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The Current Transcript for December 20, 2016

Host: Anna Maria Tremonti

STORIES FROM THIS EPISODE

Listen to the full episode

Prologue

[Music: Theme]

SOUNDCLIP

We heard glass breaking and we saw people, like, shouting, screaming, people with blood on their face. It's sad for me because I ran away from all of this, all of the violence, the terror and everything.

ANNA MARIA TREMONTI: He's a refugee from Syria whose visit to a central Berlin Christmas Market brought the violence right back to him yesterday, when a transport truck careened into a crowd that never saw it coming. It was a day of violent attacks, from the assassination of Russia's ambassador in Turkey to a shooting at a Zurich mosque and the truck that plowed into shoppers. In a moment, the implications for a continent are already weary and on edge. Also today..

SOUNDCLIP

I remember being told that I was dead for ten minutes. And I honestly don't remember even doing the drugs.

AMT: In the wake of our documentary on an epidemic of opioid overdoses on fentanyl and carfentanil in BC, we will hear ideas on how to tackle a seemingly intractable problem. From the proposal to end the prohibition of heroin to the call for more government money and help to treat addiction. That's in an hour. And emotional workspace..

SOUNDCLIP

I remember when I was a managing director, a young woman came into my office and started crying. And I was like ah ah ah and I closed the door and I said you can't do this. You know, we're just a few women here, you can’t cry at work.

AMT: Or can you? Apparently 41 per cent of women do cry at work, as do 9 per cent of men. In half an hour, the implications of a little emotional honesty in the office. I'm Anna Maria Tremonti, this is The Current.

Berlin Christmas market attack: 'We'll see more of these,' says journalist

Guests: Zadig Onnasch, Loretta Napoleoni

SOUNDCLIP

[Sound: ambulance and fire sirens blaring]

ANNA MARIA TREMONTI: Well, the sounds around that Christmas market just off the Kurfürstendamm in Berlin yesterday. As you've been hearing on the news, German officials are now clear they are dealing with terrorism in that grim scene yesterday in Berlin, when a truck plowed into a crowd of people at the outdoor Christmas Market. At least 12 people are dead, about 50 others are injured. It now appears the truck may have been hijacked. The original driver, a man from Poland, appears to have been killed earlier. Police in Berlin did arrest a suspect, now they're saying they aren’t sure he was the driver they're looking for. For many, that event immediately called to mind the attack in Nice, France on Bastille Day when 186 people died as a truck plowed through crowds that had been celebrating the holiday. Zadig Onnasch was at the Christmas Market when the truck crashed. He's in Berlin. Hello.

ZADIG ONNASCH: Hi there.

AMT: You had just arrived when all of this happened. Tell me what you saw.

ZADIG ONNASCH: So I just arrived and I scheduled to meet a friend close to the bikini house or actually just at the entrance. And we went there and weren't really sure what to do and he suggested we'll go to the Christmas Market. And he was about to turn right when we crossed the street, on the same street on which the truck then ended. And I was not really sure about that side, I don't know why, so we turned slightly more to the left side. And that is when we sort of, I mean, we looked at each other so the focus wasn't on the horizon but I could see that something was approaching from far behind, it was a black vehicle without any lights. Suddenly, you could hear the bursting of the wood from the installments on the Christmas Market, all the decorations, you heard people screaming. The truck went into the Christmas Market and then turned sort of slightly out on the street again and stopped there. And yeah, I mean, people were panicked, were running for their lives because no one really knew what had happened, is it an accident? Is it a terror attack? And yeah, we were quite shocked to see everything that happened.

AMT: What were you thinking then, as you saw this start to happen? What was going through your mind?

ZADIG ONNASCH: [sighs] Yeah, that's a difficult question. I mean, first of all, it's like this is not happening right now, this is a movie, this is not real. And the second thing is like why am I here at the moment? And it's just very shocking and overwhelming because frankly I mean, there has been reports in the media about that this could happen. About a month ago, some authorities warned people on Christmas Markets. But since I've been on a couple of Christmas Markets in Berlin, I'd expect this thing to happen elsewhere and I don't know why I didn't expect anything to happen here. But that's the point of terror, it usually hits you when you least expect it.

AMT: So how close did it actually get to you?

ZADIG ONNASCH: Well, I mean, if we would have turned to the right side as my friend suggested, we would have literally gone straight into the line where the sort of truck hit the people. So luckily we didn't turn right. I was close enough to see things I wished I would not never see.

AMT: Mm. How busy was the Christmas Market at the time?

ZADIG ONNASCH: I thought when we crossed the street that it wasn't because it was Monday evening, so I didn't thought it was as busy because I'd been there on the weekend and then it's really crowded and busy. Nevertheless, it is one of the busiest Christmas Markets in Europe and it's really really crowded and it's very narrow, everything is very close. So if there are a lot of people inside the Christmas Market, you'd sort of have to fight yourself through the installments. So that's why also so many people died.

AMT: They wouldn't have seen it coming. They would be busy going in between the little stalls and not realizing it was even there until it was on top of them then huh?

ZADIG ONNASCH: Exactly. I mean, just to sort of give you a reference, if you imagine Nathan Phillips Square in Toronto, for example. Yeah, not as big as a size as Nathan Phillips Square. And those installments would face the square itself, so the back of the installments face the street. So you wouldn't necessarily see everything that's going on the street because the installments, yeah, sort of keep your sight away from that and you have your focus somewhere else because I mean, people are enjoying their lives, they are buying stuff, they're drinking mulled wine, you know, meeting friends, colleagues, socializing. And yeah, you don't see the street, you don't know what's going on behind, except for this huge truck. So, but it's unexpected. And then also you have the church, which is in the middle. So if you'd be on the other side of the Christmas Market, you’d just hear the noise and you will not necessarily know what's going on.

AMT: The church that of course was bombed and only there's part of it that remains from the Second World War. It stands as a monument to peace, doesn't it?

ZADIG ONNASCH: Exactly. It does. It’s the Kaiser Wilhelm Memorial Church.

AMT: Yeah. As this whole thing unfolded, and I'm guessing it was pretty rapid, I'm just wondering the kinds of things you saw. What sticks with you now?

ZADIG ONNASCH: Well, it's things that I wish I'd never seen, you know. I mean, it's not a pleasant sight when a truck plows into a group of people and what happens then. And I mean, I was lucky enough to face direction so I wasn't seeing everything but the track sort of stopped on the road, so eventually I got to see much more things. And yeah, I just hope I'll be able to forget that.

AMT: How nervous are you today about being out on the streets of Berlin?

ZADIG ONNASCH: As far as I've understood from the news coverage in Germany, they've closed most of the Christmas Markets and all of the Christmas markets in Berlin are closed at the moment. It's hard to say. I mean, I need to do shopping today, so I will still go out of the house. And, you know, if something is happening, then it will happen. Nevertheless, I refuse to allow myself to be threatened to such a degree so I will have my life impacted in a way that I wouldn't be able to carry on with the good things, you know.

AMT: Zadig Onnasch, thank you for speaking with me today.

ZADIG ONNASCH: Thank you very much.

