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Many years ago, I was in my office talking with a patient about her smoking habit. As with most such encounters, I was basically checking on the fact that she was still smoking and offering the usual advice to quit. I think she said something about not being able to start her day without a ciggy, which is one of the signs of being in withdrawal after abstaining overnight, so I said something, more to myself than to her, to the effect of “ok, so you’re an addict”. At her next visit, she told me that she hadn’t smoked since she left my office that day. My offhand comment made her realize that she had an addiction, something she didn’t want to have, and that was enough to make her quit cold turkey! So (a) sometimes stigma is a motivating force, much as we are told NOT to stigmatize addicts (b) addicts can and do quit when they decide to, and it happens for all forms of addictions, often without (or in spite of) medical help.

I’m totally with you on abstinence based therapies and the need for social supports. If opiates damage the brain, then why is the “best” treatment the one that involves more poison? We learned not to replace alcohol with benzos. Quitting ciggies is the best approach for smoking. But with opiates, we “replace” one with another. I’m with you in thinking it’s motivated by profit for Big Pharma, coupled with the fact that prescribing creates the illusion of “doing something”, while the alternatives are hard work and not so well paid.

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Thanks Rick. I really value your opinion so appreciate hearing that this struck a chord with your experience.

Your comment on stigma anticipates a little bit of Part 3...

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Feb 5Liked by Pairodocs

I very much agree with your assessment, especially that if there is a motivation to quit, they will find a way to quit. Governments should help provide a motivation, not take it away.

Teach a man to fish, don't just give him fish. Same idea.

I like your assessment of that often the wrong things are counted and touted as successes, like the number of needles given out - instead of saying what matteres. I studied statistics for several semesters in depth, and I can honestly said that I do not trust any statistic that I didn't falsify myself.

Where is people's common sense? The corrupt media and school system are systematically ruining societies ability to think critically for themselves.

What is the solution? Is there a solution that has a chance to work? I am no longer so sure for this coming up generation. If there is, us "elders" need to speak out in a way that can be still understood, in my opinion, this needs to be with an attitude of faith, hope and love (aka biblical) and not "mindless understanding and laissez-faire". Age-old values have been eroded for evil purposes. I personally am trying several things in my small way to help people understand that they are not powerless, that it matters for parents how they speak with their children, that seniors (like me) are not condemned to a life of sitting around watching TV and watching dementia set in... We can and have the responsibility as elders who still can think to impart this on as many others as we can. This is my mission. Thanks so much for your thoughtful articles. Love them!

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Thanks for the very kind comment. I agree - sometimes it's hard to keep faith in the future with all that is going on. I often have to remind myself that despite the carnage we see in our downtowns, most people (including young people) don't abuse drugs, are kind, reasonable and productive. Thank God for that.

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Feb 4Liked by Pairodocs

The Gvt, NGOs and big pharma have a successful business going and they will lie, cheat and steal to keep it going.

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With this, as with the homelessness (and other issues like gender dysphoria), I find the role of the “advocacy groups” to be something of a puzzle.

Take that nursing group in B.C. that challenged the new law about using drugs in parks and playgrounds. Seems to me they were “nurses who looked after addicts”, but how many such nurses are there, and why do they have their own group? Who are these people, really? How do they form a group? Do they have a formal structure? How do they decide what they are in favour of and what they oppose? Do they base their choices on ideology or evidence? Are they really so unified in their opinions about what’s good and what’s bad? Where does the money come from (legal challenges aren’t cheap!)? Why do they get listened to when the majority of the population have no say?

I do know that disease-based advocacy groups (like, say, the Menopause Foundation of Canada) ultimately get money from Big Pharma, but it’s very hard to follow the trail from one end to the other. Who’s funding (or even organizing) the groups that advocate for addicts? I’m reasonably sure it’s not the addicts themselves, nor is it the groups that supply illegal drugs, but it could well be the ones who make the “preferable” pharmaceutical-grade drugs.

I did find it refreshing that the judge in Edmonton denied that one group standing in the legal case about homeless camp evictions, because they actually had no skin in the game. They were advocates because they said so, without much of an actual track record (they weren’t homeless, nor had they actually done anything about homelessness!). Too bad more judges and government officials don’t start questioning the advocates about their credentials and their interests (financial and otherwise).

Even the stuff this weekend in Alberta about Danielle Smith’s proposed policies on gender dysphoria show the same issue. How many advocacy groups have already spoken out in opposition? How did those groups all decide what their response was less than 24 hours after her announcement? For such a tiny segment of the population, isn’t it amazing how many people they have speaking on their behalf?

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Great comment Rick. So true. Sadly in many cases if you trace the funding it comes from you and me. These groups are non-profits that often get a lot of taxpayer funding either directly or through grants that they apply for. So the government is basically forcing us to hit ourselves over the head repeatedly..

