Bright Yellow Triangles and Opioids

Health Canada now requires that prescribed opioid medications need to clearly indicate both on the bottle and in pamphlets a clear warning as to the potential for addiction and misuse. Doctors, researchers and others who study addictions and prescription misuse have suggested that this is an important step in preventing people from developing a dependency on this medication.

I have limited experience with taking medication. Other than my beta blockers for my heart condition and the very occasional antibiotic, I have managed to avoid needing to take prescribed medication. I therefore, may not be qualified to pass comment on a health initiative that may save lives. However, I cannot believe that sticking on a bright yellow triangle on a bottle of pills will cause anyone to be more careful. It is even less likely in my mind that anyone (with the exception of a few rather bored folks) will bother to wade through a notice, typed in incredibly small print, that has been stuck into the box. Individuals are not going to look at the label or read the pamphlet at 2:00 in the morning when they need to take another pill.

It is hard for me to believe that there is a single person living in Canada who is not aware that there is an ever increasing number of individuals who are addicted to opioids. I have to believe that every doctor is well aware of the risks and that the days of extended use of such medication without supervision and review is long past. I have to hope that every time such a medication is prescribed, the doctor has a serious and clear conversation with the patient. In my limited experience, even with my rather innocuous prescribed drugs, I don't get them until the pharmacist makes sure that I understand what I am getting. It would seem to me that if the medical community is doing its job (and I acknowledge that that is not always the case), there is sufficient opportunity for the patient to get all of the information about the drug and its dangers - if they want to hear it.

While doctors, in the post-modernist world may not be on quite as high as pedestal as they use to be, they are still seen as people who can deliver on basic cures and pain relief. In spite of the near epidemic rates of cynicism, we appear to still need to believe that there are people who will always give good advice so that we can get better. In spite of some overwhelming contrary evidence, many of us want/need to believe that the doctor is always right.  People who are in pain are more likely to nod their head when the doctor is talking, ready to agree to anything as opposed to discussing other less effective but safer options. If they ever have qualms about the medication they will just say -"well the doctor said it would help". Doctors may need to find ways of explaining the dangers differently or at the very least be able to spend more time with such patients on a more regular basis.

As the over prescription of such medications as opioids is at least in part the result of people wanting quick and simple results, so is the decision to solve at least part of the problem of abusing prescriptions by printing bright yellow labels on the bottles. It sounds good. It sounds as if someone is doing something. If such warnings stops two people from going down the path to addiction it is worth it. But  for Health Canada to assume that opioid abuse is the result of a lack of education profoundly misdirects the conversation of how and why addictions happen. This initiative places the onus on the patient, when that responsibility at the very least needs to be shared with those who are handing out the pills.

Surprises

At my age - I do not expect too many surprises. I still get to meet interesting people and see extraordinary scenery; I still have the chance to try new things and to have my adventures, but most of those things are somewhat planned. I see those sights, meet those people, have those adventures because I do something that allows them to happen. For example I look forward to meeting some new, interesting people or seeing something I have not noticed before when I hitchhike, but that only happens because I decide to hitchhike. That events happen is not really surprising - in fact I sort of anticipate them happening and when they don't - I am disappointed. But last week two things happened that were just a little bit different.

I was talking to my neighbour and somehow we started talking about dowsing for water. I have always been a bit cynical about that particular bit of folk lore. We did have a well "witched" 35 or so years ago, and the person was accurate. But there is something about believing that a willow stick held in the hands of the right person will dip at a specific place and that there will be water in the ground that strikes me  as weird. It may be because I am somewhat of a natural cynic or perhaps because I just do not trust people. For whatever reason, it is easier for me to assume that a person is conning me. However my neighbour said he could do it, went into his shed and pulled two mental rods each about three feet long with a right angle bend 2/3 of the way down the rod. He held them loosely in his hands, pointing out from his body and as he walked down the street - every time he came to a buried water pipe the rods swung parallel to the depression/cracks in the road. I was quite convinced that I understood his trick. He was suggesting that the cracks in the road were the consequence of shoddy road construction done over sewer/water pipes. Whenever he came to such a spot he  manipulated the rods so that they would move. Quite frankly the rods move so quickly and definitively I was almost embarrassed at the obviousness of his trick. Then he offered the rods to me.

I told him that I had no affinity with anything of that sort and I was sure that they would not work for me. I was giving him a graceful way out - but he insisted and so I tried it - knowing that it would not work. And they did work!!! With absolutely no effort on my part, with the rods held loosely, they swung parallel to the cracks in the road. Not just once but every time.  I don't understand why and I don't care. It was just fun to do something totally outside of my experience.