AMT: Zadig Onnasch was at the Christmas Market in Berlin when it was attacked yesterday. Well, the implications of this attack go beyond security. To the politics of Germany and other European countries. Loretta Napoleoni is a journalist and author of several books about terrorism. Her latest is Merchants of Men: How Jihadists and ISIS Turn Kidnapping and Refugee Trafficking into a Multi Billion Dollar Business. Loretta Napoleoni is in Whitefish, Montana today. Hello.

LORETTA NAPOLEONI: Hello.

AMT: What were you thinking when you first heard of this attack in Berlin?

LORETTA NAPOLEONI: Well, unfortunately, I was not surprised, I was expecting something like that. A sort of copycat of what has happened in Nice. And I think we'll see more of these kind of attacks because it is a network at the moment that’s being activated inside of Europe.

AMT: What do you mean a network has been activated?

LORETTA NAPOLEONI: Well, until recently, until six months ago, the message that was coming from the Islamic State was come and join us, fight with us for the caliphate. But then it changed, the message has changed saying do not come, stay there, do something there. Now, why this is happening, it's very interesting because the Islamic State clearly is under attack. Yes, this caliphate has shrunk. So the public image of the caliphate is very very weak at the moment. And a way to relaunch it, so to represent it as a real force, it is through these attacks. And this is why right after the attack, I mean, of course we don't know if it was the Islamic State who did it but right after the attack, the Islamic State, has revindicated the attack. They said, you know, we did it. Now, we don't know if it's true or not but this is a pattern that we’re seeing in the last few months. Then no matter what happens, they try to claim [unintelligible] because this is a strategy.

AMT: How important is the symbolism of an attack on a Christmas Market in Berlin?

LORETTA NAPOLEONI: Oh, it's very important. I think the symbolism is tells us that this is not something that has been done without any thinking. Nice was done the Bastille Day, it was done in a moment of celebration for the creation of, you know, the nation state of French nation state. And this is done at Christmas, which is extremely important in Germany. Let's not forget Germany is the country that gave us the Christmas tree, the Christmas Market started in Germany, so there's a lot of symbolism in that. So this is why I'm thinking this is not something that was done on the spur of the moment. This was something that was planned.

AMT: And it's interesting because our last guest said that they had been warned in the last couple of weeks about the dangers to Christmas Markets.

LORETTA NAPOLEONI: Yes. I mean, they had been warning about Christmas Markets because it is an easy target. If you think about it, it’s very easy, it’s open, it’s full of people, we are very close to Christmas Day. So as, you know, the caller said before, people do shopping. And of course, you know, they go and shop at the Christmas Market, it's a great atmosphere, prices are quite good, so why not. The anti-terrorists knows which are the soft targets, the targets that can be hit of course more easily than others. But then what do we do? Do we stop living? I think Angela Merkel’s message today was very very good. We got to carry on living. We cannot let them stop us going about our lives as we did before. Otherwise, they really win.

AMT: What do you make, Loretta, of the fact that the police announced that they had arrested someone. They said that he was from Pakistan, he's 23-years-old and then now they're saying they're not sure, in fact, the person they have arrested was in fact the driver of that truck.

LORETTA NAPOLEONI: Well, I thought that the dynamic of the arrest was quite strange. Also, let's not forget that they didn't find the gun that was used to shoot, allegedly of course, you know, the driver. So the dynamic is somebody actually followed the guy they suspected to masterminding the attack, follow for a long time, for almost a kilometre and then eventually the police managed to arrest him. So to me it seems a bit strange. It also seems a bit strange that there's not been a declaration. I mean, if it's true that this was the individual who carried out the attack, it would not have denied it. It would probably declare publicly that he did it because this is kind of terrorist they were dealing with that. I mean, they want to make a statement and also the fact that he was running away from the truck, he did not die in the attack. It lets me think that perhaps there is more to that than we actually know.

AMT: It's interesting. ISIS today did claim responsibility for the attack in Jordan. On the weekend, the attack that killed Linda Vatcher, a Canadian from Newfoundland. Yesterday we saw the Russian ambassador to Turkey shot and killed by a gunman who shouted “Don't forget Aleppo, don't forget Syria.” There was the shooting at a mosque in Zurich that left three people wounded. What do you think of this number of events going on in the last several days?

LORETTA NAPOLEONI: Well the tactic is to bring the horrors of the civil war in Syria and in Iraq to Europe. I mean, that has been the tactic right from the beginning. And I see a pattern here, that clearly their recruitment is working out very well. Clearly the idea is near to Christmas, which is, you know, our most important holiday, I mean in the western world. These kind of attacks have an impact, they’re much stronger than during other periods. I think there is a planning behind all of that. Now we don't know how it's done, we don't know how this network works but, you know, for sure today at the end of 2016, we're dealing with a much stronger network, with a much better articulated network than we did in 2014. And this is the question that we have to ask ourselves. How did we get there? Where did we go wrong? How is it possible that this is becoming a sort of normality in Europe? Because in 2014 if something like this would have happened, it would have been unimaginable. But here we are. We're now thinking that this the normal, this is the new normal.

AMT: You talk about Europe. How susceptible is Canada to that same call then, if you say that these are leaders telling people to stay home and do it at home?

LORETTA NAPOLEONI: Well, I think Canada is safer than Europe because number one, your immigration is different, I mean, you do screen people, you do take routinely, people every year. This is part of your policy of growth. But people are screened. In Europe of course, with the crisis of the refugees, there is no screening at all. So people are let in on humanitarian basis of course. So it is much easier for people that are being radicalized outside to get in. It's also easier to radicalize people inside Europe. A lot of the people that have committed these kinds of crimes in the last two years, people that have moved to Europe after 2003, after the invasion of Iraq. They were children at that time. The integration process did not work and therefore it was easy to recruit them. Now, in Canada, the integration process actually works much better. I'm not saying that it’s perfect of course, but it works better. And the other important element is that, you know, people get into Canada and do not end up in ghettos, as it happens in Europe. They actually get spread all over the country. So it is less easy to recruit these kind of individuals in Canada than it is in Europe.

AMT: Now you actually were briefing the federal government on this just a few weeks ago were you not?

LORETTA NAPOLEONI: Yeah. Yeah. I was, yes.

AMT: What were their concerns?

LORETTA NAPOLEONI: Well, of course, you know, their concern is the concern of every single government, what is happening in the Middle East. So what is the situation of the Islamic State in particular and what are the consequences for western countries? So what I said is exactly the same thing I said to you now, that the risk is lower in Canada. That doesn't mean that there is no risk of course, but at least it is contained. While of course in Europe, Europe is on the front line. I mean, now this is clear that it is on the front line. And no country is safer than other country. Meaning it's not true that because in Italy there haven't been any attacks Italy is safer than Germany. The truth is that, you know, easily Italy's a sort of corridor so people, you know, pass through Italy to go north. So there's is not a very strong presence of people coming at the moment. Also, Italy did not take many people in 2003. Most of the people that were taken since 2003 have gone to Northern Europe. So the pattern of migration is different but nevertheless there could be an attack tomorrow in Italy also, so.

AMT: So in the little bit of time we have left, how does this play out politically? Angela Merkel is already under great scrutiny and criticism.

