Category Archives: Vancouver

2015 stats for marijuana offences show police tactics changed before Vancouver’s dispensary boom

One of Vancouver's largest dispensary operators, Don Briere of Weeds Glass and Gifts, has said he welcomes the city's proposed regulations and hopes they will help bring the industry into the light. Travis Lupick photo.
One of Vancouver’s largest dispensary operators, Don Briere of Weeds Glass and Gifts, has said he welcomes the city’s proposed regulations and hopes they will help bring the industry into the light. Travis Lupick photo.

Over the last several years, the number of medicinal marijuana dispensaries operating in Vancouver has ballooned, from fewer than 20 in 2012 to more than 100 today.

That might have people wondering how police enforcement of marijuana laws has changed during that time, especially since the City of Vancouver lent a great deal of legitimacy to dispensaries when it proposed a legal framework for marijuana sales last April.

As the VPD turned a blind eye to over-the-counter marijuana sales, one might expect the department’s overall numbers for cannabis offences experienced a sharp decline.

But it turns out VPD enforcement numbers have barely changed at all.

During the first six months of 2015, the VPD registered 473 cannabis offences. Multiply that number by two and one can very roughly project 946 for the year.

That compares to 1,048 marijuana offences in 2013 and 864 in 2012.

This means the VPD is on track to record a very average number of marijuana offences this year, despite the proliferation of dispensaries likely giving many people the perception Vancouver police tactics have shifted.

(Numbers for 2015 were obtained via a freedom of information request. The Straightrequested statistics for 2014, but the VPD withheld that data citing a section of the Freedom of Information and Privacy Protection Act that allows a public body to refuse disclosure of information previously scheduled for release within 60 days.)

In a telephone interview, the Straight asked Sgt. Const. Brian Montague why it looks like the VPD is continuing to bust people for marijuana while letting dispensaries go about their business.

“The numbers might seem a little misleading until you explain the fact these aren’t arrests, they are not charges; they are criminal offences,” he said. “In the vast majority of cases where we come across cannabis, there isn’t a charge for cannabis recommended.”

When an officer does catch somebody smoking a joint, Montague said the most likely outcome would be for them to destroy the drugs but otherwise let that citizen go about their day. The encounter still goes into a police database as a marijuana offence (along with the offender’s name and related information) but that’s usually where the matter ends.

Montague explained what statistics for 2015 and recent years actually show is that the VPD changed its enforcement strategies on marijuana long before the dispensaries started showing up at the rate they are today.

“We ask, is a recommendation of criminal charges proportionate to the offence that is being committed?” he continued. “And a lot of times, the answer to that is no.”

On September 17, the Vancouver police board formally received a complaint regarding the department’s alleged failure to enforce drug laws against storefronts selling marijuana.

Ahead of that meeting, the VPD prepared a written response to those allegations.

“In the case of dispensaries, the VPD must consider evolving community standards,” it reads. “The City’s decision to create a regulatory framework rather than using its bylaws to shut down dispensaries; the prioritization of police resources when weighed against other more serious drug offences occurring in Vancouver, and the costs and benefits of taking enforcement action against marihuana dispensaries. As a result, the Chief Constable has decided that such actions will only be taken when there are overt public safety concerns present.”

It’s noted there that since 2013, the VPD has executed 11 search warrants against dispensaries when complaints against those locations were filed and found to have merit.

The police board dismissed the September 17 complaint.

After reviewing the data for 2015, Kirk Tousaw, a B.C. lawyer who specializes in drug law, similarly said it’s his experience that in Vancouver, very few of those offences proceed to see people charged with a crime.

“It is a maintenance of the status quo,” he said. “Enforcement of simple [marijuana] possession does not appear to be a high priority.”

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This article was originally published online at Straight.com on October 1, 2015.

From activists to CEOs, here are 14 women who run Vancouver’s booming marijuana industry

Village Dispensary owner Andrea Dobbs is part of a wave of women at the forefront of Vancouver-based cannabis businesses. Travis Lupick photo.
Village Dispensary owner Andrea Dobbs is part of a wave of women at the forefront of Vancouver-based cannabis businesses. Travis Lupick photo.

One of the first lessons a marijuana enthusiast learns is to purge a grow operation of males. Only the females of the cannabis plant—identifiable by pistillate flowers, in contrast to a male’s staminate flowers—produce the cannabinoid chemicals sought for their psychoactive effects. So gardeners pull the male plants out by their roots and discard them as useless.

On the human side, nobody is actively purging Vancouver’s burgeoning marijuana industry of men, but many facets of the business are similarly dominated by women.

“Here in Vancouver, women have been at the forefront of this industry from the very beginning,” said Jamie Shaw, president of the Canadian Association of Medical Cannabis Dispensaries (CAMCD).

She recalled that one of North America’s first marijuana storefronts, the nonprofit B.C. Compassion Club Society, was founded in 1997 with feminist ideals at its core.

“In our early days, 70 percent of the Canadian workforce was male, so we made it policy that 70 percent of our staff had to be female,” Shaw told the Georgia Straight. “And we still have that policy.”

