All posts by Maureen McEwan

BC’s naloxone funding is a “good start” says Vancouver Police but the opioid crisis needs ongoing strategy.

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Photo courtesy of College of Pharmacists of British Columbia

By Maureen McEwan

The topic: British Columbia continues to face an opioid crisis. The province declared a public health emergency last April in response to an increase in drug overdoses and deaths.

In September, Premier Christy Clark announced 10 million dollars to go towards combatting overdoses and drug-related deaths. The BC Ministry of Health is providing 1.1 million dollars to provincial police forces for response training and supplies to better prepare the forces. The department’s documented goal is to ‘improve immediate responses from police to an overdose’ by training municipal and RCMP forces in naloxone administration.

(Please click the link below to view the Ministry of Health’s document)

Naloxone is a medication which ‘reverses the effects of an overdose from opioids e.g. heroin, methadone, fentanyl, morphine.’ It has been used effectively by first responders – paramedics, firefighters, etc. – in emergency situations and has saved lives from fatal overdose.

What’s new: Until December, officers in BC could be investigated by the Independent Investigations Office (IIO) during ‘officer-related incidents of death or serious harm.’ The IIO’s mandate was widely considered as a barrier to officers responding in critical opioid incidents. But the watchdog announced it will no longer investigate when an officer uses Naloxone or CPR in order to save a life. This may allow officers to use their new naloxone training in a crisis more readily.

Why it’s important: The Ministry of Health reports there were over 900 drug overdose fatalities in BC last year- the highest number in decades and the highest in Canada.

Municipal and RCMP forces are gradually being trained Canada-wide but the provincial strategies vary. Several cities, such as Calgary and Toronto, have begun training their municipal forces in naloxone administration. The RCMP has trained many members in different regions. But there are large urban areas without any Naloxone officer training in place.

If the training of BC’s forces improves overdose responses, other provinces may follow. With faster response times, lives could be saved across the country.

What the government says: Sarah Newton works for the B.C Ministry of Health’s Government Communication and Public Engagement Department. She provided a statement on behalf of the Ministry in response to interview requests.

“In B.C., we are doing everything we can to keep people safe, including expanding access to life-saving naloxone.”

The statement confirms that the province provided 1.1 million to fund intranasal naloxone costs and administration training for municipal police and RCMP. The verified funding amount currently stands at 700,000 dollars less than the initial 1.8 million proposed by the provincial government.

What others say: Jason Doucette is a Media Relations Officer at the Vancouver Police Department (VPD). In an email interview, he says the VPD was the first department in Canada to train sworn and civilian members to administer nasal naloxone. The issue and training began in September.

“The supply of naloxone we purchased is good for 18 months. The cost of replacement will be an on-going expense for the VPD every 18 -24 months. The 1.8 million dollars is a good start,” he says, referring to the Ministry’s initiatives.

(Please click below to view the Ministry’s open data file in full).

Doucette adds that the VPD has shared all of its Naloxone training materials with different police agencies across the country.

The RCMP and Toward the Heart did not respond to questions before the article was published. Vancouver Coastal Health – Insite declined to interview.

What’s next: The mayors of the largest cities and several federal cabinet ministers met on Feb. 24 to discuss escalating drug-usage and deaths. They are pledging to work together in response to the country’s overdose crises, with BC leading the task force.

The western province serves as the provincial model in opioid crisis-response. The widespread training of police and RCMP forces in naloxone administration may improve immediate responses in ‘high risk areas,’ as the VPD suggests. As a result, BC could see a decrease in overdose deaths in future.

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For instructor reference:

What is the information?
The information was a request released on January 27th, 2017 to a political party for a financial breakdown from the Ministry of Health. It requested a specific breakdown of the 10 million announced by the Premier to combat overdose deaths in September at the UBCM and the precise initiatives that the funding was allocated to in that proposal.

From which department did these pages come?
The BC Ministry of Health – Open Data Website retrieval.