LORETTA NAPOLEONI: Yes. I mean, I think this plays politically very badly for Angela Merkel of course. I think she's already a weak candidate because she's been there for a long time, people want a change. They feel that if there is a change things will get better. So any kind of attack of this type of course will be blamed on Angela Merkel. And of course, you know, people think that the problem are the migrants, which of course is not the problem, the migrants. The problem is much much bigger, it’s the integration of people coming from outside. And also, I would add that this plays in favour of Marine Le Pen in France because I mean, that is the election that we've got to watch. If Marine Le Pen wins in France, then it is possible that Europe will break because she will call a referendum and it's possible that the French will vote like the British.

AMT: So all of this then is playing into already that sense of sense of discontent among voters in different parts of Europe?

LORETTA NAPOLEONI: Oh, absolutely. Absolutely. Voters are discontent not because of what is happening in the Middle East because this is a distant war. People are discontented because of what is happening in Europe. They have been discontent since 2010, since the big financial crisis in Europe. But terrorists compounds on top of this.

AMT: OK. Loretta Napoleoni, thank you for your insights.

LORETTA NAPOLEONI: Thank you Anna Maria.

AMT: That is Loretta Napoleoni She's a journalist and author of several books about terrorism. Her latest is called Merchants of Men: How Jihadists and ISIS Turned Kidnapping and Refugee Traffic into a Multi Billion Dollar Business. She joined us from Whitefish, Montana today. Let us know what you think of what she's saying. She's someone who actually follows the money trail of terrorist organizations. You can reach us on Twitter, we are @TheCurrentCBC. Find us on Facebook. Go to our website cbc.ca/thecurrent. Still lots of questions need to be answered about what happened and who was behind what happened in Germany yesterday. And stay with us, the news is next. Then whether you hide your tears or let it all out and have a good cry, can you do that at work? We're asking whether today's workplaces should be more accommodating to emotional outpouring. I'm Anna Maria Tremonti, this is The Current.

[Music: Extro]

Crying at work could damage your career, study suggests

Guests: Kimberly Elsbach, Anne Kreamer

ANNA MARIA TREMONTI: Hello, I'm Anna Maria Tremonti and you're listening to The Current.

[Music: Theme]

AMT: Still to come, our coverage of the fentanyl crisis continues. CBC reporter Natalie Clancy spent a night shift in a Vancouver emergency department for her documentary Fentanyl Ground Zero. That aired here on The Current yesterday. You can find that on our website cbc.ca/thecurrent or with the CBC Radio app. It sparked some big questions about whether the time has come to focus on addiction therapy instead of harm reduction. We're taking up that discussion in half an hour. But first, opening up the waterworks at work.

SOUNDCLIP

[Sound: woman sobbing]

BEN: Becky?

BECKY: I’ve been here nine months Ben and she’s never asked me to take a look at anything for her ever, OK?

BEN: I hear you, that’s frustrating.

BECKY: I mean, totally. I graduated from Penn, I have a business degree but I never seem to do anything right around here. Oh my God, I hate girls who cry at work.

AMT: Well, that's a scene from The Intern. And in fact, it's just one of two scenes in that movie where women end up in tears at work. Of course, crying in the workplace happens. But many top flight business leaders do not approve, including Frances Hesselbein.

SOUNDCLIP

There is no place for tears in the workplace for women. And I would say number one, as you well know, it ruins our makeup and never do we use tears in the workplace as leaders who are women. No time for tears, how do you like that?

AMT: Frances Hesselbein, former CEO of Girl Scouts of the USA. In 1998, she was recognized as a pioneer for women by then President Bill Clinton. Now, while she warns against shedding tears in the workplace, Stephania Varalli has some different advice. She is a CEO, co-CEO of Women of Influence, a business dedicated to the advancement of professional women. She says tackling the stigma around crying at work is important for women.

SOUNDCLIP

It's this instantaneous feeling of shame and worry when a woman cries because she knows she's not supposed to do it or she's been told you're not supposed to do it. When men cry at work, people think oh, something horrible must have happened or, you know, oh, it humanizes him. He's a man in touch with his feelings. A woman cries and she is seen as someone who is out of control of her feelings. Who isn't fit to be in a leadership position because she can't handle stress.

AMT: Well, two very different opinions from two successful business women on whether today's workplace should be more accommodating to emotions. We're going to keep the conversation going with two guests. Anne Kreamer is a writer and self-described serial entrepreneur. She is also the author of It's Always Personal: Navigating Emotion in the New Workplace. Anne Kreamer is in Brooklyn, New York. Kimberly Elsbach is a Professor of Management at the University of California at Davis, where she holds the Stephen G. Newberry Endowed Chair in Leadership. She's in Davis, California. Hello.

ANNE KREAMER: Hi.

KIMBERLY ELSBACH: Hello.

AMT: Anne Kreamer, let's start with you. Have you ever cried at work?

ANNE KREAMER: [chuckles] Most notably, a time when I was the executive vice president of Nickelodeon and Nick at Nite and I had just concluded a gigantic 18 month negotiation with Sony Music and I was celebrating in my office. And the phone rang and my assistant said oh Anne it’s Sumner on line one, and that's Sumner Redstone, who still remains the chairman of the Viacom Corporation which was the parent company. And I thought oh well, awesome this boss is calling, you know, to say good job. And instead, he shrieked at me over the phone and screamed at me because the announcement of the deal, which was covered in the Wall Street Journal and all the trades had failed to move the Viacom stock price. So I went from cloud nine euphoria, celebrating this tremendous accomplishment, to kind of abject misery in less than 60 seconds. And my response was to cry.

AMT: And you were in front of your team at the time?

ANNE KREAMER: I was in front of my team at the time, yeah.

AMT: OK. Kimberly Elsbach, what's your best or worst story about crying at work?

KIMBERLY ELSBACH: I think the worst is in a meeting. I was in a meeting with the entire faculty and we were talking about some new directions for the school. And I was in disagreement with our dean about some of these things and was trying to communicate how a lot of the strategic initiatives left out a large part of the faculty and got very emotional and started to cry. And it was horrible because it was in a meeting with the entire faculty and I ended up leaving the meeting shortly after that.

AMT: Well, Kimberly Elsbach, how common is crying at work?

KIMBERLY ELSBACH: Unfortunately or fortunately, it depends on your perspective. It's relatively common. But more than how often it occurs, it’s memorable. So even if you only cry once during your time at an institution or at a particular job, that time will be remembered if it's in public. So despite the fact that you personally may not cry that often, if you cry you will be remembered.

AMT: You'll be remembered how? Fondly?

KIMBERLY ELSBACH: Depends. Our research shows that there is a right and a wrong way to behave when and if you cry. So we found that in four common situations that people cry at work, including things like a critical performance evaluation or in a heated meeting, if you cry in a way that doesn't disrupt the flow of work, if you show that you’re trying not to cry and if you can't do those things, if you can remove yourself from the situation because you don't want to make others feel uncomfortable, then you can be perceived sympathetically. If you don't do those things, you will be perceived very negatively. You will be perceived as unprofessional and in some cases manipulative.

