As you know, I work in this area. I cover three clinics in Vancouver and Surrey. Belly of the beast. Some of my patients became addicted from prescribed opiate analgesics, usually for physical injuries - professional sports, workplace accidents, MVAs, etc. These are the minority, however. If there is a common denominator, it is that most become addicted through self-medicating for an undiagnosed or untreated mental health disorder. Social anxiety, ADHD, OCD, generalized anxiety, PTSD. The drug douses that psychological pain and transforms the world into a warm, golden, happy place. Why wouldn't you imbibe in that instance. And keep imbibing until, unfortunately, your find yourself in the trap of opiate addiction. Like the rat park, the solution is to provide that warm, golden, happy place that would obviate the need for drugs. In the meantime, keeping those folks alive by providing reliable prescription drugs vs the dangerous, unpredictable street drugs makes sense. Our chief coroner keeps telling us that those prescription drugs are not causing overdose deaths while the street drugs are. As far as I know there is no evidence to the contrary although there is a lot of wailing and gnashing of teeth in the media claiming that is so. Until we have addressed root causes, offering a safe drug supply makes sense. I can't think of a better interim measure.
There are many people who deal with mental health challenges (I don't like the word "disorders" because it suggests that things like anxiety are black-and-white, as opposed to shades of grey) who never resort to using drugs. Why?
Rat park is far from a warm, golden happy place. I think that actually misses the point of it. Rat park has all the difficulties of regular life - squabbles, fights, stress. It's not utopia.
There is data (ie: latest JAMA paper, just as one) showing that availability of "harm reduction" meds actually increased hospitalizations for OD. And BC just set a new record (again) for OD deaths. Why do OD deaths keep increasing over the last number of years? Suboxone was going to fix that problem. Then "safe supply" (more correctly PSAD) was going to fix it. And yet the numbers keep worsening. Other than the word of the chief coroner, why does the actual data keep getting worse? (I am put in mind of Orwell's quote "The first and most important command of The Party was to ignore the evidence of your own eyes and ears")
One of the things that became glaringly apparent to me during COVID was that bureaucrats/"experts", or what Thomas Sowell calls "the anointed" think that we normal people are all stupid and need to be told what is right. Safe Supply is a great example of this. We are told that it is wonderful, and it's working great. Thank goodness for safe supply we are told. And all the while we see our friends and family addicted or dead from OD, tents all over our streets, parks where we used to play with our kids now inaccessible and essentially occupied. Could it be that the average person is more objective and wiser than the chief coroner (and less politically driven)?
If Safe Supply is helping, then why are things worse?
Good points. I'm afraid it doesn't look to me like we as a society are doing too well addressing those root causes. And, in so far as they are related to "the crisis of meaning" issues that Chris suggests, things are about to get a whole lot worse with the mass introduction of AGI in the near future, as I have talked about many times on my Substack. Few people see this coming, unfortunately. They still have their heads buried in the sand on AI - a state of denial. I will continue to write on the subject, because unless we prepare psychosocially for what is about to hit us, we are about to experience suicides on a scale never before seen.
I think the issue is that we (especially in Canada, but worldwide) now look to Big Government for the solution to Everything. The meaning crisis isn't something that can be solved by government fiat or top-down. It comes from individuals and communities, which are now fragmented and dysfunctional. IMO the search for top-down solutions is part of the problem, and actually disempowering.
“Harm reduction” here means clean drugs given freely. The harm they see is the dirty drugs killing addicts not the fact that all drugs kill the addicts over time.
I live in a “harm reduction” building and I can attest that it’s not reducing anything but my expectations of a peaceful life. Active users turned distributors, customers day and night. Fresh rehabs come back to this with no outside support and fall right back into using.
Wow - that sounds like an important story to tell. I note that harm reduction proponents never suggest building new harm reduction centres in their own nice neighbourhood in the 'burbs, but rather like to crap on other people for NIMBYism.
They’re actually doing just that in Vancouver - and the NIMBYs are going nuts. What used to be a small pocket of “skid row” has infiltrated and, in some cases, taken over previously gentrified communities. Property values, way of life, safety, etc has gone down the toilet.
The point is that their view of “harm reduction” is nowhere near the dictionary definition of either word. Exactly what harm are they trying to reduce? And why?
