Hamilton Urban Core Community Health Centre | ? | 2 fl | Planning

[TheHonestMaple]

Originally Posted by atnor

Most of these people are hopeless and will never kick their addiction without serious interventions. They aren’t being helped — if they were they would be put in detox programs but all that’s happening is supervised injections with clean equipment. Granted I do like the idea of needles being properly disposed of and not landing in our parks or alleys but without forced institutionalization, which I believe is the most ethical and expensive approach, the overwhelming majority of them will never get clean.

It’s a complex problem which SIS only offers bandaid solutions to. A friend of mine is a doctor in Toronto. A recurring patient of his was a crack addict that was more or less told to stay in the hospital so they can monitor her heart and start to detox or else she’ll die. She snuck out that night and wound up dead within a weak. Tell me, where is the ethics and morality in this system which leaves the most vulnerable to their own devices? Crack and heroin have such a hold on these people that they can’t quit unless they have the fortitude and resources to abstain. While having good intentions and some benefits, a SIS by definition cannot break the cycle of addiction.

If we truly want to help the most vulnerable addicts the most ethical solution is to institutionalize them with 24/7 supervision with counselling, etc.

Totally agree. I never really understood the theory behind these types of facilities. Giving people access to drugs just adds to the problems, and accomplishes nothing. Sadly the only way to help these people is institutionalise them to help them kick their addiction and get their life together. They need serious intervention.

[matt602]

I've lost half a dozen friends to addiction in the past year and the way this thread is going is disgusting me. It's becoming very hard for me to resist saying stuff thats gonna get me banned.

[craftbeerdad]

I commend your resolve matt (and sorry to hear about the loss), it's pretty bizarre to say the least the attitude and lack of empathy.

[johnnyhamont]

It sounds like a lot of us see addiction as a harmful thing people should be discouraged from embracing and not offered resources for assistance with, and sounds like the rest of us used to feel that way but had our minds changed by stories of real people's journey through addiction.

I think that discouraging addictive behaviours is kind of the natural approach we all default to until that default gets interrupted. For those who are still approaching the issue through that default lens, here's a short video that I think summarizes the journey some of us have been on to understanding the role that things like safe injection sites play in the lives of people with addictions.

https://www.youtube.com/watch?v=PY9DcIMGxMs

[TheRitsman]

Apologies on the absolutely ass photo, riding my bike and didn't want to stop, but it's at floor 2 now.

[TheHonestMaple]

Originally Posted by johnnyhamont

It sounds like a lot of us see addiction as a harmful thing people should be discouraged from embracing and not offered resources for assistance with, and sounds like the rest of us used to feel that way but had our minds changed by stories of real people's journey through addiction.

I think that discouraging addictive behaviours is kind of the natural approach we all default to until that default gets interrupted. For those who are still approaching the issue through that default lens, here's a short video that I think summarizes the journey some of us have been on to understanding the role that things like safe injection sites play in the lives of people with addictions.

https://www.youtube.com/watch?v=PY9DcIMGxMs

Interesting video. Thanks for sharing.

By the same merit I would encourage everyone to read some of the work published by Michael Shellenberger. Michael Shellenberger is a former advocate of safe supply and safe injection sites in San Francisco who had a considerable change in heart when going to tent to tent in that city trying to understand the issues. His work is fascinating, and his perspective is truly eye opening. His conclusion is that safe injection sites and the legalization of 'tent cities' in fact destroy cities and the very people they are trying to help.

What I find most concerning however, with regards to safe injection sites and those who advocate for it, is the dismissal of those who are trying to improve the system looking for alternatives. The National Post recently wrote an article on this very topic, and it's quite an interesting read.

TheRitsman: Thanks for the photo.

[ScreamingViking]

Something has to be done. Many of these people may not want help. But the most unfortunate side of the problem has been growing. Cities cannot deal with this issue on their own, yet seem to be left to do so by their "parent" governments.

I've bolded a few things here, but that last line, bolded and sized and in red, is a key point!

I don't know what the best solution is. Half-measures aren't one though.