AMT: So let's go a little further here. First of all, Anne Kreamer, why do you think people cry at work?

ANNE KREAMER: My research found and my sort of personal story corroborates this. I was angry but I felt societally kind of, you know, bound not to scream at my boss because I worried that it would jeopardize my career. My research found that the majority of people cry at work because they feel angry about something and incapable of expressing that anger. They feel frustrated a great deal of the time. And Kimberly's example shows that I think she felt she was not being heard with her issues in that meeting. You know, and they feel undervalued. And so, you know, with all those emotional responses, one wants to express them with some, you know, kind of fortitude and kind of power behind them. And oftentimes we feel because we still live in a society where, you know, it is more male dominated, particularly if you're a woman, that that might be exposing yourself to repercussions that you don't want, so you don't express the anger or the frustration clearly and you end up with these hormones in your body and you cry.

AMT: Let me just jump in. Is this something that affects women, just affects women though?

ANNE KREAMER: I think we tend to ruminate more about it. And what I was going to say is I went back and did a 360 degree review with all the people who’ve been in the room with me when I cried at that moment. And to me it’d had become this kind of isotope of grievance that ultimately I lost the company from. None of them remembered it. One man had a vague oh yeah right. We ourselves I think tend to obsess, and women more than men, over an occasional emotional display in the workforce more than other people do. So I have a slight disagreement with Kimberly on how profoundly one is viewed if one does not do this regularly.

AMT: Well, Anne Kreamer, what have you learned about the relationship between women's tears and biology?

ANNE KREAMER: Well, you know, it's an interesting thing, you know, the science of emotion is really the only fairly new in the nineties with the functional magnetic resonance imaging machines. And so it's taken a while for us to realize that you can't even figure out what to wear to work without involving your emotion on some level. You know, we are controlled by these kind of primitive biological hormones. Women produce more prolactin, which is the hormone that triggers tears our tear ducts are anatomically different from men's tear ducts, they’re sort of smaller so, you know, man and a woman might be feeling the same degree of emotional distress. But women's tears will stream down their face because of that anatomical difference. And we respond to stress differently. Men tend to predominantly produce cortisol and testosterone and women also produce oxytocin in response to stress and that’s our tend and befriend hormone. So we are biologically different. And I don't use it as an excuse but just as this sort of thing that I think helps us think about with more kind of sympathy or compassion.

AMT: But I want to just ask about that and maybe get Kimberly's view on that too. It wasn't so long ago when women couldn't actually advance in the workplace because they were seen as too emotional.

KIMBERLY ELSBACH: Absolutely, yeah. And I think despite the fact that we've come a long way, a lot of that is still there unfortunately. And a lot of the attributions people make are unconscious. And so they're not really that aware of them but they are there in the back of their mind when it comes time to select people for, you know, important projects or for promotions. Those sort of gut instincts about this person isn't that professional, this person is a little weak play a role in advancement.

AMT: Mm. Kimberly, from your research, does it matter how a person cries? Like, that first clip somebody was sobbing.

KIMBERLY ELSBACH: Mmhmm. Yeah.

AMT: And complaining about not getting attention from the boss. Does it matter, like, the context and the way the crying takes place?

KIMBERLY ELSBACH: Yeah. The context matters, you know, hugely. That's sort of the major finding that we had. If the context is seen as something where the person is crying in what would seem to be an expected way, personal issues, death, divorce, illness, those kinds of things are seen as acceptable. And if they encroach a bit on the workplace, it's OK to cry as long as you're not disrupting the workflow. If you're crying because your work is stressful or somebody criticized you at work, those are seen as things that should be expected by you in a modern workplace and that you should be able to handle. And if your crime disrupts the work of others, so in that clip, she kind of was crying in a way that could be heard outside of her cubicle or wherever she was sitting, that scene is least acceptable. Disrupting the work of others and crying in response to something that would be seen to be expected at work are the most dangerous places. And I want to be clear about this. I'm not condoning any of these perceptions, I wish they weren’t here but our research showed that they are. And so I think it's important to know that people perceive you these ways despite the right or wrongness of these perceptions, they are there.

AMT: Well, did you not also find that some observers thought the person who was crying was doing it in a manipulative way?

KIMBERLY ELSBACH: Yes, we were really surprised at how often both men and women observers perceive that the crime was done to prevent them receiving critical feedback or prevent them from having to do what was being asked of them. That they were doing this in a manipulative way to get out of something. And to a person, the criers we interviewed, which were hundreds, said, you know, if I could do anything to stop crying I would. And there's a whole range of tactics that people explain to us about things they did to try to prevent them from starting to cry and then to stop crying. So it was surprising to us that that observers believed that criers were doing this on purpose.

AMT: Well, we did talk to another person who's researching crying at work. Niels Van de Ven is an Associate Professor at Tilburg University in the Netherlands. Listen to him.

SOUNDCLIP

So basically what we're looking at is the general perception of how we perceive someone who cries. So when really a tear is rolling down someone’s cheek. And what we see is that someone who cries is seen as warmer but also has less competence. And the reduced competence makes people want to avoid them when something needs to be done. So if you need to work on an important task and there's someone at work that cries, you see them as less competent and you would rather not have them in your team to work with you.

AMT: Anne Kreamer, what do you make of that response? What he talks about?

ANNE KREAMER: I don't disagree with him but I think again it goes back to what sort of Kimberly was saying about these very deep seated kind of perceptions that we have over the expression of kind of emotion. And, you know, my research found that, you know, and I did two very giant national data driven surveys and also interviewed hundreds of people across the country and, you know, 88 per cent on average of people find the expression of emotion at work to be a positive attribute. And I think it really does humanize people, as the guy from the Netherlands was saying because I think, you know, none of us really like to work with people who seem to be perfectionist and kind of holier than thou and kind of always on top of things, because it always makes us feel like we're never going to kind of achieve, you know, their standards. And so I think the expression of some emotion is a way to sort of say I am like you, I share a kind of commonality with you and can encourage people to work in a kind of more robust way. But that niggling societal thing of, you know, I want to work with the robot, he’s going to get the work done and not sort of show the thing I think still does exist. And, you know, I think the thing that comes out here is again, it is reality, it is the world we work in. We don't want to be kind of emotionally volatile people in a workplace because that is counterproductive. But I think we want to figure out and learn how to acknowledge that the occasional expression of something is, you know, I liken it to the kind of check engine light on your car dashboard. I think it's important information for managers and employees alike to gain insight into some underlying issue that might be happening within the organization that actually could be addressed. You know, maybe you do need more resources, maybe you do need, you know, more time to complete a project, you know, professionally and well. And if you can address it then you sort of remove the underlying situation and can kind of move forward.

AMT: Kimberly Elsbach, so from your perspective how much could crying at work hurt a person's career?

