Wednesday, September 27, 2017


The following was sent to us by our friend and colleague, Pamela McColl, head of Smart Approaches to Marijuana. What can the harm reductionists now say about "evidence-based" work?

Science Spotlight
From the National Institute on Drug Abuse

September 26, 2017

Marijuana use is associated with an increased risk of prescription opioid misuse and use disorders

Research suggests that marijuana users may be more likely than nonusers to misuse prescription opioids and develop prescription opioid use disorder. The study was conducted by researchers at the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and Columbia University. 
Photo by NIDA 
The investigators analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions, which interviewed more than 43,000 American adults in 2001-2002, and followed up with more than 34,000 of them in 2004-2005. The analysis indicated that respondents who reported past-year marijuana use in their initial interview had 2.2 times higher odds than nonusers of meeting DSM-IV diagnostic criteria for prescription opioid use disorder by the follow-up. They also had 2.6 times greater odds of initiating prescription opioid misuse, defined as using a drug without a prescription, in higher doses, for longer periods, or for other reasons than prescribed.
A number of recent papers suggest that marijuana may reduce prescription opioid addiction and overdoses by providing an alternate or complementary pain relief option. That suggestion is partly based on comparisons of aggregate data from states that legalized marijuana for medical use vs. those that didn’t. In contrast, the current study focuses on individual marijuana users vs. nonusers and their trajectories with regard to opioid misuse and disorders. These findings are in-line with previous research demonstrating that people who use marijuana are more likely than non-users to use other drugs and develop problems with drug use.
For a copy of the paper – “Cannabis Use and Risk of Prescription Opioid Use Disorder in the United States” – published in the American Journal of Psychiatry, go to:
For information about the link between marijuana use and increased risk of addiction to other drugs, go to:
For more information, contact the NIDA press office at or 301-443-6245. Follow NIDA on Twitter and Facebook.

Monday, September 25, 2017


We are not alone in our inadequate and uninformed response to the opioid crisis.

The numbers in America are staggering and, by population, even worse than ours.

The New Yorker article highlighted above is worth reading.

Then we must all ask what to do next?

And if we actually
know the answer, who will listen?

Wednesday, September 20, 2017


If I told you that New England Patriots Quarterback Tom Brady has left the team and football to star in a Broadway musical about a famous NFL QB who finds happiness hiding in an Al Qaeda cell in the suburbs of Beirut...would you say that this is just too much stretching of credulity?


Then, how about this?

Company unveils kosher medical marijuana, just in time for Rosh Hashanah

Still not a believer?

That's alright. I'm a Jew and I'm struggling with this one myself.

So, here is the actual true story coming from the magical make-believe land of Canada.

Good old Rabbi Teitlebaum to the rescue.

Thursday, August 31, 2017


The Vancouver Sun has been making a habit recently of telling us things that most of us have known for ages. This morning was a prime example.


Well, you must read the whole gruesome story for all the rich details.

Like this great quote.

"We have to be concerned with protecting the health of young Canadians."

This is from the fellow who used to be responsible for how we spent our tax dollars on health issues and who now is moving to another province so that he can produce and sell marijuana.

Somehow, good old boy Terry seems to have missed the point that kids are now turning to marijuana in huge numbers by the age of eight and by their teens they are full blown addicts to crack, coke, heroin and all those new nasty opioids that are killing our citizens in large numbers.

How do we know this? Because folks like me work in recovery and treatment and we receive these human train wrecks by the car load.

But, hey. Follow the money. Because that is all this tale is about.

The article also mentions his daughter presenting some scientific information at a New York conference. What is not mentioned is that Lake's daughter worked for the number one Harm Reductionist in Canada. Oddly, that doctor regularly received millions of dollars from government offices.

Curiouser and curiouser.

Terry Lake is now channeling Donald Trump. Lying through his teeth and actually believing his own press releases.

But money can do that to you.

