Hakique Virani🟠 Profile picture
Assoc Prof/MD @UAlberta. Recovering federal Medical Officer of Health. Drugs, drug policy, social justice. Bylines: @GlobeAndMail @TorontoStar @VICE @CBC et al
Jun 9, 2022 15 tweets 4 min read
Thanks @NightShiftMD for chatting with me about drug laws and drug harms. Prohibition has never been about excluding certain drugs, but certain *people*.

The BC exemption is a step in the right direction, but it falls short of correcting an injustice. /1

cbc.ca/listen/cbc-pod… The BC exemption demonstrates the problems with talking about drugs as a "health issue" instead of a human rights and quality of life one, and the problems with understanding decriminalization only in the context of an overdose epidemic. /2
Feb 27, 2021 13 tweets 5 min read
This news release from PEI's public health authority - claiming that cannabis is laced with fentanyl - is flawed.

@DrCarlHart's Drug Use For Grown Ups makes a compelling case for for experts correcting these kinds of errors, so here's a 🧵 to do that.

princeedwardisland.ca/en/alert/provi… CBC and other news outlets picked up the story and reported it almost verbatim without fact checking. Fair, journalists might not think to fact check official sources like a Chief Public Health Officer. But we get drug facts wrong all the time.
Dec 20, 2020 15 tweets 5 min read
The idea that CERB basic income payments *caused* an increase in population overdose deaths isn't an idea that deserves analysis, but humour me? What if we applied some of Bradford Hill's criteria of causation?


(Spoiler: It makes the notion even more ridiculous) Temporality?

If CERB caused an increase in fatal ODs, the program had to come *before* the increase. The surge clearly started in *March*.

Compared to Feb:
AB: 43%⬆️
BC: 53%⬆️
ON: 19%⬆️

You couldn't even apply for CERB till *April 6*, and payments didn't come till mid-April.
Dec 4, 2020 8 tweets 2 min read
I love vaccines and vaccine innovation. But COVID vaccine availability doesn't obviate the need for major public health restrictions. It's a long time (and a lot of deaths) till a mass vaccination program is complete, and Canada has never executed one well. Remember H1N1? Image The large difference in mortality between that pandemic and this one might decrease vaccine hesitancy and pre-order procurement might help too, but the logistical challenges will be greater with multiple doses, strict cold chains etc.
Nov 30, 2020 19 tweets 5 min read
On Friday night, I chatted with @CBCNews about independent public health leadership in emergencies. No surprise, I disagreed with the conservative strategist on the panel.

Their arguments might soundbite well, but they're wrong.

#cdnpoli #MedTwitter #COVID19 “Big decisions are made by elected officials. That’s how democracy works.”

That’s crudely reductionist. Civil society depends on un-elected institutions, too. e.g., an independent judiciary to deliver justice impartially and protect minority rights - sometimes *from* governments
Nov 26, 2020 13 tweets 5 min read
Why do some Canadian provinces have among the most ineffective pandemic responses in the world? Why do we keep failing in public health crises?

@ehyshka and I wrote about the systemic lack of public health independence and how to right the ship mid-pandemic.

(Thread) The Auditor General's rebuke of Ontario's COVID response and widespread criticism (under the hashtag #mockdownAB) of yesterday's "new restrictions" announced by Alberta's Premier are examples of eroding public trust in governments' ability to protect citizens.

That's bad news.
Nov 21, 2020 16 tweets 7 min read
Had a starter conversation with @Cath_Cullen, @piya, and former Premier @BrianGallantNB on @PnPCBC this week about Mayor @kennedystewart's motion to seek a federal exemption to decriminalize drugs in Vancouver.

Some narratives worth addressing
1. The collision of COVID+OD epidemics makes drug law reform more urgent, yes, but criminalizing people who use certain drugs is no more or less unjust now compared to before. It has always been racist, classist and wrong.

As Dr. @RebeccaSaah and I wrote in @AmJPrevMed
Jul 9, 2020 5 tweets 4 min read
It's excellent news that @CACP_ACCP finally endorses decriminalization of simple drug possession. But since the "treat addiction as a health issue" chorus is getting really loud and obscuring the underlying problems (and intents) of today's drug laws, here's a thread/re-thread /1 Dr. @RebeccaSaah and I wrote a commentary on this last year and @AmJPrevMed published it in their first issue of 2020.

"Drug Decriminalization: a matter of what's just, not just a matter of health."

rsaah.ucalgaryblogs.ca/files/2020/06/… Image
Jul 7, 2020 11 tweets 3 min read
As a Canadian, Albertan, hockey-loving, public health specialist doctor, I feel like I should write this down somewhere:
I think this playoff hockey plan in Edmonton and Toronto is a bad idea. Even if every player, team staff, official, arena/ice crew, security person, food/bev worker, hotel staff, delivery driver, bus driver, etc etc can follow every aspect of the plan (excursions, room restrictions, testing and all), there are major messaging and equity issues.
Dec 25, 2019 20 tweets 6 min read
We spend Christmastime with the people we love most.
Like we do on birthdays.
My birthday happens to be Christmas Day.
And this one - the first without my dad - is the worst one of my life.

I feel like people on Vancouver's Downtown Eastside would understand.
(Story/Thread) At Thanksgiving, the man I was most thankful for died at 77. My dad was active, energetic, hilarious. He was the one who always caught his children and grandchildren when we fell.
We never thought *he* could fall.
Jan 12, 2018 19 tweets 6 min read
By now, everyone agrees (or should) that harm from opioids is a most pressing public health issue. But between smart people there’s disagreement on what role prescribing plays. Some thoughts on that (THREAD): /1 Yesterday, @CPSA_CA Registrar Dr. McLeod’s op-ed described changes in opioid prescribing in Alberta.
# of individuals prescribed opioids – ⬇️ 9000
Total morphine equivalents dispensed to population – ⬇️14% /2