Right on. Looking forward to the next installment! I have been thinking for a while - and esp since 2020 - that the crisis (war) of our time is actually being waged between we who recognize that to be alive is a mysterious miracle that blends these seen and Unseen, and those who seem doomed by their unrelenting attachment to the belief that life is mechanistic, predictable and absolutely devoid of Consciousness-as-Spirit. One need not call the Unseen Connective Power God to feel Its Presence -- but for those who believe that the highest state of being will come from human technological reinvention of the elegant symbiosis of Nature...? It seems there can be no peace or truly fulfilling Being at any time, ever. And so, from them...? We get "harm reduction" and MAID
What an absolutely wonderfully written and insightful comment. I agree. God or not, if you think that human life is ultimately meaningless, a result of random chance, it is hard to find real PURPOSE, because there ultimately is none. I think that's why 12-step programs are at their base spiritual. (Interestingly, 12-step roots go back to Carl Jung, who broke from Freud over these deeper issues. Jung thought that spirituality was a basic need for humans, Freud looked at religion as infantile wish-fulfillment.)
Sigh. Yes, I find this constant narrative touting "success" to be very deranging. We see these problems getting worse with our own eyes. And yet Experts™ tell us they are getting better. So frustrating.
I gave up on the medical post a couple of years ago. They were heavily censoring any comments from doctors who said anything against the COVID narrative. At that point I saw they had become yet another Pfizer-sponsored mouthpiece. Viva Substack!!
I’ve been thinking about the same problem, and in fact am working on a Substack post. Don’t worry, my take on it is slightly different, although I suspect we will arrive at the same conclusion, which is that the current received wisdom and approach are obviously not working.
Blimey! You guys are taking on the huge and complex with this series. Working in this field over many years I came to the conclusion that there were many ways to head into addiction. One indeed involves the drinking social life...I speak as someone who ran the medical college student bar, which certainly gave me a reason for getting up in the morning though not necessarily in a great way. As for some of the brewery reps who drank small beers but all day, professionally so to speak, I could tell you stories. Given that we have all met people who just stopped alone, after concluding that they would die if they didn't, not to mention folks who were able to return to at least socially acceptable use with change of life circumstances, and on the other hand people who just refused to consider stopping even in liver failure, are we really dealing with a moral weakness as Dalrymple has suggested, at least in most cases? Of course Mr Harari wants must of us useless to rely on drugs and computer games after the great reset is completed....bread and circuses updated.
Well said. I think it's so hard in a society that is "all-in" on a mechanistic view of humans to even consider that there could be a "moral failing", since there is no such thing as a human spirit, or a deep abiding morality. In post-modern society, morals are just human constructs and thus malleable, and ultimately meaningless.
Reading your work brings forth a lot of memories of working with patients who had alcohol and drug addictions. The first nursing unit I worked on back in the early 80’s was a EENT floor that did a small business as physical detox. I remember one family doctor whom I deeply admired.
He had a protocol for his alcoholics, consisting of IV B vitamins, paraldehyde shots that had to be given using glass syringes and another concoction ( can’t remember what) in decreasing dosages.
His patients always did well, BUT he also came on to the floor and took his patients to a 12 step program three times a week. He was a recovering alcoholic himself.
Yes, I genuinely had tremendous respect for him. It seems to me that when it came to addictions, whether drugs or alcohol, there was the chemical component but also the very real psychological/sicial component, , I believe both needs to be healed to have wholeness.
And then there is the accompanying violence. My neighbour's son disappeared 2 weeks ago with his 2 druggie friends. One friend has already been found dead and her son is still missing. I cross paths with her almost every day. The woman is broken. And this is not in the big city. (Truro, N.S.)...My town has a growing collection of addicts wandering around the town center where I work. Some of them are in a bad way mentally. I watch my back when they are close by.
That is absolutely tragic. And it is sad to watch the progression. Street drug addiction used to be a "Vancouver thing". Then an Edmonton thing. Then a Winnipeg thing. Then a Toronto thing. Then here in NS a Halifax thing. Then a Sydney thing. Now it is trickling down to small towns as they tacitly endorse street drug use and stop enforcing loitering and public intoxication laws. It is a sad trend.
As you know, I work in this area. I cover three clinics in Vancouver and Surrey. Belly of the beast. Some of my patients became addicted from prescribed opiate analgesics, usually for physical injuries - professional sports, workplace accidents, MVAs, etc. These are the minority, however. If there is a common denominator, it is that most become addicted through self-medicating for an undiagnosed or untreated mental health disorder. Social anxiety, ADHD, OCD, generalized anxiety, PTSD. The drug douses that psychological pain and transforms the world into a warm, golden, happy place. Why wouldn't you imbibe in that instance. And keep imbibing until, unfortunately, your find yourself in the trap of opiate addiction. Like the rat park, the solution is to provide that warm, golden, happy place that would obviate the need for drugs. In the meantime, keeping those folks alive by providing reliable prescription drugs vs the dangerous, unpredictable street drugs makes sense. Our chief coroner keeps telling us that those prescription drugs are not causing overdose deaths while the street drugs are. As far as I know there is no evidence to the contrary although there is a lot of wailing and gnashing of teeth in the media claiming that is so. Until we have addressed root causes, offering a safe drug supply makes sense. I can't think of a better interim measure.
