Future generations will (rightly) shame us for this moment

 

Berthold Bronisz, Pixabay

What’s underway in Canada and the United States right now is the manufacturing of new classes of people who can be discriminated against legally. Both our countries have been here before, but I’d always thought I was in the generation that would end all of that awful business, not lay the groundwork for more.

The latest target for discrimination and harassment in the US are people with first- and second-generation immigrant backgrounds from the ever-changing list that the government keeps of countries that it doesn’t like. In Canada, the target is people living homeless.

I’m not going to suggest that anyone’s wearing balaclavas and shooting people dead yet on Victoria streets. But that’s not to say there aren’t some striking – and disturbing - comparisons between ICE raids in the US and what’s happening for people living on our streets.

The principles are certainly the same: Identify a group of “undesirables” whose vanquishing can be politicized, and make life hell for them until they die or leave the area. It seems to be working to plan in the downtown, where at least 15 people have died since December.

BC’s brief and flawed experiment with decriminalizing small amounts of drugs ends today. Significantly increased search and seizure on Pandora Avenue this past week is an ominous sign of what’s coming, as the 180 people who use the overdose prevention site daily could be charged with possession anytime they walk up to the door carrying their drugs (yet are also not able to buy them inside).

Canadians don’t have to look far back in our past to find earlier examples of targeted discrimination. Indigenous people, Chinese and Japanese people, women, people with disabilities, people with certain health conditions – all have felt the wrath of state-sanctioned hate. Historically speaking, we are veteran haters.

But that was then, right? It’s 2026, and we’re so much more aware. We’re so sorry about the bad way we treated people in those days before we understood human rights and equality. We have so many nice laws now, and a library’s worth of court rulings upholding people’s rights.

So the question, then: How can we be doing this again?

I’m spending a lot of time on Victoria streets for a story-telling project. What I see is so many people needing more help than what our systems and service providers want to provide. I don’t know if it’s possible to pin down the moment when it became politically and publicly acceptable to blame and vilify this group of people rather than acknowledge the many factors and policy failures that got us here, but we’re certainly into that stage with gusto at this point.

Overlay that mean mindset with a brutal housing crisis for people in poverty, at a time when land is so valuable and neighbours are so NIMBY that there’s no welcome mat in sight for the poorest of the poor in any corner of our communities.

Add 10+ years of political paralysis as the toxic drug crisis exploded. Stir in some crazy thinking around mental health services that has resulted in the spectacle of seriously ill people being forced to take their medication yet at the same time abandoned to live homeless. Top it with not just gaps in the safety net, but no net at all.

Layer it all with a political climate so conservative that even the left leans right, and are only too happy to lure more voters by simplifying complex social failures into narratives of bad people making bad choices.

Decades into doing nothing right around addressing homelessness effectively, a growing number of people on our streets have essentially been deemed too difficult to bother with. I heard from someone who works in supportive housing that there are hundreds of such people in Victoria. They end up banned from everywhere, even “low barrier” places that they totally rely on for meals, bathrooms and a shower. They’re more or less stranded on the street; wary housing providers don’t want them as tenants, because the providers know they don’t get enough support hours to meet these people’s high levels of need.

Those needs can only increase as this group is singled out for enforcement and discrimination. They end up living in a permanently criminalized state – tents constantly searched, possessions seized, money taken without recourse if police decide that it must be from selling drugs. They sleep in stretches of two hours or less before a security guard or police rouse them and tell them to move along – to anywhere, to nowhere, just not here. Fight back and you’re a target for more harassment. The lucky ones might get a mat on a floor somewhere inside a shelter for a night, but they’ll have to be gone by 6 a.m. and line up for two hours or more that night to try for one.

Our modern society deems that this group can be spoken to roughly – in fact, MUST be, because to do otherwise is just “encouraging them.”  They can be treated disrespectfully. Called terrible names on social media platforms. Barred from fast-food restaurants just because of how they look. Denied use of restrooms. Filmed in the worst moments of their life with no consent. Discriminated against in the hospital emergency room.

Imagine for a minute if this was the situation for, say, Italians. Gay men. People with a limp. Israelis. Fill in the group of your choice, and consider how up in arms we’d all be to think of this identifiable group being singled out in our just, rights-based society for such hatred and discrimination. Intolerable.

But if a person is homeless, it’s open season.

Now maybe you’re reading this and thinking to yourself, hang on just a minute, most of these people are criminals because they’re using illegal drugs, and our society is certainly within its rights to make life difficult for people who are breaking the law. This is the same argument that ICE uses – “we’re only chasing down the sketchy immigrants who might be up to something, not the law-abiding ones.”

In this world view, it’s perfectly defensible to punish and harass people clinging to the bottom of Maslow’s hierarchy, because they’re using illegal drugs. If they don’t want to be treated like sub-humans, then they can give up drugs, the logic goes. (Of course, they would still be homeless, but let’s keep the focus on the drugs, shall we?)

So many of us use drugs, though, legal and illegal. There’s absolutely no logic to why some drugs are legal and some aren’t in Canada, and certainly no logic to how someone can sit with Beer No. 4 in their hand going on about “drug addicts.”

Personally, I think we just want to be able to discriminate against people living impoverished on our streets. The fact of the drug use is a handy cover for selling that approach to a public who might otherwise be more reluctant to openly hate people just for being poor, sick and sad.

Lots of us hate that poor people exist. Some turn that hatred toward doing something about it. Others turn it toward sending the uniforms out to crank up the pressure and see if we can’t just make people magically disappear, or at least sicken them with sheer neglect and let their deaths pass without mention.

It’s sad as hell to see which way our government has chosen.  

Rising intimate partner violence rates are just one of the many canaries in our coal mine

Today is the International Day for the Elimination of Violence Against Women. We are a long way from done. 

The line on the graph looks like a dip in the road – downhill for a few years after 2009, then slowly climbing back up over a decade starting in 2014.

It tracks the number of police reports in Canada related to intimate partner violence. For a while, things were improving. But that’s over now, with violence rates (54 per 1,000 for Canadian women) now back to the levels of 15 years ago. Similar trends are evident in the US, where aggravated domestic assaults have risen to heights not seen in more than 20 years.

What were we doing right for those good years? What did we start doing wrong? When the issue is something as deeply in the shadows as intimate partner violence, a clear answer is hard to come by. With 80 per cent of people experiencing IPV not even reporting the crime to police, any trend line is only ever scraping the surface.

But the rising stress of daily life on Planet Earth can’t be ignored. Trend lines tied to family well-being on so many fronts are headed in the wrong direction. Yet our country lacks even the most basic of plans for dealing with the multitude of issues feeding into our growing social crisis.

It isn’t just intimate partner violence that’s increasing. Police-reported violence against children and youth in Canada has hit historic highs, having risen 32 per cent since 2018.

Financial worries are increasing: 42 per cent of Canadians in a recent FP Canada survey say money is their top source of stress. The housing crisis rages on, with two-thirds of Canadians reporting they’re unable to comfortably afford a monthly mortgage payment of more than $1,700 a month even while the mortgage payment for an average-priced Vancouver condo is almost three times that much.

Business insolvencies are on the rise after their own brief dip in the road came to an end in 2020. The unemployment rate is the highest it has been in a decade. Poverty rates are rising, as are stress levels; almost a third of Canadians ages 35-49 report feeling very stressed every day.

