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Cake day: July 18th, 2023

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  • I believe the evidence is pretty clear that the best method of getting people to achieve long-term self-driven improvements around these issues is offering them health and social care (e.g., wounds, food, shelter, employment info) where they are (eg, using in a safe consumption site, on the street, admitted to emergency or hospital) and building relationships with them, as opposed to temporarily taking away all their decision-making capacity and incarcerating them. Medicalizing the problem is to treat it very superficially and has a revolving door effect on patients, which is costly and associated with worse outcomes. I appreciate the discussion. It’s making me realize that I may want to do more work in this area.






  • For 2026, I’m thinking about will Carney pass anti-privacy pro-technoligarchy online handover-identification-to-access-content laws and about the US midterms: how rigged they seem (eg, ICE-related voter suppression) will be my cue of the likelihood of 2028 election rigging and Trump (if still alive) defying another law and taking a 3rd term. I expect Ukraine/EU vs Russia/USA to renew the ongoing nature of that conflict surrounding the invasion of Ukraine. I also expect the Israeli/US/UK genocide in Gaza to stay its horrible course. I don’t expect, but hope that the EU will take steps to distance themselves from US tech, versus pass favourable legislation for them. I expect the ‘Canada as 51st state’ rhetoric to increase a bit. I’m not optimistic and hope to be wrong. I wish people would wake up sooner that fascism is here and put up a resistance to it (beyond an enlightened minority on the Fediverse, for example). My takeaway from 2025 is this: For most of my life, people have asked “how would WE respond if fascism/ Nazism rose today?” well, we are now watching that question play out in real time, most notably involving the US regime. Hitler never had social media…



  • It seems to make logical sense to move the people suffering to involuntary care. We bring physically injured people to hospital and perform life saving surgeries on those that are too injured to refuse treatment choices.

    I think you’re making a false equivalence. If you’re brought unconscious to emergency after a motor vehicle collision, the docs can legally presume you’d consent to life-saving interventions and give you them before you’re conscious. Once you’re awake, you’re free to decline treatment and leave the hospital. That could be within 24 hours.

    Involuntary treatment for substance use probably means 1 to 3 months of involuntary care: not being able to leave a hospital unit, and having most ‘resistance’ to medical treatment or the hospitalization interpreted as hostility and/or inability to care for oneself (in some eye’s justifying ongoing involuntary detention).

    Hospitalization is pretty indignifying. If you’re on board with the treatment plan, you accept it. If you’re there against your will, it feels less like healthcare and more like prison (including for the healthcare staff). From my experience of caring for people involuntarily admitted to hospital for mental health reasons - the experience is more traumatizing for them than it is a foundation to improve their lives. Addiction is a social problem; it needs a social fix: Housing, counseling, employment opportunities are far more needed than medical care.

    I also don’t believe any drug is 100% addictive. The more stress and trauma and fewer resources and alternative sources of relaxation a person has access to - the more susceptible they are to addiction. These underlying factors are what we need to treat. The only reason involuntary care is popular amongst some politician-types isn’t because it’s effective, it’s because it aligns with their neoliberal values and they don’t care about effectiveness. Money for involuntary care would be better spent treating (eg, Housing First) and preventing homelessness