Hilary Black, who cofounded the Compassion Club alongside Shaw, recalls that things happened a little more organically.

“I was 20 years old,” Black recounted. “We were all in our mid- to young 20s. It was just a group of women who were willing to engage in civil disobedience and provide services for marginalized and chronically ill people.”

Regardless of how conscious the group was of its feminist bent back then, Black said the tradition is something worth keeping alive today.

“Women were the roots and the pioneers of medical cannabis in this country,” she emphasized. “And I think it is really important that we continue to see them having a leading voice and influence as the movement moves into an industry.”

Almost 20 years after the Compassion Club opened its doors on Commercial Drive, there are plenty of Vancouver women following in its footsteps. Shaw pointed to Dori Dempster of the Medicinal Cannabis Dispensary, the Village Dispensary’s Andrea Dobbs, and Jessika Villano of Buddha Barn Medicinal Cannabis. Women are also behind some of the city’s most popular oils and edibles, Shaw continued—Brina Levittof Green Penguin Delights, for example, and Apothecary Labs’ Gabriele Jerousek. Another is Mary Jean Dunsdon, better known as Watermelon, whose online cooking show has earned her an international following. (Dunsdon also appeared on the cover of the Straight back in 2008.)

It’s not just in the dispensary industry that women are running the show.

UBC’s Rielle Capler has focused on marijuana and patient care as a research area for more than a decade. Before that, she was another woman involved early with the Compassion Club. More recently, Capler has become a big contributor to evolving legal frameworks, having helped draft the standards and certification program for dispensaries that the City of Vancouver adopted last June.

On the research front, Capler called attention to a cannabis study that was published in the journal Drug and Alcohol Review on September 14. Bucking the academic trend of papers often being dominated by men’s names at the top, that study was coauthored by eight B.C. researchers, including Capler, plus Kim Crosby, Lynne Belle-Isle, andSusan Holtzman.

“To do the dispensaries, that was civil disobedience,” she said. “And research was an area that needed pioneering as well because it is still a taboo topic.”

Of course, the Canadian cannabis movement’s most visible face is also a woman’s.

Jodie Emery has carried the crown since her husband, Marc, began a five-year prison sentence in 2010. He was released in August 2014 but has appeared content to see Jodie remain the lead spokesperson for the push to reform marijuana laws.

In a telephone interview, Jodie Emery speculated that one of the reasons women have risen to the top of marijuana reform is that pot—or at least its more legitimate areas—is a relatively new industry that’s going mainstream after efforts began to force old-boys’ networks and institutional sexism out of the workplace.

“Because the legal or semilegal marijuana industry is new, there are positions available for women that men may have otherwise filled before,” she said. “Women have had an equal opportunity to be involved.”

That doesn’t mean there isn’t room for improvement, she added. For example, Emery agreed that her husband’s name often still comes first in media reports on the reform movement, despite Marc taking a back seat for some time.

“Something that women have always dealt with is being somebody based on their husband being somebody,” she said. “I struggle with it.…But I’ve never encountered anyone belittling a female [marijuana] activist.”

At the Village Dispensary in False Creek, Dobbs similarly told the Straight that the marijuana industry is better to women than most but is still far from perfect.

“You get a lot of people calling you ‘darling’; you get a lot of references to ‘the kind of girl that smokes weed’,” she said. “Or, ‘She’s pretty for a girl that smokes weed.’ So there is a lot of that kind of stuff.”

Dobbs also noted that as Canada inches closer to legalizing recreational marijuana, she has started to see the industry adopt chauvinistic advertising strategies, like those on display in beer commercials.

“You see a lot of young, hypersexualized girls handing out leaflets and flyers feeling kind of excited to be part of it but not recognizing that they are not being taken seriously,” she explained.

Working to counter that sort of sexism is Women Grow, a professional association with groups in more than 40 cities across North America.

The Vancouver chapter was founded by Shaw and Shega A’Mula, CAMCD chief operating officer and a relatively new face in B.C.’s marijuana movement.

In a telephone interview, A’Mula gave credit to the women who blazed a trail for her and said she hopes Women Grow can help do the same for the next generation. She invited anybody interested to the group’s next meeting, a networking event scheduled for this Thursday (October 1).

“It’s a really empowering environment,” A’Mula said. “It’s not all big business, like other cannabis events.…It’s a way to have fun, connect, and have conversations you probably can’t have elsewhere.”

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This article was originally published in print and online at Straight.com on September 30, 2015.

Chris Hedges to tell Vancouver the world needs rebels to lead a revolution

Pulitzer Prize winning author Chris Hedges is scheduled to speak on state decay and revolution at a September 25 event in Vancouver.
Pulitzer Prize winning author Chris Hedges is scheduled to speak on state decay and revolution at a September 25 event in Vancouver.

Chris Hedges sees revolution on the horizon.

