Dan Small is a medical anthropologist and lecturer at the University of British Columbia.
Since 2018, British Columbia has been pursuing legal action against pharmaceutical companies for their involvement in the opioid crisis. Within the wider context of North America, there have been over 2600 such lawsuits against the pharmaceutical companies including Purdue, Johnston and Johnson, Teva Pharmaceutical and Endo International. The Purdue pharmaceutical company, the maker of OxyContin, has recently filed for bankruptcy in response to the lawsuits. I believe a suitable strategy for examining the wider variables that have contributed to the opioid crisis: a Royal Commission. This is needed in order to widen public scrutiny beyond the role of pharmaceutical companies to include investigation of the overarching causes of Canada’s overdose epidemic.
Noémie La Haye-Caty is a medical student in the Class of 2019 at McGill University
Katy is sleeping on the exam table. She came in looking tired, talking with a weak voice, and walking with small steps. I tried to ask a few questions, but her lack of sleep was evidently preventing her from answering.
She is here today for a follow-up appointment. She was admitted two weeks ago because she wanted to end her life.
I try to gently wake her up. “How are you doing, Katy?”
“Great! What’s better?”
“I was confused, before.”
“Why were you confused?”
Katy is 24 years old and has three young children. She is now a few weeks pregnant. Two of her children were recently taken by the Director of Youth Protection (DYP), while the youngest lives with Katy and Katy’s own mother. Katy tells me that the father of her kids used to be violent with her and has been in prison for the past week. ...continue reading →
Hilary Drake is a medical student in the Class of 2021 at the University of British Columbia
On my first day in a new family practice, my preceptor asked me to take a history from a patient who had listed their “reason for visit” as a sore throat. I stood in the hallway and made a mental checklist of questions to ask and observations to make. Have they had any sick contacts? Does their voice sound hoarse?
When I opened the door and asked them if they could tell me what brought them in today, they responded as expected: “My throat is sore.” When I asked what they thought might be causing the pain, they unwrapped a scarf from their neck and stated, “I think it’s because the noose didn’t work.” At that point they started crying.
They had tried to come in before. They had recognized their pain and wanted to reach out for help, but they were unable to out of fear that their physician would not believe the pain if they could not see it.
Abhishek Gupta is a research and medical sub-intern at CAMH who graduated from the Windsor University School of Medicine
The controversial debate over cannabis legalization has concluded on an official level, legally placing the drug in the hands of the Canadian public. Very soon, anyone over the age of 19 will be able to walk into a store and obtain it for personal consumption.
For mental health professionals, some aspects of this decriminalization effort are appealing. Conventional marijuana is often laced with far more dangerous substances leading to highly dangerous health outcomes. Furthermore, individuals with substance abuse issues are more likely to seek professional help when the consequences of drug possession are milder. Much like needle exchange sites, this move towards legalization provides consumers with a safer alternative for addressing their cravings for cannabis. ...continue reading →
Physicians from many specialties may care for inpatients with opioid use disorder. An acute hospital admission is an opportunity to engage with patients who have this common, chronic disorder, discuss addiction treatment and possibly affect the course of their illness. In this podcast, Dr. Joseph Donroe, Assistant Professor of Medicine at the Yale School of Medicine, discusses the best approach to specific problems that may arise when a patient with chronic opioid use disorder is hospitalized for another reason. Potential problems include withdrawal symptoms and managing acute pain.
Dr. Donroe co-authored a review article published in the CMAJ (subscription required).
Carolyn Shimmin is a Knowledge Translation Coordinator with the George and Fay Yee Centre for Healthcare Innovation and EvidenceNetwork.ca
From Chaucer to Shakespeare, women’s consumption of alcohol and other drugs has been historically written about and portrayed as an absolute affront to the dictates of socially-constructed ideals around “respectable femininity.” Girls and women living with substance issues are often falsely perceived as hypersexual and sexually promiscuous (i.e. as “sluts” and “loose”). Beneath the rhetoric that “good girls don’t imbibe” lies a dangerously entrenched stigma within our society that ― combined with the fact that two out of three Canadians don’t understand sexual consent as well as the codification of certain rape myths in law ― means the bodies of certain girls and women living with substance use problems become spaces where sexual violence can occur with impunity. ...continue reading →