Great comment. A few questions and comments:
There are many people who deal with mental health challenges (I don't like the word "disorders" because it suggests that things like anxiety are black-and-white, as opposed to shades of grey) who never resort to using drugs. Why?
Rat park is far from a warm, golden happy place. I think that actually misses the point of it. Rat park has all the difficulties of regular life - squabbles, fights, stress. It's not utopia.
There is data (ie: latest JAMA paper, just as one) showing that availability of "harm reduction" meds actually increased hospitalizations for OD. And BC just set a new record (again) for OD deaths. Why do OD deaths keep increasing over the last number of years? Suboxone was going to fix that problem. Then "safe supply" (more correctly PSAD) was going to fix it. And yet the numbers keep worsening. Other than the word of the chief coroner, why does the actual data keep getting worse? (I am put in mind of Orwell's quote "The first and most important command of The Party was to ignore the evidence of your own eyes and ears")
One of the things that became glaringly apparent to me during COVID was that bureaucrats/"experts", or what Thomas Sowell calls "the anointed" think that we normal people are all stupid and need to be told what is right. Safe Supply is a great example of this. We are told that it is wonderful, and it's working great. Thank goodness for safe supply we are told. And all the while we see our friends and family addicted or dead from OD, tents all over our streets, parks where we used to play with our kids now inaccessible and essentially occupied. Could it be that the average person is more objective and wiser than the chief coroner (and less politically driven)?
If Safe Supply is helping, then why are things worse?
Good points. I'm afraid it doesn't look to me like we as a society are doing too well addressing those root causes. And, in so far as they are related to "the crisis of meaning" issues that Chris suggests, things are about to get a whole lot worse with the mass introduction of AGI in the near future, as I have talked about many times on my Substack. Few people see this coming, unfortunately. They still have their heads buried in the sand on AI - a state of denial. I will continue to write on the subject, because unless we prepare psychosocially for what is about to hit us, we are about to experience suicides on a scale never before seen.
I think the issue is that we (especially in Canada, but worldwide) now look to Big Government for the solution to Everything. The meaning crisis isn't something that can be solved by government fiat or top-down. It comes from individuals and communities, which are now fragmented and dysfunctional. IMO the search for top-down solutions is part of the problem, and actually disempowering.
With much addiction surrounding the people that were in my life and myself as well at one point, I look forward to this series.
Destined to fail? It already has bigly in BC although no one will admit it.
The answer is always "we're just not doing it enough/the right way yet". Kind of like communism.
“Harm reduction” here means clean drugs given freely. The harm they see is the dirty drugs killing addicts not the fact that all drugs kill the addicts over time.
I live in a “harm reduction” building and I can attest that it’s not reducing anything but my expectations of a peaceful life. Active users turned distributors, customers day and night. Fresh rehabs come back to this with no outside support and fall right back into using.
It’s all bullshit from top to bottom.
Wow - that sounds like an important story to tell. I note that harm reduction proponents never suggest building new harm reduction centres in their own nice neighbourhood in the 'burbs, but rather like to crap on other people for NIMBYism.
They’re actually doing just that in Vancouver - and the NIMBYs are going nuts. What used to be a small pocket of “skid row” has infiltrated and, in some cases, taken over previously gentrified communities. Property values, way of life, safety, etc has gone down the toilet.
The point is that their view of “harm reduction” is nowhere near the dictionary definition of either word. Exactly what harm are they trying to reduce? And why?
Right on. Looking forward to the next installment! I have been thinking for a while - and esp since 2020 - that the crisis (war) of our time is actually being waged between we who recognize that to be alive is a mysterious miracle that blends these seen and Unseen, and those who seem doomed by their unrelenting attachment to the belief that life is mechanistic, predictable and absolutely devoid of Consciousness-as-Spirit. One need not call the Unseen Connective Power God to feel Its Presence -- but for those who believe that the highest state of being will come from human technological reinvention of the elegant symbiosis of Nature...? It seems there can be no peace or truly fulfilling Being at any time, ever. And so, from them...? We get "harm reduction" and MAID
What an absolutely wonderfully written and insightful comment. I agree. God or not, if you think that human life is ultimately meaningless, a result of random chance, it is hard to find real PURPOSE, because there ultimately is none. I think that's why 12-step programs are at their base spiritual. (Interestingly, 12-step roots go back to Carl Jung, who broke from Freud over these deeper issues. Jung thought that spirituality was a basic need for humans, Freud looked at religion as infantile wish-fulfillment.)
