Safe Injection Sites

On August 12, a group of activists calling themselves the Toronto Harm Reduction Alliance (THRA) opened an unauthorized pop-up safe injection site in the city’s Moss Park after a string of 3 opioid related deaths in the preceding 24 hours. The site offers information about drug use, sterile equipment, supervision by medical professionals and, if needed, overdose reversal medication to opioid users.

In May, Parliament approved Bill C-37 – streamlining the application and approval process for safe injection sites. Subsequently, in June, Health Canada approved 3 sites for Toronto to be opened in the fall upon completion of their construction. Despite recent progress, the THRA insisted that we, as a society, can’t wait any longer for the approved sites to open; with the number of opioid related deaths we are experiencing, we can’t afford to.

All evidence I have been able to find suggests that the activists at THRA are good people doing a good thing. However, if I was in a position of authority at Toronto City Hall, I would not have allowed their pop-up to remain operational; doing so sets a precedent that the lawful approval process is negotiable.

Toronto isn’t the first city in Canada to turn a blind eye to an unsanctioned safe injection site – Vancouver allowed one to remain open last year – and they, unfortunately, weren’t the last. The precedent set in Vancouver and Toronto gave activists in Ottawa the confidence to open a similar site just this past Friday. This is dangerous. We are dealing with the control of illicit drugs and the administration of health care here. Just because the evidence suggests that the existing pop-up sites are doing good doesn’t mean that the next one will. It shouldn’t be the job of our police forces to track down and supervise these sites to ensure that they are administering their services properly.

In response, Health Canada and Toronto Public Health opened an approved temporary safe injection site, announced they would speed up the opening of all three permanent sites, and widened the distribution of the opioid overdose antidote naloxone to public health staff, community agencies and first responders. This is a beautiful response and it wouldn’t have happened if the THRA hadn’t set up their pop-up in Moss Park; but that is as far as they should have gotten.

Carbon Dividends

On June 1st, in an address from the White House Rose Garden, President Donald Trump announced that the United States would withdraw from The Paris Agreement. The remaining parties reacted with anger and an even stronger resolve to hold the US accountable for its pledge. One way that the international community could retaliate is to levy a border-adjustment tax on the carbon content of American exports. If faced with such a pressure, the Trump administration would need a plan to replace the Obama-era regulations that it has repealed.

In February, the Climate Leadership Council (CLC) provided a plan titled “The Conservative Case for Carbon Dividends“. The section within the paper titled “The Need for a Conservative Climate Solution” reads:

Mounting evidence of climate change is growing too strong to ignore. While the extent to which climate change is due to man-made causes can be questioned, the risks associated with future warming are too big and should be hedged. At least we need an insurance policy. For too long, many Republicans have looked the other way, forfeiting the policy initiative to those who favor growth-inhibiting command-and-control regulations, and fostering a needless climate divide between the GOP and the scientific, business, military, religious, civic and international mainstream.

Now that the Republican Party controls the White House and Congress, it has the opportunity and responsibility to promote a climate plan that showcases the full power of enduring conservative convictions. Any climate solution should be based on sound economic analysis and embody the principles of free markets and limited government. As this paper argues, such a plan could strengthen our economy, benefit working-class Americans, reduce regulations, protect our natural heritage and consolidate a new era of Republican leadership. These benefits accrue regardless of one’s views on climate science.

In short, the CLC admits that climate change is real (though doubts that it is driven by human activity) and that climate policy is inevitable in the United States. So, instead of leaving it to the next Democratic Congress to pass legislation that actually addresses climate change, the “Grand Old Party” should take the opportunity to pass legislation that supports its “conservative convictions” instead.

The plan has 4 pillars:

  1. A carbon tax implemented at the first point where fossil fuels enter the economy, beginning at $40/ton and increasing steadily over time.
  2. All the proceeds from this carbon tax would be returned, tax-free, to the American people via dividends.
  3. Border adjustments levied on the carbon content of imports and exports.  Proceeds from these fees would be added to the carbon dividends.
  4. Elimination of regulations that are no longer necessary upon the enactment of the previous three pillars.

On a positive note, I have absolutely no issue with pillar number one. However, the same cannot be said for the remaining three pillars, especially pillar number two.