Why was this information helpful?
The information was helpful because training for naloxone is seemingly sporadic nation-wide. BC has put forth funding and policy in order to facilitate mass training for its municipal and RCMP officers. As legislation around naloxone has loosened in the past year, more and more its use is being seen in major Canadian cities.
There was a discrepancy in the BC funding total which was significant but that could be attributed to a number of factors. It was confirmed through communication with the Ministry as 1.1 million.
The information was also very intriguing in relation to the IIO’s mandate and December announcement. Officers in BC may start to engage more as first responders in incidents of opioid overdose moving forward.

Despite “gold standard” model, a safe injection site and peer-level engagement could improve downtown needle collection.

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Needle Kiosk at the Wabano Centre in Vanier.
Photo by Maureen McEwan.

OTTAWA – Rideau-Vanier marks another year as the city ward with the highest number of discarded needle and syringe complaints. Many needle collection services exist but the public says a safe injection site in the downtown core could be the solution to minimizing the issue.

The City of Ottawa received a total of 101 service calls for improperly disposed needles in 2016. Rideau-Vanier (Ward 12) was at the top of the list with 58 instances reported. The second highest was another downtown ward, Somerset (Ward 14), with 12 complaints over the year. The remaining calls for discarded needles were scattered, with most wards reporting a single complaint if any.

(Please click the link below for a map of the 311 calls.)

For years, the Rideau-Vanier and Somerset wards have received the majority of 311 calls concerning needles and syringes. Both wards have the highest calls per capita, with Rideau-Vanier having 11.8 calls and Somerset having 2.9 calls per 10,000 residents. The recent reports for January and February indicate that the trend continues into 2017.

Craig Calder is the Program Manager with Environment Health Protection at Ottawa Public Health (OPH). He says that OPH has always seen “a significant spike” in needle finds and needle box usage in Rideau-Vanier and areas.

“If you look at the numbers on the Open Data, you can certainly see a significant number in Ward 12 which is Rideau-Vanier,” Calder says. “But I don’t want to divert resources that would essentially take away from the suburban users of these boxes as well.”

Calder says that OPH maintains 78 needle kiosks around the city. The kiosks allow individuals to dispose of their needles safely at accessible public areas. Some are in the Rideau-Vanier area but many are distributed. Calder adds that the kiosks are not used exclusively by intravenous drug users but also by individuals with medical conditions such as diabetes.

(Please click the link below for a map of the needle box locations.)

There are varied services besides needle drop boxes. The City of Ottawa also facilitates the “Take-it-Back!” program which allows individuals to return needles to participating pharmacies. Needles are also collected at the Site Needle & Syringe Program and with OPH’s site mobile vans. And there are “proactive” services like the needle hunters and city internal staff members who pick up needles when 311 calls come in, Calder says.

“There’s a number of different, overlapping pieces to our fairly robust needle program – I think we have the gold standard, actually,” he says.

Since 2012, the services have collected over a million discarded needles annually.

As an Employment Coordinator, Hilary Leavens helps run the Needle Hunter program at Causeway Work Centre which employs 40 people.

Wearing their trademark safety vests, needle hunters embark every day to collect needles and safely discard them. No job experience is needed but they require a level of comfort for the work, Leavens says. Their routes are contained mostly in the downtown core. Leavens says that the Lowertown routes are busier due to increased foot-traffic, a concentration of social services, and “pockets of homelessness.”

Despite these services, the 311 trend has been consistent for years. While the city may have a strong response, needle collection may need review.

The latest census data indicates that Ottawa’s population is growing which may shift ward demographics. Calder says that the model’s resources expand as the city does but for the moment, it’s a “well-oiled machine.”

But the increase in opioid and intravenous drug use in Ottawa could place immediate pressure on services. The city may be required to adapt or reallocate resources if the opioid situation escalates.

