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Without the moralism, harm reduction is a vague term. Here in Canada the government has been pushing safe supply as a part of harm reduction. We still get the

by vivekd 3y ago

Without the moralism, harm reduction is a vague term. Here in Canada the government has been pushing safe supply as a part of harm reduction. We still get the same number of overdoses but our cities are now filled with tent encampments and people with addiction issues. It doesn't seem to have helped with anything it's just made things worse I don't deny that there are some forms of harm reduction which are proven to be effective. But I also think it's a vague weasel word for just give them drugs or just make it all legal. Which is not a good policy as we have seen here. Ironically just using vague terms like harm reduction without putting forward a specific strategy is a sort of moralizing of its own

klyrs 3y ago
No, some local governments have been doing safe injection sites. Safe supply is a political football that's scapegoated despite not being implemented anywhere in Canada. And neither is a solution to the homelessness, addictions, and mental health crises. Every time I hear a politician talking about safe supply, they say it's not a silver bullet. Which is weird because nobody claims it's a silver bullet. Know what else isn't a silver bullet? Criminalization. Or, everything else that's ever been tried. It's a hard problem, there isn't a silver bullet solution, get over it. What's harm reduction good for? Reducing harm. It isn't harm prevention, it isn't free housing, it isn't free addiction counseling, it doesn't fart roses. Safe injection sites keep users close to medical professionals so we can keep people from dying alone. Safe supply would ensure that users aren't going to accidentally OD on kerfentanyl thinking it's ordinary fentanyl. Needle exchanges keep users supplied with sterile equipment to reduce risk of injections such as HIV and hepatitis C. Each policy is an example of harm reduction. The general philosophy is to not let perfect be the enemy of good.
- vivekd 3y ago
  No your statement is incorrect. We do have safe supply in Canada. The CBC even wrote an article defending our safe supply program. https://www.google.com/amp/s/www.cbc.ca/amp/1.7071004 https://www.google.com/amp/s/www.cbc.ca/amp/1.7071004 And this is a part of my problem with all this. I live in Toronto's downtown core and the explosion in drug issues since these policies came into effect is something I see and live with. And it's the same in our other major cities. And too often the response from the proponents of these policies is outright misinformation, accusations of moralism. As someone living in an area where I am watching a drug problem spiral out of control, this is frankly infuriating. This is my city and I see these people with addiction as neighbors I want to help. But these policies don't appear to be helping them. It looks to me like it's making things worse If it's so good, if it's so helpful, why are there tent encampments full of people with drug issues popping up. We have shelters so it's not an issue of lack of shelters. Why are there so many more people high or doing drugs on our streets, why are overdose deaths the same or higher
  - afarviral 3y ago
    Could the gradual impacts of economic downturn, unemployment and unhappiness post-pandemic be a contributing factor? From available data on drug overdoses and homelessness things appear relatively stable but some data from last year is missing. An uptick may be on the cards based on your observations. I'm curious what specifically is to blame in your view and why other factors seem unlikely? What do you suggest should change? Should the drugs be recriminalized? Or is the current strategy okay but needing some supplimentary steps?
    - vivekd 3y ago
      I mean there aren't enough quality studies to make conclusions either way. But the promise to us was that safe supply would help drug users, and this uptick in homeless drug addicts and more people suffering visibility from drug issues at least seems to run counter to that that should at least give us pause and make us re evaluate This was done because Portugal did it and people in places like hacker news started pushing it as evidence based because of self proclaimed success in Portugal. Well overdose and drug use is up in Portugal, it's up in Portland and it's up here. How long are proponents going to suggest other factors - this safe supply idea is starting to look less evidence based and more like a religious belief.