Revenue-neutral carbon taxes – wherein all proceeds are returned to the public – can make intuitive sense. If the public knows that a carbon tax will increase steadily over time, they are incentivized to invest in technology that will enable them to pollute less in order to pocket more of their tax-free dividends. The problem is that this intuition assumes the rationality of the consumer. The Department of Treasury estimates that the bottom 70% of Americans would receive more in dividends than they would pay in carbon taxes. If 70% of the country is benefiting financially from the carbon tax without changing their behaviour, can you expect them to put in the effort and money to reduce their emissions?

A similar revenue-neutral carbon tax was implemented in the Canadian province of British Columbia (BC) in 2008. In 2007, the province of Quebec implemented its own carbon tax (which I will call revenue-controlled) with revenue being reinvested into energy-efficiency programs in public energy and transit. The results: greenhouse gas (GHG) emissions reduced by 3% in BC compared to 8% in Quebec from 2008 to 2015 and gross domestic product (GDP) increased by 13% in BC compared to 8% in Quebec while population increased by 3% in BC and 2% in Quebec between 2012 and 2015 (population data for 2008-2011 wasn’t available on the Statistics Canada website).

 

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In order to ideally test the efficacy of British Columbia’s revenue-neutral carbon tax, I would need to compare its performance to a simultaneously but independently implemented revenue-controlled carbon tax in the same province, which is impossible. Although the comparison to Quebec’s carbon tax is not ideal, it is still valuable. It demonstrates that a revenue-neutral carbon tax is likely inferior to a revenue-controlled carbon tax at reducing emissions. What it does do better is stimulate the economy; one of the foremost “conservative convictions”.

“Recomposition”

With every wake or funeral I attend, I become more uncomfortable with the way we bury and remember our dead. In North America anyway, there are two main ways that bodies are prepared for burial – embalming and cremation.

When a body is embalmed, bodily fluids are removed and replaced with a formaldehyde-based chemical solution that delays decomposition. Then, the body is dressed and cosmetically prepared by styling the hair and applying make-up. On the other hand, when a body is cremated, it is incinerated in a chamber heated to 1000°C. The remaining ashes are then collected and ground into a fine powder.

Neither of these processes are at all safe for the environment – formaldehyde is a proven carcinogen and fossil fuels are burned to heat cremation chambers. To make matters worse, the prepared remains are then placed in metal, wood or stone boxes and buried underground or in a mausoleum. The amount of resources – money, material and land – that are poured into modern burials is absolutely ridiculous. Please don’t get me wrong, I completely understand the need to honour our dead, but there must be better ways to do so.

Every organism produces and consumes nutrients in order to live. When it dies, and decays, the organism’s nutrients are released into its surroundings.  Humans are no exception. Unfortunately, the modern practices of burial and cremation do not allow our nutrients to be returned to the environment. In cremation, nutrients are consumed by fire, while in modern burial, the casket and burial vault prevent most nutrients from being released into the soil. If we were instead buried in a simple shroud or wooden casket – as we were in the past – we would effectively be recycled into the earth.

So why did we move away from this method? As far as I can gather, there are three main reasons: it was thought that modern caskets were aesthetically superior, would protect against grave robbers and would protect soil and groundwater quality near cemeteries. I believe that only one of these – the protection of soil and groundwater quality – may be a legitimate reason for supporting modern burial in this day in age. However, The World Health Organization has found that even with modern burial methods, soil and groundwater around cemeteries is contaminated. In fact, the formaldehyde in embalming fluid and the metals in modern caskets arguably pose a greater risk to soil and groundwater quality than the products of natural decomposition. Further study is required to know for sure.

Researchers at the University of Western Carolina are conducting this research as part of their Urban Death Project. They are researching the effects of “recomposition” – their system that transforms bodies into soil through natural decomposition. The whole process would look something like this:

When a person dies, their body is transported to a morgue for refrigeration. It is kept there until funeral and/or burial plans can be made. The body is then placed in a simple shroud or wooden casket and transported to the “recomposition” site. My vision for the “recomposition” site (the Urban Death Project has yet to release a rendering) looks something like the Vietnam War Memorial in Washington DC. The burial ground (above) is separated from a public park (below) by a retaining wall marked with the names of all those buried there. Over time, the bodies become a part of the soil which is used to grow memorial gardens.

Image result for vietnam monument dc

Hopefully, the Urban Death Project’s testing is successful and these “recomposition” sites are deployed by the time I “go” because, in my opinion, the existing options aren’t working for anyone – living or dead.