Sean LeBlanc is a founder of Ottawa’s Drug User Advocacy League (DUAL) and a former opioid addict. DUAL supports users and advocates for services like the safe injection site.

LeBlanc says that the City and OPH services, like the needle hunters and black boxes, do “a great job” with their work. But there’s a gap: Leblanc says more program involvement from people with lived-experience would help. In other cities, peer-level models have proven effective with needle distribution and collection, he adds.

The Sandy Hill Community Centre put forth a proposal for a safe injection site to the federal government. The Centre is located in the Rideau-Vanier ward. In a September OPH survey, respondents indicate that the site could improve needle collection.

As Table 8 demonstrates, 1432 respondents indicated that a Sandy Hill safe injection site would reduce discarded needles in public areas. This was one of the top benefits identified in the survey.

To support needle collection efforts in the downtown wards, further community services and engagement could be needed soon.

The legacy of the 1967 Omnibus Bill and those still waiting for “an act of recognition.”

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Pierre Elliott Trudeau speaking to the press after Bill C-195 is tabled. Photo courtesy of the CBC Archives.

Fifty years ago, it was a bold statement. Pierre Elliott Trudeau declared publicly that “there’s no place for the state in the bedrooms of the nation.” As Minister of Justice, Trudeau introduced The Criminal Law Amendment Act or C-195 on December 21st, 1967. The omnibus bill proposed controversial reforms to the Criminal Code including the decriminalization of homosexuality and the legalization of abortion under certain conditions.

Days before Trudeau tabled the bill, Prime Minister Lester B. Pearson tendered his resignation and Cabinet Members questioned the bill’s language, suggesting it be pushed to later session. Trudeau urged them to proceed with the reforms, regardless of timing or politics: “If the government was prepared to deal with abortion, it might just as well deal with gross indecency as well.”

(Please click the link below to view some Cabinet Conclusions from December 19th, 1967.)

The Minister of Justice Pierre Elliott Trudeau speaks to the proposed Criminal Code reforms and the inclusion of "gross indecency" with fellow Cabinet Members. Source: Library and Archives Canada

The legislation was amended and passed as Bill C-150 when Trudeau was prime minister.

Rebecca Bromwich is a lawyer and a professor at Carleton University. Bromwich describes the legislation as a “watershed” event in Canadian criminal law which allowed for further legal reforms and for the development of a more accepting society.

“People have called it the “Bedroom Bill” because it moved criminal law out of a kind of moralizing of people’s sexuality into a very kind of different perspective on what types of conduct should be criminal,” Bromwich says. “And so it decriminalized homosexuality. And at the time, there were people in penitentiaries serving time for same-sex, sexual conduct.”

(Please click the link below to see the introduction of Bill C-195 to the House on December 21st, 1967.)

As introduced by the Minister of Justice Pierre Elliott Trudeau on December 21st, 1967.

Bromwich explains that the charge of “gross indecency” criminalized consensual sexual contact. At the time, she says there was no recognition of same-sex sexual contact and no distinction between assaultive and consensual sexual contact in this area of law.

“It was all an abomination. It was all criminal,” Bromwich says.

The last person to be criminally convicted for homosexual acts was Everett Klippert. Prior to the reforms, Klippert was incarcerated twice on dozens of charges of gross indecency in the 1960s. Following his last conviction, he filed an application for leave to appeal to the Supreme Court of Canada on the charge of “dangerous sexual offender.”

After the application to appeal was granted, lawyer Brian Crane received a request to assist Klippert. Crane drafted a factum and appeared before the Supreme Court, arguing Klippert’s case briefly in the early stage of his appeal.

“It was a question of whether the law was appropriate. And that was the issue – a pretty simple issue,” Crane says.

In November 1967, Klippert lost the appeal at the Supreme Court in a 3-2 ruling. The dissenting justices wrote reasons “indicating the unsatisfactory state of the law,” Crane remembers. He also recalls the case being cited in the House by different parliamentarians. Crane describes Klippert’s case as having a “significant effect” on the Liberal omnibus bill.