KIMBERLY ELSBACH: Yeah, I think Anne’s example is a great case where context played a key role in how she was perceived. If somebody is perceived to be crying because they're being bullied or unfairly criticized and if it doesn't disrupt the workflow, then people are very sympathetic to it and are not, and in many cases, will blame the person who made you cry. So it doesn't surprise me that the perceptions of you were not negative or even that memorable in that case. But we have found cases where people, even a woman we talked to who was expecting to be promoted to the top position in her organization, cried in a meeting and that promotion never came. We have talked to many women who said that they ultimately felt like they had to leave the organization because they were labeled as a crier. These were people who cried, you know, not every day, maybe cried once or twice but in an important meeting, in an important context, where it really disrupted the work flow and that it made a lasting impression on their colleagues that they were unfit for professional service.

AMT: So what advice would you give to women who know they cry easily?

KIMBERLY ELSBACH: I would say to know how to cry. So at the very least if you know you're a crier and you feel like you're going to start to cry, do what you can to not disrupt the work of others. And so sometimes that means apologizing and leaving the area. Sometimes you can't but it means just being open and saying look, I'm sorry, I'm getting emotional here, I want to continue and just give me a second. But really if you can cry in a way that doesn't a, disrupt the workflow and b, make other people feel uncomfortable, then you're less likely to have some negative repercussions.

AMT: Of course, if you can control all that, isn't crying kind of an uncontrollable emotion?

KIMBERLY ELSBACH: That's right. So for a lot of people it is just leaving. Just saying look, you know, I think we should reschedule because that means that you really do want to get the work done, that you really do want to address the issue but that you don't want to do it right now.

AMT: Anne Kreamer, what advice would you give to women?

ANNE KREAMER: Oh mine’s very very similar because you really, once you feel that kind of wave of tears coming off, even if you don't have tears down your face, your chin’s quivering, you know, it's obvious. I think that the best thing you can do is if you're in a meeting or even if you're a boss observing this with one of your employees is to say exactly what Kimberly said, which is wow we've clearly touched a nerve here. You know, and I think we should both, you know, step back and think about this for a little bit, and how about we meet tomorrow morning at 9? I think the critical thing to do is to have some specificity of revisiting whatever was the underlying trigger to the moment and not just pretend like it didn't happen because that again gets to my point. No one wants to cry at work, none of us do. You know, no one goes to work saying boy I'm looking forward to crying today.

AMT: [chuckles]

ANNE KREAMER: It comes up in the context of your daily kind of workplace and it comes at you from a surprising source I think a lot of the time. And so what we want to kind of do is to create an environment where people aren’t ashamed of it, where they learn and have the basic tools. We’re never taught how to handle emotions really, you know, when we go into the workforce. And I think being aware of the complexity of them and the kind of way we, you know, deeply and inadvertently judge them can help us sort of move forward and help people reset. Just getting up and walking and getting a glass of water can often help you to stop the actual emotional feelings.

AMT: and maybe there's something in the wider workplace. I've got a clip here from Judith Orloff about crying in the workplace. She is a Professor of Psychiatry at UCLA.

SOUNDCLIP

I think it needs to be more accepted among workplaces and in every situation. And ideally they would have counselors that you can go to, you know, if you're having an issue where you can cry in the workplace. So I would like to see workplaces evolve, where the human beings in the workplaces could be more comfortable.

AMT: Kimberly Elsbach, what do you think of that?

KIMBERLY ELSBACH: I think that's great. And I do know there are some professions, some helping professions, counseling, people who work in medical professions where there are often emotional issues going on with patients, that I have talked to people in those professions where there is much more of an acceptance of the need to be emotionally expressive. I have even talked to counselors who have meetings where their sole purpose is just to vent and emotionally express and cry and this is an important part of their work. So I think that, you know, recognizing that we all have this and that we need to be open about it and accepting of it in the workplace is a great idea.

AMT: Anne Kreamer, what do you think?

ANNE KREAMER: Agree 100 per cent. I think we should be starting this certainly at the collegiate level, if not sooner. Like, I coach so many young people who have no idea how to manage any of this and particularly this generation that's used to sort of letting every single thing, every thought hang out, you know, on social media in some capacity, that they then enter this place where they have to develop different kind of professional protocols and they just are clueless about what's appropriate or inappropriate or how do we do this or who do I talk to. And so I think creating a curriculum almost to coach young people on sort of how to navigate emotions in the workplace would make everybody happier and more successful in life I think.

AMT: So Kimberly, you have described yourself as a crier to our producer [chuckles] who contacted you at the beginning. Have you learned how not to cry at work and how have you done that?

KIMBERLY ELSBACH: Well, no. I haven't learned how not to cry. And I have a bit of a different perspective on that, having raised a boy who now at the age of 17 knows how not to cry much better than I would ever have. And I really believe that socialization in addition to the anatomical differences that Anne talked about, that boys are socialized from a very young age to not cry. And they learn how when those emotions come up to do something else. What it is I don't know. And girls are not to a large extent socialized that way. And so by the time they're young adults it's not work for them to not cry. They just don't do it. They have figured out how to channel their feelings in other ways. So I don't think I'll ever be a non-crier but I have learned that if I feel those things coming on to very quickly remove myself from the situation.

AMT: Anne Kreamer, when's the last time you cried in a professional setting?

ANNE KREAMER: Well I'm self-employed now. [laughs] I don't make myself cry all that often. [laughs] So this really was the last time, you know, and that was a long time ago.

AMT: Is he the reason you moved on?

ANNE KREAMER: He's part of the reason but this is what I mean about getting at the underlying values. The values of the organization that I had joined were being profoundly shifted by this emphasis on short term gain and quarterly reports and bottom lines. And I knew I wasn't working for, you know, I wasn't a fine artist creating paintings in my basement but people are prepared I think to endure a lot of abuse and do different things if the work that they're doing they believe is contributing on their same value plane. When those values are no longer there I think that the contract gets broken profoundly and that was what really drove me away from the organization.

AMT: So there may be a deeper message in some people's tears.

ANNE KREAMER: Oh, that's my point. That is completely my point. It's telling you very important things.

AMT: Fascinating to speak to both of you. Thank you for your time today.

ANNE KREAMER: It was great Anna Maria, thank you.

KIMBERLY ELSBACH: Thank you.

AMT: Anne Kreamer, author of It's Always Personal: Navigating Emotion in the New Workplace. She's in Brooklyn, New York. Kimberly Elsbach, Professor of Management at University of California Davis. Holds the Stephen G. Jean Newberry Endowed Chair in Leadership. She's in Davis, California.Over to you. Have you ever cried at work? What happened? If you need to cry at work, where do you go? Tweet us we’re @TheCurrentCBC, find us on Facebook. Go to the website cbc.ca/thecurrent, click on the contact link and let us know. Stay with us, this is The Current.

ANNA MARIA TREMONTI: Hello, I'm Anna Maria Tremonti this is The Current. Now before I move on to our next story, I want to share some feedback. Yesterday I spoke with Ian Scheffler. He's a competitive cuber, a Rubik's cuber that is. He's also the author of a book called Cracking the Cube: Going Slow to Go Fast and Other Unexpected Turns in the World of Competitive Rubik's Cube Solving.

SOUNDCLIP

That's the core question I wanted to try to figure out. What about this diminutive piece of plastic has had such enduring appeal, because after all you can see it everywhere you look, whether it's the movies, television, the news, the life of Edward Snowden. And I think the answer is that there isn't one single answer. You know, the Rubik's cube company has tried to digitize the cube and never quite succeeded, it's got this tactile element that is very appealing. So it really I think touches on something very fundamental to the human, which is the desire to make order out of chaos.