“What The Health!”

Two days ago, my uncle told me that he watched “What the Health“. He said that after watching the film, he felt for the first time like he needed to change his diet. I was immediately curious and decided to watch it on Netflix last night.

The purpose of the film is to present a plant-based (vegan) diet as the secret to preventing and even reversing chronic diseases – and to expose the corruption in government and business that keeps the public from adopting such a diet. I want to take a closer look at some of the facts used in support of the filmmaker’s arguments.

1. Approximately half of deaths are caused by cancer and heart disease(U.S.)

2. The World Health Organization (WHO) classifies processed meat as a Group 1 carcinogen – the same group as cigarettes and asbestos – and classifies red meat as a Group 2 carcinogen.

From the Frequently Asked Questions on the WHO website, the Group 1 category is used when “there is convincing evidence that the agent causes cancer”. The classification only describes the strength of scientific evidence, not the associated level of risk. In other words, consumption of processed meat has been classified in the same category as tobacco smoking and asbestos, but this does NOT mean that they are all equally dangerous. Furthermore, the Group 2 category is used when an agent is “probably carcinogenic to humans” but convincing evidence has yet to be found.

3. Cooked meats – including pork, fish and poultry – release chemicals that are carcinogenic.

When meats are cooked at high temperatures, especially over an open flame, heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs), which have been proven to cause cancer in animals, are formed. A definitive link between these chemicals and cancer causation in humans has not been found.

4. Meat consumption is a higher risk factor for diabetes and heart disease than consumption of alcohol, carbohydrates, or sugar.

5. Eating 1 egg per day is just as bad as smoking 5 cigarettes per day for life expectancy

Tl;dr: The amount of cholesterol in an egg yolk is unhealthy (100-200mg, 40-75% of the suggested daily limit) but not nearly as unhealthy as smoking 5 cigarettes per day.

In 2010, a Nurse’s Health Study was published outlining mortality risk factors – how lifestyle and dietary choices impact mortality. The study began in 1986 when researchers surveyed 50,112 female registered nurses in the United States aged 30-55. Follow-up questionnaires were sent to participants every two years until their year of death or 2004, whichever came first. A theoretical model, a Cox proportional hazards model, was used to compute hazard ratios for associations between each risk factor and mortality. Through this analysis, the researchers reported that smoking the equivalent of 1 pack/day for 46 years increased one’s risk of death by 108% (relative to never smoking) while consuming 105mg of cholesterol/day increased one’s risk of death by 17%. How Dr. Greger inferred from those results that the daily consumption of the amount of cholesterol in a single egg yolk cuts a woman’s life short by the same amount as smoking 5 cigarettes per day is beyond my understanding.

In the video linked above (see 5), Dr. Greger goes on to describe another study on the relationship between egg yolk consumption and carotid plaque. He correctly interprets that eating more than 3 eggs/week was found to significantly increase carotid plaque area, and that carotid plaque area increases exponentially with both pack-years of smoking and egg-yolk years, but I think he misinterpreted the definitions of pack-years and egg-yolk years. In the study pack-years are defined as the number of packs/day of cigarettes times the number of years smoking while egg-yolk years are defined as the number of egg yolks/week times the number of years consumed. Given these definitions, I struggle to see how even the most aggressive egg yolk consumers are exposing themselves to a risk equivalent to those that smoke a pack/day for 40 years or more.

6. The American Cancer Society, American Diabetes Association, and American Heart Association are sponsored by animal product and pharmaceutical companies.

At this point I could continue to investigate each argument that the film makes but I am starting to feel like I am beating my head against a wall – and I’m sure that you are too. The purpose of the last 6 points was twofold: to demonstrate that a plant-based (vegan) diet is generally healthier than a diet heavy in animal products, but that the filmmaker’s have significantly dramatized the facts.

All of the health risks associated with animal-based diets make sense when you understand that our bodies were designed by evolution for a plant-based diet. Given that there doesn’t seem to be a nutritional advantage to consuming animal products, why are we wasting resources raising animals as a food source? If all of the nutritional value in animal products originally comes from their food – plants – then why don’t we just eat the plant?  Both of these points make complete sense to me now that I have seen “What the Health” but I am somewhat confused as to why I didn’t come to these realizations on my own. I suppose that I never really stopped to think about my diet and I certainly wasn’t exposed to these ideas in my daily life – proof that the money animal product and pharmaceutical companies are spending is serving its purpose.