Hamilton has seen an 'exponential rise' in opioid deaths. Is it a 'state of emergency'?
Councillors to ask staff to lay out what kind of response an emergency would require

Saira Peesker · CBC News · Jan 16, 2023

https://www.cbc.ca/news/canada/hamil...ency-1.6713522

Following a year that saw Hamilton paramedics respond to 827 suspected opioid overdoses, city councillors are weighing whether to declare a state of emergency — and are hoping such a declaration could bring additional provincial resources to address the issue.

It's a step being praised by some front-line workers as one among many needed to address a crisis that is hitting people who live in shelters — some of the city's most vulnerable residents — the hardest.

Councillors voted in favour of a motion Thursday to have the city's medical officer of health look into whether the latest data on opioid deaths and overdoses meets the threshold for declaring a state of emergency.

Kim Ritchie, who spent 15 years living on the streets and is now a social worker serving marginalized residents, says that declaration could force Hamilton to better support what she says are underfunded and understaffed shelters. Many of their workers are students or recent graduates who barely make enough money to support themselves, she says, and aren't always trained to handle the frequent overdoses they are seeing.

"If we declared it a state of emergency we could secure funding to properly fund these facilities," she told CBC Hamilton on Friday, adding that monitoring residents for overdoses is taking staff away from essential tasks such as helping them find housing.

According to city statistics, Hamilton saw 100 deaths linked to opioid use in the first half of 2022. There were 170 deaths in 2021 — an "exponential rise" from 26 in 2005, according to a report coming to the city's Board of Health when it meets Monday morning.

The report, called Population Health Assessment and Public Health Priorities, says more than 65 per cent of opioid deaths are among men between the ages of 25 to 65, and that Hamilton's opioid-related death rate is 45 per cent greater than Ontario as a whole.

City data shows paramedics are being called to dozens of overdose calls every month, with 87 such calls in August, the worst month last year.

Coun. Brad Clark (Ward 9 — Upper Stoney Creek) cited some of those statistics at Thursday's general issues committee meeting while discussing the motion he put forward, which directs Medical Officer of Health Elizabeth Richardson to investigate the "threshold of opioid deaths and overdoses that would enable the declaration of a state of emergency and report back to the Board of Health."

The motion, which received unanimous support from those present, also directs staff to lay out the response required to address such an emergency.

"What was striking to me is ... every single ward in the City of Hamilton has had overdoses," he said, suggesting that an "all hands on deck" approach may be warranted. "People seem to think it's a downtown issue.

"I think the motion itself will help us create a more holistic approach to it rather than just dealing with it as one-offs every time there's a call… If it is a state of emergency, we may be opening the doors to [provincial] funding."

...

"These are human beings. They matter."


full story here

[Chronamut]

I think we need a mental ward hospital that these people are sent to, they get the help they need over x amt of time and are only released when they show they can function on their own for a period of time. Sure some may relapse but hopefully others would actually get the help they need.

Of course many need psychiatric help too - like why are they doing the drugs to begin with? Peer pressure? Depression? We need to address what is causing so much homelessness and drug abuse in this city. Rewind a few decades back and things were nowhere near as bad.

Also what is the demographic? Largely local born or maybe from other places where there are already rampant drug issues they bring here? We clearly need to do something.

[ScreamingViking]

Alcohol is probably the most widely abused substance in "western" society. Yet we manage it through restricted distribution, and use it to fund government via taxation. So many societal and family and health issues are related to it though. Does the government step up to help? Ha. Organizations like AA have filled the void... they're not perfect either, but do help some people.

Cannabis is turning into that, though its risks differ from so-called "hard" drugs.

Institutionalization was the way things were done long ago. I don't think that's humane today. If we're going to do that, lets lobotomize people again too.

[TheHonestMaple]

Originally Posted by ScreamingViking

Alcohol is probably the most widely abused substance in "western" society. Yet we manage it through restricted distribution, and use it to fund government via taxation. So many societal and family and health issues are related to it though. Does the government step up to help? Ha. Organizations like AA have filled the void... they're not perfect either, but do help some people.

Cannabis is turning into that, though its risks differ from so-called "hard" drugs.

Institutionalization was the way things were done long ago. I don't think that's humane today. If we're going to do that, lets lobotomize people again too.

Alcohol and cannabis are not fair comparisons to opioids or crack, not even close. We see it every day, opioids completely ruin peoples lives in a matter of weeks and turn people into literal zombies.