Families with children are under even greater stress, as are their children. More than a quarter of the cohort of young Canadians followed in a national study tracking mental health perceptions reported in 2023 that their mental health wasn’t good, which was twice as many as four years earlier during the first wave of the study.

School absentee rates are up, with some Canadian school districts reporting as many as two-thirds of elementary-age students absent at least 10 per cent of the time.

All of those trends are known to have an impact on the incidence of family violence. Stressors like household finances, job insecurity and poor mental health are known risk factors for increased violence within families.

Life pressures are mounting in all directions. A rise in family violence is too often the result.

Family violence causes harm long after the act is done and gone, both to the person experiencing the abuse and to any children in the home who see it happen.

The direct victims of an act of violence are at major risk of brain injury if the abuse involved impacts to the head, shaking, or strangulation. At least 65 per cent of victims of intimate partner violence end up with a brain injury.

A child who witnessed the violence may have their own health and economic opportunities negatively affected long into adulthood, or end up with a brain injury themselves if they’re also targeted for abuse. So many people living with a brain injury from abuse won’t even know they have one, even as it complicates their health, relationships, parenting, and ability to function at work.

We have talked for decades in Canada about the urgency of ending intimate partner violence. But reducing family violence can’t be achieved in isolation from work that strengthens Canada’s social safety net and supports a strong, equitable economy.

On that front, the trend lines are equally alarming. The gap between Canada’s richest and poorest citizens hit a historic high earlier this year. The top 20 per cent of wealthiest Canadians now accounts for two-thirds of our country’s total net worth, while the bottom 40 per cent accounts for just 3.3 per cent.

The rise in intimate partner violence is a red flag across multiple indicators of social health. We are not doing well. Worse, we have no actionable plan for doing better.

We have been winging it for far too long. With so many social indicators going in the wrong direction, the question that hangs over all of us is how much worse we’re prepared to let it get.

Word volley on the social crisis from the local newspaper, in order

Wal_172619 Pixabay

If words in a newspaper could solve the social crisis on our streets, we'd be on our way with the back-and-forths that have been happening in the Victoria Times Colonist since a Sept. 24 column by Les Leyne kicked things off. 

But things have gotten confusing on Facebook what with the ridiculous fight between Meta and the Canadian government that has left us unable to share newspaper links in Canada. So here's all four parts of the back-and-forth laid out in order - Les's piece, then my response, then a comment piece by retired nurse Barbara Wiggins, then my response to that.

Hope this helps for those trying to follow all of this. And while there are some differences in opinion throughout, it's really heartening to see the TC devoting all these column inches to this issue.

Les Leyne column in the Sept. 24 Times Colonist that started things off:

B.C. has slid into an attitude of “endless accommodation” of antisocial behaviour by desperately ill people on downtown streets, says the man at the epicentre of the epicentre of Victoria’s downtown decay.

Julian Daly, CEO of Our Place, the agency most directly involved in the drug-infused mental-health crisis most obvious on Pandora Avenue, told municipal leaders at the Union of B.C. Municipalities convention that the balance between compassion and enforcing expectations has been lost.

The ongoing “what to do” debate has flattened into an overly simple artificial choice between compassion and enforcement, he said, but both elements and a lot more are needed to make a difference.

One camp, which the B.C. government endorsed for years, focuses on empathizing with drug addicts. It stresses that addiction is a health problem, not a choice, and concentrates on the sufferers.

On the other side are people suffering the consequences of the disintegration of social order and losing patience.

But reducing it to that choice is a mistake, said Daly, who has spent his career caring for the marginalized.

“We’ve slid into what sometimes feels like endless accommodation of behaviours on our streets that … frighten people and make them feel unsafe, including other homeless people.

“In our desire to be compassionate, we have sometimes lost the balance for accountability.

“When ‘anything goes,’ it really does.”

Our Place is the largest provider of free meals on Vancouver Island, but Daly said “many people who desperately need our food … are simply too frightened to come into our building … because of what’s happening outside.”

Meanwhile, the charitable donations the organization relies on are dropping because of disgust at the situation outside their doors.

“Long-time generous donors have told me bluntly they’re no longer giving because they associate us with the disorder … They believe wrongly that we are somehow responsible …”

Daly said that while the desperately ill are being demonized by some, the compassion-first stand is also problematic.

The NDP’s disastrous decriminalization effort, which disintegrated as an official policy within months, was well-intentioned, Daly said, but had unintended consequences.

It gave people permission to use drugs openly and took away police leverage to discourage drug abuse.

“What was once hidden is now everywhere at the same time.”

The firmly established catch-and-release process in the judicial system has reduced police morale, Daly said.

Police want to maintain order, but when the legal system doesn’t impose consequences for criminal behaviour, they shy away from enforcement, and there is no fear of repercussion on the street.

“It may sound harsh to say, but sometimes well-meaning interventions can end up feeding the problem.”

Once-shocking scenes of misbehaviour have been normalized now and are a routine part of city life, Daly said.

People just walk on by, which fosters complacency.

The government spent millions buying motels for homeless people, and housed 800 of them in the region in recent years. But many of those still on the street today were in safe housing. They lost it because of their continued addiction and mental-health problems, he said.

An all-encompassing strategy of housing, treatment, recovery and enforcement is needed.

He said involuntary care is controversial, but has to be part of the solution. Leaving someone to die on the sidewalk — with their liberty intact — “is not compassion, it’s abandonment.”

“Sometimes the most compassionate thing we can do is intervene.”

After years of dithering, the NDP government took the first tentative steps toward secure involuntary care last year. It was telling that they had to hire an outside special advisor — psychiatrist Dr. Daniel Vigo — to chart the rationale for doing so.

Daly said the New Roads recovery programs are showing real results.

He urged more targeted enforcement by police. Not to criminalize addiction or poverty, but to attack predators within the street population who exploit homeless victims.

“Enforcement used wisely is not the enemy of compassion. It is a tool of protection.”

He also stressed the need for prevention, by way of immediate interventions before the cycle gets entrenched.

That means stepping in “when the first tent goes up” in order to start solving the crisis instead of just managing it.

It feels like the province has adjusted its stance over the past year or so, partly in the general direction that Daly advocates.

But the government drifted a long way from the balance he stressed is needed before the course correction came.


My response to Les Leyne’s column, which ran as a comment piece Sept. 27:

Everything about Les Leyne’s Sept 24 column filled me with rage, most especially Our Place CEO Julian Daly’s stunning misrepresentation of problems at the core of this social crisis burning in the hearts of our communities.

To take the tragic situation that is happening on our streets and blame it on our “anything goes” attitude and “endless accommodation” – I don’t even have words for the fury that evokes in me after decades of observing how this four-alarm social crisis came to be. We simply must quit listening to people speaking from the comfort of their nice, non-impoverished lives and get a grip on this tragic humanitarian crisis from the point of view of the people living it.

Medical triaging treats the sickest people first. Social triaging works in the opposite way – you must prove yourself to be sufficiently ready, worthy and stable enough to get help like housing and treatment. What that approach has created is a situation where the absolute sickest people are the ones left without care.

Imagine if cancer patients had to prove themselves “ready” to qualify for support. Still smoking? Not eating enough greens? Overweight? No care for you. Unable to fill out dozens of forms that you don’t even know exist while maintaining a polite, pro-social façade despite being racked with pain and anguish? Back of the line, buddy.

