Tag: drugs

Winnipeg Mayor Brian Bowman speaks at the Nov. 22 forum Wide Awake. According to Ivy Kopstein of Jewish Child and Family Service of Winnipeg, he “is advocating to all levels of government for resources to deal with this health crisis.” (photo by Nik Rave)

“It is a significant issue in both Winnipeg and Vancouver,” Dr. Ruth Simkin told the Independent. “In Vancouver, it has been overshadowed by the opioid crisis, but is a significant problem there, too. It is seen in the Winnipeg Jewish community. I don’t have stats on its prevalence in this particular group, but it is likely similar to other populations.”

Simkin is a family physician working at a community health clinic in Winnipeg and part-time with the addictions unit/addictions consult service at the Health Sciences Centre (HSC) and Rapid Access Addictions Medicine (RAAM). The JI recently interviewed her about addiction; in particular, to methamphetamine, in light of a Nov. 22 forum in Winnipeg on the topic.

Wide Awake – An Eye-Opening Look at Methamphetamine in Winnipeg was held at the Asper Jewish Community Campus. It was co-presented by Jewish Child and Family Service (JCFS) of Winnipeg, Gray Academy of Jewish Education and the Rady Jewish Community Centre.

Amphetamines were developed in the late 1900s and used commercially from about 1930 for various reasons, including nasal congestion and to keep soldiers awake. Because of their adverse effects and addictive properties, however, their use became legally restricted in the 1970s.

Methamphetamine (crystal meth) belongs to the amphetamine class of drugs – stimulants that speed up the body’s central nervous system. Although not legally available in Canada, crystal meth has been used recreationally for a very long time.

“The initial effects of methamphetamine on the user are a sense of well-being or euphoria, increased energy and alertness, increased confidence and little need for food or sleep,” said Simkin. “Unwanted potential side effects include racing heart, dry mouth, nausea and vomiting, anxiety and restlessness. It can also produce paranoia, delusions and aggressive and violent behaviour.”

“Methamphetamine comes as a powder that can be used by ingesting, snorting, smoking or injecting,” explained Dr. Erin Knight, medical director of the HSC’s addictions program, who was a Wide Awake panelist. “It also comes in a crystal form (crystal meth). It is produced in illegal labs with fairly inexpensive and sometimes toxic ingredients. It may be made with ingredients from antifreeze, batteries and cleaning fluid.”

It is estimated that one percent of students in Manitoba from grades 7 to 12 have tried methamphetamine over the last year. It is easily accessible and inexpensive. Its price has dropped significantly in the last few years, from approximately $30 per gram to $10 per gram.

In her work at the HSC, it is common for Simkin to see patients who use meth, usually along with other drugs.

“It is a growing problem,” said Simkin about the use of the drug. “It is very accessible, cheap, has a prolonged effect on the user – six to eight hours if injected and 10 to 12 hours if smoked – and it is very reinforcing (addictive).

“As well, its effects are more unpredictable than other drugs. The number of users has doubled over the last few years. And, we’re also seeing a shift from individuals smoking meth to them injecting meth.”

According to Sheri Fandrey of the Addictions Foundation of Manitoba – who also was a Wide Awake panelist – drug mixing increases the potential for challenging behaviours and the possibility of a serious overdose. That meth is bought and sold in an unregulated market increases the risk that it may contain adulterants and contaminants that can cause further harm.

“There is no specific treatment in terms of medication,” said Simkin regarding addiction to meth. “There is some evidence for the use of motivational interviewing (MI) and rewards-based treatment.”

A recent Winnipeg Regional Health Authority (WRHA) report stated that, in the 2014-2015 fiscal year, 682 people who sought treatment at the Addictions Foundation  had used meth over the prior 12 months. A year later, that number had increased to 1,198. Meth was no longer being reported to be an occasional drug, and women were using more than in the past.

“As far as we know, meth use crosses all lines: rural/urban, high/low income and male/female,” said Simkin. “However, as with other substances, there are higher risk groups. These higher risk groups are students, low-income, rural, homeless, disenfranchised groups and people with co-occurring mental health disorders.”

Last year’s theme for Addictions Awareness Week, chosen by the Canadian Centre for Substance Use and Addiction, was “All Walks of Life.” Substance use issues and addiction do not discriminate by age, gender, class or religion.

Simkin said this is a complex and difficult issue, but suggested that having education programs in schools would be helpful, as are forums such as Wide Awake.

As a community, Simkin said there are several things that can be done to improve the situation:

1. Reduce the stigma around substance use in general, so people who need help aren’t afraid to seek it.

2. In terms of government, increase funding for detox beds and addiction treatment, including harm-reduction services.

3. Work on other determinants of health, like poverty, housing and education, as well as mental health, to try to prevent addiction in the first place.

Another resource now available in Winnipeg are the RAAM clinics that have been instituted recently by the WRHA to provide low-barrier access to resources for individuals needing help with substances abuse issues, including crystal meth.

“The City of Winnipeg and law enforcement are responding to the crisis on the streets and have included public education programs in all areas of the city,” said Ivy Kopstein, coordinator of the substance use and addictions program at JCFS Winnipeg. “Our mayor is advocating to all levels of government for resources to deal with this health crisis.”

“Emergency Medical Services (EMS) has now been given the authority to give meth users the antipsychotic drug Olanzapine,” Simkin offered by way of an example.

When a loved one has a substance abuse issue, it impacts the whole family, she said. Family members may feel stressed and anxious and it’s important for them to also seek support.

In British Columbia, the B.C. Centre on Substance Use (bccsu.ca) “is a provincially networked organization with a mandate to develop, help implement and evaluate evidence-based approaches to substance use and addiction.” Other resources include Crystal Meth Anonymous (crystalmeth.org), which is similar to Alcoholics Anonymous and lists a meeting place on Hornby Street in Vancouver, and Jewish Addiction Community Services (778-882-2994 or [email protected]).

Rebeca Kuropatwa is a Winnipeg freelance writer.