The Servants of hope society - outreach and events
Feeding the Homeless at Christmas in Pigeon Park
December 17, 2012 6pm
We are in need of Corporate Sponsorship.
Receipts for Income Tax Deduction Provided
get together and go into the Downtown Eastside to feed the homeless and do outreach
Bringing the message of Hope And Recovery to the Downtown Eastside. The success of the last 6 years of outreach involved over 100 people with minimal financial and material support. We were still able to feed and meet the needs of over 1000 people . The majority of the people involved with this cause have a history of substance abuse and a high percentage of those people came from the downtown eastside and are now free from their addictions and are productive members of society today. It is both a privilege and an honor for me and the people involved being able to give back to those in need during such a dark and lonely time.
http://www.servantsofhope.ca/
CHRISTMAS APPEAL
* * *
Addicts don’t need a new drug
Opinion: They require support to a new way of life
Lorne Hildebrand, executive director of Edgewood Addictions Centre in Nanaimo.
I
read with interest Evan Wood’s opinion (Vancouver Sun, Nov., 3, 2012)
of a new drug, unavailable in Canada that could aid in the battle
against addiction. While I would love to be able to support the notion
that Vivitrol (naltrexone) will be a huge asset in the fight against
addictions, I am highly skeptical.
In my experience as executive director of Edgewood, one of North America’s most respected addiction treatment centres right here in British Columbia, we have yet to find anything that is as effective as well-structured, long-term, abstinence-based residential treatment. No pill, injection, short-term detox or therapy-of-the-month has had any lasting benefit for the majority of substance-dependent people and their families suffering from this disease.
In his article Wood states, “Vivitrol reduced heavy drinking in alcoholics by 25 per cent.” I find no comfort in the thought that an alcoholic might only drink three out of four days, or cut back from 40 ounces of Scotch daily to 30 ounces. The terrible impact to an alcoholic’s health, their family and loved ones involved, will not be significantly reduced by a 25-per-cent decrease in their consumption. An alcoholic advised by his physician that he will die if he takes another drink, will still die at 75 per cent of his drinking.
Absolutely there is a critical role for physicians, psychiatrists and a wide range of mood stabilizing medications in the treatment of addiction. But our experience is many physicians do not fully understand the disease of addiction. In fact, most get very little training in it. It seems treatment often includes substituting one chemical for another. For example, Methadone, an opiate initially developed as a pain killer, may indeed reduce some harms. It is however, still an opiate. I believe the goal should be to have people come off opiates completely. And, don’t be fooled by the notion that opiate addicts never get clean. Many who have come through Edgewood for treatment for their addiction have remained clean for years.
Edgewood has three full-time, physicians who specialize in addiction medicine. We could not do proper treatment without them, but they are just part of a multi-disciplinary team that includes addictions counsellors, nurses, dietitians, fitness specialists, spiritual advisers and other staff.
It may surprise you to learn that the vast majority of actively using, substance- dependent people hold down full-time jobs. Yet discussion and proposed solutions are often focused around addressing Vancouver’s Downtown Eastside issues. While a case can be made for medications such as naltrexone being prescribed for an at-risk population, it should not be assumed that this is the solution for the vast majority of Canadians suffering from the disease.
Post-treatment strategies or “aftercare” plans may include anti-psychotic or anti-depressant medications, but in most cases, they do not include anti-addictions medicines. Remember Antabuse? The drug caused a mild to severely unpleasant reaction when alcohol was consumed. It also was touted as the answer to alcoholism. Perhaps good in theory, but in reality the alcoholic, so driven by the disease, would drink through the sickness or stop taking the medication. It is now rarely used.
Rather than creating a reliance on another drug to achieve sobriety, we need to encourage a new way of life, a new emotional reality and connect people to a strong support system that will keep them from using.
The questions we need to answer are whether society wants to invest in the long-term costs of properly treating this disease and whether substitution therapy or any drug therapy, as quick treatment is an acceptable solution?
My answer is that many of the most challenging people we have worked with, in the direst of circumstances, have responded to abstinence-based treatment. They have regained their lives, their jobs, their families and their sense of self- respect and self-worth. They are wonderful human beings in recovery, a pleasure to know and befriend. I am not convinced medications like Vivitrol will achieve those same results.
