Helping the addicted

It is unfortunate that in 2017, despite mountains of scientific evidence, people deny the effects of climate change. For those of us in the medical profession, our parallel is harm reduction.

A spectrum of treatments from needle syringe programs to safe-injection sites fall under this umbrella. Thousands of peer-reviewed papers in medicine and the social sciences have found positive impacts of trying to reduce harm for those who continue to use drugs. Reduced criminal activity, decreased overdose and reduced spread of HIV are just some of the benefits in meeting patients where they are at instead of demanding they change immediately.

The oldest and at once most controversial harm-reduction technique — methadone — is now the backbone of addiction treatment. Countries where methadone is illegal in eastern Europe are seeing resultant spikes in HIV rates.

For years, people from different camps have spoken past each other instead of collaborating on this issue. Harm reduction and drug abstinence are not mutually exclusive but rather fall on a spectrum. I have seen many of my patients live extra months or years thanks to harm reduction, and a number of them have stopped drug use entirely.

For one young woman who had had dozens of overdoses, our team used harm-reduction principles to keep her comfortable and earn trust. A woman who a year ago wouldn’t look a doctor in the eye has had 12 months without overdose and four months without any drug use at all.

Like cancer, every patient with addictions needs a different treatment. Some cancer patients need chemotherapy; others need surgery and some cannot be cured. For addictions, the same is true. Some need medications, some need psychotherapy and some cannot be cured. It is our responsibility to help them all.

For too long, addiction treatment has been inconsistent depending on where you happen to live — even in Canada. Some are forced inappropriately to stop all drugs, losing tolerance and dying of overdose. Others can be stuck in cycles of use, in neighbourhoods of drugs and never get the evidence-based treatments they need.

Articles that dismiss an entire branch of medicine do nothing to advance the response to the opiate epidemic. Sensible discussion on how to help those who can’t stop, and how to move forward those ready for change is the only way to solve these problems. excellent service and more than edible food.

As a former frequent traveller, I enjoyed the superb service of Air Canada, but especially Ward Air. Max Ward, the owner of Ward Air, knew how to attract and keep his customers happy. Present day flyers would probably not believe that real cups and saucers, dishes, table cloths, glass wine glasses and metal knives and forks were standard offerings. Add to that the well-dressed, well-trained and personable stewardesses (yes I know — cabin attendants!) and we could be guaranteed a pleasant flight experience.

It would seem that in Canada, we are suffering from an attitude of “catering to the lowest common denominator.” Surely, the airlines are capable of providing a service that is pleasant and enjoyable, without being priced out of business. It’s time that we demanded more. is the availability and selection of alcohol (particularly in premium class travel). Nonsense. Ask any true frequent long-haul traveller (as she focuses on) about their key preferences, and they will typically answer convenient routing, premium cabin seat functionality and flat bed comfort, design, lounge quality, loyalty program and price.

I don’t recall ever choosing an airline for booze (I could have imbibed on a recent New York-Seoul business class flight), though I am aware of most airlines’ total inflight service reputation including inflight entertainment, meals and yes, the wine list.