As if. But that’s what we’ve done here. We set up rules that only the healthiest of a sick population can possibly achieve, and blame the ones left behind for not trying hard enough. We dangle the promise of housing like a carrot to be had if someone can sufficiently demonstrate that they’re worthy of it. We tear apart encampments as if we expect the people living in them will vanish.

This is the criminalization of poverty and disability. We are sectioning people under the Mental Health Act as risks to themselves or others and then sending them, still sectioned, into the community to live homeless. We are walking all over people’s human rights, every single damn day.

This is not “endless accommodation” – this is brutal, socially sanctioned neglect of extremely ill human beings, who are viewed with something far from compassion.

None of this is about drugs. Any of us would be using drugs if left in this situation. The drugs are the top layer on people’s multi-layered problems, but they’re the symptom, not the cause.

Why does this deepening social crisis never respond to any of our actions? Think about that. They’re the wrong actions. The sickest people are being shut out of support. That’s not “endless accommodation,” that’s just stupid, inhumane policy that leaves the very visible flames of a four-alarm social crisis to burn unattended on our streets.


Next, retired nurse Barbara Wiggins responds to my piece with her own comment Oct. 9. She has a degree in health ­informatics from the University of Victoria:

I am pleased to see several letters and opinions recently on our urban crisis of addictions and social disorder.

It is worthwhile to revisit the theories that our policies are based on and determine if ­evidence supports those ­theories.

With any social policy, ­evaluating our efforts and ­determining whether we are making a difference, whether we could do better and whether our policies are creating new problems is imperative.

Jody Paterson wrote an impassioned commentary from which I inferred she believes that compassion is the ultimate guiding principle.

I believe that she and many others employed in this sector are both sincere and committed to their noble cause.

But there is a key element to her argument that needs to be examined.

She contends that in medical triage, the sickest are treated first, whereas in social triage, they are treated last. In fact, the exact opposite is true.

Medical triage was established as a means of streaming the injured into similar groups in a mass-casualty event.

The first group is the walking wounded and those whose treatment can safely be delayed. Their treatment is delayed.

The second group is those who need immediate, usually intensive, intervention to survive. This group receives priority care.

The third group is those who are terminal — either dead on arrival, or whose condition is so dire that death is inevitable. This group gets little or no intensive treatment, as the efforts to revive them will be futile, and comfort measures may be the best that can be offered.

Furthermore, the efforts of caregivers are better spent on those outcomes that can be improved by medical interventions. This system, far from being heartless, is born of both compassion and logic.

I am not advocating a harsh “let them fend for themselves” approach.

But I will support the notion that some individuals are in the unfortunate overlap of brain injury, addiction, mental health disorders and criminality, who are not only not benefiting from our social programs, but who make it more difficult to provide effective service and care to those who have a chance of being helped.

Also, some of these individuals may victimize those clients for whom the programs were created.

Unfortunately, there is so little hard data or program evaluation to guide decision-makers one way or the other.

But it has become clear that we have an unmanageable, expensive, inefficient, illogical, heartless mishmash of programs.

Can we at least agree that the state of unresolved addiction is a hell we wouldn’t wish on our worst enemy?

If we can agree on that, then perhaps we could all get off our ideological soapboxes and start planning and funding programs based on the likelihood of success in helping people transition back to a non-addicted life, where it is possible to have a healthy life with healthy social connections.

And we provide compassionate care to those for whom recovery is no longer part of their care plan, as long as their programs don’t increase the risk of harm to others.

And, for those who perpetually victimize the most vulnerable, we need to have the courage to incarcerate them using the prison system.

If this smacks of heartlessness, it is anything but.

Out here in the homes and neighbourhoods, we live with and witness the damage done by the addiction/social disorder crisis.

We witness our children, the children of our friends and the friends of our children fall victim to this mass casualty event. We see that not all approaches work for all people and that some are lost despite massive attempts to help.

We have a vested interest in this problem that goes way beyond our role as taxpayers. We have skin in this game.

One definition of madness is to endlessly repeat the same action and expect a different outcome. It is time for a fresh perspective.


And my Oct. 16 response to Barbara Wiggins'  piece. Last in the series, so far....:

Thank you to Barbara Wiggins for her informed commentary on Oct. 9, which clarified that medical triage actually has three groupings: Help these ones right away; these ones can wait a bit but must be prioritized for care; and the group that is essentially the walking dead, who need medical help the least because there’s no chance they’ll make it.

The social triage is similar but different: Easiest to help so pick them first; these ones next because at least they’ve got an advocate; and the final group, essentially the “dead man walking” group noted in the medical triage description. The people who the system decides are not worth helping.

But while this group takes care of itself neatly in the medical world — they just die — that’s not how it goes with social crisis.

The people deemed “hopeless” don’t die, they end up living hard, sick, poor, ­incredibly stigmatized lives in ways that are not only cruel, wrong and expensive, but that annoy the hell out of the neighbours, ­business owners, city councils and every colour of government.

Wiggins rightly points out that the hopeless group at least get comfort in medical triage. In the social triage, this group is treated as harshly as possible.

They live in dystopian ­conditions — chased from place to place, personal items freely taken from them, rounded up for forced injections and then released to the street.

A young man is shuffling his feet ­endlessly on Pandora right now, affected by a major side-effect of the psychiatric drug he has to be on and is helpless to ­challenge. More importantly, the people we’re talking about are only looked at as hopeless cases because they’ve been left for years without the support they need.

In medical triage terms, a lot of them would have been in the “priority care” group once, born into challenges and with ­disabilities, but they were left in line so long that now they’ve come to be thought of as beyond help.

They’re definitely not. But they also don’t fit in our boxes. We keep pushing them in and they keep falling back out.

That’s not an unsolvable ­problem. But it is if you continue to view the problem from the perspective of the people ­wanting it gone, not living it.

What might we learn if we listened?

Image by Couleur: Pixabay

Nobody knows the challenges of getting out from under harmful substance use like someone who has actually done it. The third event in the Peers Victoria speaker series on the toxic drug crisis brought together a powerful panel of six past and present substance users to talk about their journeys with frankness, wisdom and so much insight. (I was the lead organizer of the series.)

But while we've got a complete video of the event, it's a rare devotee of the subject who would watch the whole thing, clocking in at over two hours. So I made a "greatest hits" compilation, if you will - 40 minutes all in, with clips reordered and with a bit of categorization that helps bring more focus to the panelists' comments. 

Here it is for your viewing pleasure. If you have people in your circle who are still saying stupid nonsense about substance users not wanting recovery sufficiently or being content to exist in a state of oblivion, please share it with them. 

What kind of systems for substance disorders might we have if we just listened to the people who have already been through this toughest of life challenges? 

As these six voices remind us, of course, we would be foolish to just listen to ONE voice when designing approaches (Marshall Smith, you're on my mind). The path to healing is so very distinct and different for each person, and the underlying pain and trauma that lead up to harmful substance use are highly individual as well. But if we genuinely wanted to address this crisis, the experts are all around us. 

Don't buy the snake oil

ChatBox AI image created by me

I generally stay out of the fray when it comes to commentary on politicking, so much of which is about as reliable as a snake-oil pitch.

But having caught Pierre Poilievre’s promise of addiction treatment for 50,000 Canadians, paid out of the money that will be saved when safe-supply programs are cut, I just can’t let that blatantly misleading statement stand unchallenged.