Lorne Hildebrand is the executive director of Edgewood Addictions Centre in Nanaimo. For more information see www.edgewood.ca
* * *
In my experience as executive director of Edgewood, one of North America’s most respected addiction treatment centres right here in British Columbia, we have yet to find anything that is as effective as well-structured, long-term, abstinence-based residential treatment. No pill, injection, short-term detox or therapy-of-the-month has had any lasting benefit for the majority of substance-dependent people and their families suffering from this disease.
In his article Wood states, “Vivitrol reduced heavy drinking in alcoholics by 25 per cent.” I find no comfort in the thought that an alcoholic might only drink three out of four days, or cut back from 40 ounces of Scotch daily to 30 ounces. The terrible impact to an alcoholic’s health, their family and loved ones involved, will not be significantly reduced by a 25-per-cent decrease in their consumption. An alcoholic advised by his physician that he will die if he takes another drink, will still die at 75 per cent of his drinking.
Absolutely there is a critical role for physicians, psychiatrists and a wide range of mood stabilizing medications in the treatment of addiction. But our experience is many physicians do not fully understand the disease of addiction. In fact, most get very little training in it. It seems treatment often includes substituting one chemical for another. For example, Methadone, an opiate initially developed as a pain killer, may indeed reduce some harms. It is however, still an opiate. I believe the goal should be to have people come off opiates completely. And, don’t be fooled by the notion that opiate addicts never get clean. Many who have come through Edgewood for treatment for their addiction have remained clean for years.
Edgewood has three full-time, physicians who specialize in addiction medicine. We could not do proper treatment without them, but they are just part of a multi-disciplinary team that includes addictions counsellors, nurses, dietitians, fitness specialists, spiritual advisers and other staff.
It may surprise you to learn that the vast majority of actively using, substance- dependent people hold down full-time jobs. Yet discussion and proposed solutions are often focused around addressing Vancouver’s Downtown Eastside issues. While a case can be made for medications such as naltrexone being prescribed for an at-risk population, it should not be assumed that this is the solution for the vast majority of Canadians suffering from the disease.
Post-treatment strategies or “aftercare” plans may include anti-psychotic or anti-depressant medications, but in most cases, they do not include anti-addictions medicines. Remember Antabuse? The drug caused a mild to severely unpleasant reaction when alcohol was consumed. It also was touted as the answer to alcoholism. Perhaps good in theory, but in reality the alcoholic, so driven by the disease, would drink through the sickness or stop taking the medication. It is now rarely used.
Rather than creating a reliance on another drug to achieve sobriety, we need to encourage a new way of life, a new emotional reality and connect people to a strong support system that will keep them from using.
The questions we need to answer are whether society wants to invest in the long-term costs of properly treating this disease and whether substitution therapy or any drug therapy, as quick treatment is an acceptable solution?
My answer is that many of the most challenging people we have worked with, in the direst of circumstances, have responded to abstinence-based treatment. They have regained their lives, their jobs, their families and their sense of self- respect and self-worth. They are wonderful human beings in recovery, a pleasure to know and befriend. I am not convinced medications like Vivitrol will achieve those same results.
Lorne Hildebrand is the executive director of Edgewood Addictions Centre in Nanaimo. For more information see www.edgewood.ca
* * *
The cure for substance abuse isn’t a pill
Opinion: I know; I've been there and done that
Jeff Vircoe is communications coordinator at Edgewood.
I
didn’t wake up. I came to. Usually abruptly. Panicked. Terrified. The
first five minutes were always the worst. Where was I? Who is that
person beside me? Is anything broken? Where’s my wallet? Where am I
supposed to be? I need water. I smell like a brewery. What did I do with
my car?
The essence of my addiction was simple. Predictable. Vicious. Dangerous. To me and others. It stayed that way from age 13 to age 28. Twenty-four years after my last drink, toke, snort or pill, I still get quiet when I think about it. I am all too aware I can still have all that misery back in the snap of a finger. I’m not cured. I’ve seen too many lose their sobriety date after weeks, months or even multiple years. I’ve been to many, many funerals. But drugs like Vivitrol have me pondering. A pill that would allow me to consume alcohol or other drugs with little to no effect? Wow. Am I ready or willing to wander back into the life I resigned from in 1988?
My answer is no. Why?
