CCBI News: Ethical questions, health care: addictions, the opioid/fentanyl crisis, deaths

September 15, 2023

Dear Friends of CCBI,

Welcome Back to our Readers of NEWS!

Climate change certainly made its mark over the summer months and continues to wreak havoc over many parts of the globe, including an incredible number of wildfires in Canada. The effects on society are immense, while yet another form of disaster continues to cast a shadow over this country and many others.

We are learning that the number of deaths from opioid and other drug consumption is rising at an alarming rate, and many media outlets have highlighted the death toll and the personal tragedies suffered by families coping with the death of a loved one who has become addicted.

The Globe and Mail has featured this topic several times this year, and this week’s Catholic Register (September 10) devoted a whole section, “Steps from the brink: Faith in addiction recovery,” an insert of excellent articles and interviews mostly written by Michael Swan, together with a strong editorial column focusing on bringing hope to people with addictions. Such articles from multiple sources demonstrate the desperation of those suffering from various forms of addiction, together with powerful examples of people who have overcome addiction through trust in God, concerned and dedicated friends, 12-step programs, and so on.

The opioid/fentanyl crisis is the current danger point, with high death rates among all categories of society, but especially in our younger generations. According to Public Health Canada, “There was a total of 36,442 apparent opioid toxicity deaths between January 2016 and December 2022. A total of 7,328 apparent opioid toxicity deaths occurred in 2022, an average of 20 deaths per day.” Added to the abuse of opioids, Public Health Canada reports that over half (56%) of accidental apparent opioid toxicity deaths that same year also involved mixed use with a stimulant drug: 64% involved cocaine and an opioid while 53% involved methamphetamines and an opioid.

Health care and life challenges abound in these situations. Not only is the death rate high, but so, too are hospitalizations as a result of overdosing or toxicity which frequently result in further harm to the person’s health, employment, income and relationships, while also incurring the need for further treatment in rehabilitation programs. According to the same source, “There was a total of 36,233 opioid-related and 15,696 stimulant-related poisoning hospitalizations” from 2016-2022 (excluding Quebec), with a total of 5,265 opioid-related poisoning hospitalizations in 2022 alone. The average hospital stay was three days for both opioid- and stimulant-related poisoning hospitalizations in 2022, although there was a significant decrease in rates of opioid-related poisoning hospitalizations between the third quarter of 2021 and the fourth quarter of 2022, as the country emerged more fully from the pandemic.

Several ethical questions stare us in the face. What can be done to protect people from beginning to take drugs in the first place and, as numbers increase, what can be done to help people from addiction? Two major questions have arisen over the availability of safe-sites and safe supply. Proponents say that these measures save lives and are morally justified. Naturally, these are complex matters, and we need to look at the facts and make an evidence-based decision about the rightness/wrongness of these tactics.

Over the years CCBI has been asked about Catholic teaching on safe-injection sites, and we have always replied that the teaching is not entirely settled yet — neither prohibitive, nor completely accepting. It is one of those situations where there are so many pros and cons that it can be difficult to take a stand. Please see the video (below) I did with Salt and Light a few years ago to see at least one opinion on this matter from a Catholic perspective. Overall, I agree with The Catholic Register’s stance: “We knew the enslavement of people either through substances, processes or as actual bought-and-sold chattels, was of major societal concern.” Something, therefore, must be done.

A few years ago, we received a letter from the CDF (Congregation for the Doctrine of the Faith) asking about CCBI’s views on safe injection sites and how they are being handled in Canada. I replied that the current evidence is that harm reduction through the provision of clean needles and supervised sites where drugs are assayed for contamination all help to keep people alive, even if they are not a remedy or cure. On the evidence, it seems better to help people stay alive, when possible, as opposed to ignoring use of dirty needles or contaminated supply. This could be seen as dangerous ground, ethically speaking, but where the Church itself has not given clear statements or prohibitions there is at least a presumption that we should take actions known to be life-saving or, at least, life-extending in light of the death-dealing effects of addiction when people have become ‘enslaved.’

CCBI has never advocated for ‘safe supply’ of the drugs themselves, although currently there are two streams of thought over this method of saving lives. This aspect and its possible drawbacks need to be considered more fully in light of the serious ethical questions involved, although Pope Francis himself once declared that drugs should never be supplied. There is much to be explained and considered here, and we will focus on this second ethical dilemma next week.

Opioid- and Stimulant-related Harms — Canada.ca
Editorial: Church plays role in recovery (catholicregister.org)
INTERVIEW: Dr Moira McQueen | behold S1E5 on Vimeo
Pope Francis: Don’t legalize recreational drugs | CNN

Pope Francis’ Intentions for September

Let us pray for those people on the margins of society in subhuman living conditions, that they may not be neglected by institutions and never be cast out.

Moira and Bambi