On Saturday I was at the market. It was wet and it was cold. It was raining when we set up and it was raining when we packed up seven hours later. The fact that anyone came to the market was in my mind a bit of a miracle. I did not expect to sell anything - it was far too miserable for anyone to browse. But a woman did come by and decided to buy a shawl. I was , of course, delighted. We did our business, I gave her some washing instructions, we chatted a bit and then she left. A few minutes later I saw her across the street and realized that I had not told her something - something that I say to all of my customers who spend a lot of money and that is - "When I give something I have made to one of my kids or a relative and they say thank you - that is really nice but they would say thank you whether or not they liked it. But when someone buys something from me, something that in my mind is a lot of money - it makes me feels good, it validates the work that I have done and I get excited to know that someone likes and appreciates my work as much as I do.

The lady was told me that she was an artist and had just sold one of her works. She had decided to take the money and buy something special just for her. She understood the joy of an artist (although I never call myself that) in finding someone who wants their work. We hugged. I have never hugged a customer before but it felt right. Somehow for that brief moment, we stopped being salesperson and customer and became two people who knew what it meant when someone else liked how you spent your day.

Pretty special indeed

Truckers' Training

In a typical western way of reacting after a crisis, provincial governments such as Saskatchewan and Alberta are either planning on doing something about the lack of training for truck drivers or at least are thinking about it. There seems to have been great shock on the part of the media, the politicians and the general public about how easy it is to get a licence to drive those large trucks - those trucks that we depend upon to get much of our food and other necessities of life to our stores in a timely fashion.  I don't know why everyone is so surprised. It has been common knowledge in the trucking industry for decades.

I appreciate the fact that I have perhaps had more contact with truck drivers than some but all one would have to do is ask any experienced truck driver and they would have told you about some of the truckers on the road. I have even written a number of times in my blog about what some truck drivers had said about the poor training and the fact that so many of the new drivers have very little sense of what it means to be a truck driver. I can remember one of my drivers in northern Ontario saying to me that it was harder to get a motorcycle licence that a trucking license and he had been an instructor! While all of my drivers have seemed to be skilled, and the ones who drive through the mountains especially so - there is no doubt that there are drivers who are less skilled or experienced.

One of the problems in the trucking industry are the owners - some of whom appear to be quite willing to bend the rules. One of my drivers (again in Northern Ontario) who clearly had had little training and who spoke very little English, did not drive in cities. He would go to a specific truck stop,  drop his trailer, pick up a new one and then drive back to North Bay. Conveniently his route in fact had only one truck weighing station - one that is very seldom open. This gentleman never did his log books, he did not know how - he said someone else did them for him - which is illegal. After spending 18 hours with him, my singular impression of him was that he was very afraid of being caught doing something wrong. Drivers such as this one are seldom seen eating in the restaurants, nor do they appear to socialize with other drivers. A number of my drivers have suggested that truck drivers new to this country get paid less than others and therefore were undercutting other drivers. While it is tempting to blame the trucker and even perhaps the government for poor training (or lack thereof), it is the owners who hire such drivers, who push the drivers to maximize their time; it is the owners who hire poorly trained drivers, do little or nothing to train them on the job and in the end trust that things will be okay.  

While a heightened public awareness as to the training of truckers is a good thing, especially if it leads to reasonable new policies - I suspect that at least in the short term the people who drive cars (some truckers call them 4 wheelers) will have discovered more reasons to disrespect truckers, to drive dangerously around them and to blame them when there is an accident. It is fair to argue that all truckers need to be trained to a certain level of proficiency including being mentored by more experienced drivers but it is important to remember that there is a whole system of delivery in place and all components of that system must work together ensure the public safety. Training alone a few drivers will not ensure my safety on the roads.

Toronto

Yesterday a young man in Toronto got into a vehicle and then intentionally drove it into people on the sidewalk, killing 13 people and hurting numerous more.

I can imagine, just barely, somewhere at the far reaches of my imagination being so angry that in a moment of complete impulsiveness - that I would want to kill someone. For that instant, without planning, without thought. I can also, I think, somewhere in the deep recess of my mind, imagine feeling so crushed by an invader, someone who is in my place, my country - that the only option left would be to kill them before they hurt my family. I think I understand the deep sense of frustration and anger that is generated by weeks, months and even years of bullying and abuse, and fantasying about getting back at the instigator of that abuse.  But I cannot, no matter how hard I try, no matter how deep I search those dark, hidden corners of my mind ever conceive of intentionally hurting someone who is a complete stranger; to try to kill someone just because they are there, because I am so angry at everything and everyone that the only option is to lash out at anyone.

