Category: Community

Posts by Jano Klimas about community, collaboration, charity and social welfare.

War on drugs, war on wolves

Wolves in cage

Have you ever heard of compound 1080? No? I’m not surprised. Illegal in most countries, this poison (sodium monofluoroacetate) is used to kill wolves in Canada. Read more about a recent visit to the Northern Lights wolf centre near Golden, BC, that opened my eyes to the cruel practices of money and politics – the usual suspects from the war on drugs.

Caribou’s population in Western Canada is dwindling. Some Canadian provinces, like Alberta and British Columbia, have put in place aggressive measures to save Caribou.

wildlife logo wolves
photocredit: northernlightswildlife.com

Wolves are Caribou’s natural predators. To kill them seems logical in the fight for the Caribou’s survival. But only if we forget that Wolves are keystone species. “A keystone in anarch’s crown secures the other stones in place. Keystone species play the samerole in many ecological communities by maintaining the structure and integrityof the community.” This means that their killing will kick-start a chain reaction, leading to extinction not only of Caribou, but also other species and desolation of the land. The Yellowstone example is a worthwhile lesson: when the park eradicated the thriving predators, the antelopes overcrowded and nearly destroyed the grasslands. Predators have been reintroduced successfully.

“The recovery of the gray wolf after its eradication from Yellowstone National Park, almost ninety years ago, demonstrates how crucial keystone species are to the long-term sustainability of the ecosystems they inhabit.”

Drugs have predictable effects on people – the higher the dose, the more toxic they are. This is different from the addictive potential. Even the most dangerous of drugs – like heroin or cocaine – are used by millions of people relatively without problems and without addiction. Nobody becomes addicted after one dose. This means that we have been lied to about drugs and their effects.

Meanwhile, Canadian’s officials keep laying poisoned baits that will be eaten not only by the wolves, but by all other carnivore, such as, foxes, ravens, etc. The 24-hour delay of the poison kills not only the alpha-female, but her cubs too. When she comes back from the hunt, feeds them the food from her stomach, all of them will die. Seems effective. How come that this strategy won’t save the Caribou?

drug policy
photocredit: drugpolicy.org

Our strategy to solve the drug problem has been based on the lies about drugs’ effects. The war on drugs was declared as the most powerful strategy to eliminate them. Research has shown that it doesn’t work. Instead, wrong people are put to jail when the drug laws are enforced selectively. What’s needed is often viewed as bad by the general public. Clean needles, safe injecting rooms and prescribed heroin are seen as helpful to maintaining harmful behaviour of people with addiction. The opposite is truth. They save lives. Because it’s the public opinion, and not the science, that wins elections, politicians will selectively use to please the public and ignore the science in solving the drug problem. Too bad for people who use drugs, but who cares about them anyway?

Not only are wolves the keystone species, they also are not the reason for Caribou’s sudden decline. Who’s to blame? Firstly, it’s the oil and fracking industry. By taking the land where the old-growth forest hosts Caribou, the industry is pushing them out of their natural habitat. Secondly, Caribou thrives in old-growth forest only. It takes 80-100 years for the forest to grow back again. Finally, they’ll die before they could return back.

Most likely, the Caribou will disappear from Canadian’s landscape. People will say that they were destined to die. We have done everything we could. We even killed the wolves. Similarly, many people who use illicit drugs will die or go to prison. People will say that they lacked motivation or were beyond help. We have done everything we could to help them. We banned the drugs and enforced the law.

The bottom line: end war on wolves

 

“We need wolves to have a future; we need the to have water, air and biodiversity.” But they need your help and your voice. Vote! Contact the politicians and ask them about environmental issues. Likewise, people will continue to use drugs in future. We need an open and science-informed discussion about drugs.

Inspired about parallels between animal and addiction research? Read my blog about killer whales and researchers here.

Disclaimer: the organisations and individuals named in this article have not seen or reviewed this article. The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of any agency mentioned.

6 ways to improve addiction training

new skills training

Addiction training is feasible and acceptable for doctors and junior physicians; however, important barriers persist. We need to learn more about the experience of addiction physicians in the fellowship training programs. Here are the 6 ways to help improve the training.

