When I was working on harm reduction part of this submission, one of the things I struggled with was wording. A lot of writing I read said "people with chronic pain/illness & people who are drug users" as if the latter might not also be ppl w chronic pain https://www.broadbentinstitute.ca/submission_to_the_b_c_government_on_accessibility_legislation

Which is why the issue of harm reduction and safe supply is a disability rights and most certainly a disability justice issue.

This seems like a good paper and certainly support approach being suggested re safe supply. My one issue is that it seems to feel current approach for those seeking to access prescriptions who don't have addiction is fine, which I don't think it is. https://twitter.com/DrMtyndall/status/1297917155468439554?s=20

I used to take a lot of pain meds. A lot. For years.
Hydromorphone - PRN (as needed)
Methadone - 3 times a day. (Yes they do use methadone for pain. I used to leave pharmacy with a bag of bottles of it which I'm fairly certain they don't give out to people with opioid addiction.)

When I went into remission - a thing I identified was happening and only went later to doctor to confirm via bloodwork - I started to reduce all my meds on my own but it's trickier with pain meds bc of the amount of monitoring aka policing around them.

I literally ended up on doctor's radar for having too little opioids in my urine. It would later turn out my that unbeknownst to me my then BF was stealing them so that's why. But I didn't know. AFAIK I was taking my meds. Didn't matter, I was now 'suspect' & doctor dropped me

Anyway I eventually ended up with a fantastic pain doctor and what made her fantastic is she treated me with genuine respect and bc of that I trusted and knew that if I said I want to try titrating down but then couldn't handle the pain she would listen to me.

I felt safe to try lowering the dose. And it took time. She wrote scripts for 3 months at a time I think. And this went on for probably a year. Sometimes I'd go back up for a bit. It was me who decided when we'd go down, how fast, when it would twice than once a day. Me. My body.

My point is that IDK if I would ever have tried going off them in this current climate.
My experience around my dental surgery was mind-blowing for me. The man was so filled with hydromorphone is worst thing on earth and way too strong he gave me way higher dose of morphine

Sidenote: Doctors aren't great around meds. This is part of it imo. They don't learn nearly enough about them in medical school. With specialists it's better because they learn the meds in their area. But outside of pain specialists, most ime have little more knowledge than news.

Anyway I had to fight with this dental surgeon bc I am unable to take codeine which is their new fave replacement. I personally hate morphine and it makes me really sick but I ended up accepting that bc what was my choice? Agony after surgery?

So I think we need to look both at providing safe supply, housing and support to people who are using drugs now, but we also need to look at the way chronic pain patients are being dealt with. Med loves the word upstream - I think they should use it here.

Because I'm your 'ideal' pain patient in that I hate being in altered state and I hate taking any meds - like any. I just do. No big ideology behind it I just don't like anything to do with any of it. And I was still viewed and treated as 'criminal' by doctors.

This comment brought to you by fact only some doctors are licensed to prescribe methadone so if you end up admitted on Sat. night they'll try to do a conversion to morphine. I knew it was wrong they wouldn't listen, I refused, endured hell till doc on duty https://twitter.com/mssinenomine/status/1298382032397938688?s=20

The pain doctor and pharmacologist the next day - they paged someone in - confirmed the dose they were suggesting would have been lethal.

Still not sure if that was 'accident' or attempted 'accidental eugenics.'

But other than for 2 days after dental surgery I haven't taken pain medication in...IDK five or six years anyway.

Oh I can also confirm I started 'acting like a criminal' to some extent bc I was sent for one of those urine tests & lab bathroom wasn't accessible to me so...

I asked if I could bring in a sample but they said no I had to do it on site, told me a place with larger washroom. OK. But one of the barriers was at that point I was incontinent. And it was odd incontinence - w/out tmi basically every transfer even w depends was messy - whoosh

So not wanting to pee all over their floor the other option was to sit there for awhile drinking, which I tried but of course that made them angry that I was taking too long and also suspicious - because pain meds = drug seeker = criminal.

So, you don't know me but I am an exceedingly honest person. Like the only time I called in sick and wasn't my friend did it for me bc I just really suck at lying and feel bad & ugh. So what I did next is really out of character for me but...

I had sample bottles at home and so I filled one at home and then went into the lab.

OK so criminal genius I am not because did I think about body temperature? No I did not.
I mean at last minute it occurred to me that it was really cold so I ran it under tap but...

Sure enough the lab tech corners me as I'm leaving. Fortunately she was pretty cool and looks me up and down and says 'you're ice lady' then decides if I am a 'criminal' I deserve a pass just for being so bad at it.

I shrug & have huge urge to explain but realize no one believes me even when I'm telling the truth so what is the point. Honestly at that point if they were going to cut me off or call the cops I was just like fine IDC anymore this is fucking ridiculous.

So this is what I mean by look upstream. You've literally created a system that encourages lying and not following rules and staying on medications you don't need anymore.

I can't believe they don't think that's a problem.