I don't think 'institutionalizing' people is what Chronamut is advocating for. More likely something similar to the Portuguese model. Where if you're found on the streets in a zombie like state on hard drugs, you are arrested, brought before a special drug addiction tribunal (where your family are part of) and then admitted to a special treatment centre if determined it is necessary. I highly recommend reading the book San Fransicko, where Michael Shellenberger lays it out bare on how these progressive policies of safe injection and safe supply quite literally destroy cites.

It's extremely clear that the status quo isn't working, then why are advocates for safe supply so extremely opposed to finding alternatives that do work?

[ScreamingViking]

Originally Posted by TheHonestMaple

Alcohol and cannabis are not fair comparisons to opioids or crack, not even close. We see it every day, opioids completely ruin peoples lives in a matter of weeks and turn people into literal zombies.

I can't speak to cannabis, but alcohol has done its fair share of ruination.

The effects may not be as immediate, but the long-term impacts are huge. Not just on the person abusing, but families, descendants, friends, and even strangers.

So we can agree to disagree. Or not agree.

Strategies to deal with opioids have not been working, I agree with that. There does not seem to be a will to deal with it as a health care issue on the part of higher-tier governments. And that's sad.

[atnor]

Originally Posted by atnor

Most of these people are hopeless and will never kick their addiction without serious interventions. They aren’t being helped — if they were they would be put in detox programs but all that’s happening is supervised injections with clean equipment. Granted I do like the idea of needles being properly disposed of and not landing in our parks or alleys but without forced institutionalization, which I believe is the most ethical and expensive approach, the overwhelming majority of them will never get clean.

It’s a complex problem which SIS only offers bandaid solutions to. A friend of mine is a doctor in Toronto. A recurring patient of his was a crack addict that was more or less told to stay in the hospital so they can monitor her heart and start to detox or else she’ll die. She snuck out that night and wound up dead within a week. Tell me, where is the ethics and morality in this system which leaves the most vulnerable to their own devices? Crack and heroin have such a hold on these people that they can’t quit unless they have the fortitude and resources to abstain. While having good intentions and some benefits, a SIS by definition cannot break the cycle of addiction.

If we truly want to help the most vulnerable addicts the most ethical solution is to institutionalize them with 24/7 supervision with counselling, etc.

This was my post from 2021, glad to see the idea of (for lack of better term) forced institutionalization and rehab is picking up steam in other online forums.

[atnor]

Anyways, I was in town this weekend visiting a friend. Noticed more progress at this site. Hamilton needs more development on Cannon east and west of James.

[atnor]

Originally Posted by Chronamut

meth is probably the worst as it apparently destroys a part of the brain with long term use that actually is responsible for being able to say no - so once you go so far you literally CAN'T go back, you're just fucked. Is it right to let them shamble about at that stage? What is the proper course of action to do when a person is actually too far gone to be rehabilitated? Ethics questions nobody wants to have to think about..


If our govt stepped in theyd probably advocate for assisted suicide lol..

You are so right, no one wants to grapple with the ethics and instead would rather shout platitudes about employing an empathetic approach to addiction and that criticism of safe injection sites and such lacks empathy. Just look at the comments above and the recent CBC article.

When you examine the ethics of a lot of controversial topics (ie: abortion and euthanasia) the ethical course of action isn’t as black and white as the loudest voices make it out to be.

[atnor]

Originally Posted by Chronamut

Hehe when i was a kid I thought euthenasia was actually "youth in asia" as I never saw it spelt just said, and I'm like "what's so BAD about the youth in Asia??"

But in all seriousness yes one has to wonder when a person stops being a functional person and what do we do about it. I mean it's great to keep them around and HOPE they change while they willingly self destruct, but is that any more humane..? I mean theyre living in poverty screaming at people and well.. everyone just looks at them and has no clue what the right solution is..

..and I'm not talking about the just deeply addicted person that through help and willpower can turn their lives around -I am talking about the far.. FAR gone people whose lives are destined for opioid overdose and death.

It's like dog rabies for humans.. (and yes I know humans can get rabies to lol..)

I can only imagine what opioid addiction is like. Cigarettes was a pain in the ass to quit and weed is surprisingly very difficult for me, especially for long term abstinence, so I can only imagine how difficult it is for those with opioid addictions. They need to be admitted against their will to a rehab clinic like with the honest maple spoke to.