Wednesday, July 12, 2017


In physics and finance and a few other human concerns, there is a moment called the tipping point. It is that Nano-second just before the break boundary when something becomes entirely something else. Kitty Hawk is suddenly the Apollo Mission.

In this country, we have reached that tipping point when it comes to addictions and recovery.

It was only a scant 20 years ago, that Vancouver Mayor Philip Owen began talking about something called Harm Reduction, the notion that the very least we could do for these poor bedraggled, mystifying infuriating crazy drug addicts was ‘make them comfortable.’ Give them something and some place that would not cure them, but at a minimum keep them from getting diseases from using shared needles and other unsavory practices.

We had already been giving some addicts a substitute lab-made narcotic called methadone for many years. Soon we were giving many, many more people methadone and free heroin and free crack pipe kits and free alcohol and nice tidy, nurse-run places to shoot up. Insite in Vancouver’s Downtown East Side is world famous and considered a great role model for civic minded people all over the world who clamor to open as many similar locations as Cineplexes.

We don’t have mobile cancer clinics or osteoporosis wagons – even though we have hugely skewed aging populations in this country – but many mayors are shopping for mobile ‘safe injection’ units to patrol the leafier neighbourhoods of towns hither and yon.

Today, the ideology of Harm Reduction holds sway in every corner of the community – health authorities, legislatures, parliament, doctors, psychiatrists, universities and colleges.

Sitting on my desk today is a 77 page document entitled “A Guideline for the Clinical Management of Opioid Use Disorder.” It is published and distributed by the British Columbia Ministry of Health (The retiring Minister will be heading up a medical marijuana enterprise when he returns to civilian life.) and something called the British Columbia Centre on Substance Use. The list of well-initialed academics who are contributors or reviewers to this new bible runs a full three pages. Topping the many individuals, groups, associations and governments to whom grateful acknowledgements are offered is the College of Pharmacists of British Columbia.

Residential treatment can be found on page 21. It is largely dismissed due to lack of ‘evidence.’

Everything else in this hefty tome claims to be based on ‘science.’

What is everything else?

Pharmaceuticals, of course.

At this point, let’s remind the reader of the first principle of journalism. Follow the Money.

Keep that uppermost as you read on. Here are some numbers

Last year and the year before, the Province of British Columbia spent $365 Million on a four square block of land in Vancouver called the Downtown East Side. There are over 100 social service agencies plying their trade in that neighbourhood. Many of these non-profits have Executive Directors being paid in six figures.

The same government spent about $100 Million on methadone, but those monies are shifted across the table to another expenditure column so they don’t really show up under the budget of Mental Health & Addictions.

We are currently supporting over 20,000 human beings on long term methadone maintenance with no known or projected date to taper off and quit.

Everyone is aware of the worldwide nightmare and tragedy called Fentanyl.

But not enough people know these two dreadful facts:

One. Of the people who die of a Fentanyl overdose, 20% of them are methadone users. Whoops! How well is that idea working?

Two. Emergency Response Team members, most of whom are suffering massively from PTSD having to attend to addicts in overdose too often, will tell you that they are mightily tired of reviving a guy named Eddie 5 times a day. The problem with the mythical Eddie is that no one is allowed to revive him and then take him to a recovery centre so that he could start the hard and honorable work of getting away from his addictions. And the reason that EMT folks cannot take that extra step is because we, as a society believe that it is Eddie’s Charter given right to keep being a fool, hang the cost to the public purse.

Now, I have worked successfully with addicts for many years now and I can’t imagine bringing Eddie back to life and NOT taking that extra step.

It is important at this juncture to recognize that addictions are not only a problem and a scourge and a tragedy and a stain on our lives, but they are also very Big Business.

The Harm Reductionists, who at the moment are in the driver’s seat, are exactly like the addicts they fail to help. The addict wants to simplify the challenges and exigencies of daily life. Instead of dealing with the mortgage, the spouse, the business partner, the kids, the neighbour or the guy whizzing by at dangerous speeds, the addict has a drink or a line of coke or a needle or a pipe. He or she bottles and encapsulates all of life’s problems. Simple. The Harm Seduction people also want a simple answer to a complex problem. We’ll give them a substitute drug and a place to use and call it a day.

