looking, had no advertisements and the products were at first not even openly displayed, so you had to know what you were buying and ask for it. And no smiling here buddy, are you drunk? We don't sell to drunk people. And why are you buying that many bottles at a time? Do you have an alcohol problem? Perhaps we should send a social service worker to your place.

It was really effective in cutting down people's alcohol use. Still easier and safer than buying illegal alcohol, but often too much hassle for people to bother. It also quite clearly lacked the atmosphere of "this is how a fun night starts".

I think this general idea would work for drugs.

Wow.

We've had some crazy laws here too, but nothing like that. When my dad moved here in the 60's, he was shocked to find that if you went to a "beer parlour" with a lady, she had to sit in a different room.

And doesn't Ontario have some weird system where you go in and write an order down and hand it to the guy and your booze comes out from the back? Or did that go out a long time ago?

[peter12]

Originally Posted by RougeUnderoos

Wow.

We've had some crazy laws here too, but nothing like that. When my dad moved here in the 60's, he was shocked to find that if you went to a "beer parlour" with a lady, she had to sit in a different room.

And doesn't Ontario have some weird system where you go in and write an order down and hand it to the guy and your booze comes out from the back? Or did that go out a long time ago?

Nope, the Beer Store is still a thing. An awful thing.

[jar_e]

Originally Posted by Leeman4Gilmour

I read 3 more pages trying to find your follow up to this and saw that you actually didn't dive into the discussion. Please do as I am quite interested in your viewpoint, and I'm positive I'm not the only one.

It just drivels into the same old stuff when I've spoken to the topic (albeit, different drugs) as always.

There is absolutely no way our society could function with legalizing these drugs. Maybe decriminalized but to think that society would be able to accept these things is insane. We're talking about a doses the grain of rice that are the difference between life and death. Even if there was a market for this, people will always be able to sell it cheaper and the addicts who cause the majority of problems will always go the cheapest route.

I'd say without a doubt (IMHO) that the spike in property crime in the Calgary area is 100% directly related to fentanyl use. These people will cause thousands of damage to get a piece of property that is worth $100 and then swap it for one pill (give or take $20 value). It is insanely addictive and like that Vice documentary shows, just consumes their minds. These people are exploited by dealers as they're literally making money or stolen goods hand over fist. I have been doing this for eight years and it is by far the most rippled effect drug I've seen. Even comparing to meth, which has relatively been replaced by fentanyl derivatives or heroin, which is pretty much guaranteed to be cut with fentanyl, the addicts are more brazen, more desperate, then I've seen. Anecdotal obviously, but it's a huge issue and it is an epidemic.

Unfortunately, in the land of synthetic drugs, this will just be replaced by something in 5-6 years and the drug after that in 10-15 years. It's never ending. A proper social structure with rules and enforcement, even if it isn't criminal, is still required to have some sort of control over this. Addiction services is packed to the brim with clients. I obviously don't deal with those who turn their life around. But I can guarantee you that rehab is usually abused frequently for various reasons and takes away spots from people who would genuinely benefit from them.

To speak to Aleks point, I definitely share his cynicism. I don't need some SJW to tell me about addiciton and how they should be seen as a victim in this. I've heard it from various professional groups, from people online, whatever. I've literally done CPR on a guy who OD'd on fentanyl, had AHS administer narcan, and 30 seconds later he was conscious and breathing and a minute after that, we were fighting him to get him into the ambulance to goto the hospital.

These addicts, however mentally ill they are, do not realize how dangerous these drugs are and how they are one bad hit from dying. None of this stuff is regulated, there's varying dosages in every pill and even seasoned addicts have troubles with it. A ton of our fatal overdoses that I've seen have been guys who would average x amount of pills a day, goto jail for five days, get released and think they could continue with that same amount of pills, and then ultimately OD. I'm sure Street Pharmacist could speak to how quickly your body recovers and loses its dependency to it, but it is incredibly quick when you speak to guys who use drugs regularly. Most build up a dependency to stuff and it remains constant for long periods of time.

This is far from a "crackhead" type problem too. I've been to middle class kids/parents who had OD'd. Mind you, they can usually fund their habit for a long time before it ripples into other things.

Anyways, this is all incessant rambling. The only thing I can recommend to who ever reads this and uses is to never shoot up alone and to have narcan kits available.

[peter12]

No, that was absolutely excellent.

[Locke]

Originally Posted by peter12

Nope, the Beer Store is still a thing. An awful thing.

And in small Ontario towns they close at 5.

[Itse]

Originally Posted by RougeUnderoos

Wow.

We've had some crazy laws here too, but nothing like that. When my dad moved here in the 60's, he was shocked to find that if you went to a "beer parlour" with a lady, she had to sit in a different room.

And doesn't Ontario have some weird system where you go in and write an order down and hand it to the guy and your booze comes out from the back? Or did that go out a long time ago?

Forgot to mention that you could still get alcohol from bars, but only with food, and only beer unless you were a nightclub. (Which needed to have acceptable entertainment such as live music. And none of that suspicious rock'n'roll.) And there was a ton of other rules, like only waiters could move alcohol from one table to another. Anything to stop people from socializing. Single ladies in bars were of course not allowed.

(Obviously this lead into all kinds of tricks, like the more dodgy bars having that one sad sandwich that would circle the tables all night without anyone touching it. The law said nothing about people actually needing to eat the food.)

Also worth mentioning that over time the government controlled alcohol shops started to relax bit by bit, until they've become pretty much the exact opposite. They now have excellent selections and a really highly trained and friendly staff. In fact they've become so nice that it's a major reason why the government is still allowed to hold on to the very lucrative (partial) alcohol monopoly. After all, since the government has the monopoly, those same quality selections with highly-trained staffs are now available all over the country, something which would never otherwise be the case in a country as small as ours.

(Beer and equivalent "mild drinks" are available at grocery stores and kiosks.)