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Harm reduction and fighting poverty centre of Manitoba NDP addictions strategy

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Manitoba’s Opposition NDP has released its ideas for how to combat the ongoing crisis of drug abuse and addiction in the province, and harm reduction and reducing poverty are at the heart of the strategy.

NDP Leader Wab Kinew says reducing poverty is a long-term goal with significant resources and investments required, while a new harm-reduction strategy could create some more immediate and positive outcomes.

The 20-page report suggests the current battle with methamphetamine is only the latest version of a struggle to deal with addiction that goes back many years and includes the use of opioids and fentanyl.

“Manitoba has an addictions crisis, not just a meth crisis,” reads one of the report’s headlines.

Called We Have to Start Here, the report’s authors canvassed health and addictions workers and members of law enforcement agencies.

The contributors, Kinew says, were kept anonymous to prevent “reprisals related to their jobs.” He also declined to say how many people were consulted while gathering the information. 

NDP Leader Wab Kinew says ‘if we want to put the addictions issue to bed in Manitoba we need to fight poverty.’ (Gary Solilak/CBC )

Much of the background data on the addictions crisis has been widely covered in media. Meth-related ER visits have spiked, provincial health authorities distributed more than two million needles in 2017-18, and there is a significant increase in cases of blood-borne illnesses like hepatitis C, HIV and syphilis.

Respondents cited in the NDP’s report say poverty is a major contributor to addictions, and the government should make significant investments in its reduction to lower drug abuse rates.

If somebody has housing, if somebody has food, if somebody has a meaningful life — they don’t use meth.– Wab Kinew, Manitoba NDP leader

Citing the Virgo report on mental health and addictions, released last year, “the link between high rates of addiction among children and youth was poverty,” the NDP’s report says.

The report also says Indigenous people, because of the impact of colonization, poverty and residential schools, are more likely to turn to substance abuse.

The Opposition party is calling for provincewide job creation and training programs, increases in the number of social housing units and an overhaul of the Child and Family Services system.

“If somebody has housing, if somebody has food, if somebody has a meaningful life — they don’t use meth,” Kinew told reporters.

Poverty only 1 driver of addiction: Main Street Project

That comment caught the attention of Rick Lees at the Main Street Project.

Lees, who directs the substance abuse shelter and outreach program in Winnipeg’s core area, says many of the report’s suggestions aren’t a surprise, and are things he and others have been advocating for.

But Lees warns that addictions aren’t always connected to poverty. He says it’s just one driver of addiction.

Main Street Project’s executive director, Rick Lees, said poverty is only one driver of addiction. (Tyson Koschik/CBC)

“Addiction levels the playing field and crosses all strata, demographics and class, so I am not sure that just putting a roof and food in someone’s way is going to be helpful,” Lees said.

He told CBC News he welcomed more dialogue on dealing with the city’s drug problem, but urged all sides to “stop looking at addictions through political lenses.”

Harm reduction

The second major thrust of coping with addictions in the province is harm reduction, according to the NDP report. Experts in the field told the authors the current view of drug use must end.

Kinew acknowledged reducing poverty was a long-term goal with strategies that take years to implement.

“In the absence of being able to accomplish those larger-term objectives immediately, what we need to do is implement harm-reduction techniques,” Kinew said.

The NDP is calling for a supervised consumption site in Winnipeg, 50 new long-term treatment beds across the province, research into new drug treatment programs and an overhaul of education on drug use.

Kinew declined to cost out either the poverty-reduction strategy or harm-reduction efforts, saying the NDP would hold a policy summit later in the year to chose specific programs and release the numbers as part of its position for the 2020 provincial election.

The NDP’s look into addictions also warned past efforts based on a “just say no” approach have failed, especially among children.

“Respondents believe a focus on abstinence-based education must be abandoned because as long as poverty, adverse childhood experiences and systemic inequality exist, drug use will remain in our society,” the report said.

Kinew reiterated this point, saying the experts he’s spoken to believe the old “war-on-drugs” stance and warning children on the evils of drugs have failed and may even prompt kids even more to try illicit substances.   

‘Half-baked,’ says PC minister

Justice Minister Cliff Cullen lashed out at the NDP’s contention that saying no to drugs is a failed effort.

Cullen says the report contains “half-baked, dangerous ideas.” 

“Wab Kinew wants to tell kids it’s OK to do meth and other illicit drugs. I have raised three boys to adulthood and I am proud to say I told them never to use illicit drugs. And they haven’t,” Cullen told reporters.

Justice Minister Cliff Cullen defended his government’s efforts to combat drug addiction.

Cullen says his Progressive Conservative government will receive recommendations from its own task force on addictions in June and expects many substantial policy changes will come from it.