6 ways to better training

Recently, new programmes have emerged to train the comprehensive addiction medicine professionals internationally and one of them is in Vancouver, Canada. We interviewed 26 persons who completed this training programme. They were psychiatrists, internal medicine and family medicine physicians, faculty, mentors, medical students and residents. All received both addiction medicine and research training. We found six barriers and enablers of training implementation: (1) organisations, (2) structures, (3) teachers, (4) learners, (5) patients and (6) community. Human resources, a variety of rotations, peer support and mentoring fostered implementation of addiction training. Money, time as well as space limitations hindered implementation.

Why training clinicians in addictions

Addiction care is usually provided by unskilled lay-persons in most countries and thus the resulting care inadequate. Effective treatments are overlooked and millions of people suffer despite recent discovery of new treatments for substance use disorders. In rare instances when addiction care is provided by medical professionals, they are not adequately trained in caring for people with substance use disorders; therefore, feel unprepared to provide such care. Physician scientists are the bridge between science and practice. Despite large evidence-base upon which to base clinical practice, most health systems have not combined training of healthcare providers in addiction medicine and research.

Klimas, J., Small, W., Ahamad, K., Mead, A., Rieb, L., Cullen, W., Wood, E., McNeil, R. (2017) Barriers and Facilitators to Implementing Addiction Medicine Fellowships: A Qualitative Study with Fellows, Medical Students, Residents and Preceptors. Addiction Science & Clinical Practice, 12:21
https://ascpjournal.biomedcentral.com/

What are the core skills of an addiction expert?

expert button

Should all medical doctors receive the same training in addiction medicine? Here’s what international experts think about core skills of and addiction specialist.

core skills

In a new article published by the Substance Abuse journal, we report on interviews with members of the International Society of Addiction Medicine who identified progression for the core skills and addiction medicine competencies at three educational levels: (i) undergraduate (ii), postgraduate and (iii) continued medical education (CME). The experts described broad ideas, such as knowledge/skills/attitudes towards addiction, for the undergraduate level. At the graduate level, they recommended knowledge of addiction treatment. Next, the experts also described specific recommendations, including the need to tailor the curriculum to national settings and different specialties. We still don’t know whether a global curriculum is needed. But a consensus on a core set of principles for progression of knowledge, attitude, and skills in addiction medicine to be developed at each educational level among medical graduates would likely have substantial value.

Why are the core skills important?

Our findings provide a consensus opinion on core skills for progression of knowledge, attitude, and competencies in addiction medicine. A panel of international scholars recommended that medical students and physicians should learn these skills throughout medical education. This is particularly important for the development of new addiction medicine curricula and enhancement of available courses. If applied, our findings would have profound effects on the quality of medical education. Better education can improve subsequent clinical care provided to people with substance use disorders worldwide.

Study title:

Two birds with one stone: physicians training in research

Combined training in addiction medicine and research is feasible and acceptable for physicians – a new study shows; however, there are important barriers to overcome and improved understanding of the experience of addiction physicians in the clinician-scientist track is required.

Addiction care is usually provided by unskilled lay-persons in most countries. The resulting care is inadequate, effective treatments are overlooked and millions of people suffer despite recent discovery of new treatments for substance use disorders. In rare instances when addiction care is provided by medical professionals, they are not adequately trained in caring for people with substance use disorders and, therefore, feel unprepared to provide such care.  Physician scientists are the bridge between science and practice. Despite large evidence-base upon which to base clinical practice, most health systems have not combined training of healthcare providers in addiction medicine and research. 
In recent years, new programmes have emerged to train the comprehensive addiction medicine professionals internationally.

We undertook a qualitative study to assess the experiences of 26 physicians who completed such a training programme in Vancouver, Canada. They included psychiatrists, internal medicine and family medicine physicians, faculty, mentors, medical students and residents. All received both addiction medicine and research training. Drawing on Kirkpatrick’s model of evaluating training programmes, we analysed the interviews thematically using qualitative data analysis software. We identified five themes relating to learning experience that were influential: (i) attitude, (ii) knowledge, (iii) skill, (iv) behaviour and (v) patient outcome. The presence of a supportive learning environment, flexibility in time lines, highly structured rotations, and clear guidance regarding development of research products facilitated clinician-scientist training.  Competing priorities, to include clinical and family responsibilities, hindered training.

Read more here: http://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-017-0862-y
Klimas, J., McNeil, R., Ahamad, K., Mead, A., Rieb, L., Cullen, W., Wood, E., Small, W. (2017) Two birds with one stone: Experiences of Combining Clinical and Research Training in Addiction Medicine. BMC Medical Education, 17:22