To be fair, I don’t think that there is anything inherently wrong about consuming animal products. It is the quantity in which we consume them, and subsequently the way in which they are produced, that are the issues. If we were to move back to diets that are 80-90% plant-based we and our environment would be much healthier – saving an extraordinary amount on healthcare and resource costs. Maybe incentivizing plant-based diets should be at the forefront of the Republican’s new Better Care Reconciliation Act.

Dental and Vision Should Be Free Too

Universal healthcare is, for good reason, just as quintessentially Canadian as the words “Eh” and “Sorry”. Rivaled only by the Scandinavians, the Canadian public healthcare system is consistently acknowledged as one of the best in the world.

I initially intended this post to be a comprehensive review of Canadian healthcare but the complexity of the system forced me to scope down. Routine dental and vision care should be covered by the public system.

In the best case scenario, public health insurance covers the cost of one routine visit to the dentist and optometrist every year but only for children under 19 and seniors over 65 years old. If you are 20 to 64 years old, you have to pay out of pocket, purchase private insurance or rely on employer benefits. Currently, coverage is only mandated for surgical interventions.

The government’s decision to make dental and vision care an “individual responsibility” is convenient for dentists and optometrists lobbying to keep their fee-for-service model.

My Position on Abortion and Medical Assistance in Dying

I am an active Canadian citizen and a practicing Catholic. As a result, I stand on both sides of the passionate debate surrounding Canada’s legalization of abortion and medical assistance in dying. I know that these are not “popular” topics but they are two of the most important issues facing our society today.

Abortion

In 1892, 25 years after confederation, Parliament passed Canada’s first Criminal Code. It prohibited abortion as well as the sale, distribution and advertising of contraceptives.

In 1969, 77 years later, Parliament wholly decriminalized contraception and decriminalized abortion under one circumstance – if a committee of doctors decided that continuing the pregnancy would endanger the mother’s life or health.

In 1988, the Supreme Court of Canada ruled that existing abortion laws violated Section 7 of the Charter of Rights and Freedoms which states:

“Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.”

The Chief Justice at the time, Brian Dickson, wrote:

“Forcing a woman, by threat of criminal sanction, to carry a fetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman’s body and thus a violation of her security of the person.”

Medical Assistance in Dying

In February 2015, the Supreme Court of Canada ruled to decriminalize medical assistance in dying. Now, there are two options available to Canadians – each must include a doctor or nurse who directly administers or provides a prescription for a substance that causes their death.

In order to be eligible for medical assistance in dying, one must:

  • be eligible for health services funded by the federal government, or a province or territory
  • be at least 18 years old and mentally competent
  • have a serious illness, disease or disability
  • be in an advanced state of decline that cannot be reversed
  • experience unbearable physical or mental suffering from one’s illness, disease, disability or state of decline that cannot be relieved under conditions that one considers acceptable
  • be at a point where one’s natural death has become reasonably foreseeable
  • make a voluntary request for medical assistance in dying that is not the result of outside pressure or influence
  • give informed consent to receive medical assistance in dying at the time of one’s request and immediately before medical assistance in dying is administered

My Position

I do not agree with medical assistance in dying, but I do agree that it should be legal. Everyone has freedom of choice. That includes the choice to end one’s life as long as the individual is mature and mentally competent enough to make an informed decision that does not harm or restrict the freedom of another person.

For that very same reason, I believe that abortion should be illegal. A mother or doctor should not be able to end the life of a child that cannot speak for itself unless the mother’s life is in danger and there is a higher probability of saving her life than the child’s. I agree that sanctioning abortion is contrary to a woman’s right to liberty and security of the person but I still don’t understand how that was enough to strike down the 1969 abortion law. The right to life is clearly given priority in Section 7 of the Charter of Rights and Freedoms. Both the mother and the baby should share this right equally. We need to do a better job of providing public support to women so that they can see their pregnancies through, regardless of how they got there.

These are the facts and my positions on abortion and medical assistance in dying; both are subject to change as we continue to learn and grow.

