Where Is Life Promotion Advocated when Preventable Deaths Are Among Our Biggest Crises?
A person dear to me recently asked where I thought power might lie in preventing preventable deaths in Canada. Preventable deaths are “those that occur among people under the age of 75 years and are considered preventable given changes in lifestyle or behaviours, or treatable given access to proper health care” (Statistics Canada, 2023). My immediate response was that it would naturally be those at the governance level who wield power. But what if there is also a crisis in leadership? She pushed for revision of this singular focus.
As a systems issue and crisis, also in leadership, the responsibility and care must begin where sustainable solutions lie. That means leading the self in these systems, our families, and our communities. This is not to absolve those wielding positional power of making more urgent and concerted efforts through their positions of leadership. But, also, why aren’t we inquiring into the sustainable and most meaningful means so that individuals can feel whole, families can be safe; so that our communities are spaces of support and strength?
And preventable deaths are among our biggest crises. It’s everywhere around us. Regarding opioids, an American dies from fentanyl use almost every eight minutes, and the majority due to fentanyl surged to nearly 107,000 in 2021 (Jorgic, May 9, 2023). More broadly, in 2020, alone, 77,000, or one-quarter, of the over 307,000 deaths in Canada were potentially avoidable. In B.C., in 2020, there were 148 deaths per 100,000. The preventable death rate in the territories was at 391 per 100,000 population (Statistics Canada, 2023). According to a May 5 release by the Yukon Coroner’s Service, eight people died between April 7 and April 27, 2023, in the Yukon, related to substance use (Hatherly, May 8, 2023), presently putting the territory at the number one spot in Canada per 100,000 deaths.
Preventable death due to substance use can devastate any family, from any background, at any age. Fentanyl only takes about two grains of rice worth to overdose and die (Westhoff, cited in Boas, April 19, 2023). Fentanyl is 50 to 100 times more potent than cocaine or heroin (Boas, April 19, 2023; Travere & Giraudat, Dec. 8, 2020), comparatively much cheaper, and is in almost all street drugs and, make no mistake, that can include marijuana or street Adderall (Attia, 2023)! Substance-related death can occur after years of use and can happen on the first use.
Mobilizing seemingly benign drugs into possession is now extremely easy – considering, among the vulnerable, the younger demographic that tends to use Snapchat, it’s not unusual for their Snapchat to include people promising they’ll alleviate anxiety or help to focus on homework, through their drugs (Attia, 2023). Fentanyl can be found on Pinterest ads (Travere & Giraudat, Dec. 8, 2020). While precursor chemicals may have been smuggled from China, Mexico is no longer a transit country for Chinese-produced fentanyl but also a major production hub (Jorgic, May 9, 2023). Yet, who would be the target if one were to narrow efforts to Mexico? Fentanyl can be transported in small and undetectable packages (Boas, April 19, 2023).
Power to address this crisis does not lie only in the hands of politicians and regulatory bodies, such as the International Narcotics Control Board (INCB) – a non-binding entity - or inspection authorities. Surveillance and change also rely on the goodwill of companies (Travere & Giraudat, Dec. 8, 2020). These entities have a critical responsibility, nonetheless! But if such macro-level systems are failing us, and cartels are ever more steps ahead in adaptability, we very well need to be focusing on multiple systems of support and guidance, as well as understand not only where they are breaking down but where and how we can promote life in a holistic, comprehensive way.
In their book Deaths of Despair and the Future of Capitalism (2020), Case and Deaton point to capitalism, which they say over two centuries helped countless people out of poverty, is now destroying the lives of blue-collar America. Despair is most certainly something for us all to ponder. And the person who asked where power lies also pointed out, North American society with the nuclear family structure is not able to weather this crisis. It takes a community to truly care for and keep our children and our most vulnerable safe. As a systems issue, there is no one space or directive to set course for life promotion (wise practices, 2023). But beginning the conversations among the population might, and so I leave a question she further asks: what lessons and helpful hypothesis should garner our attention when we consider the current devastation of the opioids "epidemic" and British Imperialism and the Opium Wars with China?
Attia, P. (2023). Interview with Anthony Hipolito: The fentanyl crisis and why everyone should be paying attention. https://www.youtube.com/watch?v=i2K-_UTLNR4
Boas, P. (2023, April 19). There’s a reason America has lost more to fentanyl than war. And we’re not addressing it. Arizona Republic, https://www.azcentral.com/story/opinion/op-ed/philboas/2023/04/19/fentanyl-killed-more-americans-than-war-sadness-despair/70126706007/
Case, A. and Deaton, A. (2020). Deaths of despair and the future of capitalism. Princeton University Press.
Hatherly, D. (2023, May 8). Yukon coroner confirms 8 substance-use related deaths over span of less than 3 weeks, Yukon News. https://www.yukon-news.com/news/yukon-coroner-confirms-8-substance-use-related-deaths-over-span-of-less-than-3-weeks/
Jorgic, D. (2023, May 9). How El Chapo’s sons built a fentanyl empire poisoning America. A Reuter’s Special Report. https://www.reuters.com/investigates/special-report/mexico-drugs-chapitos/
Statistics Canada. (2023, April 18). Premature and potentially avoidable mortality in Canada, provinces and territories, 2011 to 2020, https://www150.statcan.gc.ca/n1/daily-quotidien/230418/dq230418b-eng.htm
Travere, A. & Giraudat, J. (2020, Dec. 8). Revealed: How Mexico’s Sinaloa cartel has created a global network to rule the fentanyl trade, the Guardian. https://amp.theguardian.com/world/2020/dec/08/mexico-cartel-project-synthetic-opioid-fentanyl-drugs
Wise Practices. (2023). A life promotion toolkit by Indigenous youth. https://wisepractices.ca/life-promotion-toolkit/
Photo by Hannah Busing on Unsplash