AMT: Well, we rediscovered after speaking to Ian Scheffler that he's not the only Rubik's cube enthusiast. Many of you told us of your own love for that classic toy. Danielle Donders shared her appreciation in a tweet, “loved the segment on the Rubik's cube. My 12-year-old can solve it in under 30 seconds, me not at all. On Facebook, Caroline Csák shared this memory, “my dad came back from visiting his family in Hungary with several Rubik's cubes, an early version of them that didn't move smoothly at all and kept falling apart. There's no way they could have been solved in 14 seconds. Still, dad figured that they could be big. Too bad he didn't act on that.” And TJ Mair sent us this tweet on the broader topic, we talked about the significance of play, “the Spanish word for fun is divertido, encapsulating that it is not just about happiness. It is a diversion and challenge.” If you missed the conversation on the Rubik's cube and the case for playing, it is on our website cbc.ca/thecurrent. We also have some videos there with tips on how to crack the Rubik's cube. You can always add your voice to any story you hear on The Current. Find us on Facebook, facebook.com/CBCTheCurrent. Tweet us @TheCurrentCBC, email us through our site cbc.ca/thecurrent, click on the contact link. And while you're there check out pictures, links, download the podcast, cbc.ca/thecurrent.

[Music: seductive electronic synthesizer]

Addiction experts discuss solutions to opioid overdose crisis

Guests: Dr. Keith Ahamad, Mark Haden

ANNA MARIA TREMONTI: And this is The Current on CBC Radio One, Sirius XM and online on cbc.ca/thecurrent, I'm Anna Maria Tremonti.

SOUNDCLIP

NATALIE CLANCY: You had that? Have you had the same person come again and again and you've saved them and tried to help?

NURSE: Oh yes. Yesterday we had someone come back seven times in one day, getting narcanned in the community or here every single time. So it can get overwhelming, it can get to the point where you're just like why are we doing this? This is getting too much.

AMT: That is Nurse leader Tanya Campbell, inside the emergency room at St. Paul's Hospital in downtown Vancouver. We met her yesterday on The Current as part of our documentary Fentanyl Ground Zero. That was from the CBC's Natalie Clancy. And new numbers just released by the BC coroner's service are underscoring just how devastating the crisis has become. British Columbia saw 128 fatal overdoses in November alone. That brings the year's total so far to more than 750 deaths in BC. Up more than 70 per cent over the same period last year. The spike is being blamed on the synthetic opioid fentanyl. It has been detected in more than 60 per cent of the overdose deaths. For a sense of just how prevalent and dangerous fentanyl has become, consider this grim detail. The BC funeral industry is now suggesting that funeral homes have OD kits on hand for their workers who may be exposed to the drug in human remains. As to the search for solutions, here is BC’s Chief Coroner Lisa Lapointe speaking yesterday.

SOUNDCLIP

The question everyone is asking is why? Why with all the new harm reduction measures in place are we still losing so many members of our communities to illicit drugs? And why was the law so much higher in November? Clearly, illicit drugs are becoming increasingly unpredictable and increasingly perilous.

AMT: That is BC’s Chief Coroner Lisa LaPointe. Valerie Wilson is one of the many Canadians to experience the human cost of fentanyl. Her 22-year-old-son Dayton has struggled with a heroin addiction since he was 17-years-old. He's been in and out of treatment. He's tried the heroin replacement suboxone, as well as 12 step abstinence programs. Nothing has worked for him. Then in late August on Vancouver's downtown eastside, he overdosed on fentanyl. He survived but barely. He now has brain damage. We spoke to his mother Valerie Wilson from Port Coquitlam, BC.

SOUNDCLIP

He needs almost 24 hour care. Now he's better than he was. He's still a bit stumbly. He doesn't have a lot of balance. His speech is very impaired. To see him going through addiction and then going through this, I mean the going through addiction part is absolutely horrific. It’s like living in a war zone almost and your heart is breaking but at the same time you're almost fighting him to keep yourself sane and to keep your other child safe — I have another child — and now I go through, I mean I'm thankful everyday, I know where he is at night. I don't need to bring my purse to bed with me anymore because he's not going to steal from it. I don't need to worry when police slowdown that they're coming to tell me that he's dead. At the same time, it's still heartbreaking to see him be a different person than he was just months ago. His capabilities just aren't there anymore.

AMT: Valerie Wilson says she believes the solution to this is complicated, but that at present there's too much emphasis placed on harm reduction, not enough on treatment.

SOUNDCLIP

I do believe harm reduction is being prioritized because it's necessary. Right now the situation is absolutely horrifying the amount of people who are dying. Obviously it's needed, but the beds have to be there. It's not doing any good. The harm reduction is saving lives for the short term but if there's not somebody standing there with a naloxone kit next time they use then it's for nought. There has to be more beds for these people to get treatment to get off these drugs hopefully and save lives in the long term.

AMT: That is Valerie Wilson in Port Coquitlam, BC. BC may be the worst hit but it is not the only province grappling with a rise in overdose deaths linked to fentanyl. This year, Alberta recorded 193 fentanyl related deaths between January and October. Last year, Ontario saw 162 people die in overdoses related to that opioid. Experts say other parts of the country will continue to see their own numbers climb as well without intervention. Last week, the federal government announced a new drug strategy to cope with opioid related deaths and that included making it easier for cities to open safe consumption sites or supervised injection sites. Some say much more needs to be done. They say that would include additional funding for addiction treatment. My next two guests are following all of this closely. They are actively engaged in discussions aimed at finding a solution to this crisis. Dr. Keith Ahamad is addiction Physician and Researcher at St. Paul's Hospital in Vancouver. That's where you heard that the emergency team working yesterday. He is also with the BC Centre for Excellence in HIV/AIDS. Mark Haden is an Adjunct Professor at the University of British Columbia School of Population and Public Health. He's also Executive Director of MAPS Canada, Multidisciplinary Association for Psychedelic Studies. And we have reached them both in Vancouver. Hello gentlemen.

DR. KEITH AHAMAD: Morning.

MARK HADEN: Good morning Anna Maria.

AMT: Dr. Ahamad, the fentanyl statistics released yesterday in BC were pretty shocking. How does that square with what you see on a day-to-day basis?

DR. KEITH AHAMAD: Yeah. Well, I think anybody working on the front lines during November wouldn't be overly surprised to hear these tragic numbers from November. We certainly saw overdoses presenting to first responders and emergency departments surging and seeing astronomical levels at St. Paul's Hospital in Vancouver. Of all the overdoses that are seen in emergency departments, we see over 70 per cent. And we were just overwhelmed during November.

AMT: Why are so many people dying?

DR. KEITH AHAMAD: Well that's a really good question. We have seen the introduction of another illicit and toxic opioid called carfentanil. And I think that when you have an increasingly toxic and poisonous illicit drug market at the same time with absolutely non-existent evidence based or harm reduction strategies that are supported by science and data including safe consumption sites. And that also coupled with the fact that there's inaccessible treatment across Canada and in particular in Vancouver, you're going to see skyrocketing overdoses and overdose deaths.

