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Tag: fentanyl

Drugs and teens

When we hear the word addiction, it often conjures up negative images or stereotypes. We might think someone has made poor choices, is down and out, or weak-willed; we might think that it’s a problem confined to the Downtown Eastside. Rarely do we think of the word disease or think of addiction as a mental health issue.

Jewish Addiction Community Services (JACS) is committed to providing opportunities for the community to learn together and, on April 4, JACS and the Jewish Community Centre of Greater Vancouver youth department are presenting a community forum called The Fentanyl Crisis: How It Affects Our Teens. This free event, geared to parents, teens and youth workers, is designed to help build awareness of illicit drugs, specifically fentanyl, and to teach how these drugs affect the teenage brain, and how to talk to teens about drugs.

According to a B.C. Coroners Services report, which was published last month, 86% of fatal illicit drug overdoses in 2018 occurred inside (i.e. not on the street) – 58% in private residences. The majority of these deaths were men between the ages of 19 and 59.

While the problem of addiction in British Columbia is well known, what is less well known or acknowledged is how our Jewish community is affected. In fact, denial that the problem exists is more the reality. Rabbi Shais Taub, a specialist in addiction and spirituality, who visited Metro Vancouver in 2012, said one in 10 people are touched by addiction – whether directly or through a close family member. It makes sense that those statistics are similar in our community.

Compare the reaction of when you hear about a friend who has recently been diagnosed with cancer, or another debilitating disease. While we may not know how to help, when a loved one is affected with a life-altering illness, we are usually motivated to offer assistance, whether it is making meals, visiting or giving money to a cause. In sharp contrast, addiction tends to push us away and we tend to blame the person who has a substance use disorder, instead of wanting to rally around and help them.

Why does a family feel shame and the need to shield others from knowing their loved one is affected by the disease of addiction? Why does the person themselves feel the need to hide? Clearly, the answers are complex. In a recent visit to an emergency department, a patient pleaded with a nurse that “no one in my community must know I am here.” That person was a member of our Jewish community. Not only are people struggling with an illness, but they often can’t reach out for help or don’t know where to turn.

We must and can work to reduce the stigma of addiction so that both families and people with addiction are supported. It begins with awareness of resources and education, with fostering a culture of being less judgmental, of being curious and open, and being willing to talk about how someone may have found themselves suffering from addiction. We also need to remind ourselves of the Jewish values of teshuvah (repentance), tikkun olam (repair of the world), community and chesed (loving kindness). People knowing that there are resources available, when they are ready, is key to recovery.

The April 4 community forum includes panelists Dr. Alana Hirsh, a physician working in the Downtown Eastside; Lee Gangbar, a registered nurse who works both at St. Paul’s Hospital’s emergency department and as an outreach healthcare nurse; and Anne Andrew, a parenting coach and author. To attend the forum, RSVP at eventbrite.ca (Fentanyl Crisis). For more information on the program or JACS, email [email protected].

Shelley Karrel is the manager of counseling and community education with JACS. She has her master’s in clinical counseling, is a registered clinical counselor and also has a private counseling practice. She can be reached at [email protected].

Posted on March 22, 2019March 20, 2019Author Shelley KarrelCategories Op-EdTags addiction, education, fentanyl, healthcare, JACS, JCC, tikkun olam
How best to treat addiction

How best to treat addiction

The Feb. 22 panel discussion at Congregation Schara Tzedeck featured, left to right, moderator Dr. Auby Axler and panelists Rabbi Andrew Rosenblatt, Dr. Jenny Melamed, David Berner and Rebecca Denham. (photo by Zach Sagorin)

Approximately 5,000 Jews in the local Jewish community need support around addiction, according to Jewish Addiction Community Services Vancouver.