The incident in Toronto appears to be just that, someone who may have developed some bizarre rationalization for their act - but in the final analysis appears to be someone who was not happy with the way his life was going, who perhaps thought that he as a male should receive better treatment. Someone who appears to have idolized other mass murders with similar agendas. And like so many of those who copy their childish outrage from other equally as immature adult males, it appears as if he assumed that as his final act of glory, he would be killed by the police, thus absolving himself from any of the consequences. The police did not kill him and now he will, at some point, go to trial.

There may be some who will try to explain his actions by suggesting that he clearly has a mental illness. Others on the far fringes of society will argue that the values of our society and the roles of men and women are so distorted that violence is a reasonable option. Both sets of apologists or rationalisers are wrong. He is a silly, selfish little boy in a man's body who still sees himself at the centre of his universe (and therefore at the centre of everyone else's universe). He, at least from what is known of him, deserves no sympathy and little compassion. Most of all he deserves and should get no fame.

The world would be better off if news reports never mentioned his name, if they never discussed hypothetical reasons for his acts. While those who survived the attack and the families and friends of those who did not survive need and deserve our support, that support should be private. This killer needs stop existing in the eyes in the public, so that none of those who have silly childish dreams of fame ever believe that they too will be rewarded with their 15 minutes of fame.

Defining What is True

Yesterday morning, I was all set to do a blog. For the past few days a minor irritant had been bubbling in the back part of my brain and it was time to get it out.

I had seen two pieces of information on Facebook that begged for a comment. One of the "news items" was a bit on the BC government's decision to allow antibiotics to be used on farm salmon, the second was the BC government's decision to allow a mine to have its tailings run off directly into a lake. In the both situations the decisions appeared to have been made in direct opposition to environmentalists, scientists and to the First Nations communities in the area. My point was going to be that if the BC government is going to invoke the environment, science and the concerns of First Nations in their dispute over the Kinder Morgan pipeline expansion, that they must remain consistent and stop approving things elsewhere in the province that are contrary to what the environmentalists, scientists and First Nations are saying. To cherry pick some items and not others makes the government look, at best, two faced and insincere - at worst they look like political opportunist.

As always before I quote a source, I did a quick check to insure that the information was accurate, I wanted to be able to cite a source that was legitimate. Unfortunately neither story could be confirmed. That is not to say that the stories were inaccurate, perhaps the BC government did approve both the pouring of antibiotics into the ocean and a mine's tailings into a lake - but there is no proof  that they did. While there were a number of stories available on the internet around the antibiotics, they all used the same picture and none of them said where the original information came from. There was even less information about the mine. While it could be possible (as is frequently alleged) that these stories were buried by the mainstream press because they did not want to anger the corporate elite etc., the original writers of these stories had to have gotten their information from somewhere other than their imagination. No one said where the information came from or if they did, I could not find it.  I didn't publish the blog.

It is right and proper that we are all concerned about where Facebook gets its information and how it uses the data it collects. We  are right in feeling some unease when we learn that Facebook is being used to propagate false information; to feed us information so that we can be manipulated. But these two stories were re-posted by people I know, people who are intelligent thinkers, people who at least on some occasions debate facts and look for solutions. If we can't trust our friends to look at what stories they are re-posting, if we cannot even be sure that the people we know are trustworthy, then we are all in serious trouble.

I understand that in the world where it feels as if we are being overwhelmed on all sides by the destruction of our planet, where countless thousands of people die each day because of useless wars and famine, where politicians consistently break their promises - that the temptation to hang onto any fact, no matter how unsupported, that suggests that we are not alone, that other people are equally concerned and prepared to do something about it is almost too much to resist. I understand that in a world where so much of the news is shaped by the victors, by those who are in control, that we grasp at any fact that supports our beliefs. But we must resist that temptation, we cannot afford to blindly accept information just because it fits our world view.

 

The original blog was going to be about "if you talk the talk, you have to walk the walk". That is - if you are going to say that others need to act in a certain way - then you have to act the same way. And perhaps in some convoluted way, this blog is about that. If we demand honesty and transparency from those in power, if we argue that those people need to present and consider all of the facts, if we say that they should never hide behind their closed doors, then we must do the same.  

 

Neither I or any of my friends have a lot of control over big business and how they use social media, we can't control what some political entity pays to have posted on the internet, we can only control what we post. If we cannot guarantee the integrity of our information, then no one will be able to trust anyone. We will be reduced to only looking at pictures of cute animals.