“It became a matter of public attention and it certainly was one of the factors, if not the major factor, in having that legislation come forward.” Crane says.

Decades later, with a second Prime Minister Trudeau in office, the question of legal legacy arises. In November, the government announced the repeal Section 159 of the Criminal Code – a law widely-held as discriminatory to homosexual Canadians. This week, they announced further revisions with the removal of “zombie laws” on abortion and other areas.

But the legal history raises another concern for Klippert’s lawyer. Crane asks about a general pardon for those like Klippert, convicted of similar crimes.

“It’s righting a historical wrong,” Crane says. “And I think from the gay rights perspective it would be, would be certainly, important and useful and I imagine would get unanimous consent in the House.”

In 2016, Prime Minister Justin Trudeau’s government announced its recommendation for Klippert’s posthumous pardon but it has yet to be granted.

“To have a pardon – it’s an important historical act, I would think. An act of recognition,” Crane says.

Brian Crane is a partner at the Gowling WLG law firm in Ottawa.

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Documentation Notes for the Instructors:

Document 1
What is the documentation?
The debates or Hansard from the House of Commons on December 21st, 1967.

How did you find/obtain it?
After looking through different government archives online, I reached out to a source at the Canadian Parliamentary Press Gallery. The source was able to locate the Hansard and send me a copy. We verified the copyright conclusions prior to posting online.

Why was the documentation helpful?
It was helpful though the tabling of C-195 was succinct. It was my assumption that lengthier debate ensued after the Minister of Justice Pierre Trudeau tabled the bill on the floor; however, it went to committee it seems. The bill was amended (to C-150) over several parliamentary sessions and years, therefore there was much documentation to sift through ultimately. This was a useful perspective for the initial C-195 tabling.

Document 2
What is the documentation?
A selection of Cabinet Conclusions from December 19th, 1967 which notes discussion on the Criminal Code reforms.

How did you find/obtain it?
I accessed it through different searches on the Library and Archives Canada website.

Why was the documentation helpful?
It was very helpful. There were numerous Cabinet Conclusions from the week before the bill was tabled that were incredibly interesting. The internal politics at the end of that particular session appeared tenuous – not to mention the wider societal political context. Specifically, the documentation helped me to better understand the discussion around the bill’s language and timing. It also re-inforced the idea that Minister of Justice Trudeau was adamant about the bill’s tabling at the end of 1967.

Additional Documents
I also included hyperlinks to the Klippert Supreme Court Case in 1967 and to Pierre Elliott Trudeau’s 1967 comments to the media for added reference.

Where to grow from here: Cineplex reports record media revenues and looks to expand

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Cineplex Inc – Stock Prices on Trading View by mmcewan on TradingView.com


Source: Trading View

Logo courtesy of Cineplex Inc.

In its most recent financial statement released Sept.30, entertainment conglomerate Cineplex Inc. reports a record quarter with $44.8 million in media revenue and $376 million in total revenue.

The company anticipates that 2016 will make its best fiscal year to date, projecting over one billion dollars in total revenue.

As Cineplex expands, the question of growth remains. How will the company maintain its revenues moving forward?
Cineplex Inc. is one of the biggest entertainment companies in Canada. With 164 theatres across the country and approximately 77 million customers annually, the motion picture company is dominant in the market.

Through a series of mergers and acquisitions, Cineplex established its prominence over the last decade. Former Canadian entertainment enterprises such as Famous Players, Cinemark, Empire Theatres, and others were subsumed into Cineplex. As of Sept.30, the company reports control over 77.5 per cent of the industry’s market share.

However, in the era of Netflix and online entertainment streaming, the nature of the market has changed. Competition has driven Cineplex to diversify in the shifting media environment.

Exhibition forms the largest source of revenue for the company. Typically, box office sales provide half of the annual revenue. But further and further, the company is expanding its revenues beyond box office and concession sales.