It’s a phenomenon he’s witnessed before. Hedges draws on decades of experience reporting from revolts and counter-insurgencies around the world. He’s covered the dissolution of the Soviet Union in Czechoslovakia and Romania, met with guerilla leaders amid conflicts in Central American, and reported from Yugoslavia as the country fell into civil war and acts of genocide.

“The veneer of power appears untouched before a revolution, but the internal rot, unseen by the outside world, steadily hollows out the edifice state,” Hedges writes in his latest book, Wages of Rebellion. “And when dying regimes collapse, they do so with dizzying speed.”

The world is once again characterized by “popular uprisings exploding in waves”, he continues.

“The promised prosperity that was to have raised the living standards of workers through trickle-down economics has been exposed as a lie,” Hedges writes. “A tiny global oligarchy has amassed obscene wealth, while the engine of unfettered corporate capitalism plunders resources; exploits cheap, unorganized labour; and creates pliable, corrupt governments that abandon the common good to serve corporate profit. The relentless drive by the fossil fuel industry for profits is destroying the ecosystem, threatening the viability of the human species. And no mechanism to institute genuine reform or halt the corporate assault are left within the structures of power, which have surrendered to corporate control. The citizen has become irrelevant.”

On Friday, September 25, the American journalist and Pulitzer Prize winning author is scheduled to opine on those ideas in Vancouver at St. Andrew’s Wesley United Church at Nelson and Burrard.

Ahead of that engagement, Hedges spoke with the Georgia Straight. The transcript of that conversation that follows has been lightly edited for length.

Georgia Straight: “Can you give us a short preview of your upcoming talk in Vancouver?”

Chris Hedges: “The system of corporate capitalism, or what political philosopher Sheldon Wolin called inverted totalitarianism, is not only not sustainable, but it is unravelling. We can’t continue this kind of assault on the climate, we can’t continue these kinds of wars, we can’t continue the reconfiguration of the global economy into a global neo-feudalism, where money is concentrated into the hands of an all-powerful, tiny, oligarchic elite at the expense of everyone else. We are already seeing the signs of disintegration. You look at the political farce that is happening in the United States because the system has been seized by corporate oligarchs and no-longer responds to the grievances, needs, justices, or rights of the citizenry. You see it in the refugee crisis that is besetting Europe, you see it in the wildfires that are sweeping across California. We better wake up and we better respond quickly, or we’re headed for massive societal breakdown. It is already beginning.”

GS: “Getting to your latest book, Wages of Rebellion: You use the word ‘rebel’ with a positive connotation. Let’s begin there: What is a rebel and why is that what’s needed?”

CH: “A rebel is somebody who rises up against the established order and is willing to carry out acts of self-sacrifice in order to defy that order. It is rebels that have always moved history forward. Rebels very rarely succeed. Most of them are wiped out. I mean, that is just a historical fact. But our passive acquiescence to this system, at this point, makes us complicit in our own self-annihilation. So it is to the rebels that we have to listen.”

GS: “When you look around today, who do you see who fits that description?”

CH: “There are lots of them. [Edward] Snowden, [Julian] Assange. They’re there. [Noam] Chomsky, [Ralph] Nader.”

GS: “Early in this conversation, I wanted to raise the issue of Canada’s upcoming election happening this October. Are you watching or thinking about Canada’s election?”

CH: “I’m aware of it. You are able to mount a third party in the NDP in a way that we [the United States] are not. I mean, the game is fixed here.”

GS: “What differences do you see between the two systems? Are the differences as strong as they used to be?”

CH: “There is quite a bit of difference. There is more room within the national discourse for more radical critiques in Canada. Canada is not, like the United States, an inherently violent culture. You are not an imperial power; we, across the border, are infected with that imperial hubris, that belief that we have the right to use our military to impose our ‘virtues’ on the rest of the world. And your political system is not as corrupted as ours. So there is more space for dissent within the system. Now, I don’t know to what extent, if the NDP takes power, it can actually confront these corporate forces embodied in TransCanada and everything else. That I don’t know. I just don’t spend enough time in Canada to know the answers to those questions.”

GS: “Speaking more generally now, how would you describe your faith in electoral politics?”

CH: “I don’t have any faith in electoral politics. We have to begin to build mass movements that take power back. I spend a lot of time in the book, Death of the Liberal Class, chronicling how all the mechanisms by which citizens once were able to defend their interests have been taken from them. So I don’t waste much time on electoral politics.”

GS: “Electoral politics is obviously failing to solve very big and complex problems like inequality and climate change. After so many years, what can be done?”

CH: “I think what people are doing: organizing at a local level to stop fracking, getting arrested at military bases that operate drones, severing ourselves as much as possible from the tentacles of consumer society – that’s what local food production and sustainable agriculture is about. There is a myriad of ways in which we can fight back, and on all of those fronts, that is what offers us hope. But believing that the NDP or Bernie Sanders is going to come in alone and change anything of any substance is very naïve.”

GS: “Towards the end of Wages of Rebellion, you present the story of an Albertan man named Wiebo Ludwig. Some people would call that example radical or an extremist. Is that what’s needed and where we’re at?”

