Jeremy Devine’s op-ed raised serious concerns for me

Tags:

Shannon Riley | March 17th, 2017

Harm reduction, as it relates to people with dependencies on substances, is a philosophy that supports people. It does this by guiding people in order to reduce other harms in their life, even if that means continuing to consume a substance that is potentially causing them harm. I would argue much of the actual harm that people with dependencies on illicit substances endure are actually the fault of archaic drug laws. The harm is not actually intrinsic to the substance itself. For example, if I had to wake up each morning to steal or perform survival sex work in my community in order to get my daily dose of unregulated (street-grade) insulin, I would also be in a harmful situation. The harm would come both from not knowing if what I was buying was actually insulin, and also the personal risks I was taking in order to obtain it.

 

In the news

Jeremy Devine, a medical student from the University of Toronto’s Faculty of Medicine, wrote an opinion article to the National Post on Mar. 2, 2017 entitled Harm reduction programs like safe injection sites don’t beat addiction. They just sustain it.
You can find it here.

In summary Mr. Devine wrote how the harm reduction movement ‘doesn’t beat addiction it sustains it,’ though he offered no laudable alternative. He evidently felt justified in writing this stigma-laden piece in order to prove some nebulous point. Mr. Devine’s article is targeting the most vulnerable people, people who have had severe histories of alcohol and opioid dependence. He questions, ‘Is their drug use no longer a problem because they’re off the street? And where exactly do the patients go from here?’

I can tell you.

 

About the patients

The people who are now in managed alcohol programs are fortunate people. They are no longer living on the street drinking non-beverage alcohol because that is all they can afford. They are sleeping indoors and they are getting the regulated alcohol medicine they need to be alive and not be at risk of death on a daily basis. They now have a chance to live with dignity by being housed in a system of care designed for their needs. I have known many beautiful people with severe alcohol dependency who have died alone on the street or in a hotel room because of our society’s inability to house them with a model of care that is needed in order to keep them safe and alive. Programs that provide alcohol to people with alcohol dependencies create healing communities.

 

Harm reduction works

The patients of the Crosstown Clinic, are also in a similar situation. At this clinic, patients who have failed on every treatment western medicine has to offer for a person with an opioid use disorder, receive either injectable hydromorphone (Dilaudid) or Diacetylmorphine (heroin). They are provided with the regulated medication they need to be well. If you have not seen the video about the patients in the Crosstown Clinic, I can see how you might not understand how drastically life has improved for these patients, especially if you have never had any exposure to this model of care. But take a few minutes to watch this video and honestly tell me that you can still doubt that this model of care is not in these patients’ “best interest” – a point which Mr. Devine suggests is “highly questionable.”.

A few weeks ago I was attending the Canada-wide Supervised Consumption Conference in Vancouver, when I heard about Raffi Balain’s overdose death. My colleagues in attendance who knew this inspirational man were absolutely devastated. He was the heart of their community. I unfortunately never had a chance to meet him, but I have since learned that through his work that he inspired and taught many people to treat people who use drugs with the dignity and respect they deserve in the face of a stigmatizing point of view that Mr. Devine perpetuates through his writing. Raffi’s death is not proof that harm reduction does not work. It is federal drug policies that do not work. Prohibition does not work now, nor has it ever.

 

Let’s move beyond stigma

Mr. Devine’s op-ed raised serious concerns for me about how patients can be stigmatized by health care professionals based on the substances they use, even if those substances help them to survive each day. How will patients have open and honest conversations with providers? I believe as health professionals we must move beyond Mr. Devine’s way of thinking and fight for the dignity and respect that all humans deserve. Only together can we shift this paradigm and change the drug laws that continue to harm our friends and families every single day.

What are your thoughts on this issue? Post your comment below.

About the Author

Shannon Riley
email iconShannon.Riley@vch.ca  

Project Manager, Illicit Drug Overdose Response at Vancouver Coastal Health.

A Beginners Guide to Disqus

Disqus is a great platform for adding comments to blogs and articles. For the most part it's straightforward and easy to use, but at first the amount of options can be daunting and intimidating. Luckily for us, once past the initial process, commenting is really made easy.

This guide is to help users understand the user interface of Disqus in order to use it in the most effective way for their needs.

Note: You can write the comment at any time during the process, before, after, or during.

  • 1. Your first click:


  • 2. Choose your account, or dont:


  • 2. a) Facebook example:


  • 2. b) Guest example:



  • 3. Submit your post:



  • 4. You're done, that's it!

    All comments are moderated, so if your comment doesn't appear right away it's because it is awaiting moderation from administrators.

4 comments on “Jeremy Devine’s op-ed raised serious concerns for me

  • Patti Caldwell says:

    Well said Shannon – your comments echo the success of the Portugal Fix that was recently aired on CBC.

    • Dan says:

      I just love that there is an open conversation for discussion around these issues. I worked with many individuals who use. They often share with me that they want to stop, that they are not happy. There statements tell me that “using” is a much bigger issue than a personal choice. Yet, we individualize persons who use what are considered illegal drugs, we problematize their behavior, we medicalize, institutionalize, while all along we marginalize. I can’t help but think that “using” is a mark of their victimization; it is their acceptance of their lot in life, without visible question, without organized protest, without collective anger or rage”. The process of marginalization is to alienate; to other; to oppress; to extinguish hope – in the absence of choice. To render to body docile in this way helps us sleep at night. For if, we can keep quiet, what we are complicit in doing, which is to feed the hegemony of the dominant norm, then why quibble about a harm reduction? The problem is that the issue is so much bigger than harm reduction. I cannot even say the word community anymore, but rather we are a fractured mass, protecting our own interests, still predicated on getting more at whatever costs possible. As we fortify and add to what we have, so what if there are a few casualties along the way? The question is not whether harm reduction works or not, the question is what purpose does it serve?

  • Kerrie Watt says:

    Thank you Shannon for your response… I find this position of Mr. Devine’s to be patently inaccurate and misplaces the onus of harm reduction by highlighting tired moralistic arguments that are nothing more thinly veiled attempts at othering people and blaming them for the systemic and social failings of our current system. Sadly he was printed in the National Post and not you.

Leave a Reply

Your email address will not be published. Required fields are marked *

All comments are moderated.

Email addresses will not be made public.

You may comment anonymously, but a valid VCH email address is required to verify that you are an employee.

Only comments attributed to a valid VCH.ca or providencehealth.bc.ca email address will be published.

Quality Safety & Patient Care.

This is the place for discussion, debate and collaboration on issues and ideas that advance engagement with VCH’s strategic True North goals and objectives. It is not just for executives, but the tone of this stream is tailored to those serving in a leadership role or those who have interest in the “why” behind organizational priorities.

Recognizing Excellence & Success

This is the place for discussion, debate and collaboration on issues and ideas that advance engagement with VCH’s strategic True North goals and objectives. It is not just for executives, but the tone of this stream is tailored to those serving in a leadership role or those who have interest in the “why” behind organizational priorities.

Photos & Fun

This is the place for discussion, debate and collaboration on issues and ideas that advance engagement with VCH’s strategic True North goals and objectives. It is not just for executives, but the tone of this stream is tailored to those serving in a leadership role or those who have interest in the “why” behind organizational priorities.