We Still Need Electric Vehicle Incentives

In December 2016, Canadian governments announced the Pan-Canadian Framework on Clean Growth and Climate Change. Under the framework, Canada will have nationwide carbon pricing in 2018 – British Columbia, Alberta, Ontario and Quebec already have a carbon pricing policy in place. (By the way, I don’t like “carbon” pricing. We should have a more general “pollution” pricing but that is a topic best left for a future post).

In preparation for the roll-out of nationwide carbon pricing, Canada’s Ecofiscal Commission recently published a paper titled Supporting Carbon Pricing: How to identify policies that genuinely complement an economy-wide carbon price. In the paper, among other things, the commission recommends that “with the implementation of an economy-wide carbon price, governments should phase out and avoid redundant, high-cost, or ineffective policies” like electric vehicle incentives. I disagree.

To justify their recommendation, the commission carried out a case study on electric vehicle incentives in Quebec. Under Quebec’s Drive Electric program, drivers who purchase or lease fully electric, plug-in-hybrid or hybrid vehicles are eligible for up to $8000 in rebates from the government. The program began in 2012 and will run until 2020, or until the $93 million in total rebates are exhausted. Through the case study, the commission concluded that by 2030, Quebec’s Drive Electric program will by responsible for a reduction of 3 Mt CO2e at a cost of $395/tonne. These estimates were reached by comparing model scenarios between the years of 2017 and 2030 in which the subsidy exists within one but not within the other. The province’s carbon pricing policy was included in both scenarios.

Now, it’s possible that I could be misunderstanding the details of the commission’s calculations but I have two issues with their method as I understand it. First, assuming that the $93 million in funds was not exhausted in the model before 2020, the Drive Electric program would only be in effect for the first 3 years of the scenario. They did not run a scenario where the Drive Electric program was extended to the year 2030. This design decision seriously underestimates the emission reduction potential of the program. Second, I don’t believe that advancements in electric vehicle technology and their supporting infrastructure were factored in to the models. As technology and infrastructure improve, the percentage of fully electric vehicles purchased under the program will rise. Moreover, those vehicles will be able to drive further per unit of energy. Both of these facts would lead to a improvement in the cost effectiveness of the program below the estimated $395/tonne CO2e. Unless you believe that by 2020 electric vehicles, nudged along by carbon pricing, will reach critical mass in the market, it doesn’t make sense to exclude my two points from the simulation. Still, I will concede that even accounting for the two potential downfalls I pointed out, electric vehicle incentives are still much more expensive to the government than the universally agreed upon, though somewhat arbitrary, $20-$30/tonne CO2e cost of carbon pricing. However, just because electric vehicle incentives are more costly than carbon pricing doesn’t mean they aren’t worth continuing.

In addition to the high cost, the commission recommends that electric vehicle incentives be phased out because they reduce competition in the “alternative fuels” marketplace. Essentially, they argue that electric vehicles should not overtake the passenger vehicle market as a result of government policy but by natural costs and preferences. I agree with this thought in theory but not in this case, the risks of not acting quickly are too high to let the market run its course. We need to agree that electric vehicles are a far better solution to our transportation needs than what we have now and that they are a good enough solution to move forward with. I have many reasons to support those claims but here are three…

Below is the electricity generation capacity mix of each province and territory in Canada in 2014 and projected to 2040 from the National Energy Board. (I don’t really agree with the projections so try to pay more attention to the 2014 numbers).

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The only place it doesn’t make sense to drive an electric vehicle, from a purely environmental perspective, is Nunavut because they generate 100% of their electricity from oil anyways. Even in Alberta, with less than 20% of its electricity generation from renewable sources it still makes environmental sense to drive an electric vehicle. You can do the math for yourself using the carbon emissions numbers for coal, oil and natural gas from the U.S. Energy Information Administration if you don’t believe me.

Second, electricity prices will likely fall due to the proliferation of electric vehicles. More electric vehicles on the roads will put a higher demand on electricity. As a result, governments will be forced to increase generation capability. The cheapest way to due that right now is through renewable sources, typically solar and wind. Since the “fuel” for solar and wind is free, the operating costs of those generation sites are drastically reduced and those savings will be passed on the consumers.

Finally, you never know what we will discover by investing in electric vehicle technology and infrastructure. If you need proof, look no further than the breakthroughs we can thank the space race for. When we invest in electric vehicle incentives we aren’t just paying for carbon reductions. We’re paying for health benefits, cheaper electricity, technological advancements and things we probably can’t even imagine at this point in time. Let’s keep going.