CH: “He was an extremist and he was a radical.”

GS: “And is that what is needed?”

CH: “Yes. Wiebo Ludwig found out that it didn’t matter how many letters he sent. They were going to take that sour gas out of the land and he was right.”

GS: “Can you talk about online activism? Where does it fit into all this? And young voters and the need to overcome apathy?”

CH: “The young generation kind of gets it. Obviously, you have that segment that is staring with their mouths open at their electronic hallucinations, which is just what the corporate state wants. But you look in the United States at groups like Black Lives Matter, or at Idle No More or the Quebec student movement, and you have pretty sophisticated movements among young people who have figured out the political system. Even the protests at the G20. Occupy was a youth-driven movement, the Quebec student movement was a youth-driven movement, Black Lives Matter is a youth-driven movement. And I’ve met all of these leaders and I am a lot more impressed with them than I am with people my own age.”

GS: “I’m surprised we were able to end on an optimistic note.”

CH: “I’m not very optimistic. Things are pretty grim. And that is part of the existential crisis of our time. We do have to grasp the reality that we face and yet resist anyway. But I certainly find a lot more hope in the young, in this generation – which is not being fooled by Obama – than I do anywhere else. I certainly don’t find it among the old, established left, which has kind of just sold out to the Democratic Party of the United States. The political consciousness in the groups that I just mentioned, I think, is quite high.”

Chris Hedges is scheduled to speak in Vancouver at St. Andrew’s Wesley United Church at 7 p.m. on Friday, September 25.

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The article was originally published at Straight.com on September 20, 2015.

Ottawa threatens to bypass VPD and send in RCMP to bust Vancouver marijuana dispensaries

Don Briere of Weeds Glass and Gifts is just one of dozens of Vancouver marijuana dispensary operators whose businesses could be at risk if Ottawa makes good on a threat to shut them down using the RCMP. Travis Lupick photo.
Don Briere of Weeds Glass and Gifts is just one of dozens of Vancouver marijuana dispensary operators whose businesses could be at risk if Ottawa makes good on a threat to shut them down using the RCMP. Travis Lupick photo.

The Vancouver Police Department is playing it cool in response to the suggestion the RCMP could be on its way into the City of Vancouver to shut down marijuana dispensaries.

“We have a great working relationship with the RCMP,” VPD Const. Brian Montague told the Straight. “I’ll let them [RCMP] respond to any insinuation that they are going to come into Vancouver.”

The spokesperson for the force made those remarks in response to the distribution of letters sent from Health Canada to a number of Vancouver marijuana dispensaries. In those documents, Ottawa threatens to send RCMP officers into the City of Vancouver.

“If the [named dispensary redacted] does not immediately cease all activities with controlled substances, we will contact, within 30 days of the date of this letter, the Royal Canadian Mounted Police for enforcement action as they deem necessary,” reads a copy of the letter posted online at LiftCannabis.ca.

“The Controlled Drugs and Substances Act (CDSA) prohibits any person from engaging in activities such as production, provision, sale (including offering for sale, import, export, transport, delivering of controlled substances unless authorized under its Regulations),” it continues.

The letters do not include an individual’s signature but are marked “Office of Medical Cannabis” and “Health Canada”.

In an email to the Straight, Health Canada spokesperson Patrick Gaebel subsequently confirmed the letters’ authenticity.

“On September 9, 2015, the Department (Office of Medical Cannabis) sent 13 letters to organizations who were found to be illegally advertising the sale of marijuana. The letters require that all advertising activities with marijuana cease,” Gaebel wrote. “Health Canada will attempt to work cooperatively with all parties involved to encourage compliance. If continued non-compliance is identified, the Department may refer the case to law enforcement agencies for appropriate action.”

If RCMP officers did cross into Vancouver and began to shut down marijuana storefronts, that would be a de facto overruling of both the City of Vancouver and the VPD. Those bodies have at least tacitly worked together on a hands-off approach while stating publicly that the illegal dispensaries are simply not a policing priority.

On the prospect of the RCMP conducting policing activities within the City of Vancouver and without the VPD’s cooperation, Montague declined to comment further and directed questions to the RCMP.

Speaking more generally, Montague said the nature of the Lower Mainland means the VPD and RCMP work together on a routine basis and regularly coordinate regional policing efforts.

“The Vancouver police will go into RCMP jurisdiction cities like Surrey, Coquitlam, and Richmond, to investigate crimes that originated in Vancouver,” he explained. “Of course criminals don’t look at city borders so there are often cases that take us beyond the City of Vancouver as well as cases the RCMP would have that would take them into our jurisdiction.”

The RCMP refused to grant an interview.

In June 2015, the City of Vancouver responded to a proliferation of marijuana storefronts by adopting a legal framework and regulations that Mayor Gregor Robertson has said will bring order to an illegal industry that the federal Conservative government has ignored.

Today (September 10) Robertson responded to the alleged Health Canada letter by calling it “curious”.