AMT: Now, Dr. Ahamad, there are those who say there's been a lot of investment in harm reduction not enough in addiction treatment. That sobriety is the best way to save lives. What do you say to that?

DR. KEITH AHAMAD: Sobriety is certainly an answer for some people. I don't feel like these two initiatives are mutually exclusive. They represent two pieces on the same piece of the pie. And we need to invest equally in both of both. But to say that there's been too much emphasis on harm reduction, currently, the only real sanctioned supervised consumption site in all of North America is in downtown Vancouver. So I don't think that we've really even come close to investing enough in harm reduction. At the same time, we need to significantly increase the funding and expanding the treatment system in Canada as well.

AMT: OK. Mark Haden. It is Haden is it, not Haden?

MARK HADEN: Yes.

AMT: OK. Just checking. [chuckles] Mark Haden, last week the federal government announced it would make it easier for cities to open safe consumption sites. What do you think of that change?

MARK HADEN: Well I think it is a small step in the right direction but fundamentally it's not thinking about it in the right way. If you look at the study done by the Centre for Excellence in HIV and St. Paul’s hospital they said we as a society spend 17 per cent of our tax dollars dealing with this problem on treatment, two per cent on harm reduction and 70 per cent on enforcement. Essentially, this is history replaying itself. This is a problem with drug prohibition. When alcohol was prohibited, what we had is widely available strong concentrated often toxic alcohol on our streets. And only when we ended that process did the death toll stop from alcohol. So what we see is illegal markets always will produce more concentrated products because smugglers want small packages and we need to deal with the actual problem, which is the problem of drug prohibition.

AMT: OK so are you talking about, well, first of all when you say you want to get rid of prohibition, on heroin or all illicit drugs?

MARK HADEN: Well I actually advocate for ending prohibition for all currently illegal drugs based on public health principles. That's my area of academic interest.

AMT: What does that mean?

MARK HADEN: Certainly for heroin, yes.

AMT: OK. And when you end prohibition, does that mean you decriminalize it, you make it legal? What do you actually do?

MARK HADEN: Well, all drugs are different to be honest but with heroin we already prescribe opiates. We prescribe methadone, we prescribe suboxone. So we would give heroin to the same people that are prescribing them now, in a slightly different context because most of the drugs that we prescribe or the drugs that we prescribe now are oral, so we need to provide injectable. But we have history with that. We've had the SALOME trial, we’ve had the NAOMI trial, we supervise people who are injecting. So we understand how to supervise people who are injecting, the only problem with INSITE is we don't give the drugs. So people bring toxic drugs into them. If we started providing clean pure heroin, then we wouldn't have the same problem that we're seeing today. Actually, heroin addicts don't like fentanyl — they like heroin. And if we gave them pure heroin, we wouldn't have the problem that we're seeing today.

AMT: They don't know they're getting the fentanyl.

MARK HADEN: That's true. Yeah.

AMT: And so you would administer it at a safe consumption site or a supervised injection site but you would know the quality of it.

MARK HADEN: Yes, within the context of health. I mean, individuals who inject heroin have lots of issues, they have trauma issues, they have physical issues and mental health issues. So within the context of a health service provision situation, people would come and receive their heroin and they would be cared for. The very sad story that Valerie Wilson told us wouldn't have happened if her son had access to clean heroin within the context of a healthcare setting.

AMT: And would then that include helping someone get off the heroin?

MARK HADEN: Oh, absolutely yes. I mean, for example, the example what we have is INSITE has an abstinence based detox above it called ONSITE. So yes, you always link those kind of facilities with abstinence based treatments. They go well hand in hand.

AMT: So you want to end this, the prohibition of heroin specifically and other illicit drugs. A lot of people see that as radical. How do you respond to that and is anybody talking about this in government?

MARK HADEN: Well, I've been involved with this debate for decades and it's a lot less radical than it used to be. I mean, certainly slowly cannabis around the world has become legalized and what people are seeing is the sky does not fall in. We spend less costs on enforcement and there are significant benefits as a result, there's less violence on our streets. Prohibition doesn't protect anybody, it doesn't protect our communities, it doesn't protect our children. And as we move to a public health model of controlling drugs, what we see is a wide range of benefits, including less expenses on something that simply doesn't work.

AMT: Dr. Keith Ahamad, what do you think of that argument?

DR. KEITH AHAMAD: Yeah, well I think it's clear that the war on drugs has obviously failed. It's a failed experiment and the reality is that as we see this illicit drug market continue to get more toxic, if we were to replace a drug with a known dose in purity, we would see the serious harms like overdose and death plummet. But of course, it needs to be balanced with increasing access to on demand treatment that is supported by data and science for people that want it. But in the interim, for sure, providing a pure and known dose for a drug would reduce the overdoses.

AMT: We asked Valerie Wilson, who you just heard, whose son survived a fentanyl overdose but is now brain damaged. We asked her view of this. Listen to what she has to say.

SOUNDCLIP

It needs to be a means to an end. I've heard of the idea once before. And when I applied it to my child, I thought oh God, I hope for a better end for him. I would hope for him to get clean. To what end? Like, are you just going to give them heroin for the rest of their lives until they're, like, it's basically like writing them off.

AMT: Mark Haden, what do you think?

MARK HADEN: Well, if we take the money out of enforcement and we put it into treatment. The massive expenditures that we're doing now which don't work, if we put it into a system that it does work, her son would have available treatment that he wouldn't have had. And that would have made a difference in his life.

AMT: We did receive a letter yesterday from a listener named Petra Schulz in Edmonton. She lost a son to a fentanyl overdose in 2014. She is now part of a group called Moms Stop the Harm. And she wrote that in addition to harm reduction and addiction treatment programs, “we need” and I'm quoting here, “we need to offer heroin assisted treatment, heroin on prescription to those with chronic addiction issues for whom other treatment options have not worked.” Mark Haden, that's exactly what you're suggesting right?

MARK HADEN: Yes it is. Certainly, within the context of a healthcare setting. We're not putting buckets of heroin in the street corner and saying come and help yourself. It's within the context of nurses and physicians and counsellors and people who deal with mental health concerns and quite frankly trauma is very common in this population. And so trauma treatment specialists would be available. And as people come to get their heroin, they're engaged in a whole variety of other services as well.

AMT: Dr. Ahamad, do you think we will see support for this approach grow as more families are affected by overdose deaths?

DR. KEITH AHAMAD: Yeah I think so. It's an intervention that's available in many European countries. And we've done two trials in our own backyard here in Vancouver. And for some people non-medication assisted treatment is going to work, for some patients suboxone and methadone is going to be effective. We're seeing other evidence based or science supported interventions like sustained release oral morphine being shown to be effective. And we have two injectable trials that have been done here in Vancouver, showing that we can significantly reduce the harms that are associated with opioid addiction. So we really do need a step wise approach and for some people, this will indeed be a way of reducing the harm associated with their addiction.

AMT: So where's the hesitation?

