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Fentanyl-laced fake oxycodone pills collected during an investigation.Uncredited/The Associated Press
Downstream effects
Re Canadians Should Avoid Extreme Measures To Coerce The Unvaccinated (Opinion, Nov. 20): The unvaccinated carry on with their lives for the most part, infected, infecting, then recuperating nearly all the time. I believe this remains a rather innocuous virus in the grand scheme of virulence. The downstream infections stemming from their brushes with COVID-19, however, multiply exponentially with devastating consequences for others, such as death, or the 80-year-old waiting for a hip replacement.
I do not believe our Constitution and Charter of Rights allow for the degree of civic selfishness that non-vaccination carries. The health care choices cited by columnist Robyn Urback put the consequences primarily on the person making them. I see the choices of the unvaccinated as primarily harming everyone else through pain or death.
Eric Sutherland Winnipeg
Media messaging
Re What’s At Stake With Rogers-Shaw (Editorial, Nov. 24): Where’s Keith Davey when we need him? The late senator who, in 1969, headed Canada’s first detailed inquiry into the mass media, had serious reservations about the trend in media concentration at that time. He was right.
Since then, conventional broadcast media has morphed into a handful of behemoth telecoms. To justify the Rogers takeover of Shaw, Edward Rogers told the Canadian Radio-television and Telecommunications Commission that Canada needs his company to become even bigger to compete globally. But the real question should be: Can Canada afford a company with so much power, concentrated in a dysfunctional board structure?
Nobody seems to be looking at that question, and certainly no one with the vision of Mr. Davey.
J. Richard Finlay The Finlay Centre for Corporate and Public Governance, Toronto
Safe supply?
Re First, Do No Harm (Opinion, Nov. 20): While appreciative of contributor Vincent Lam’s analysis of drug dependency treatment, I believe he underestimates the risks of methadone and benefits of a safe supply of opioids.
Dr. Lam worries about diversion of a safe supply of prescription hydromorphone. Over my 30 years of prescribing methadone, an allegedly safer alternative to hydromorphone, its diversion was always the dominant concern. Methadone-prescribing has been one of the most heavily regulated practices in medicine.
Over the past year, I also prescribed large doses of hydromorphone for opioid users at a hotel for COVID-19-infected people without homes. Access to safe supply precluded the need for users to leave and seek drugs – and spread COVID-19.
It was humane medicine and a smart public-health initiative.
Philip Berger OC, MD; Toronto
The standards and guidelines that governed methadone-prescribing were rescinded earlier this year by the College of Physicians and Surgeons of Ontario, and there is a strong push toward more liberal prescribing, including “safe supply.” At the same time, patients with chronic pain are struggling with more pain and less function as physicians attempt to lower opioid doses to comply with different guidelines.
Increasing opioid access for one group while restricting access for another raises questions of fairness and safety. There will be no easy answers.
Tavis Basford MD, CCFP, DCAPM; Hamilton
Contributor Vincent Lam is surely right that we can’t prescribe our way out of the opioid crisis. We should have improved programs for housing, doctor education, addict engagement, holistic treatments and rehab.
Readers may say, “Wow! The cost! The time! All better spent saving the more deserving and more easily cured.” But that’s just what Dr. Lam aims for: a 70-per-cent cut in crime and a 50-per-cent cut in medical emergencies. And with them, less trauma for victims, less need for police, prisons, judges and victim restitution, as well as more resources for curing other patients, speeding surgeries and maintaining longer lives.
James Russell Ottawa
Dosis sola facit venenum: The dose makes the poison. Contributor Vincent Lam captures the dangers of prescribing addicts their drug of choice: “The notion ‘safe supply’ looks more like an infinite escalator than a destination.” Many addicts are unable to achieve a desired high on the same dose as the initial one which begins addiction.
Although I agree with Dr. Lam that we should base our beliefs and actions on science and not anecdotes, anecdotes are often more persuasive to those without scientific predisposition. We should encourage friends and family to share futile experiences of trying to limit an addict’s intake to “safe” products and doses.
I agree that the solution involves treatment, which is expensive in the short term but cost-saving in the long term. Canada should have more residential treatment centres and mental health and social support for addicts.
Isabelle Emery Calgary
In 1982, I ran for Vancouver city council with Philip Owen, who would go on to become mayor of Vancouver and lead the creation of the first safe-injection site in Canada.
Is it an accurate assumption that, once a person is “hooked,” there is no way out? If that were true, Alcoholics Anonymous would not be so successful. Solution? Not cut down, but cut out.
Is it not time to invest in facilities to which people with drug problems can go to break the cycle, not just control it? Even if such facilities meant pain and rolling in one’s own vomit, with counselling to show a better life at the end, would not some people choose that?
Paul McCrea Vancouver
Builders and buildings
Re The Canadians Behind Champlain Towers (Report on Business, Nov. 20): In my 40-plus years of practising real estate law in Toronto, I became acquainted with many of the people mentioned in this investigation. Most are deceased and cannot defend themselves against reports of “dubious business deals.”
Many of that generation of builders came from Europe after the Second World War with shattered lives, but also with a fire burning in their bellies to succeed. They came as immigrants to a world that did not particularly welcome them. They wasted little time in not only rebuilding their own lives, but in building thousands upon thousands of rental units, which to this day form the heart of the affordable rental housing pool in the Greater Toronto Area.
The buildings illustrated in The Globe and Mail are a small sampling of their achievements. I believe their contributions to this type of housing have yet to be duplicated.
Morris Sosnovitch Toronto
Toronto in the postwar years is referred to as “an uninspired place … the skyline consisted of church spires piercing through treetops, overlooking rows of single-family houses. The city was still relatively small. Many neighbourhoods in midtown today were still farmers’ fields.”
Uninspired? Sounds heavenly to me.
Jim Duholke North Vancouver
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