According to the Globe and Mail’s Andrea Woo, Robertson added he is hopeful the federal government “actually does something meaningful here — has some modern policy toward marijuana”.

It’s estimated there are more than 90 cannabis shops operating within Vancouver city limits.

In April 2015, Canadian Health Minister Rona Ambrose and Public Safety MinisterSteven Blaney co-signed a letter sent to Robertson and the VPD wherein they expressed Ottawa’s disapproval of Vancouver’s plan to regulate those dispensaries.

“Storefront sales of marijuana are illegal and under our government, will remain illegal,” it reads. “Like the vast majority of Canadians, the Government expects that police will enforce the laws of Canada as written.”

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The article was originally published online at Straight.com on September 10, 2015.

Downtown Eastside hotel tenants dying at a rate eight times Canada’s average, UBC study finds

Despite sometimes-shoddy conditions, residents of Downtown Eastside hotels have protested the gentrification of their neighbourhood and called for the city to protect that kind of affordable housing stock. Travis Lupick photo.
Despite sometimes-shoddy conditions, residents of Downtown Eastside hotels have protested the gentrification of their neighbourhood and called for the city to protect that kind of affordable housing stock. Travis Lupick photo.

Downtown Eastside residents living in the city’s derelict hotels are dying at a rate more than eight times the national average, a UBC study has found. The risk is especially great for people living with a mental illness, even when that group is compared to people similarly living in poverty.

“The probability that an individual with psychosis would survive to age 50 is 68% compared with 94% for those without the diagnosis among marginally housed individuals,” reads an August 2015 paper published in the British Medical Journal Open. “Individuals with psychosis may face a greater than eightfold increase in mortality risk compared with those without psychosis.”

While those grim statistics may not come as a shock to those familiar with the impoverished neighbourhood, what’s causing many of these early deaths did surprise researchers.

The paper presents findings based on a sample of 290 men and 81 women who were recruited through Downtown Eastside single-room occupancy hotels (SROs) and Vancouver’s Downtown Community Court. The group was monitored from November 2008 to August 2012 and, during that time, 31 participants died. That’s a rate of eight times the national average. And for those aged 20 to 59, the mortality rate was 10 times the Canadian average.

Contrary to popular assumptions, researchers “did not find any link with HIV or substance addiction”, a UBC media release states. In cases where participants passed away, psychosis and hepatitis C-related liver dysfunction was “significantly associated with increased mortality”.

For younger participants under the age of 59, the situation is even worse. For that group of Downtown Eastside residents, the mortality rate was found to be 10 times Canada’s average.

“We were somewhat surprised because most people thinking about the Downtown Eastside think about HIV/AIDS or the possibility of overdosing on opioids like heroin,” said William Honer, one of the study’s co-authors and head of UBC’s department of psychiatry, quoted in the release. “Our system is not doing as well in getting treatments out there for psychosis and hepatitis C in this group, and it’s interesting that those two illnesses are causing risk for early mortality.”

It was discovered only one-third of the 173 participants diagnosed with psychosis were receiving treatment for that mental-health condition. And for the 57 people with an active hepatitis C infection and related liver dysfunction, not one of them was receiving treatment for that illness.

“Psychosis is an extremely prevalent issue among inner city populations and we need to address this,” said Andrea Jones, another of the study’s authors and an MD/PhD candidate in mental health and addictions research at UBC, quoted in the release. “We need to be ready to detect and treat mental illness in an integrated way that really meets the patients where they’re at. We need to improve the detection and treatment of psychosis and hepatitis C in marginalized people across Canada.”

The study was funded by the Canadian Institutes of Health Research and by B.C. Mental Health and Substance Use Services.

It states there are some 3,800 people living in SROs in the Downtown Eastside.

There are an estimated 2,000 “severely ill” SRO tenants not receiving the care they require for mental-health and addiction challenges, according to a September 2014 report of the Mayor’s Task Force on Mental Health and Addictions.

Vancouver Coastal Health (VCH) is the regional authority the province tasks with delivering the bulk of health-care services provided to the Downtown Eastside. It spends roughly $55 million a year in the neighbourhood. A February 2015 policy paper lays out strategies and specific recommendations for a “second generation” of health-care designed for the Downtown Eastside. It acknowledges that VCH has largely failed to keep pace with changing needs, and promises the health authority will adapt and improve.

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The article was originally published in print and online at Straight.com on September 10, 2015.

SFU study finds illegal drug-injection sites are saving Vancouver taxpayers money

SFU researcher Ehsan Jozaghi looked at the numbers and found that unsanctioned supervised-injection facilities that run similar to Insite can save lives and save the city money.
SFU researcher Ehsan Jozaghi looked at the numbers and found that unsanctioned supervised-injection facilities that run similar to Insite can save lives and save the city money.

It has long been an open secret in certain health-care circles that the Vancouver Area Network of Drug Users (VANDU) will, from time to time, operate an unsanctioned drug-consumption site.