First, let’s start with safe supply. That’s the term used for when people are able to swap out their completely unregulated opioid-based street drugs for a prescription opioid from a health professional. It’s the most obvious immediate strategy to stop a toxic drug crisis that has killed 50,000+ Canadians – more than a quarter of them in BC - in the decade since the anesthetic fentanyl began dominating the street drug market.

That Poilievre actually thinks there’s enough money in the country’s teeny-weeny safe-supply response to pay for a major expansion of treatment beds and the cost of putting people into them for three, four or more times through – totally predictable with a relapsing health condition – well, that’s the first glaring sign that this promise is pure snake oil.

Here in BC, we have an estimated 100,000-125,000 people with opioid use disorder. A mere 4,600 of them are on the safe-supply program that BC launched at the start of the pandemic. That’s four per cent of the people who could actually benefit from safe supply.

Elsewhere in Canada, 10 other cities launched pilot safer-supply programs during the pandemic, nine of them in Ontario and one in Fredericton, NB. Federal funding ran out for most of them already.

In the few short years since, the mercurial public mood has shifted toward a view of safe supply as having “failed,” even though it actually barely got a start. So good luck grabbing all that big money invested in safe supply into treatment, Mr. Poilievre.

What really gets me with stuff like this is that a politician's comments are rarely challenged by reporters, leaving the public to assume that there really is some massive government investment in safe supply that can be transferred over to treatment.

I figure that whichever party ends up elected at the end of this month, we’ll get a few more treatment beds. That’s a good thing, because we really need them, along with government funding to support people accessing those beds without having to come up with tens of thousands of dollars multiple times to buy their way into a largely private system of care.

But any new beds will barely make a dint on the actual issues that are troubling the public - one of which is an unregulated drug supply managed in the shadows by international drug cartels that is killing their children, grandchildren, employees, partners, siblings and neighbours; and the other being a multi-faceted crisis of poverty, homelessness and mental illness manifesting ever more ferociously on the streets of our communities.

Substance use is definitely layered into that latter problem. But the main driver of the tragedy unfolding on our streets is poverty, mental illness and a housing crisis. Until we deal with those underlying causes, we’re going to be living with the soul-searing visibility of enormous suffering no matter how many treatment beds come into play.

Safe supply is an easy scapegoat for politicians, I suspect because we’ve been convinced over many decades to view the kind of drugs that end up on our streets as evil. BC’s tiny safe supply program was dealt a very hard blow recently when Premier David Eby got fussed about the supply being diverted into the illicit market, and withdrew people’s right to take their prescription drugs in the privacy of their own home.

Picture how that would go for whatever prescription drugs you might be taking, if suddenly you had to visit your local pharmacy twice a day, within their operating hours, to take your heart drugs, for instance, or use your asthma puffer.

Your job, your family time, your recreation activities – all of that would have to fit around getting yourself to the pharmacy twice a day, every day, to swallow your pills or inject your insulin in front of a health professional. How long would it take any of us to be looking for alternatives on the black market to spare us such misery?

Yes, diversion happens. An issue with safe supply is that it decrees what drugs you can swap onto, and fentanyl isn’t one of them. So some people on safe supply sell whatever drug they’ve been given to get the money for the fentanyl that they actually want.

You can look at that as a failure, I suppose. But toxic substances laced with unknown quantities of fentanyl and fentanyl analogs are now the No. 1 cause of death for British Columbians ages 10 to 59, exacting a massive impact on our collective productivity that is second only to cancer. What could possibly be a bigger failure than that?

So now let’s consider treatment as a “cure” for that failure, as Poilievre wants us to do.

First, the obvious: Many of the people dead in the toxic drug crisis weren’t in need of treatment. They were just average people using drugs for fun – not aberrant behaviour in a country where three-quarters of us consume alcohol regularly. They died because a toxic drug supply doesn’t differentiate between whether you’re a first-time user or an “addict.”

Then there’s also this tricky truth: Treatment for any chronic, relapsing condition is a long, hard slog. Whether it’s Type II diabetes, hypertension, or this thing we call addiction, 40-60 per cent of people will relapse after treatment. They will need many passes through treatment to reach a state of recovery, and some will never get there. Getting to where we need to be in terms of quick access to treatment is going to be expensive, just as it is for any other long-term health care interventions.

People using opioids are particularly vulnerable to dying during a relapse, as their tolerance falls significantly after a period of abstinence. Add in that little ongoing problem of a toxic drug supply - any hope of accessing safe supply during a relapse having evaporated under Poilievre’s plan - and it’s clear that expanding treatment alone will not get us out of this crisis.

And one more tricky truth: Treatment for this thing we call addiction is almost completely owned by the private sector – and increasingly, by multinational corporations and private-equity firms interested in consolidating many small community treatment centres into one big entity that will attract investors. (As is happening with veterinary services, lab services, mental health services, employment training, etc.)

Treatment for substance use problems is outside of the Canada Health Act. Private treatment centres are free to set their own rates and their own methods. If they report on their effectiveness at all, the data collection stops the moment a person leaves the centre. A person could relapse within hours of “graduating” and still be counted as a success.

The lack of transparency and absence of meaningful data collection leaves us with scarce knowledge to prove or disprove the effectiveness of any treatment approach. Nobody can actually say what’s working, or what happens once someone leaves a treatment facility in a state of abstinence and walks out into the big world where all their troubles await.

We simply don’t know how many times people relapse, because we don’t measure or track. We don’t know how long an individual stays abstinent after a round of treatment. There are no national standards for treatment. No followup.

So yes, let’s talk treatment. It’s a pillar of any health-care approach, as is access to regulated medications. But please don’t buy the snake oil.

One more walk down the road to failure

Sunil Kargwal, Pixabay

Thank you to long-time community organizer Ann Livingston for pointing me to this 17-year-old blog post that takes us back to 1950s Vancouver to remind us that there's nothing new about the strategies being talked about now to improve health care for people who use substances - or the political tactics used to block those efforts.

The Community Chest and Council, the forerunner to the United Way, struck a Narcotics Committee in 1952 to examine the problem. The Committee recommended a comprehensive drug strategy that included rehab centres, educational campaigns, and stiffer penalties for traffickers. But what really stirred debate was its proposal for clinics that would provide maintenance-level doses of heroin to addicts.

The drug clinic scheme was intended to “maintain a constant check on the number of addicts in any community. It would also protect the life of the addict and support him as a useful member of society. This existence would hasten his rehabilitation, or at least reduce the amount of his addiction since many of the stresses in the addict’s life would be reduced.” What’s regarded today as the novel philosophy of harm reduction was simple pragmatism in 1952.

Both the Province and Sun newspapers printed the Community Chest’s report along with gushing editorials endorsing its recommendations. The Sun noted that Vancouver alone had four times as many addicts as all of Britain, leaving “little doubt that the European system of cheap drugs and medical treatment is infinitely superior to our faltering system of straight police suppression.” The editor agreed that the Community Chest’s plan would eliminate the illegal drug trade by “destroying its root – the fabulous underworld profit in drugs.”

The Community Chest anticipated resistance to the drug clinics, predicting they would be “violently opposed by those who profit from drug trafficking and one should expect opposition and interference from such criminals.” Stiff opposition did kill the clinic plan, but it came from the government rather than criminals.

Soon enough, the government of the day was promoting involuntary care. What is now Matsqui Institution was in fact purpose-built in 1966 for the forced treatment of men and women using heroin. But they built it so it could be repurposed as a prison just in case - a good move, as it turns out, because the forced-treatment project was deemed a failure a mere three years later and Matsqui became just another jail. 