JACS offers various support programs for those battling addiction, and their families and friends, and organizes events for community education and awareness. On the evening of Feb. 22, at Congregation Schara Tzedeck, the agency partnered with Schara Tzedeck and the Jewish Federation of Greater Vancouver for a panel discussion on the fentanyl crisis and addiction in the Jewish community in general. Participating panelists were Rabbi Andrew Rosenblatt, addiction medical specialist Dr. Jenny Melamed, addiction therapist David Berner and director of services at JACS, Rebecca Denham; the moderator was Dr. Auby Axler.

“JACS Vancouver is a new agency trying to tackle a taboo and shame-filled topic that can ignite passionate responses and strong resistance,” explained Denham in an email. It is committed to supporting community needs relating to substance use, and values a diversity of perspectives on addiction treatment.

At the panel discussion, Rosenblatt spoke about some of the community concerns and the internal conflicts that some people experience when trying to determine the best approaches to addiction support.

Melamed, an addiction doctor who has been treating people with opioid addiction for 15 years, said, “People have been dying from heroin, people have been dying from all drugs…. There are many drugs out there that are as dangerous. Alcohol is one of the most dangerous drugs out there, 90% of the trauma seen in the [emergency room] after midnight is from alcohol. A heroin addict is a calm, sedated person who is nodding off in a corner, he’s not violent; he’s a danger to himself, and he’s not a danger to anybody else.”

She explained, “Addiction is a … disease situated in the primitive part of the brain…. The addiction goes and sits there and it says, ‘if you do not use me, you will die, you need me.’ This is where the team comes in…. We’ve got the ability to say, ‘I’m not going to listen to you anymore.’ But the power to overcome that is what is needed and it is strong and it requires meetings, it requires therapy, it requires a team, it really is a village to keep somebody sober in the long term.”

About 40 people attended the discussion and Melamed commented, “When you look at how big the Jewish community is and how small the attendance is here tonight … we live with our heads in the sand and we don’t realize how many of us have family members who are in addiction.

“We need to remove the stigma related to addiction. When we tried to get somebody in recovery to talk tonight, we couldn’t find anybody in the Jewish community who would come and stand up, because we put that big addiction sticker on people’s forehead. But we all know that it can happen to anybody. Yes, there is an enormous genetic component, a 40% genetic component when it comes to addiction, but there is trauma. Sexual abuse happens in any religion. Everything happens across the board.”

While the Downtown Eastside is often considered the centre of addiction and drug use, Melamed said this is not the reality. “The people on the DTES make up maybe one to five percent of the drug-using population. Seventy-five percent of people using drugs are what we call functional … nobody knows what is going on out there. If you can afford your heroin habit, then you’re OK until you overdose and it takes you over to the other side.”

Berner, founder and executive director of a residential treatment centre for drug addicts and alcoholics, has conducted almost 11,000 therapy groups.

“Addictions are coping mechanisms…. I’ve never met someone in addiction who hasn’t had a terrible upbringing, who hasn’t had severe trauma, serious trauma,” Berner said. “I’ve rarely met anyone who has addiction who hasn’t suffered physical or sexual abuse, or emotional-psychological abuse, or financial abuse.”

Berner posed the rhetorical question, “Can you change? No.” But, he said, “You can change the things you do, including picking up [drugs or alcohol].”

He said, “Every week I give a lecture, every Tuesday morning, and then do group therapy. One of the things I say week in and week out is, I don’t want to hear about your substance.”

Berner also commented on the government’s spending on addiction services in Vancouver.

“We’ve got harm reduction, that’s it!” he said. “And then prevention, treatment and the law are not only ignored officially … they are officially denigrated by the health department, by the ministry of health, and anyone that can make a decision.”

In response to an audience question – “How does the word recreational fit in with the level of risk that’s involved in drugs?” – Melamed responded, “I think you have to replace the word recreational now with Russian roulette because that’s the word we’re using. There is no safe use.”

“Even with marijuana?” asked another audience member.

Melamed said she knows, based on urine samples she has taken, that “some of the marijuana is laced with fentanyl.”