He also defended what the Tories have done so far to push back against the issue of addictions in the province, citing an increase in treatment beds, opening new paid access addictions clinics and signing a deal with Ottawa for more funding for mental health and addictions treatment.

Cullen was also critical of the NDP’s decision not to name sources in their report.

Manitoba’s Opposition NDP has released its ideas for how to combat the ongoing crisis of drug abuse and addiction in the province. 2:39



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B.C. health official questions value of handing out free naloxone nasal spray

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A pharmaceutical company was handing out free samples of their naloxone nasal spray at a Surrey, B.C., SkyTrain station on Wednesday — but health officials are skeptical about the approach.

Naloxone reverses the effects of opioids and can help prevent overdose deaths.

Since 2012, the B.C. Centre for Disease Control has handed out thousands of injectable naloxone kits as part of a province-wide overdose prevention program.

“We come from different perspectives,” said Dr. Jane Buxton, harm reduction lead for the B.C. Centre for Disease Control.

“We have a pharmaceutical company whose main motive, presumably, is profit. But when we look at a public health program, we want to save lives — that’s our main intent.”

Some have blamed pharmaceutical companies for playing a role in the opioid crisis by downplaying the addiction risks of the drugs.

The province announced a lawsuit against 40 drug companies last August, accusing the wholesalers, distributors and manufacturers of being responsible, in part, for B.C.’s ongoing opioid crisis.

Injecting naloxone provides ‘a very effective, reliable dosage that is absorbed and it works in a quick way,’ Dr. Jane Buxton said. (CBC)

Concentrated form of naloxone 

Aaron Sihota, a community pharamcist who was promoting the nasal spray on behalf of Adapt Pharma — which makes the naloxone nasal spray — says it can help save lives and is much simpler to use than the injectable kits.

“Sometimes, it’s difficult for those who are not health-care professionals to go through the motions of breaking open a glass vial, withdrawing a dose and then injecting it in the right place,” Sihota said.

The one-time use spray kits contain a highly concentrated form of naloxone, roughly 10 times the dosage in a vial, and is administered through the nostril.   

But Buxton said there are challenges with administering the medication through the nose compared to injecting it into a muscle.

“Somebody may have snorted cocaine, for example, in which case it’s not absorbed because the blood vessels can’t carry or there may be damage to the nose internally,” she told Stephen Quinn, host of CBC’s The Early Edition.

The higher dosage may also mean some people will absorb significantly more of the medication, which can lead to withdrawal symptoms, she added.

The injectable naloxone kits include three doses of the medication, although about 60 per cent of people only need one or two.

‘By administering [naloxone] intramuscularly, it’s a very effective, reliable dosage that is absorbed and it works in a quick way,’ Buxton said. 

Buxton also disagreed that the injectable kits are difficult for users to administer.

“We’re not hearing that it’s a problem,” she said.

“We know that the people who are most at risk are the people who use substances and their friends and colleagues — those are the folks who are actually quite comfortable using needles.”

A for-profit pharmaceutical company is handing out free samples of their naloxone nasal spray at a Surrey SkyTrain station on Wednesday but some health officials are skeptical about the approach. 7:16



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No fix for vaping addiction in teens, experts warn

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Matthew Perrone , The Associated Press


Published Wednesday, January 16, 2019 4:18PM EST

WASHINGTON — The nation’s top health authorities agree: Teen vaping is an epidemic that now affects some 3.6 million underage users of Juul and other e-cigarettes. But no one seems to know the best way to help teenagers who may be addicted to nicotine.

E-cigarettes are now the top high-risk substance used by teenagers, according to the latest U.S. figures , which show that Juul and similar products have quickly outpaced cigarettes, alcohol, marijuana and other substances that have been tracked over more than four decades.

The handheld devices heat a liquid solution that usually contains nicotine into an inhalable vapour. Federal law prohibits sales to those under 18, though many high schoolers report getting them from older students or online.

In recent months, government officials have rolled out a series of proposals aimed at keeping the products away from youngsters, including tightening sales in convenience stores and online. In November, vaping giant Juul voluntarily shut down its Facebook and Instagram accounts and pulled several flavours out of retail stores.

But there’s been little discussion of how to treat nicotine addiction in children as young as 11 years old. While some adolescents should be able to quit unaided, experts say many will be hampered by withdrawal symptoms, including anxiety, irritability, difficulty concentrating and loss of appetite.

Physicians who treat young people now face a series of dilemmas: The anti-smoking therapies on the market — such as nicotine patches and gums — are not approved for children, due to lack of testing or ineffective results. And young people view the habit as far less risky, which poses another hurdle to quitting.

The harshness of cigarette smoke often limits how much teenagers inhale, sometimes discouraging them from picking up the habit altogether. That deterrent doesn’t exist with e-cigarette vapour, which is typically much smoother, according to experts.