[TheHonestMaple]

Originally Posted by atnor

I can only imagine what opioid addiction is like. Cigarettes was a pain in the ass to quit and weed is surprisingly very difficult for me, especially for long term abstinence, so I can only imagine how difficult it is for those with opioid addictions. They need to be admitted against their will to a rehab clinic like with the honest maple spoke to.

Yep, literally the most addictive and dangerous substance we know of. Yet some people seem to think that giving them more of it, and giving them a place where they can do it easily is ethical?

Ethical is getting them off of it for good and helping them enter society again, by pretty much any means necessary. And yes, that might include forcing them to get treatment against their will.

[SFUVancouver]

Due to the complexity of the subject, it feels like any comment one makes is doomed to be superficial and trite. With that said, and as someone who lives a few blocks from this site and appreciates that a meaningful investment is being made in community health in my neighbourhood, these facilities are an important part of the addiction hard reduction-treatment-recovery landscape. But they are just one part.

Yes, data has conclusively shown that supervised consumption sites lead to fewer overdoses, less public consumption in the vicinity, and fewer discarded needles and paraphernalia. Those are positive outcomes and unquestionably fulfill the role of reducing the harm of drug use to addicts and society writ large. However, alone they are insufficient to address the individual and societal harm of addiction.

There simply must be on-demand instant-intake voluntary drug treatment and recovery facilities that protect and support the addict (and society) through withdrawal and provide an opportunity to recover in a stable residential environment for a period of months. We also need long-term residential psychiatric facilities for those for whom drug addiction is a symptom of their mental health disorders. Such facilities would include shorter-term remand facilities to which an addicted person arrested for a criminal act may be involuntarily committed by the courts to protect themselves and society (by not immediately releasing them) through withdrawal and recovery to ensure sobriety when the person stands trial. Likewise, we also need, for lack of a better term, mental health jail for those people who are found guilty of committing criminal acts due their mental health disorders, for which drug use may also have been a factor in their arrest, and who would otherwise be incarcerated in the penitentiary system where little to no appropriate care is feasible.

And we clearly need a tremendous amount more supportive housing throughout the city to provide deeply affordable long-term housing for vulnerable people and provide them with on-site wrap-around healthcare, mental healthcare, employment and life skills services. This, plus a far more robust social safety net to protect all of us from destabilizing crises like job loss, family disintegration, abuse, and a hundred other awful events, from quite literally ruining one's life. Rent banks, food banks, emergency shelters, long-term social worker-patient matching, effective public transit, family doctors, psychologist and counsellor referrals, prescription drug coverage and basic dental under OHIP, rent control, new rental housing construction, etc., etc.

<gestures wildly>

All of this helps keep people in crisis from spiraling into despair and succumbing to the numbing embrace of addiction in all its forms. No one part prevents addiction, just as no one part solves addiction.

[TheHonestMaple]

Originally Posted by SFUVancouver

Due to the complexity of the subject, it feels like any comment one makes is doomed to be superficial and trite. With that said, and as someone who lives a few blocks from this site, these facilities are an important part of the addition hard reduction-treatment-recovery landscape, but they are just one part. Yes, data has conclusively shown that supervised consumption sites lead to fewer overdoses, less public consumption in the vicinity, and fewer discarded needles and paraphernalia. Those are positive outcomes and unquestionably fulfilling the role of reducing the harm of drug use to addicts and society writ large. However, alone they are insufficient to address the individual and societal harm of addiction. There simply must be on-demand instant-intake drug treatment and recovery facilities that protect and support the addict (and society) through withdrawal and provide an opportunity to recover.

Balanced post. I don't disagree with anything said here.

Harm reduction like safe injection sites can be part of the solution, so can forced rehabilitation programs. They can work together to solve the problem.

[SFUVancouver]

Originally Posted by TheHonestMaple

Balanced post. I don't disagree with anything said here.

Harm reduction like safe injection sites can be part of the solution, so can forced rehabilitation programs. They can work together to solve the problem.

Thank you. And in fairness, I have extensively edited and expanded my post since you replied and quoted it, so do not feel obligated to support my revised comments.

[Crapht]

Lots of windows installed here already and the front north west sectioned is bricked. Real hand set yellow bricks. It looks quite sharp.