However, a man in the audience, identifying himself as a federal prosecutor who works with the police on narcotics, countered that assertion. “My understanding, after looking at various police files on where this has been reported, [is that] marijuana laced with fentanyl … is anecdotal. It is from people who have overdosed in a non-fatal manner and have reported it to hospital authorities, doctors, police officers, [saying] ‘all I used was marijuana,’ and this is to avoid, in my understanding, the stigma of being labeled a hard drug user…. There has been no actual seizure by police in B.C. of marijuana laced with fentanyl.”

However, the prosecutor added, “We see cocaine laced with fentanyl, we see a lot of heroin laced with fentanyl, we see methamphetamine laced with fentanyl.”

With Purim approaching, Rosenblatt noted, “Drinking on Purim happens a lot, especially in the Orthodox Jewish community, because there is a statement in the Talmud – a person is obligated to drink on Purim until they don’t know the difference between cursed be Haman, who is the villain of the story, and blessed by Mordechai, who is the hero.”

He said, “Maimonides says the way you should be happy on Purim is by spending most of your effort feeding the poor on Purim. Why? You would think that maybe Maimonides was democratic and would say something very nice like the poor deserve a holiday, too.… That’s not what Maimonides says at all. Maimonides says that there is no greater joy in the world than helping another person.”

“JACS was born out of a necessity and I think it is important to remind you that JACS is here to support you,” said Denham in wrapping up the event. “If a question doesn’t get answered tonight or if an issue gets triggered for you, reach out to us and we will support you just as the community has supported us. We wouldn’t be here today without the kind accepting spirit that runs deep throughout this community. From the support of the rabbinical leaders, professionals, individuals, family foundations, the support of the Federation … all of whom continue to strengthen JACS services … we are bringing this much-needed discussion away from shame and into a supportive light.”

To learn more about JACS Vancouver, Denham can be reached at [email protected].

Zach Sagorin is a Vancouver freelance writer.

Format ImagePosted on March 10, 2017March 8, 2017Author Zach SagorinCategories LocalTags addiction, fentanyl, health, JACS, Rebecca Denham, substance abuse
מגפת הפנטניל

מגפת הפנטניל

מגפת הפנטניל: חמש מאות חמישים וחמישה תושבים מתו בבריטיש קולומביה בתשעה חודשים. (צילום: Crohnie via Wikimedia Commons)

מצב חירום הוכרז במערכת הבריאות של מחוז בריטיש קולומביה לאור מגפת הפנטניל, הסם הקטלני שהורג מדי יום בממוצע שני מכורים במחוז. מספר המתים בבריטיש קולומביה מהסם, בתשעת החודשים הראשונים של השנה הגיע כבר לחמש מאות חמישים וחמישה. לעומת זאת בכל שנת 2015 מתו מהסם בסך הכל חמש מאות ושמונה איש. כוחות ההצלה והמשטרה מסתובבים באזורים בהם מרוכזים נרקומנים שברובם הומלסים, ובידיהם ערכות חירום להציל ממוות משתמשי יתר בפנטניל. להדגמת חומרת המצב: ביום אחד באחד החודשים האחרונים, בתוך כעשרים דקות הגיעו לחדר המיון באותו בית חולים באזור העיר דלתה, שמונה מכורים במצב קריטי ביותר כתוצאה מהשימוש בסם.

הפנטניל שנחשב לזול ונגיש הרבה יותר מהרואין והוא אף חזק פי חמישים ממנו, התחיל להגיע לשוק בקנדה ובארצות הברית לפני כארבע שנים. הוא מיוצר בעיקר בסין ומשם מגיע למעבדות בבתים פרטיים ברחבי בריטיש קולומביה. הסם מורכב ממשכך הכאבים החזק פנטניל (שהוא אופיואיד סינתטי) בתוספת חומרים שטבעם עדיין לא ידוע. ישנן שתי סיבות עיקרתיות לסכנת המוות מהשימוש בפנטניל. הראשונה – סוחרי הסמים מוכרים אותו כהירואין והמשתמשים מזריקים חומר רב כהרגלם (כי הם כאמור חושבים שמדובר בהירואין) ופשוט מתים ממנת יתר. השנייה – הסם מעורבב בחומרים רעילים והדרך על המות קצרה מצד המשתמש.