Unlike Insite, North America’s only government-approved supervised-injection facility (SIF), the VANDU sites run illegally. Usually occupying a spare room somewhere in the Downtown Eastside, these locations serve as relatively safe places for crack cocaine and heroin users to access clean equipment and consume drugs. They will sometimes remain open for months before shutting down.

Now an August 2015 paper authored by SFU researcher Ehsan Jozaghi has examined one such site and found that the illegal operations have been a good deal for Vancouver taxpayers.

“VANDU’s unsanctioned SIF establishment in the DTES saves taxpayers’ money,” reads the paper published in the academic journal Health & Justice. It explains that significant cost savings occur because consumption sites lower the transmission rates of diseases such as HIV and hepatitis C, thus saving health-care expenditures on treatment. For example, researchers estimated that one additional SIF site can run on $97,203 per year to avert 30 new HIV cases and 81 new incidents of hepatitis C.

The paper notes that Insite is operating at its maximum capacity and that efforts to establish additional SIFs have long stalled in Ottawa on account of opposition from the federal Conservative government.

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This article was originally published in print and online at Straight.com on September 9, 2015.

Vancouver hospitals predict 2015 will see emergency mental-health visits surpass 10,000

St. Paul’s has gained only nine new long-term mental-health care beds since the City of Vancouver made a call for 300. Charlie Smith photo.
St. Paul’s has gained only nine new long-term mental-health care beds since the City of Vancouver made a call for 300. Charlie Smith photo.

Vancouver is experiencing a crisis in mental-health care that continues unchecked. That’s the conclusion Vision Vancouver councillor Kerry Jang draws from data covering 2009 to the end of June 2015, which show emergency mental-health and substance-misuse hospital visits have increased every year and are on track to hit a record high come December.

“We clearly need more long-term mental-health care,” Jang said in a phone interview. “We know that there are so many people in the Downtown Eastside who don’t see or have any contact with mental-health professionals at all. So the emergency ward is very much becoming primary care. That is something that has to change.”

Jang was responding to information provided at the Straight’s request by Providence Health Care, which operates St. Paul’s Hospital, and Vancouver Coastal Health, which runs Vancouver General Hospital. The statistics show that during the first six months of this year, the two hospitals together saw 5,110 people experiencing a mental-health crisis admitted and 3,703 visits for substance-misuse problems such as a drug overdose. The comparable numbers for 2014 are 4,895 mental-health emergencies and 2,830 cases of substance-misuse issues.

By the end of 2015, these numbers are projected to surpass 10,220 mental-health emergencies and 6,146 substance-misuse incidents. Taken together, that translates to an increase of 76 percent compared to 2009.

Over the last five years, the Vancouver Police Department has observed a similar rise in the number of apprehensions its officers make under the B.C. Mental Health Act. In 2014, officers detained 3,010 people under Section 28 of the act, which allows police to take into custody an individual deemed mentally unfit and a threat to themselves or others. That’s up from 2,278 in 2009. During the first six months of 2015, the VPD made 1,510 Section 28 apprehensions.

Jang, who sits on the Mayor’s Task Force on Mental Health and Addictions, said what’s needed to reverse these trends is greater involvement by the province. He reiterated a call for more long-term-care beds that Mayor Gregor Robertson has made repeatedly since declaring a “mental-health crisis” in September 2013.

The B.C. Ministry of Health declined to make a representative available for an interview.

In recent years, the province has allocated money for mental-health-care infrastructure. For example, in January 2015, it announced that an addition to VGH will open in 2017 as the largest facility for mental-health and addiction services in British Columbia. However, the city has said what’s required to address the problem in Vancouver is 300 “long-term and secure mental health treatment beds” and, in September 2014, warned that the province was falling short of that number by 250. (The province has made small numbers of new beds available—nine at St. Paul’s Hospital, for example, and 14 on the Riverview grounds in Coquitlam. But the majority of funding is going to replacing outdated facilities.)

Mark Levy is the medical manager of the VGH psychiatric-assessment unit. He told theStraight the statistics match what he’s observed on the ground.

“It does put a strain on resources,” Levy said in a phone interview. “There really hasn’t been an increase in in-patient beds to any significant degree. We do run into situations where we are in a crisis mode and we have to accommodate patients that are in the emergency room.”

Levy emphasized the numbers make clear there is a problem. But he also said they include good news, explaining that they’re at least partly the result of changing attitudes and a shift away from the justice system in favour of health care.

“People who might have been taken to cells in the past are seen by an arresting officer as suffering from a mental-health issue,” Levy said. “Now, rather than charge them—as long as it’s not a serious offence—they will bring them to hospital.”

He suggested the next step should be making more mental-health care available in communities where people live, so they receive treatment before their mental health declines to a point where they end up in an emergency room.

“These are chronic problems,” Levy said. “Are people best treated in a hospital or should we try to do whatever we can to help them deal with their problems while they are residing in the community?”

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This article was originally published in print and online at Straight.com on August 19, 2015.