The John Howard Society also reported “a radical upswing in addict deaths in BC” since Matsqui opened. [The JHS's] Mervyn Davis explained that it was probably “the result of increasing police pressure on the drug market, which usually results in inferior drugs and a wider variety of potentially dangerous drugs – such as barbiturates – being used as a substitute for heroin.”

 But hey, 20 times is the charm, right? With more than 17,000 dead just since BC declared a state of emergency almost nine years ago and such a long, long history of abject failure on this issue, you'd think we might be ready for something new. Nope. We're pulling back even farther, leaving politicians, police and hysterical media pundits to continue calling the shots on a massive public health crisis. 

Watch this segment on moral panic from the Peers Victoria speaker series on the toxic drug crisis that just wrapped this week. There's the conversation we need to be having. 

 

Could the stories of the dead shake us out of this moral panic?

Pixabay: Erika Wittlieb

This is a callout to people who know someone who has died in the toxic drug crisis in the last decade. I've got an idea. I'll need your help. 

Nobody can look at the faces in this Moms Stop the Harm video of lost loved ones without questioning what's going on, with more than 17,000 people dead in BC since 2016 and us seemingly powerless to act. (We aren't, but I've already written about that, so more on that later.)

That emotional connection is exactly what's needed to shake off this ennui around a four-alarm public health crisis. We seem to have parceled the toxic drug crisis into the part of our brains where we hold faint understanding of something that we don't think affects us. But it does affect us, in so many ways. 

Normally I'm all about the stats and evidence, but as the fantastic panel on moral panic pointed out at the Feb. 26 event in Peers Victoria's speaker series, we've got stacks of evidence on this issue and quite a lot of stats, at least at the death end of things. So the question becomes how you get past moral panic to actually implement the evidence-based strategies that will substantially ease the crisis. 

I think it's through the heart. Not in a Sally Struthers way - teary-eyed, sobby, pleading (sorry, Sally, loved you in Man on the Inside) - but in that way that almost instantly shakes off some of that "this is not my problem" way of thinking. I don't know what it is, but it's like the blinders come off and you finally see. For me, it was Stephen Lewis, of all things, pointing his finger out to the audience that I was in one spring day in 2004 and saying, "What are YOU doing?"

I've seen it happen a multitude of times for other people, where someone sees or experiences something out there in the realm of suffering that hits them where they live, and they get it. You can't predict when they'll have it or what's the magic sight that will open their eyes, because everybody is different, but it's a beautiful thing to see. (Tony Joe, I saw you have one.) Here's harm reduction and recovery advocate Guy Felicella talking about his father-in-law's moment. 

It can often be a long way to action from that point. But there will be zero action until a person at least has that moment. That's an important strategic reality to ponder for anyone pushing for social change, especially when an issue is stigmatized.

So let's help get them to that moment, I say. Let's bring the faces and stories of people killed in the toxic drug crisis into the world. Moms Stop the Harm's video has 300 faces, but there are thousands upon thousands more. I think there would be much power in a Humans of New York style of story-telling (an image and 150 words max) for all these people we have lost to an entirely preventable crisis.

What I'd ask for is an image, and the answer to this question: What did the world lose when this person died? I'd like their age and at least their first name, and two names are even better, because being out there with your full self, while hard, is a rejection of stigma.

The tools are in our hands, and free. Instagram would be great. Facebook has potential, though my personal sense is that the algorithm doesn't like things about toxic drugs. On the other hand, it DOES love things about people. 

Podcasts are a possibility, to bring out the voices that will reveal the enormous grief hanging over this province solely because of this preventable crisis. It would be very brave to consider X, but we could warm up on the friendlier BlueSky initially. 

We'll need some kind of consent form, of course. It's a proposal that people will need to think all the way through before participating. Some thought is needed as to who can consent to the use of an image and story. I'm imagining that things will go wrong, because they always do, and I'll tell you right now that the haters are going to hate. You're going to have to be like little Ruby Bridges in 1960 Louisiana, bravely entering the first integrated school while the white protestors hurled vile insults. 

But if you are one of the many frustrated families and supporters who can't bear the lack of action on this issue one minute more, then maybe you're OK with that. 

This thing I'm thinking about is meant to memorialize and honour those who have died, and hopefully stab people in the heart until we get action. But the use of drugs that our society believes are "evil"  is also possibly the most stigmatized social issue of our times, so it isn't an easy choice to step up. 

If you're reading this and are one of the lucky ones who doesn't know anyone who has died in the toxic drug crisis, I'd ask that you ask around and then share this with someone you know whose name comes up. Because there's definitely going to be someone in your circle. 

If you do know someone, write to me at jodypatersonmobile@gmail.com and tell me what you'd want to know before going ahead with something like this. I'm just seeing us spinning our wheels while people die, and it feels way past time to take things up a notch. 

Stigma deepens. People suffer and die. Just another day in BC

A hundred years from now, our descendants will feel sick to their stomachs when they read about how we treated people who used drugs in ways we didn't approve of. It will be like the revelations of priest-pedophiles and residential schools were for my own generation – one of those things that an evolved person struggles to come to terms with.

”Our governments did that?” they will ask. “And the people just put up with it?” Yes, Grasshopper, because even though almost everyone used drugs in that era, governments could get elected by singling out and causing to suffer anyone no longer able to hide the signs of their drug use, most especially if they were poor and sick.

In any logical world, offering prescribed drugs as a substitute for toxic street drugs would be a good thing. Now that dying of an overdose is the No. 1 cause of death in BC for anyone ages 10 to 59, substituting non-toxic drugs is pretty much the best strategy we’ve got to stop the deaths.

But today’s announcement from government, which follows on the heels of a big media fuss about legal opioids being “diverted” into street sales, cuts the legs out from under BC’s own prescribed-alternatives program. The 4,000 people on the program will no longer be able to bring home their prescriptions like any normal person, they will now have to go to wherever the health professionals are, in whatever hours those professionals work, and take their prescribed drugs in front of them.

The news release is loaded with hot words like “predators” and “bad actors” to make a reader think we’re fighting evil with this bold move. But sweep away all the noise and what you’ve basically got is government intensifying the stigma around drug use and making life even harder for people who don’t need any more of a hard time.

The cynical move, so blatantly political, will almost certainly push many people back to the deadly street supply. Some will die. The rest will just have their complicated lives made even more complicated. I hope David Eby feels that weight on his soul forever, and may it be all the more crushing because he’s a man who actually knows he’s doing the wrong thing.

Picture what this edict would look like in your own life. You like to come home after work and have a couple glasses of wine. Nope – you want that wine, you’re going down to the drug store to drink it fast in front of the pharmacist, while whoever is in line waiting for their own prescriptions watches. “Oh, what a shame,” they’ll whisper.

You like a cannabis gummy just before bedtime? Get on those bunny slippers and head on down to the clinic to eat it in front of the nurse, if anyone’s even open that late. If they’re not, you’ll be eating it at 6 p.m., and tough luck if what you really need it for is bedtime.

And yeah, you’ll be doing that every night.

Got high blood pressure? Keep the car warm or a bus pass in your pocket for those twice-daily visits to take your drugs where a health professional can see you do it. Have a job with odd hours? Get ready to figure out a work plan that lets you get to the pharmacy however many times a day, every day.