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Feb 4Liked by Pairodocs

I think the effect we see could be a result of them fooling themselves into believing what they want to believe (they're making money and doing good!), then convincing others who also want to believe (be nice to people, give them what they want in a safe way, we can't impose our will for them to change on them) ...

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I agree. I find there is some overlap with all of the race stuff these days. If you disagree in any way you get accused of being a bad person, not understanding things properly, not being an expert, etc. People who are really on board with harm reduction and safe supply accuse anyone who criticizes the approach as lacking compassion and empathy, not caring if addicts die, etc. Most of us are afraid to take a chance at being called those names, so we shut up and go with the flow and leave it to "experts" like Bonnie Henry to tell us that opiate addicts can never get better because they have a brain disease.

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Feb 4·edited Feb 4Liked by Pairodocs

It's funny, I'm not a doctor, but the brain seems quite malleable to me, and there is a whole field of medicine that seems to be based on getting people's behavior and emotions to change based simply on talking to them, but so many things we fight over today relate to differences in whether people can actually change their beliefs and behaviors to those that would seem to be healthier. We shall not judge someone else's mental health is, I suppose, the basis for this argument. You can't make them change, you have to persuade them to want to change - but to do this without their permission is judgemental.

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Well stated. I think what this gets into is the following:

-if you want to wear a blue shirt or a brown shirt, it doesn't really matter much to me and a society where someone tries to enforce conformity is unhealthy and overly restrictive

-if you want to do drugs, set up a tent in a park where kids used to play, defecate in the bushes and then expect society to provide you with free services, then it does have a very profound impact on others, and thus becomes an issue where people become judgmental

The sad thing is that we're not supposed to be "judgmental" about anything anymore, and doing drugs and living into a park is the same as wearing a blue or brown shirt in post-modern ideology.

Theodore Dalrymple said:

"These days, one sometimes hears people praise themselves for being non-judgmental, but this is a misuse of language. What they mean is that they are not, or at least do not consider themselves to be, censorious, that is to say the kind of person who makes quick and damning judgments on others (actually, they are very likely to be censorious towards those whom they consider censorious). They cannot possibly mean that they do not make judgments, because the supposed desirability of not making judgments is itself a judgment." 

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Feb 8Liked by Pairodocs

googling Theodore Dalrymple ...

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I was told that I was uneducated.

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I get this too. It's a great way for those who don't like your opinion to silence you. Rather than make a real argument, they fall back on "if you were as smart and knew as much as me you would agree with me" and "only someone with no compassion would believe what you believe". Neither argument actually addresses the issue at hand.

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Feb 4Liked by Pairodocs

the Bonnie Henry quote is amazing....there are many of us who support abstinence but the interesting issue is how our views have been so completely sidelined with results as expected. In NS we are now told there is an initiative to involve docs in service changes ...of course it will be window dressing....but even if genuine it is difficult to see how this could work when most if not all of these malign enthusiasms, with disastrous results, are top driven by politicians and woke authoritarians and opposition is censored.

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Feb 4Liked by Pairodocs

I returned to San Francisco last year, marking my second visit after an initial trip over two decades ago. This recent experience was profoundly unsettling; I was taken aback by the pervasive presence of homeless individuals grappling with addiction, a stark contrast to my memories of the city. The transformation of San Francisco since my last visit was disconcerting. The insights provided by investigative journalist Erica Sandberg in the cited article offered valuable perspective on the current situation in San Francisco. It is deeply troubling to witness the detrimental impact of misguided policies on individuals' lives and the broader community fabric.

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So sad. It was a great city. Julie and I for years talked about visiting there but I now feel that we missed the window of opportunity.

Last time I was in Vancouver I had the same experience. It was so sad to see what the city had become over the 12 years or so since I'd last been there.

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Big bad Pharma and doctors definitely have a hand in this addiction explosion. It has gotten out of hand by a big stretch. It has become acceptable and rather than actually helping people get clean from their addiction, they propel it and make it 'easier' for them to stay addicted. For some folks, addiction happens easy and they think they can shake it. They fool themselves and keep fooling themselves. Often they are trying to fill a void in their heart/soul and alcohol or drugs seem the route they choose because their inner pain and/or their physical pain is alleviated for awhile. Instead of helping people find meaning in their lives, we throw the means to keep them down and struggling. So many things these days are topsy turvy and lack common sense.

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Feb 7·edited Feb 7Liked by Pairodocs

Very informative. We don't read articles like this one elseware. A man I know worked at a local pharmacy. He said that with methadone, they make $30,000 a year per addict.

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I don't think it's that much here in NS, but I do know it's very lucrative.

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Feb 5Liked by Pairodocs

Awesome read!

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