Red tape blocks B.C. health officials’ proposals for dealing with fentanyl overdoses

Naloxone kits that are used to reverse the effects of an opioid overdose area vailable at 88 health-care sites around B.C. Toward the Heart photo.
Naloxone kits that are used to reverse the effects of an opioid overdose area vailable at 88 health-care sites around B.C. Toward the Heart photo.

Provincial health officials are discussing a variety of interventions that could be deployed in response to a recent surge in overdoses linked to the synthetic opioid fentanyl. However, several of those ideas remain blocked by legal or bureaucratic challenges.

During an August 11 conference call, Jane Buxton, harm-reduction lead for the B.C. Centre for Disease Control, said one suggestion is to open drug “checking” sites where people could bring illicit narcotics to be analyzed without fear of police persecution.

“The possibility of testing street drugs, that is something that would be of value,” Buxton said. “Currently, there is no way to do that in the legal framework that we have and there is no test available.” (A test for fentanyl does exist but it requires specialized equipment and a trained technician.)

On August 5, the Straight reported that the Vancouver Police Department would not oppose such drug-testing.

Joining Buxton on the call was deputy provincial health officer Bonnie Henry. She said she would like naloxone, a drug used to counter opioid overdoses, made available without a prescription in B.C. That decision has to be made by Health Canada, she noted, and though it is being discussed, it is unlikely to come soon.

Although ambulances in B.C. are equipped with naloxone kits, police and RCMP officers still respond to calls without them, Henry added. In a subsequent telephone interview, she explained that there is concern about officers carrying needles and the risks those can pose. In the United States, some police departments equip their officers with an intranasal form of naloxone, but that has not been approved in Canada.

Buxton said she would also like to see an expansion of harm-reduction services in B.C. But again, she noted, there are barriers such as opposition from the federal Conservative government.

Buxton maintained the province is advancing these ideas, especially in the case of naloxone. But she conceded that it is “frustrating”.

According to an August 11 warning issued by the B.C. Coroners’ Service, so far in 2015 it has detected fentanyl in 66 overdose deaths. That’s up from 13 in 2012 and on track to surpass the 90 seen in 2013.

This article originally appeared in print and online at Straight.com on August 12, 2015.

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Vancouver prescription heroin program hits a snag that interrupts treatment for some patients

The supervised injection room at Providence Crosstown Clinic, where patients are given prescribed heroin as a means of managing their addictions. Travis Lupick photo.
The supervised injection room at Providence Crosstown Clinic, where patients are given prescribed heroin as a means of managing their addictions. Travis Lupick photo.

Perhaps to no one’s surprise, it turns out that supplying heroin to people without breaking the law is not an easy or a simple thing to do.

Since November 2014, a program run out of a clinic in Vancouver’s Downtown Eastside has done just that—that is, giving chronic addicts free prescription heroin, otherwise known as diacetylmorphine. But there was recently a hitch in the supply chain, which effectively put the harm-reduction initiative called heroin maintenance on hold.

David Lefebvre, a spokesperson for its operator, Providence Health Care, told the Straight that “due to a permit issue”, doctors at Crosstown Clinic had to transition patients to another drug called hydromorphone, a synthetic derivative of morphine. He noted that for some addicts, the change has been a struggle.

“This is the first time in North America that any clinic has provided diacetylmorphine to people who have chronic heroin addictions and that is a process that is extremely complex,” he said in a telephone interview.

Lefebvre explained that Crosstown was forced to begin transitioning patients roughly two weeks ago and hopes to have a majority of those people back on diacetylmorphine when a shipment of the drug arrives from a supplier in Europe “sometime in mid-September”.

“The reality is, the movement of diacetylmorphine is governed internationally, so it is so much more complex than people realize,” he explained. “It is not just a national issue with Health Canada, it is not just a national issue with the Office of Controlled Substances. It is also an international issue.”

Lefebvre said where exactly in the supply chain this problem occurred is in transit at a point across the Atlantic Ocean.

“The permit system in Europe takes six to eight weeks for drugs to be exported to Canada,” he said. “That results in delays that affect our ability to provide diacetylmorphine to our patients. Due to this time lag, Crosstown has had to transition some patients onto hydromorphone.”

Lefebvre cautioned that even after Providence receives its next shipment of diacetylmorphine in mid-September, the same problem could occur again.

“We are expecting continued issues with regard to supply due to this importation time lag,” he conceded.

Lefebvre acknowledged that for many long-term addicts, the transition off of heroin, even to another opiate such as hydromorphone, is not a painless experience. “We appreciate that this is challenging for them,” he said.

In past interviews, Lefebvre stressed that heroin-assisted treatment is only recommended as an appropriate intervention for individuals who have repeatedly failed with traditional therapies such as methadone.

In accordance with a B.C. Supreme Court injunction granted in May 2014, to be eligible to receive prescription heroin, a patient must have participated in the Study to Assess Longer-term Opioid Medication Effectiveness (SALOME), an academic program that began at Crosstown Clinic in 2011. The average SALOME participant has failed with traditional treatment for opioid dependence an average of 11 times.