  - c4ptnj4ck 3y ago
    Did you read the article you posted? The article states how its beneficial to their patients for stabilizing their use and keeping them off the streets. Additionally the program has a total of 274 patients so it's not some widespread supply occurrence whatsoever, even if all of those people were located just in Toronto. That's a fraction of the addicts out there in that city alone. Or did I miss something?
    - vivekd 3y ago
      You missed that I was replying to a poster who said we don't have safe supply in Canada and it was just a political scapegoat. Other papers have written about the more nefarious effects of safe supply but I avoided them because I suspected I was dealing with a group that would dismiss all criticism of it as propoganda from opponents who want to punish addicts with prison. So I posted a supportive article from a government sponsored source to prove safe supply actually exists in Canada and is not just a political scapegoat
- d0gsg0w00f 3y ago
  As a former substance abuser I can assure you that criminalization was a strong motivator to stop. Anything and everything that made my behavior seem OK/normal in any way fueled the addiction. Fear of permanent incarceration was significant factor in hitting my bottom.
  - steve_adams_86 3y ago
    I think this is true for anyone in a situation in which making positive change works against short term interests. That excessive positivity encouraged in discourse around addiction is quite corrosive and misguided. We certainly shouldn't shame people suffering from addiction. No one would choose that life if they knew what was coming or if they had sufficient control at any given moment. We also shouldn't pretend it isn't normal, because addiction is extremely common. Yet it's ironically unkind to encourage someone, in any shape or form, to consider their addiction acceptable on any level. It's purely only welcoming death into life and burdening the world around you. It's a net loss and nothing more. To accept anything about it is absurd. Yes, accept the person and their shortcomings, but don't pretend the state of their life, especially contrasted with their potential, is anything like acceptable. The hard thing here is that this kind of engagement and narrative arguably demands a lot more support than we're willing to give people. Telling them it's okay and giving them safe sites and supplies is a lot easier if it's financially viable. This sort of calculus, in my opinion, is a major cause of the tear in the social fabric which has lead to such widespread suffering in an unprecedentedly rich society where you might otherwise intuitively expect addiction to be eradicated. We're eager to invest financially before we do so emotionally or spiritually.
jdietrich 3y ago
Drug use and addiction are complex biopsychosocial phenomena with many causal factors and associated harms. It is to be expected that any effective response would likewise be complex and multifactorial. People living with drug addictions are usually living with a multitude of other problems, many of which would still remain if a magic wand were to cure their addiction instantly. A homeless schizophrenic heroin addict would still be in a dire situation if heroin didn't exist. Drug policy in North America seems to be ideologically fixated both on addiction as a singular problem, and on singular solutions to that problem. Addiction is an important and very hazardous part of someone's life, but it's only one part. Lots of people who live in tents or behave erratically in public aren't addicted to drugs; lots of people who are addicted to drugs don't live in tents or behave erratically in public. Giving someone an adequate and reliable supply of pharmaceutical opioids is quite likely to reduce their risk of overdose if it gets them away from a highly variable supply of very potent synthetic opioids, but thinking that it'll solve all of their problems is pure fantasy. Keeping people alive is a prerequisite to fixing the rest of their life, but nothing more than that.