Ah, but those are the “good” drugs, I can hear you saying. (Not really, because the only people who have read this far already think like me.)

Sure, but they’re the good drugs only because we say they are. There’s no actual science connected to which drugs are legal and which ones aren’t. Every “illicit” drug has its story in our country’s history, but none of it is about careful science establishing which drugs harm us the most and making those ones illegal.

Somehow, people have come to believe that the visible suffering we’re all witnessing in our communities is about drug use. They hate talking about drug use and are very sure it looks nothing like the six bottles of wine they drank over the week.

In fact, the sad state of our streets is about a social safety net left to crumble over the last 30 years and a housing crisis. Harmful drug use is a symptom, not the underlying problem. And the toxic drug crisis isn't even about harmful drug use, it's about unregulated drugs of unknown potency, egalitarian in their deadliness whether you're a first-time user, an injured construction worker, or an "addict."

No difference. People are going to read the government’s cruel news release about deepening the humiliation for people trying to get well, and they’re going to think that something decisive is happening to stop the misery. 

Not at all. Something decisive is happening to increase the misery. David Eby is tightening the screws. The prescribed-alternatives program offered the tiniest ray of hope that government was beginning to grasp that one of the more obvious solution to toxic drugs is to switch to drugs that aren’t toxic. The light has gone out at Hope Farm tonight.

“We are committed to saving lives and getting the people who are suffering from addiction the treatment they need,” says Health Minister Josie Osborne in the news release.

Oh, please. That line doesn’t stand up 21,000 deaths later, most of them under the watch of the current government. Why do we let them get away with it? Why is the media just so damn useless, recording the empty words of whoever saying whatever, as if they see no role for themselves in digging deeper to solve a problem that can never be solved this way?

David Eby and his government will be on the wrong side of history one day. Another generation will tear their MLA names off plaques and schools, and be baffled that people with such a mindset could have ever been left to run government and cause such harm.

But that’s little comfort to the people being shamed and harmed now. David Eby would rather see them take poison on the streets than risk losing a political base who he imagines admires him for his decisive stand. Shame on YOU, David Eby.

***  

If you haven't discovered Garth Mullins' podcast Crackdown yet, make that a priority. 

Lock 'em up: Everything old is new again

Image by Gerd Altmann from Pixabay

And just like that, institutionalization is back. 

My head is in a whirl. After untold hours of my early journalism career spent documenting the hard-won battle to banish BC's bad old institutions rife with abuse and civil-liberties violations, the former executive director of the BC Civil Liberties Association is now the premier of the province and pitching involuntary care like it's a fresh new idea whose time has come. 

“This announcement is the beginning of a new phase of our response to the addiction crisis," said Premier David Eby in a statement released yesterday in which government outlined how British Columbians could now be held against their will for mental illness, drug use or brain injury if they are making their communities feel "unsafe."

"We’re going to respond to people struggling like any family member would. We are taking action to get them the care they need to keep them safe, and in doing so, keep our communities safe, too," said Eby. 

If it was possible to believe that a return to institutionalization would actually play out that way, maybe it wouldn't feel so damn sad to have us rolling the clock back 50 years. History tells us otherwise, however. The stories of suffering that journalists all heard in those years leading up to the closure of BC's big institutions were absolute heart-wrenchers.

The whole reason we abandoned institutionalization back in the 1980s is because it's a horrible idea that doesn't work, except as a means to shield "normal" people from realities they'd rather not have to think about. 

Like what happens to people with severe mental illness when they don't get help and support. Or, in this latest incarnation of "secure care" (aka imprisonment), the tremendous damage a product can have on its customers in a market totally controlled by the sellers/manufacturers and abandoned by the regulators.

Instead of trying to fix any of that, it appears we're just going to lock people up again so we don't have to see our policy failures in their shattered faces.

As researcher Gillian Kolla noted in The Tyee last week, B.C. is jumping to institutionalization without even trying to see how things might go if we actually had spaces in voluntary, trauma-informed, evidence-based treatment programs for all the people who are desperate for such services. Research and experiences all over the world - much of it right here in BC - have demonstrated time and again that institutionalization does not make people well, and in fact puts them at risk of even more harm.

Sure, temporary secure care might have a role in helping to manage some aspects of the social crisis unfolding in all of our communities. But it's meant to be a last resort, after all other attempts to help a person have failed. Please don't let anyone tell you that the people we're seeing spilling out onto our streets have had every social intervention provided to them already. That is so very far from the truth.

Our current social crises are in fact a result of decades of social needs gone unmet. We haven't even begun to try hard to help people with mental illness, substance disorders and brain injuries. Virtually all of the services we've got are patchwork, disorganized, uncoordinated, short-term and often unevaluated. BC doesn't even have an overarching social policy.

We have orchestrated a disaster with our indifference - and now we're going to "fix it" by finding new ways to hold people against their will? Not a chance. 

As Kolla also pointed out, BC does have the power right now to hold people against their will under the Mental Health Act. If someone is deemed a danger to themselves or others, they can be held. (And that definition includes threats and anti-social behaviour, as my uncle Joseph McCorkell found out back in the 1990s when he fought his own incarceration in the years before Riverview Psychiatric Hospital was fully phased out.)

How low will be the bar be for this new initiative? No details yet, but I'm going to take a wild guess that people who are impoverished, traumatized, unable to maintain paid work and with a lifetime of struggle and hardship will be the first ones in. Interesting as well that these new secure facilities are mostly going to be sited at prisons, not hospitals. 

To see brain injury thrown into the mix this time out just adds to the wrongness. Someone suffers a serious injury that causes behavioural changes that unravels a life, and our government decides the best course of action is to make it really hard for them to get any help, and then lock them up indefinitely when they inevitably fail to recover. 

As soon as I read that Vancouver story earlier this month about one person getting their hand severed by a stranger with a machete in a mental-health crisis and another person dying, I knew where this was going, especially mere weeks before a provincial election. 

Eby has been hinting at a return to institutionalization since 2022, when he was angling to replace John Horgan. BC Conservative leader John Rustad has made institutionalization part of his party's platform.  I suspect both will get plenty of support from the electorate for their positions, because everyone I know is sickened and fed up with the social disasters unfolding on their city streets. 

But the answer to the tragedies we're seeing in the hearts of our communities is not to lock people up. Where is the announcement of preventive measures to slow the flow of people onto our streets? Where are the services that would catch people early in their crisis? Why are we embracing the harshest "solution" first? 

I wonder if I will live long enough to be throwing out a bitter "I told you so" in 15 or 20 years when we are back to trying to undo the damage of this deeply sad return to institutionalization. People, we are making a mistake. 

BC leads pack by a long shot when it comes to Canada's missing persons

 

Image by 愚木混株 Cdd20 from Pixabay

My news feeds have been bringing me so many reports of missing persons in BC recently that I finally went looking for stats this month to clarify what was going on. Was there actually more people going missing, or was I merely trapped in a bad Google algorithm?

The truth turned out to be astonishing. Not only has BC been leading by a long shot the missing-person stats in Canada for adults age 18 and up every year since 2015, when the Missing Persons Act took effect, but the number of adults reported missing in BC has grown by more than 48 per cent since then. (Our population has increased by 10.2 per cent in the same period.)

In 2022, BC police filed 14,751 missing-person reports involving adults to the Canadian Police Information Centre (CPIC). The province with the next-highest number of reports was Ontario, at 7,298. While various provinces have been No. 2 over the years—all with roughly the same notable gulf between BC’s numbers and theirs—BC has always come in at No. 1.