I drank for effect. I have no desire to consume alcohol or drugs just for the hell of it. Pay five bucks a drink and not get a buzz? Come on. A painfully shy guy, I drank and drugged because I had found something that for a few years made me feel inside like they looked outside. Smarter. Sexier. Funnier. I loved it. And if I could still be out there dancing with it I would be. But I couldn’t. The blessing, or curse, of being an addict is the thing you love begins killing you. When I reached that point of near death, in my case by my own hand, I had to make a decision to either get it over with, or to ask for help. I didn’t know which one sounded worse. Back then, death had a nice ring to it. Sobering up in a room full of misfits and people who believe in God did not. At least not to me. But not anymore.
Turns out those misfits were my peers. Damn, I too was a misfit. That’s why I drank, remember? So I could fit in. The “God thing” was my stumbling block, but it turned out that I didn’t have to worry. The wording of the step literally says ‘God as we understood Him.’ I didn’t understand him. So I borrowed Pete’s concept. Or Marti’s, or Kelleigh’s. Sure maybe it’s all a big mirage. But I keep going to the meetings, praying, reading about other’s opinions on the “God thing” just the same. And low and behold I’m still sober and mostly happy. And with no urge to use or drink.
So Vivitrol would allow me to re-enter the bar scene and sip the foam off a beer or two again? Hmmm. Why would I want to do that? Without the effect, I already know I won’t fit in. I don’t even like being around drunks or stoners when they’re using. Most of what I hear from them is what I heard from me. Nonsensical, arrogant, pointless arguments or attempts to manipulate others to join me.
I believe if I miss the bar scene, or the lazyboy (the cockpit of my spaceship to la-la land), then there is something wrong with my approach to my life, it’s not even about drinking or drugging. Drinking and drugging were my solutions, not my problem. My problem was my attitude about my life. I just needed another solution.
My solution these days does not come in a pill form. It comes in acceptance. In action. What I’ve been doing for 24 years. At least three meetings a week with guys and gals who know what it’s like to wake up, or come to like I used to. Prayers to something I do not understand. Helping others to get on track. Doing the steps and trying to be rigorously honest about where I am at, no matter how crazy it may sound.
A drink or toke without the buzz would be like hugging a cardboard cut-out of my daughter. Give me the real thing or give me nothing. I don’t do fake. And when it comes to drugs and alcohol, I just can’t do the real thing. That train has left the station.
A friend of mine once told me something that has saved me many times. He said “We realize the boat we are asking you to row is invisible. Row anyway.”
The boat is not a pill.
Jeff Vircoe, a former weekly newspaper and magazine editor and recipient of the Stuart Keate Memorial Award for writing, is communications coordinator at Edgewood. He lives in Parksville.
The essence of my addiction was simple. Predictable. Vicious. Dangerous. To me and others. It stayed that way from age 13 to age 28. Twenty-four years after my last drink, toke, snort or pill, I still get quiet when I think about it. I am all too aware I can still have all that misery back in the snap of a finger. I’m not cured. I’ve seen too many lose their sobriety date after weeks, months or even multiple years. I’ve been to many, many funerals. But drugs like Vivitrol have me pondering. A pill that would allow me to consume alcohol or other drugs with little to no effect? Wow. Am I ready or willing to wander back into the life I resigned from in 1988?
My answer is no. Why?
I drank for effect. I have no desire to consume alcohol or drugs just for the hell of it. Pay five bucks a drink and not get a buzz? Come on. A painfully shy guy, I drank and drugged because I had found something that for a few years made me feel inside like they looked outside. Smarter. Sexier. Funnier. I loved it. And if I could still be out there dancing with it I would be. But I couldn’t. The blessing, or curse, of being an addict is the thing you love begins killing you. When I reached that point of near death, in my case by my own hand, I had to make a decision to either get it over with, or to ask for help. I didn’t know which one sounded worse. Back then, death had a nice ring to it. Sobering up in a room full of misfits and people who believe in God did not. At least not to me. But not anymore.
Turns out those misfits were my peers. Damn, I too was a misfit. That’s why I drank, remember? So I could fit in. The “God thing” was my stumbling block, but it turned out that I didn’t have to worry. The wording of the step literally says ‘God as we understood Him.’ I didn’t understand him. So I borrowed Pete’s concept. Or Marti’s, or Kelleigh’s. Sure maybe it’s all a big mirage. But I keep going to the meetings, praying, reading about other’s opinions on the “God thing” just the same. And low and behold I’m still sober and mostly happy. And with no urge to use or drink.