Absolutely brilliant piece, Chris. Thank you.
Excellent piece. We need to give everyone a reason to get up and have a goal to achieve every day..
Like a job!!!
Just this morning I read an article in the Medical Post about the "success" of the BC Safer Supply Program. Since it was introduced, overdose deaths have increased, not decreased! Yes, they claim the program is a success even though the death rate continues to rise. This is mind boggling! https://www.canadianhealthcarenetwork.ca/health-officer-advises-bc-offer-smokable-fentanyl-report-backing-safer-supply?utm_source=swiftmail&utm_medium=email&utm_campaign=CHN_NL_Physician_DoctorDaily&mkt_tok=ODI1LUxTUC01NDUAAAGRDWKhsENnB48a2-FTbScNQ-Ed51uOQ12D6jkerN04cjgmmdaPdspSi8p2WTlVa_Fbklg2UJ-gyGi-md4HkSyXcc_MRUqG_uA2h0ETqJXSYdjk
Sigh. Yes, I find this constant narrative touting "success" to be very deranging. We see these problems getting worse with our own eyes. And yet Experts™ tell us they are getting better. So frustrating.
I gave up on the medical post a couple of years ago. They were heavily censoring any comments from doctors who said anything against the COVID narrative. At that point I saw they had become yet another Pfizer-sponsored mouthpiece. Viva Substack!!
I’ve been thinking about the same problem, and in fact am working on a Substack post. Don’t worry, my take on it is slightly different, although I suspect we will arrive at the same conclusion, which is that the current received wisdom and approach are obviously not working.
Please share with me when you're done.
Blimey! You guys are taking on the huge and complex with this series. Working in this field over many years I came to the conclusion that there were many ways to head into addiction. One indeed involves the drinking social life...I speak as someone who ran the medical college student bar, which certainly gave me a reason for getting up in the morning though not necessarily in a great way. As for some of the brewery reps who drank small beers but all day, professionally so to speak, I could tell you stories. Given that we have all met people who just stopped alone, after concluding that they would die if they didn't, not to mention folks who were able to return to at least socially acceptable use with change of life circumstances, and on the other hand people who just refused to consider stopping even in liver failure, are we really dealing with a moral weakness as Dalrymple has suggested, at least in most cases? Of course Mr Harari wants must of us useless to rely on drugs and computer games after the great reset is completed....bread and circuses updated.
Well said. I think it's so hard in a society that is "all-in" on a mechanistic view of humans to even consider that there could be a "moral failing", since there is no such thing as a human spirit, or a deep abiding morality. In post-modern society, morals are just human constructs and thus malleable, and ultimately meaningless.
Up with Dalrymple!
Reading your work brings forth a lot of memories of working with patients who had alcohol and drug addictions. The first nursing unit I worked on back in the early 80’s was a EENT floor that did a small business as physical detox. I remember one family doctor whom I deeply admired.
He had a protocol for his alcoholics, consisting of IV B vitamins, paraldehyde shots that had to be given using glass syringes and another concoction ( can’t remember what) in decreasing dosages.
His patients always did well, BUT he also came on to the floor and took his patients to a 12 step program three times a week. He was a recovering alcoholic himself.
What an important story. So interesting that he was a recovering alcoholic, so saw the value of a 12-step program himself.
Yes, I genuinely had tremendous respect for him. It seems to me that when it came to addictions, whether drugs or alcohol, there was the chemical component but also the very real psychological/sicial component, , I believe both needs to be healed to have wholeness.
Brilliant, Chris, as always! Can't wait to see the next piece! Take care!
Good work, as usual. Many thanks.
And then there is the accompanying violence. My neighbour's son disappeared 2 weeks ago with his 2 druggie friends. One friend has already been found dead and her son is still missing. I cross paths with her almost every day. The woman is broken. And this is not in the big city. (Truro, N.S.)...My town has a growing collection of addicts wandering around the town center where I work. Some of them are in a bad way mentally. I watch my back when they are close by.
That is absolutely tragic. And it is sad to watch the progression. Street drug addiction used to be a "Vancouver thing". Then an Edmonton thing. Then a Winnipeg thing. Then a Toronto thing. Then here in NS a Halifax thing. Then a Sydney thing. Now it is trickling down to small towns as they tacitly endorse street drug use and stop enforcing loitering and public intoxication laws. It is a sad trend.