Looking at per-capita rates, BC has been a consistent leader there, too. In 2022, British Columbia had the highest number of missing-adult reports per capita, with 273 reports per 100,000 people. The next highest was Saskatchewan, with 146 reports per 100,000 people.

In fact, 42 per cent of Canada’s 33,913 adult missing-person reports in 2022 originated in BC. That number is on the rise as well, up two per cent since 2020.

Equally worrying is the growing number of adults who aren’t being found quickly, in BC and across the country.

In past years, 60 per cent of CPIC reports on missing Canadian adults were taken out of the system within 24 hours, and 90 per cent were removed within a week. But in 2022, for the first time since stats have been kept, those numbers dropped to 34 per cent removed within 24 hours, and 73 per cent within a week.

I mentioned some of the startling BC-specific stats to an acquaintance with decades of experience in high-level provincial government positions.  He said any dramatic gap between the provinces for virtually any stat almost always comes down to some reporting difference. “Nothing is ever that different from one province to another,” he said.

So I looked into that.

The stats are based on missing-persons reports filed by Canadian police departments into the CPIC database. Missing-person reports can be filed immediately (forget all those cop shows you’ve seen where people are always having to wait 24 or 48 hours before reporting a missing person), and you could certainly speculate that different departments or regions could have different cultural practices around how quickly they file a report to CPIC.

Perhaps there’s a Robert Pickton effect, too. BC police departments looked bad when the details came out about the 1990s-era serial killer, what with so many of his victims missing for years but ignored by police because they were survival sex workers living in poverty and addiction. Maybe BC police ended up being more devoted than most to filing missing-person reports from that point on.

So I tracked down media relations at the RCMP’s national communications headquarters, the spokespeople for missing-persons information, and asked them if they could help me understand why BC seemed to have so many more missing persons.

They noted “many caveats,” from not assuming that the stats are actually complete (many cases are resolved before they get to CPIC), to being very cautious when considering the 11 categories of probable cause that missing-persons cases are slotted into at the time of reporting.

“You cannot be assured that every single person categorized in each category indeed belongs there,” wrote RCMP media relations rep Robin Percival in her email to me.

They agree that the stats are almost certainly affected by “differences in reporting procedures, as well as geography, urban/rural mix, demographics, culture mix and other factors.”

But taking all that into account, I still see no way to explain away BC’s huge lead on the number of adult missing persons as just being about reporting differences. We just seem to have a whole lot more people who go missing. (Click here for the list of active missing persons investigations in BC RCMP jurisdictions.)

“BC has its own peculiar mix of factors, including an ocean,” wrote Percival, adding that many fishermen go missing. “It is also an area where people drift to and then go missing.”

On the upside, our rate of missing children seems much more in line with the rest of the country, though we’re still consistently among the top three. In 2022, we placed second behind Ontario with more than 5,500 children missing, after Manitoba managed to bring down some high missing-child numbers from years past and fell into third spot. Per capita, Saskatchewan and Manitoba have the highest rates.

Nationally, 33,394 children under age 18 went missing in 2022. Three-quarters of them were deemed “runaways,” and more than half were female.

Among Indigenous children, the percentage of missing girls is even higher. Girls account for two-thirds of the 8,300 Indigenous children reported missing last year.

Things that make you go “Hmmm…” Whatever the reason for BC to be lapping the pack when it comes to missing adults, it doesn’t feel good. Hope somebody other than a random blogger like me is taking a look at these numbers.

***

But also...I happened to be in my Google News settings recently for other reasons, and discovered that Google had singled me out for having a big interest in "missing persons" and had been sending all the stories of missing people everywhere to my news feed. So while it did turn out to be true that more people are going missing, I was also getting a tailored feed that was bringing this to my attention by feeding me way more sad news stories than a person could possibly handle on people gone missing. 

BC's decrim experiment: One giant step for governments, one really tiny step for fixing the problem

Credit: No Name 13, Pixabay

The BC government doubtlessly had to work very hard to get the OK from the federal government for a three-year test of illicit drug decriminalization. 

It's a good thing to have fought for, even if the pilot is so hamstrung with exceptions and rules that it can't help but be of minimal impact. We are so lamentably, tragically overdue to move on this problem of poisoned street drugs killing thousands of British Columbians every year that virtually any glimpse of a different future must be welcomed with enthusiasm. 

But just to be clear, the vast majority of people who use illegal drugs will not benefit from this pilot. Nor will it stop the endless tide of deaths.

That's not to say that any move toward decriminalization isn't to be treasured. But we do need to go into this teeny, temporary change in our senseless and destructive drug policies with the understanding that it's a flea on a fly compared to the complex issues that are actually driving BC's illicit-drug miseries.

The pilot will have no impact, for instance, on the disturbing reality of some 2,300 British Columbians dying year after year due to a toxic drug supply, almost all of whom are men. 

What the pilot will do is instruct police not to charge people if they find them carrying small amounts of four specific drugs, none of which can have been cut with any other drug. (Alas, anywhere from 20 per cent to more than half of BC's confiscated illicit drugs in 2022 were found to be cut with benzodiazepines, so there's a rather major stumbling block right there.)

The toxic drug crisis, on the other hand, is about illegal drugs being cut by sellers with all kinds of other stuff because it's cheaper and more readily available, and people dying because virtually nobody knows what they're getting anymore. 

Fixing that big issue is about figuring out how to ensure people know what they are purchasing and how to use a particular drug combo safely if it's that or nothing. It involves a full understanding of how drugs come into our province, and how and why they are altered once here. 

That would require consultations with the importers and the sellers, as would have happened long ago were it any other product. But an opportunity has been missed again, with sellers dismissed in the usual way as "predators" in the government's latest messaging.  

One of the most significant insights we've had into the workings of BC's bustling illicit-drug industry comes from a lone seller featured in a research paper published in the January 2021 BC Medical Journal.

"When asked about selling a bad batch of drugs and people overdosing, he said, 'If it’s a bad batch, I’ll probably still sell it because I don’t want to waste it and lose profit. That’s just the truth and the reality,'" noted the researchers who interviewed the anonymous John Doe.

A small exemption on possession charges will have no effect on the illicit-drug industry. As John Doe points out in the paper, the industry is a masterful example of unfettered capitalism that can quickly turn any disadvantage into opportunity, including the supply-chain disruptions of the COVID-19 pandemic.

Nor will the pilot do much to move people toward treatment who weren't already well along on the arduous journey of wanting treatment.

Being charged with drug possession is arguably pretty low on the long list of worries for British Columbians trying to access treatment, starting with how impossible it is to find it in the first place for anyone without major resources; the reality of having to wait months for a spot while magically staying "clean"; an absence of other problems like poor mental health; and the ability to put your life on hold with no support for weeks of residential care.

Even John Doe understands that people use drugs for complex reasons that are often rooted in trauma and pain. “It would be hard to treat someone with just their addiction and not treat their mental health," he told researchers. 

Now there's the kind of guy whose insights would be useful if the day ever comes when we get serious about all of this.

I wouldn't even expect that the pilot will stop many people from being charged with possession. The small amount of drugs a person can possess under the pilot - 2.5 grams - and the requirement for those drugs to be pure, are pretty much impossible scenarios in the current drug scene. 

But as Premier David Eby rightly notes, it's vital to do something. 