So Vivitrol would allow me to re-enter the bar scene and sip the foam off a beer or two again? Hmmm. Why would I want to do that? Without the effect, I already know I won’t fit in. I don’t even like being around drunks or stoners when they’re using. Most of what I hear from them is what I heard from me. Nonsensical, arrogant, pointless arguments or attempts to manipulate others to join me.
I believe if I miss the bar scene, or the lazyboy (the cockpit of my spaceship to la-la land), then there is something wrong with my approach to my life, it’s not even about drinking or drugging. Drinking and drugging were my solutions, not my problem. My problem was my attitude about my life. I just needed another solution.
My solution these days does not come in a pill form. It comes in acceptance. In action. What I’ve been doing for 24 years. At least three meetings a week with guys and gals who know what it’s like to wake up, or come to like I used to. Prayers to something I do not understand. Helping others to get on track. Doing the steps and trying to be rigorously honest about where I am at, no matter how crazy it may sound.
A drink or toke without the buzz would be like hugging a cardboard cut-out of my daughter. Give me the real thing or give me nothing. I don’t do fake. And when it comes to drugs and alcohol, I just can’t do the real thing. That train has left the station.
A friend of mine once told me something that has saved me many times. He said “We realize the boat we are asking you to row is invisible. Row anyway.”
The boat is not a pill.
Jeff Vircoe, a former weekly newspaper and magazine editor and recipient of the Stuart Keate Memorial Award for writing, is communications coordinator at Edgewood. He lives in Parksville.
© Copyright (c) The Vancouver Sun
* * *
Here is the Letter to the Editor sent to the Vancouver Sun, that was not published, followed by the news item that prompted the letter:
I work with addicts in recovery and I can tell you for a fact that when
OxyContin was widely available last year, the abuse was not 'notable' or
'troubling'; it was an epidemic.You must have noticed that every
pharmacy and every doctor's office and clinic had conspicuous signage
declaring "NO OXY ON THE PREMISES."
Now Leona Aglukkaq, our federal Health Minister, flying fast in the face of advice from doctors, researchers, police chiefs and Provincial health ministers, has approved new generic versions of this nightmare. Her ironic defense is that she doesn't want politics to interfere with science. Huh?
Aglukkaq is an aboriginal from the Far North. No demographic is more tragically effected by this blind decision. What is she thinking?
David Berner
Drug Prevention Network of Canada
Now Leona Aglukkaq, our federal Health Minister, flying fast in the face of advice from doctors, researchers, police chiefs and Provincial health ministers, has approved new generic versions of this nightmare. Her ironic defense is that she doesn't want politics to interfere with science. Huh?
Aglukkaq is an aboriginal from the Far North. No demographic is more tragically effected by this blind decision. What is she thinking?
David Berner
Drug Prevention Network of Canada
Aglukkaq approves 'Hillbilly heroin' copies
Manufacturers have been asked to submit risk management plans on safe use of the generics
By Sharon Kirkey, Postmedia News
Health
Canada has swiftly approved six generic copies of the widely abused
painkiller OxyContin, despite urgings from some of the country's leading
pain doctors and researchers to delay approval in the name of "patient
and public safety."
The first generic versions of the drug dubbed "Hillbilly heroin" were authorized by Health Canada on Monday - one day after the patent held by Purdue Pharma for its long-acting formulation of oxycodone, the active ingredient in OxyContin, expired.
Purdue began phasing out OxyContin earlier this year, replacing it with OxyNEO. Oxy-NEO tablets have been hardened to make them more difficult to abuse. When crushed, the pills form a thick, gummy-like gel in water, making them harder to snort or inject.
But the generics will use the same older, "easy to tamper with" formulation in the now discontinued OxyContin, doctors who treat patients with chronic pain or addiction wrote in a letter to federal health minister Leona Aglukkaq Nov. 19.
"If there were some foolproof way to stratify patients into low risk vs. high risk, perhaps we could provide the generic versions to low-risk patients and reserve the tamper-resistant formulations for the higher risk patients," read the letter, endorsed by 34 doctors.
But even with screening and monitoring, "it is always a challenge in practice to be confident that a given patient is using pain medication appropriately."
