James Downar

Raghu Venugopal MD Verified account @raghu_venugopal · Oct 15

Mercifully tabloidist Brian Lilley won't have a duty to care for the public. His lunatic right-wing populist ideas (safe consumption sites cause opioid deaths and closing them saves people) are laughable. He can't cogently respond to my 2024 post to him or anything below. 👇👇👇

Why are there now less opioid deaths.

1-Less opioid deaths isn't just in Ontario. It's across Canada and the US. Ontario's obtuse abstinence-only approach can't explain why opioid deaths are significantly down in for example, British Columbia or the states of Washington or Oklahoma.

Ontario's abstinence-only approach can't explain the 14% reduction in opioid deaths in the majority of American states in 2025 (and in 2024 and 2023).

2-Opioid deaths sharply declined in Ontario from Dec 2024 to Feb 2025, long before Ontario started shutting down safe use sites in March 2025. In fact, death rates declined while safe consumption sites were open and in place.

3-The drug supply has changed. A factor behind less deaths is what is cut into street fentanyl. Less benzodiazepenes in the drug supply means less respiratory depression which naloxone can't reverse. This is a moving target, but is an important factor. What's tragic is that when Ontario Conservatives ended safe consumption sites, a lot of drug-checking was lost with it. Drug checking is really important for people using drugs and for ER doctors like me, to know what to expect with overdoses and withdrawal.

4-Naloxone has flooded the zone. This is crucial reason we see less opioid deaths. Naloxone is widely available compared to ever before.

5-More community and public awareness. The community using drugs is more aware of life-saving naloxone. Pharmacies and ERs give it out for free. This is crucial.

6-Treatment and recovery does play a key role. There's more awareness of the importance of this approach, and here, Ontario Conservatives deserve praise for adding new funding for HART hubs - at the unfortunate expense of slashing safe use sites. It was never supposed to be either/or - it was supposed to be harm reduction and treatment/recovery.

7-Many of the most vulnerable are now dead. This includes patients I've cared for. I remember who they were. This is a tragic truth. 56,631 Canadians have died from opioid toxicity between 2016-2025.

8-Those still alive are using street drugs more carefully and are better supported across North America. For example, a lot of healthcare workers - ER doctors like me - know that the overdose patient in the ER - is probably the sickest patient and the most soon to die - compared to all the rest of the patients in the ER that day.

9-Harm reduction has been effective. In 10 years, Canada had 6 million visits to safe consumption sites. There were 70,000 overdoses. None died.

Brian - try to frame an intelligent argument using facts, professional experience and without a political axe to grind and even despite your paycheque coming from American MAGAs.
@brianlilley @MooreintheAM

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Dr. Brian Goldman Verified account @NightShiftMD · Sep 22

The tell of a conspiracy theorist. When respected institutions don’t agree with their judgements, they say the institution is in on it.

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Leonid Sirota @DoubleAspect · Jun 24

I have resigned as Senior Fellow of the @MLInstitute, which in my view has abandoned its commitment to constitutionalism and the Rule of Law in Canada and become adverse to these principles. A bit more on my reasons for having come to this conclusion: doubleaspect.blog/2026/06/24/not…

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MAiD in Canada @MAiDCanada2016 · Jun 24

The Most Dangerous Anti-MAiD Messaging We Have Ever Encountered!
Opposing MAiD is one thing. But trying to scare people away from accepting palliative care in the moment of their greatest need is amoral on every level. This organization's scare tactics need to be denounced at the highest level. Shame on you Gordon Friesen, Alex Schadenberg, and the Euthanasia Prevention Coalition.
maidincanada.substack.com/p/the-most-dan…

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