The number of eligible past SALOME participants is 202. Of that group, Lefebvre said doctors have written diacetylmorphine prescriptions for 120 patients. He declined to specify how many of that group were affected by disruptions in the supply chain.

Health Canada has steadfastly opposed Vancouver’s prescription heroin program. The province’s Health Minister, Terry Lake, has stood behind regional authorities and supported it.

This article originally appeared online at Straight.com on August 5, 2015.

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B.C.’s top doctors place fentanyl deaths in the context of prohibition

Police warn that pills sold on the street as OxyContin can contain dangerous amounts of a synthetic opiate that’s 50 to 100 times more toxic than morphine.
Police warn that pills sold on the street as OxyContin can contain dangerous amounts of a synthetic opiate that’s 50 to 100 times more toxic than morphine.

It is not safe to use street drugs in Metro Vancouver this summer. That’s the message from police following another rash of overdoses related to the synthetic opiate fentanyl.

And part of the reason for that is prohibition-style drug laws that keep illicit substances beyond the reach of regulations that could save lives, health authorities told the Georgia Straight.

In a telephone interview, Const. Brian Montague emphasized that a problem once confined to heroin addicts now concerns recreational drug users of every sort.

“These are teenagers, husbands, wives, and family people with jobs,” the Vancouver Police Department spokesperson said.

Montague explained that authorities are finding fentanyl, a drug anywhere from 50 to 100 times more toxic than morphine, mixed with and sold as cocaine, methamphetamine, and ecstasy, and in fake pharmaceuticals such as pills labelled as OxyContin.

Montague’s warning follows the August 3 death of Jack Bodie, a 17-year-old boy who was found unconscious in an East Vancouver park after he took fentanyl sold in the form of a green pill. Bodie died later in hospital, while a 16-year-old friend narrowly avoided the same fate. Before that, on July 31, a 31-year-old North Vancouver man died of another overdose in which fentanyl is suspected. And on July 20, a North Vancouver couple in their early 30s died in their home after taking fentanyl. They left behind a two-year-old son.

In discussing these deaths, some of the province’s top health officials told the Straight they are open to unconventional methods to manage drug-use risks. Going further, they placed deaths linked to fentanyl in the context of prohibition, saying that existing drug laws are at least partly responsible for avoidable fatalities.

“We are in a situation where these drugs are prohibited,” said B.C.’s top doctor, Perry Kendall. “It is not helping. People are still taking them.”

In a separate interview, Dr. Mark Lysyshyn, a medical health officer for Vancouver Coastal Health (VCH), suggested overdose deaths could be avoided if illicit drug sales could be raised from the shadows.

“This is definitely a problem that a legal, regulated drug market could solve,” he said. “A legal, regulated drug market doesn’t solve every problem associated with substance use, but it does solve this particular problem where there is a drug contaminating the drug supply. We don’t see that in the area of prescription medicines because that is a regulated market.”

The same argument was made by Jane Buxton, harm-reduction lead for the B.C. Centre for Disease Control (BCCDC).

“Because it’s an unregulated market, people don’t know what the substance is in the drug they are taking,” she said. “If we had a regulated market, we would know what was in the drugs.”

None of the interviewees favoured full legalization of hard drugs, but rather a nuanced version of decriminalization that would involve heavy regulation. Buxton named Portugal as a working example, while Kendall pointed to New Zealand.

A July 12 BCCDC bulletin stated that a provincewide study found 29 percent of participants tested positive for fentanyl, and of those drug users, 73 percent said they did not consume fentanyl knowingly. It noted that the portion of B.C. overdose deaths tied to fentanyl jumped from five percent in 2012 to 25 percent in 2014.

On specific measures, Montague said the VPD is also open to less traditional policies that could help prevent deaths linked to fentanyl. For example, he said, police would not oppose drug-testing sites like those deployed at some music festivals.

“We’re not naive,” Montague explained. “The police can stand here forever until we’re blue in the face and tell people not to use drugs, but we know people will use drugs.…So if people are going to use drugs, we would much rather have them use them safely than die as a result of an overdose.”

He stressed, however, that he has concerns about the limitations that drug testing can involve.

Lysyshyn noted that the Downtown Eastside has struggled with an influx of fentanyl for several years. He recalled one particularly challenging weekend, in October 2014, when Vancouver’s supervised-injection facility, Insite, recorded dozens of overdoses that were later linked to fentanyl. Lysyshyn emphasized that not one of those incidents ended in a death.

“People who live in the Downtown Eastside, even though that is the neighbourhood where you see the most overdoses, we are not seeing the most deaths there,” he said.

Lysyshyn pointed to data from Insite and B.C.’s take-home naloxone (a drug used to counter opioid overdoses) program that proves such harm-reduction initiatives save lives. With those initiatives deemed a success in the Downtown Eastside, Lysyshyn suggested there’s no reason variations wouldn’t work in other communities around the Lower Mainland.

This article originally appeared in print and online at Straight.com on August 5, 2015.

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