DR. KEITH AHAMAD: I think the hesitation comes from decades of culture, not understanding that addiction is a public health issue, it's a chronic relapsing disease. The science for treating addiction and reducing the harm associated with addiction is way out in front of our cultural practices and our medical practices. I think we really need to catch up to the science here.

AMT: Mark Haden, you are the Executive Director of MAPS Canada, the Multidisciplinary Association for Psychedelic Studies. Do you think part of the problem or the hesitation comes from sort of a view of these drugs that is decades old?

MARK HADEN: Absolutely, yes. In fact, I was involved with drug education. I worked for much of my career in the addiction services and I’d provided drug education. And at the beginning of it, I told lies, you know, no drugs don't put holes in your brain. You know, the drug educators of the world need to be brought up to speed with the reality that any drug can be used and any drug can be abused. And really, a nuanced approach to drug education that sends accurate evidence based messages is still not being done by some drug educators. So the messaging that we have about drugs in our society has to be thoughtful and appropriate and evidence based and we have a long way to go to get there.

AMT: Keith Ahamad, we've got a lot of people out there who are suffering, who want help, can't get access to treatment. How would you describe the level of addiction treatment in the province now?

DR. KEITH AHAMAD: Well there, you know, our provincial government in British Columbia have made some serious and major changes to increase access to treatment. But it takes time. The reality is across Canada, all across North America we don't have a functioning treatment system that is evidence based, that's built on science and data. What we really need to do across the country is the federal government looks at increasing funding for treatment across the country. They really need to earmark money specifically for addiction. We can't continue to fund and put money into mental health and expect that it trickle down to addiction, addiction is a far too common problem. And we need to really look at federal national guidelines and training healthcare professionals. And at the same time that we build the treatment system, we have to look at evidence based other treatment options that are novel, like prescribed heroin and invest in harm reduction to catch those people, because as I said, it's a chronic relapsing disease and as people move from their active addiction into evidence based treatment and recovery, a portion of people in recovery ultimately will relapse and we need to have safeguards in place to catch them when they relapse and reduce the harm associated with their active disease.

AMT: I want to ask a little bit more about prescribed heroin. Mark Haden, we know that a great number of people who end up on fentanyl overdoses and who die originally got addicted to opioids through prescriptions. So how do you separate that out?

MARK HADEN: Well, that's true. And certainly if you chase that down, if you unpack that thought, what happened was the pharmaceutical companies decided to start to advertise opiates and they were influential with the medical community in promoting opiates within that context. So really, what we need isn't to have a commercialized approach to this. We need to have an evidence based approach to this, where yes, some people have access to opiates under certain circumstances. So it's easier to manage prescriptions when they're handled by the physicians of the world then it is to handle opiates when they're provided by organized crime. We can find the doctors, it's a lot harder to find the organized crime folks.

AMT: Keith Ahamad, what do you think?

DR. KEITH AHAMAD: Yeah, that's absolutely true. If you look at what we've done with smoking rates in Canada, in the sixties we had smoking rates that were the highest in the Western world, with men smoking over 60 per cent across the country. And with it being a legal substance with a lot of harm associated with it, we were able to use evidence based public health policy combined with public education and evidence based treatment. And rates of smoking in Canada have plummeted. And we can do the same thing with all substances. The only way to regulate them appropriately though of course is if these substances are legal and we can tightly regulate those substances that are associated with a lot of harm and will regulate other substances like cannabis that is not associated with the same amount of harm in a different way.

AMT: So in other words, Mark Haden, there would be supervision obviously of somebody using the heroin but then supervision of opiates in general too?

MARK HADEN: Absolutely.

AMT: In a way that we don't have now, that people get these prescriptions and then they're kind of left on their own to sort it out.

MARK HADEN: Yes. If you think about how methadone is provided now, it's often in the context, always in the context of medical care and often counselors are available. And so having a whole range of different mental health and physical health services would absolutely be available. Yes. So as people start to deal with the reality that they have more going on than just an addiction, they have a trauma history, they have all kinds of things that need to be treated. And within the context of a health care system, you can treat them. With the concept of an enforcement based system you can't.

AMT: So before I let you go, Keith Ahamed, what do you want us to understand then about addiction and how we need to actually see it and confront it?

DR. KEITH AHAMAD: Well, I think culturally we have to understand that this is a public health issue. That addiction is indeed a chronic relapsing disease and we need to treat it similarly to how we treat other chronic relapsing diseases. We need to invest in treating those people with active disease and moving them along the spectrum, with using interventions all the way along, including harm reduction, expanding the treatment system and engaging with people in their recovery. And all of those interventions need to be supported by science and data and using an evidence based approach to reduce the harms that we're seeing.

AMT: Gentlemen, thanks for your time today.

MARK HADEN: Thank you Anna Maria.

DR. KEITH AHAMAD: Thanks very much.

AMT: Good to talk to you both. That's Keith Ahamad, addiction Physician and Researcher at St. Paul's Hospital in Vancouver and the BC Centre for Excellence in HIV/AIDS. And Mark Haden, Adjunct Professor at UBC’s School of Population and Public Health, also the Executive Director of MAPS Canada, the Multidisciplinary Association for Psychedelic Studies. They joined us from Vancouver. That's our program for today. Remember you can always take The Current with you on the CBC Radio app. It is free, it lets you browse through past episodes of our show, you can listen in just a few seconds. Search for the stories you missed, catch something that you're just joining us partway through. Again, that's at the App Store or Google Play. Now finally today, after a discussion about crying in the workplace, we're going to leave you with a memorable scene from the movie A League Of Their Own. That's the 1990s comedy about an all-American girls or women's professional baseball league that briefly flourished in the Second World War era. In this scene, the manager Jimmy Dugan, who is played by Tom Hanks, is still figuring out how to coach female players, including Evelyn played by Bitty Schram. We'll leave you with that. I'm Anna Maria Tremonti, thank you for listening to The Current.

SOUNDCLIP

JIMMY DUGAN: Say Evelyn, can I ask you question? You got a moment?

EVELYN GARDNER: Mmhmm.

JIMMY DUGAN: Which team you play for?

EVELYN GARDNER: Well, I’m a Peach.

JIMMY DUGAN: Well I was just wondering because I couldn't figure out why you would throw home when we've got a two run lead. You let the tying run get on second and we lost the league because of you. Now you start using your head. That’s the lump that’s three feet above your ass.

EVELYN GARDNER: [crying]

JIMMY DUGAN: Are you crying?

EVELYN GARDNER: No.

JIMMY DUGAN: Are you crying? Are you crying? There’s no crying, there’s no crying in baseball.

DORIS MURPHY: Why you don’t you leave her alone Jimmy.

JIMMY DUGAN: Oh, you zip it Doris. Rogers Hornsby was my manager, and he called me a talking pile of pigs--t. And that was when my parents drove all the way down from Michigan to see me play the game. And did I cry?

EVELYN GARDNER: No, no, no.

JIMMY DUGAN: No, no. And you know why?

EVELYN GARDNER: No.

JIMMY DUGAN: Because there’s no crying in baseball. There’s no crying in baseball. No crying.

[Music: Extro]

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December 20, 2016 full episode transcript

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