כידוע הזמר האמריקני פרינס מת משימוש בפנטניל. כעת המשטרה מנהלת חקירה מורכבת כדי לבדוק האם פרינס ידע מראש באיזה כדורים נגד כאבים הוא השתמש. או שהודבקה תווית לא נכונה על הבקבוק שהשתמש בו שהיה מלא בפנטניל.

מדד התיירות הרפואית: קנדה במקום הראשון ואילו ישראל במוקם השלישי והמכובד

קנדה ממומקמת במקום הראשון ואילו ישראל נמצאת לא הרחק אחריה במקום השלישי והמכובד, במדד התיירות הרפואית לשנת 2016, המתפרסם על ידי המרכז הבינלאומי למחקר רפואי (איי.איץ’.אר.סיי) שמושבו בפלורידה. המדד שמורכב משלושים וארבעה קריטריונים שונים כולל ארבעים ואחת מדינות.

עשר הראשונות במדד התירות הרפואית העולמי: ראשונה כאמור קנדה, שנייה בריטניה, שלישית כאמור ישראל, רביעית סינגפור, חמישית הודו, שישית גרמניה, שביעית צרפת, שמינית דרום קוריאה, תשיעית איטליה ועשירית למרבית הפלא קולומביה.

בחלוקה לפי אזורים: חמש עשרה מדינות מהמזרח התיכון ואפריקה (מהוות כשלושים ושבעה אחוז מסך התיירות הרפואית בעולם), תשע מדינות מאירופה (מהוות עשרים ושלושה אחוז מסך התיירות הרפואית בעולם), תשע מדינות מצפון ודרום אמריקה (מהוות עשרים ושניים אחוז מסך התיירות הרפואית בעולם) ושמונה מדינות באסיה (מהוות למעלה משמונה עשר אחוז מסך התיירות הרפואית בעולם).

המרכז הבינלאומי למחקר רפואי מצא עוד נתונים מעניינים לגבי התיירות הרפואית בעולם. חמישים ואחד אחוז הם נשים ואילו ארבעים ותשעה אחוז גברים. למעלה מחמישים ושניים אחוז הם נשואים, כשלושים ושניים אחוז רווקים ואילו כשישה עשר אחוז גרושים. למעלה משישים ושישה אחוז לבנים, כארבעה עשר אחוז שחורים, כשניים עשר אחוז לטינים וכשבעה אחוז אינדיאנים.

גם בשנתיים הקודמות (2014 ו-2015) ישראל מוקמה במקום השלישי. לישראל מגיעים כיום למעלה משלושים אלף תיירים בשנה לקבלת טיפולים רפואיים (שכוללים ניתוחים מוסבכים וטיפולים מורכבים). ובנוסף מגיעים לארץ למעלה משישים אלף תיירים להחלמה ומנוחה (בעיקר לאזור המרחצאות של ים המלח).

בהתאם לנתוני המרכז הבינלאומי למחקר רפואי, מדי שנה גדל מספר החולים שנוסעים לקבל טיפולים רפואיים במדינות אחרות ברחבי העולם. עם זאת אין מספרים מדוייקים של התופעה בקרב המדינות השונות והמדד מתבסס בעיקר על נתונים סטטיסטיים.

Format ImagePosted on November 9, 2016November 8, 2016Author Roni RachmaniCategories עניין בחדשותTags Canada, fentanyl, Israel, medical tourism, התיירות הרפואית, ישראל, פנטניל, קנדה
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