This might work if the substance was the issue. It is not.

The substance is the symptom of a much larger and puzzling malaise. Work and time are the solutions.

The people who are running the great official addictions enterprise now actively and openly denigrate 12-step programs and residential treatment. They claim, in what is a classic example of psychological projection, that folks like me and my colleagues are ideologues and that they in their wisdom are great evidence based scientists. 

They are hauling in and spending many billions of tax dollars with little or no demonstration of any clean or sober citizen clients. They are building corrals of drugged up, stunned human beings forever dependent on the largess of these clever men and women. A dystopian and ugly scenario.

Note how much of their ‘research’ and funding comes from Big Pharma.

Harm Reduction has the microphone for the moment. May the return of what one great Canadian called ‘sweet reasonableness’ be upon us sooner than later.

Harm reduction and Insite are palliative.

They both spring from a deeply cynical and arrogant world view – You are an addict and you are hopeless. We will keep you “comfortable” while you continue to die.

This is a curious position considering the millions of men and women who admit that they are addicts and choose every day not to pick up their poison. We know thousands of such clean and sober citizens.

We as a body politic owe one another a chance at dignity. To offer less is not only costly, it is monstrous.

Saturday, April 1, 2017


Stop worrying about foreign investors buying up all the property in your neighbourhood. The new owner is moving in.

Read today's New York Times article called A REAL ESTATE BOOM POWERED BY POT.

The numbers are mind-boggling...that is, for anyone who still has a functioning mind.

It is easy to understand why former mayors, premiers, ministers of health and police chiefs are all heading boards of "medical" marijuana companies.

Just as easy to see why some of you may feel like you're watching a new live-action version of "The Invasion of the Body Snatchers."

Sunday, March 12, 2017


Dr. Ray Baker and I got into a bit of a debate over the last post here about Human Rights vs. Public Safety. 

Because he was part of the team who developed the new IMPAIRED AT WORK protocol for the Canadian Human Rights Commission, I asked him the following:

Can an employee who appears to be impaired during his/her duties be removed for the next 24 hours?

I think this is the case in the airlines and I think the Americans are tougher than we are, yes?

His answer:

It comes down to a case of human rights vs. safety. If safety is a factor than it always trumps the individualy worker’s rights.

So, yup, safety sensitive workers ( vehicle operators, equipment operators, people who perform functions who when they mess up might hurt somebody else) or highly responsible (teachers, doctors) personnel MUST be immediately removed from the safety sensitive task if impairment is suspected.  To not do so is both a criminal and WCB offence.

Usually when they are removed, they may be sent for some sort of brief evaluation to determine the cause of impairment.  Sometimes it’s drug testing, but sometimes its a more thorough occupational medical evaluation. Then they can’t go back to work until/unless found medically fit.  Sometimes that means a treatment program followed by a period of monitoring.

Which he followed by adding:

The neat thing about this approach is this:

If a lousy employee with bad attitude is impaired at work or if he/she demonstrates unacceptable attendance, performance or behaviour, then the employer may discipline them up to firing them (just cause)

But if the employee can demonstrate a disability or disorder that could account for the impairment/attendance/performance/behaviour, then the employer is forced to “accommodate them”

But built into this is the obligation for the bad employee to:

1. undergo diagnostic evaluation and treatment planning
2. demonstrate compliance with the treatment plan
3. continue to demonstrate ongoing compliance with a continuing care plan in the case of a chronic condition with relapse potential

so either way you got them: either the employer gets back an improved worker
or the worker continues on their path and the employer will be allowed to get rid of them

Get well or get gone.

Works like a hot damn.

And I know more than a few people who are now in good recovery because their employer finally grew a spine and fired them.  That was enough of a ‘bottom’ for them to do what only they can do and seek help