Media revenue has diversified the company’s financial base. In a document accompanying the latest financial report, Cineplex Investors suggests this is achieved through its “wholly-owned advertising business covering everything from onscreen advertising to magazines, online advertising, naming rights and our digital media business, Cineplex Digital Media.”

Simply, media revenue is generated by offering ad space to clients and companies on the wide variety of Cineplex’s platforms. Please click here to review potential ad space.

The effects of diversification have been quick. As indicated, Cineplex’s media revenue was $44.8 million in the latest term, a 30.7 per cent increase from the same period last year.

(To review and compare the recent 2016 financial statement in DocumentCloud, please click on the annotated image below).

As noted above, media revenue is generated from two distinct areas within Cineplex: Cineplex Media and Cineplex Digital Media. In the Q-3's accompanying factsheet, media is defined as "Cineplex’s wholly-owned advertising business covering everything from onscreen advertising to magazines, online advertising, naming rights and our digital media business, Cineplex Digital Media."

Source: Cineplex Q3 2016 Report

Over the last six years, media revenues have steadily increased in the third quarter. In 2011, Cineplex reported a 5.6 per cent decrease in media revenue due to reduced spending in automotive manufacturing. Since then, media revenue has increased gradually from $22.1 million to $44.8 million – a 102.0 per cent increase.

(To review and compare the 2011 financial statement in DocumentCloud, please click on the annotated image below).

The third quarter in 2011 saw a decrease in the media revenue. As noted above, the revenue was impacted by both domestic and international economic conditions and events. This is noteworthy as media revenue does not have its own, specified risk assessment in the 2011 MD&A. In later reports and management discussions, the economic concern here is noted. For example, the "media risk" identified in the Cineplex 2014-2016 third quarter reports identifies the following: "Media revenue has been shown to be particularly sensitive to economic conditions and any changes in the economy may either adversely influence this revenue stream in times of a downturn or positively influence this revenue stream should economic conditions improve."

Source: Cineplex Q3 2016 Report

Michael McIntyre, an Associate Professor of Finance at Carleton University, notes the increase and confirms the trend. He says that advertising in the theatre is a newer, immature model which dates back only five or ten years. The expansion of the “leisure dollar” beyond box office sales warrants further analysis, he suggests.

As media revenues increased, the recent financial statements include a Media Risk analysis in the Management’s Discussion and Analysis (MD&A). In the assessment, media revenue is stated as being “particularly sensitive to economic conditions” and that any economic changes could impact this revenue source – as noted in the Cineplex Q3 2016 Report.

Additionally, the MD&A states that Cineplex may not be able to replace the revenues created by major media customers if they were lost.

In reviewing the risks, McIntyre says that the company may be viewing the media revenue as a discretionary expense in the MD&A, whereas the revenue and risk could be more substantial:

Michael McIntyre is an Associate Professor of Finance at Carleton University. Photo courtesy of the Sprott School of Business.

“It is discretionary in the sense that you can just turn it [advertising] off like a tap. Whether they really can from a business exigency point of view, is debatable.” McIntyre says.

“In a downturn, you’re fighting harder for your customers. So to me it’s quite debatable whether that really is as discretionary as they are eluding to.”

Cineplex is looking to expand further in the North American market, as confirmed by CEO Ellis Jacob in fall press releases.

With its large market share in Canada, McIntyre says that Cineplex may have run out of room to grow domestically. He says it could impact share price and capital in turn if growth “flat lines” and shareholders decide to invest elsewhere. The ways to counter are diversification or expansion, options Cineplex continues to explore.

Cineplex’s media strengths are identified as a strategic corporate priority. Moving forward, the media revenues should be expected only to grow.

The 2016 Cineplex annual report will be released on February 15th, 2017.

Cineplex-Investors did not respond to requests for comment by the deadline.

Photo courtesy of Cineplex Inc.