Kicking any addiction requires discipline, patience and a willingness to follow a treatment plan — something that doesn’t come easily to many young people, experts said.

“Teenagers have their own ideas of what might work for them, and they’re going to do what they do,” said Susanne Tanski, a tobacco prevention expert with the American Academy of Pediatrics. “But we desperately need studies to figure out what’s going to work with this population.”

Since debuting in the U.S. in 2007, e-cigarettes and other vaping devices have grown into a $6.6 billion business. Driving the recent surge in underage use are small, easy-to-conceal devices like Juul, which vaporizes a high-nicotine solution sold in flavours such as creme, mango and cucumber. Despite industry worries of a crackdown on flavours, the FDA has taken no steps to ban the array of candy and fruit varieties that companies use to differentiate their offerings.

E-cigarettes have become a scourge in U.S. schools, with students often vaping in the bathroom or between classes. One in 5 five high schoolers reported vaping in the last month, according to 2018 federal survey figures.

Juul and other brands are pitched to adult smokers as a way to quit smoking, but there’s been little research on that claim or their long-term health effects, particularly in young people. Nicotine can affect learning, memory and attention in the teenage brain, but there’s virtually no research on how e-cigarette vapour affects lungs, which do not fully mature until the 20s.

“It’s frightening for me as a pediatrician because I really feel like there’s this uncontrolled experiment happening with our young people,” Tanski said. “They don’t perceive the harm, and we can’t show them what it’s going to be.”

Tanski and other experts will meet this Friday at the Food and Drug Administration to discuss the potential role for pharmaceutical therapies and non-prescription medications such as nicotine gums and patches.

Regulators acknowledge they are starting from square one: The FDA “is not aware of any research examining either drug or behavioural interventions” to help e-cigarette users quit, the agency noted in its announcement.

The FDA will also hear from researchers, vaping executives, parents and teenagers.

“We want to make sure our voices are heard and that — most importantly — our kids’ voices are heard,” said Meredith Berkman, who plans to speak at the meeting with her 10th-grade son.

Berkman said she first realized her son and his friends were “Juuling” last year when she heard them repeatedly opening and closing his bedroom window. With two other New York City mothers, she formed the group Parents Against Vaping E-cigarettes, which is asking the FDA to ban all e-cigarette flavours.

“Unless the flavours are off the market, kids are going to continue to be seduced by these highly addictive nicotine-delivery systems like Juul,” Berkman said.

Quitting smoking is notoriously difficult, even for adults with access to various aids and programs. More than 55 per cent of adult smokers try to quit each year, yet only about 7 per cent succeed, according to government figures.

Nicotine gums, patches and lozenges are available over-the-counter for those 18 and older, and are occasionally prescribed “off-label” for younger patients. They provide low levels of nicotine to help control cravings. Prescription drugs include Zyban, an antidepressant, and Chantix, which blocks the effects of nicotine on the brain. But neither has shown positive results in teenagers, and both carry worrisome side effects, including suicidal thinking for Zyban and nausea and abnormal dreams for Chantix.

That leaves counselling as the go-to option for teenagers trying to quit cigarettes.

In November, Colorado dropped the minimum eligibility age for its quit-smoking hotline from 15 to 12, in response to the explosion in vaping among students as low as 6th grade. The state’s underage vaping rate is the highest in the U.S., with 1 in 4 high school students reportedly using the products, according to federal data. The state’s over-the-phone and online programs provide free coaching to help users create a quit plan, manage cravings and avoid relapse.

But even counselling has shown only “limited evidence” in helping teenagers, according to an exhaustive review of the medical literature published in 2017.

Still, addiction specialists see growing demand for such programs, particularly group sessions that often have the most promising results.

Addiction psychiatrist Jonathan Avery says he gets four to five calls a week from pediatricians referring patients or asking about treatment options. One of the biggest problems is an education gap — many doctors haven’t heard of Juul and don’t even recognize the vaping devices brought in by parents.

On the other side, teenagers are often “suspicious” when he informs them that they are inhaling a highly addictive substance, said Avery, of New York-Presbyterian Hospital.

About two-thirds of U.S. teenagers do not realize that Juul contains nicotine, according to a recent survey by the Truth Initiative, an anti-smoking advocacy group.

The U.S. Surgeon General, Jerome Adams, hammered that point home in a rare public advisory last month. He said even his 14-year-old son believed that e-cigarette vapour was essentially harmless.

“Youth like my son have no clue what’s in these products most of the time,” he said.

——

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.



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Researchers look at the anticancer potential of cockspur grass

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(Natural News) Cancer is a major health problem brought about by factors like high body mass index, poor diet, sedentary lifestyle, smoking, and alcohol consumption. Researchers continue to search for alternative cancer treatments such as medicinal plants. Their search led them to the discovery of anticancer compounds in various plant species. A recent study by researchers…

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