by vivekd 3y ago

klyrs 3y ago

No, some local governments have been doing safe injection sites. Safe supply is a political football that's scapegoated despite not being implemented anywhere in Canada. And neither is a solution to the homelessness, addictions, and mental health crises. Every time I hear a politician talking about safe supply, they say it's not a silver bullet. Which is weird because nobody claims it's a silver bullet. Know what else isn't a silver bullet? Criminalization. Or, everything else that's ever been tried. It's a hard problem, there isn't a silver bullet solution, get over it. What's harm reduction good for? Reducing harm. It isn't harm prevention, it isn't free housing, it isn't free addiction counseling, it doesn't fart roses. Safe injection sites keep users close to medical professionals so we can keep people from dying alone. Safe supply would ensure that users aren't going to accidentally OD on kerfentanyl thinking it's ordinary fentanyl. Needle exchanges keep users supplied with sterile equipment to reduce risk of injections such as HIV and hepatitis C. Each policy is an example of harm reduction. The general philosophy is to not let perfect be the enemy of good.

vivekd 3y ago
No your statement is incorrect. We do have safe supply in Canada. The CBC even wrote an article defending our safe supply program. https://www.google.com/amp/s/www.cbc.ca/amp/1.7071004 https://www.google.com/amp/s/www.cbc.ca/amp/1.7071004 And this is a part of my problem with all this. I live in Toronto's downtown core and the explosion in drug issues since these policies came into effect is something I see and live with. And it's the same in our other major cities. And too often the response from the proponents of these policies is outright misinformation, accusations of moralism. As someone living in an area where I am watching a drug problem spiral out of control, this is frankly infuriating. This is my city and I see these people with addiction as neighbors I want to help. But these policies don't appear to be helping them. It looks to me like it's making things worse If it's so good, if it's so helpful, why are there tent encampments full of people with drug issues popping up. We have shelters so it's not an issue of lack of shelters. Why are there so many more people high or doing drugs on our streets, why are overdose deaths the same or higher
- afarviral 3y ago
  Could the gradual impacts of economic downturn, unemployment and unhappiness post-pandemic be a contributing factor? From available data on drug overdoses and homelessness things appear relatively stable but some data from last year is missing. An uptick may be on the cards based on your observations. I'm curious what specifically is to blame in your view and why other factors seem unlikely? What do you suggest should change? Should the drugs be recriminalized? Or is the current strategy okay but needing some supplimentary steps?
  - vivekd 3y ago
    I mean there aren't enough quality studies to make conclusions either way. But the promise to us was that safe supply would help drug users, and this uptick in homeless drug addicts and more people suffering visibility from drug issues at least seems to run counter to that that should at least give us pause and make us re evaluate This was done because Portugal did it and people in places like hacker news started pushing it as evidence based because of self proclaimed success in Portugal. Well overdose and drug use is up in Portugal, it's up in Portland and it's up here. How long are proponents going to suggest other factors - this safe supply idea is starting to look less evidence based and more like a religious belief.
- c4ptnj4ck 3y ago
  Did you read the article you posted? The article states how its beneficial to their patients for stabilizing their use and keeping them off the streets. Additionally the program has a total of 274 patients so it's not some widespread supply occurrence whatsoever, even if all of those people were located just in Toronto. That's a fraction of the addicts out there in that city alone. Or did I miss something?
  - vivekd 3y ago
    You missed that I was replying to a poster who said we don't have safe supply in Canada and it was just a political scapegoat. Other papers have written about the more nefarious effects of safe supply but I avoided them because I suspected I was dealing with a group that would dismiss all criticism of it as propoganda from opponents who want to punish addicts with prison. So I posted a supportive article from a government sponsored source to prove safe supply actually exists in Canada and is not just a political scapegoat
d0gsg0w00f 3y ago
As a former substance abuser I can assure you that criminalization was a strong motivator to stop. Anything and everything that made my behavior seem OK/normal in any way fueled the addiction. Fear of permanent incarceration was significant factor in hitting my bottom.
- steve_adams_86 3y ago
  I think this is true for anyone in a situation in which making positive change works against short term interests. That excessive positivity encouraged in discourse around addiction is quite corrosive and misguided. We certainly shouldn't shame people suffering from addiction. No one would choose that life if they knew what was coming or if they had sufficient control at any given moment. We also shouldn't pretend it isn't normal, because addiction is extremely common. Yet it's ironically unkind to encourage someone, in any shape or form, to consider their addiction acceptable on any level. It's purely only welcoming death into life and burdening the world around you. It's a net loss and nothing more. To accept anything about it is absurd. Yes, accept the person and their shortcomings, but don't pretend the state of their life, especially contrasted with their potential, is anything like acceptable. The hard thing here is that this kind of engagement and narrative arguably demands a lot more support than we're willing to give people. Telling them it's okay and giving them safe sites and supplies is a lot easier if it's financially viable. This sort of calculus, in my opinion, is a major cause of the tear in the social fabric which has lead to such widespread suffering in an unprecedentedly rich society where you might otherwise intuitively expect addiction to be eradicated. We're eager to invest financially before we do so emotionally or spiritually.

jdietrich 3y ago

Drug use and addiction are complex biopsychosocial phenomena with many causal factors and associated harms. It is to be expected that any effective response would likewise be complex and multifactorial. People living with drug addictions are usually living with a multitude of other problems, many of which would still remain if a magic wand were to cure their addiction instantly. A homeless schizophrenic heroin addict would still be in a dire situation if heroin didn't exist. Drug policy in North America seems to be ideologically fixated both on addiction as a singular problem, and on singular solutions to that problem. Addiction is an important and very hazardous part of someone's life, but it's only one part. Lots of people who live in tents or behave erratically in public aren't addicted to drugs; lots of people who are addicted to drugs don't live in tents or behave erratically in public. Giving someone an adequate and reliable supply of pharmaceutical opioids is quite likely to reduce their risk of overdose if it gets them away from a highly variable supply of very potent synthetic opioids, but thinking that it'll solve all of their problems is pure fantasy. Keeping people alive is a prerequisite to fixing the rest of their life, but nothing more than that.