There is also a risk that public and private insurers would consider the drugs interchangeable, they added, and that pharmacists would automatically substitute a prescription for OxyNEO that was specifically prescribed for a high-risk patient, with one of the cheaper generics.
Provincial health ministers, as well as the Ontario Association of Chiefs of Police, had appealed to Aglukkaq to delay approval of generic Oxy-Contin. But Aglukkaq said she is compelled by law not to withhold approval for a drug that is otherwise considered safe and effective for its intended use.
"The minister has made it clear that she doesn't feel it's the place for politicians to interfere with the scientific review process," her spokesman, Steve Outhouse, said Tuesday. "It's fine for doctors to write a letter saying, 'Don't approve this drug,' " Outhouse said. "The reality is that this drug never hits the streets unless it is prescribed. So if there are 34 doctors who are concerned about it, none of them need to prescribe a generic version of OxyContin to anyone."
Health Canada said manufacturers have been asked to submit "risk management plans" on the safe use of the generics. Licensed dealers have also been told to report spikes in sales, sudden changes in distribution patterns or other potential signs of diversion.
Montreal physician Dr. Mark Ware said the government has approved a drug formulation with known health hazards. He said data from the United States suggested that removal of OxyContin from the market has led to reduced rates of oxycodone abuse in that country.
Opening the market to generics "means that it's now fair game once again for abuse," said Ware, director of clinical research at the Alan Edwards Pain Management Unit at the McGill University Health Centre in Montreal.
Generic drug makers "are not interested, and have never been interested in doing education of physicians," he said. "I can't see them stepping up and driving the opioid use guidelines out to physicians and making sure that they're implemented."
The first generic versions of the drug dubbed "Hillbilly heroin" were authorized by Health Canada on Monday - one day after the patent held by Purdue Pharma for its long-acting formulation of oxycodone, the active ingredient in OxyContin, expired.
Purdue began phasing out OxyContin earlier this year, replacing it with OxyNEO. Oxy-NEO tablets have been hardened to make them more difficult to abuse. When crushed, the pills form a thick, gummy-like gel in water, making them harder to snort or inject.
But the generics will use the same older, "easy to tamper with" formulation in the now discontinued OxyContin, doctors who treat patients with chronic pain or addiction wrote in a letter to federal health minister Leona Aglukkaq Nov. 19.
"If there were some foolproof way to stratify patients into low risk vs. high risk, perhaps we could provide the generic versions to low-risk patients and reserve the tamper-resistant formulations for the higher risk patients," read the letter, endorsed by 34 doctors.
But even with screening and monitoring, "it is always a challenge in practice to be confident that a given patient is using pain medication appropriately."
There is also a risk that public and private insurers would consider the drugs interchangeable, they added, and that pharmacists would automatically substitute a prescription for OxyNEO that was specifically prescribed for a high-risk patient, with one of the cheaper generics.
Provincial health ministers, as well as the Ontario Association of Chiefs of Police, had appealed to Aglukkaq to delay approval of generic Oxy-Contin. But Aglukkaq said she is compelled by law not to withhold approval for a drug that is otherwise considered safe and effective for its intended use.
"The minister has made it clear that she doesn't feel it's the place for politicians to interfere with the scientific review process," her spokesman, Steve Outhouse, said Tuesday. "It's fine for doctors to write a letter saying, 'Don't approve this drug,' " Outhouse said. "The reality is that this drug never hits the streets unless it is prescribed. So if there are 34 doctors who are concerned about it, none of them need to prescribe a generic version of OxyContin to anyone."
Health Canada said manufacturers have been asked to submit "risk management plans" on the safe use of the generics. Licensed dealers have also been told to report spikes in sales, sudden changes in distribution patterns or other potential signs of diversion.
Montreal physician Dr. Mark Ware said the government has approved a drug formulation with known health hazards. He said data from the United States suggested that removal of OxyContin from the market has led to reduced rates of oxycodone abuse in that country.
Opening the market to generics "means that it's now fair game once again for abuse," said Ware, director of clinical research at the Alan Edwards Pain Management Unit at the McGill University Health Centre in Montreal.
Generic drug makers "are not interested, and have never been interested in doing education of physicians," he said. "I can't see them stepping up and driving the opioid use guidelines out to physicians and making sure that they're implemented."
© Copyright (c) The Vancouver Sun
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