“When you talk to parents who have lost a kid who thought they were taking party drugs at an event, and end up taking fentanyl and dying, you understand how serious this issue is and how it crosses partisan lines and how we all need to work on solutions,” he told CityNews last week after federal Conservative Leader Pierre Poilevre called the Downtown Eastside a hell on earth and said all the usual uninformed stuff about drug use.

And if this pilot turns out to be the way to crack the door open on decriminalization overall, hurrah. Until then, it's just the smallest of stepping stones at the edge of a raging river.

We won't slow climate change with niceness

Extinction Rebellion UK says it will prioritize "relationships over roadblocks" this year and move away from public disruptions as a prime strategy for getting the world's attention on climate change. 

That's a warm and fuzzy statement for a new year. But hopefully they aren't going to get too nice. Nobody's going to solve the climate crisis with niceness. 

Of course, one does want to be strategic when in the business of disrupting. Throwing cans of soup at famous works of art - not the work of Extinction Rebellion; that was Just Stop Oil - and other poorly considered attention-grabbing antics may get your unknown organization headlines, but simply being offensive in a public space is not a strategic protest. (Put away the soup cans, go disrupt a fracking operation.) 

That said, we sure as hell won't move this crisis with niceness. Co-operative behaviour is one component of an effective change strategy, just like acts of protest, but systemic change at this grand scale cannot be achieved without anger, shouting, threats, arrests, financial loss, deaths and a lot of other not-nice things.

In the case of the climate crisis, consider the long list of potential opponents who benefit from the current system, a number of them with deep pockets for dragging this out indefinitely.

First, there's the vastly wealthy fossil-fuel corporations, which have enjoyed almost $3 billion US in daily profits for the last 50 years. Then there are the governments that are absolutely dependent on the revenue and jobs. International energy policies so friendly to industry that countries that sign on have to promise not to make energy policy changes without consulting Big Oil first. 

There are the global investors clamouring for endless returns on investment. The billions of people completely reliant on fuel to heat their homes, operate their businesses, get to work, and wage war on real and imagined enemies. The travellers, the tourists, the legions of individualists who have never had a collective thought in their life and are just fine with riding Earth into oblivion as long as they can be "free."

There are mega agricultural operations spread across mega land holdings to serve a world that eats 350 million tons of meat a year. There are more than 50,000 merchant ships criss-crossing our oceans every day just to feed our hunger for stuff. There are trade agreements in all directions that bind our governments' hands even when they're willing to do better.

Every one of those things and so much more is going to have to change if the end of this global story we're living is going to be remotely happy. We need to have so many big, brave conversations. We need big, brave leadership at all political levels - leadership that gets past the typical political urge to pander and please and treats this issue like the global emergency that it is. 

And while we can strive to be respectful in all of that, we can't expect that any of this is going to be nice. 

Extinction Rebellion says part of its decision to shift tactics is because we live in times in which protest has been criminalized. "Thriving through bridge-building is a radical act," the group says.

But really, what big change has ever come about without arrests and conflict with the law? In the case of global emissions, we're talking about trying to stop activities that make people so much money. They're not going down that road without a really big fight. Read sociologist Frances Fox Piven's eye-opening Poor People's Movements for more on that.

While it's certainly important to get your allies in order and build those relationships, there still has to be disruption in a crisis this big. If XR wants to play nicer, then somebody else needs to step up to be the disruptor. Climate change is a disruptor itself, and those of us who want better for our world are going to have to meet its chaos head-on.

Change this big will be very painful for those who benefit from the current system. That can't be sugar-coated. 

For the sake of future generations, let's just go straight to being tough and skip the part where we all think we can settle this like friends. That's just going to drag out the bloody ending that's coming one way or the other. 

Drugs don't kill people, poisoned drugs do

BC's crisis of poisoned street drugs is hitting men in the prime of their working years the hardest. Three-quarters of the 10,000 deaths in BC from poisoned illicit drugs since 2015 have been men ages 30-59.

As this fact-filled story in The Tyee today highlights, one in five of them was working in the trades or transportation when they died. But while this information matters, it's not where we're going to find solutions for BC's poisoned street drugs. 

There are many reasons for why tradespeople are dying from using drugs, as the piece explains. The manly-man culture of the trades, the chronic pain of injury, crazy shifts, intense working conditions, long stints isolated in work camps, reluctance to reach out for help and risk looking "weak."

But BC is a resource province, and we've had manly men working in pain, isolation and wild working conditions throughout our history. They have used drugs to numb all that - or as a reward at the end of a hard day -  for as long as rough jobs have existed. Those of us who grew up with our eyes open in any BC resource town can attest to that.

Admittedly, such men have probably been dying at a much higher rate than the rest of for all this time; we just didn't think to measure those deaths in relation to the type of work the dead man was doing at the time. But they weren't dying like they're dying now.

So what's different this time? The drugs. They're poisoned. How and why they have ended up poisoned is a story I'm still waiting to read, but it seems pretty obvious that we won't slow this crisis until we figure it out. 

The standard how-why responses for illicit drugs having become so toxic tend to focus on suppliers using cheaper substances to increase profits. Street drugs are being cut with fentanyl, benzodiazipines and other weird and deadly stuff because it allows a much greater profit for the supplier and seller.

But cutting drugs with weird stuff to increase profits is also a time-honoured tradition in BC. The crisis in toxic drug deaths that we're seeing now is very specific to the last 10 years, and strangely specific to BC. 

The United States has its own drug crisis going on with opioid overdoses, now killing more than 1,500 Americans every week. But an overdose is not the same as poisoned drugs. The people who are dying in BC aren't dying because they used more drugs than were safe, they're dying because the drug supply is toxic.

This is an important distinction. You can't set about fixing a problem until you fully understand it, and it's important for us to let go of this wrong idea that people are dying just because they used drugs (a belief that lets us fall back on moralizing and dismiss this crisis as something that "good people" don't have to worry about). 

Were you ever a kid who gulped down street drugs without a second thought? Because I was. Happily, I grew up in the 1970s, when the drugs that a kid could access mostly weren't going to do anything worse than send you into a gas station bathroom to barf your guts out, or get you in trouble with your parents. 

Had I been a teen in today's world, I'm pretty sure I'd be dead. 

The Tyee's story notes that the employers of tradespeople have a lot to answer to, from inhumane shifts and their own culture of denying anything is wrong in their industry. But understanding why tradespeople need drugs to hang in at their jobs, while important, will not solve the toxic drug crisis. That won't be solved until we no longer have a poisoned drug supply.

The judgment we feel about the use of any drug other than alcohol so quickly sends us off into pointless and meaningless conversations about why people use drugs. (We use drugs because they make us feel better.) But addressing this toxic-drug crisis has to focus on the poisoned drugs, not the users. 

Imagine for a moment that more and more infant formula coming into Canada was turning out to be poisoned, and babies were dying. 

We would not address that with a public awareness campaign about breastfeeding, would we? We would not call it a solution to distribute pharmaceuticals to new moms so they could inject their babies and stall off the effects of the poison long enough to get to the hospital. We'd just dig in to figure out why the formula was poisoned, and how we could ensure a safe supply.

Where are the big drug importers in this conversation, and what could they tell us about how those imports, or their own practices, have changed? Where are the policy makers who can put aside political qualms and posturing to act bravely in the name of saving lives? 

We are stuck, and so many people are dying. This is so wrong.