“Influenza 1918” – A book summary and thoughts on THEN and NOW (LONG)



Book – “Influenza 1918: Disease, death, and struggle in Winnipeg” by Esyllt W. Jones (2007)

The COVID-19 Pandemic has turned our world upside-down. I wanted to do what I usually do in difficult times, which is to educate myself on what we were up against. Although the novel coronavirus is new, pandemics are not. The world has had other deadly and highly contagious microbes that it has dealt with, and it is documented in history. There are similarities to the Influenza of 1918-1919, also known as the “Spanish Flu.”


Arthur Hilton Davis (1880-1919) and his wife Nellie Ian Kitchen (1883-1955). Circa early 1900.

There are many books written on pandemics, and I wanted to start with something closer to home. I live in Winnipeg, Manitoba, Canada, and my late grandfather (Hilton Arthur Davis, see the photo of him and his family below) used to tell my mother, Virginia, stories about how, when he was 7-years-old, there was a flu outbreak, and he lost his father and a sister in the spring of 1919. My great grandfather (Arthur Hilton Davis see photo above) and his daughter (Muriel Davis) are now buried in the Brookside Cemetery here in Winnipeg (date of death April 4, 1919). My grandfather was laid to rest with them (and his mother) many years later.


My late grandfather Hilton Arthur Davis with his late wife Eunice Philips and children Virginia (baby) and Philip. (1946)

“Influenza 1918” by the historian Esyllt W.  Jones is a scholarly volume, based on the research she did during her post-doctoral fellowship at the University of Winnipeg. It is well-edited and referenced, making it a credible read. My current lived experience during this pandemic has already been made more understandable by having a glimpse into what my ancestors dealt with. Some were survivors; some were victims. I feel closer to them now after having devoured what Jones has revealed to us through her investigative and thorough research.

We are a month into the COVID-19 Pandemic, which was proclaimed on March 11, 2020. Manitoba’s Premier Brian Pallister declared a State of Emergency on March 20, 2020. Prime Minister Justin Trudeau has been taking the lead on the pandemic, with most of his press conferences delivered from his home. His wife, Sophie Gregoire Trudeau, had tested positive for the novel coronavirus, and both she and the Prime Minister were self-isolating (March 12, 2020). There is no better way to get an official leader on board with effective pandemic planning than having a spouse diagnosed with it. We are very fortunate here in Canada to have a federal leader and provincial premiers who “get it” and are making important decisions to help “flatten the curve,” in the hopes of saving lives. The latest prediction by our Canadian government is that we will lose 11,000 – 22,000 lives to COVID-19. We can keep that number on the low end if we all do our part by staying home (unless necessary), practicing physical (social) distancing (2 metres/6 feet apart), washing our hands often, not touching our face, and wearing a cloth mask when out in public to help reduce the chances of spreading our germs.

Jones has uncovered many facts and stories to help us understand what Winnipeg went through during 1918-1919. World War 1 had been raging for the past four years when the influenza epidemic (the flu) hit Winnipeg. The first signs of the flu started in March of 1918 in the USA, and it took a few months to reach our city. A truce was declared on November 11 in 1918, as the flu raged on. Sandwiched between the First World War (1914-1918) and the Winnipeg General Strike (May – June 1919), it is estimated that in a city of 180,000, the flu took the lives of 1,216 Winnipeggers. Thousands were infected. Globally, it is estimated the flu claimed between 50 and 100 million lives. Why was this monumental event practically glazed over and forgotten in our human history? Historians, epidemiologists, and others ask the same question.

I will now share some of the highlights in “Influenza 1918” that I found helpful and insightful. When we are up against what many have called an “unprecedented” and “unchartered” time, many of us feel unsettled, afraid, and anxious. Stress can be at an all-time high. Not knowing what the future holds can cause us to have difficulty coping in these uncertain times. “Influenza 1918” sheds some light on what has been done in the past, illuminating what was done right and what could have been done differently.

The book has seven chapters, covering a range of topics. Some chapters were of more interest to me, so you will have to read the book to get the “whole story.” The introduction provides a lay of the land and says the flu arrived in Winnipeg on September 30, 1918. The flu had travelled along with soldiers and “troop trains” carrying war veterans all across Canada. Mail boats were also suspect. Sydney, Nova Scotia, had had five deaths by that date. The early strategies implemented in Winnipeg were similar to those used by our neighbours in the USA, which was to educate the public and to reduce crowds. In our modern-day pandemic, we are doing that. We have also put in additional strategies such as frequently washing our hands, physical (social) distancing, not touching our face, staying home if we are sick, self-isolating for 14 days when we return from travelling, staying home in general, and the ultimate extremes of closing our borders and non-essential services.

Chapter One, “Influenza Spans the Globe.” Although there is some debate about how and when the flu started (a variant of Influenza A), many historical accounts point towards the first wave starting in the spring of 1918 in a military camp in Kansas. I watched a PBS documentary, “American Experience: Influenza 1918,” and they think it was when the soldiers were burning a pile of manure. These soldiers came down with an illness on March 5, 1918. The documentary uses the date of March 11, 1918, as the start date (this is very ironic, as the WHO declared the COVID-19 outbreak a pandemic on this day, 102 years later). The second wave began in either France or the USA in August 2018. In Winnipeg, the peak of the epidemic arrived in early November 1918. Nearly 700 new cases were reported to the health authorities daily. Many who died had not received any medical care. The flu had arrived in Winnipeg on the second of its third global waves. A less severe wave followed in early 1919, which is when my great-grandfather and one of his daughters succumbed to the illness. My late grandfather, a young boy at the time, told my mother (his daughter) of the flu epidemic, and he recounted memories of seeing boxes and caskets outside of houses.

Symptoms of the Influenza A variant included some mild and some severe:

  • General depression
  • Chills
  • Fever (sometimes 105 degrees)
  • Headache
  • Pain in the legs
  • Weakness and dizziness
  • Sore throat
  • Congestion
  • Frequent vomiting in severe cases
  • Respiratory infections (bronchitis and pneumonia)

For those afflicted, there was no medical cure, so they were “urged to rest and get plenty of fresh air.” There were many alternative and home remedies such as hanging mothballs around the neck to prevent infection and violet-leaf tea. Some advice was harmless; other advice was quite the opposite. The recommendation to use enemas perhaps caused more harm than it helped, as it caused more dehydration in the already dehydrated flu sufferers. The only advice I have been given by my doctor (and I am immunosuppressed) is to take Vitamin C supplements to help strengthen my immune system.

This flu was often fatal, and the most considerable number of deaths occurred in people between the ages of 20-40 (my great-grandfather was 39, my great-aunt was 6). The flu rarely took the lives of the very young or very old. The wealthier population, those with better food and shelter, suffered less than those who were poor. It has been estimated that Canada, with a population of about 9 million in 1918, experienced a loss of 55,000 people to the flu. This is equivalent to about 6.1 people per 1,000 (similar to India, England, and the USA). The death rates were higher in Italy and Spain (10.7 and 12.3 respectively) and tremendous in Western Samoa (236.1) and Cameroon (445.0).

Various strategies used to combat the flu included:

  • Quarantining entire communities
  • Fumigating incoming trains, passengers, luggage, and public transportation
  • Masks (in some communities it was optional, in others compulsory)
  • The public was told to avoid congregating
  • Closing schools, universities, medical school, boarding schools
  • Closing cinemas, theatres, billiard rooms, and other places of entertainment
  • Closing lodges,
  • Banning exhibitions and all public meetings and gatherings
  • Closing churches (less often)
  • Health authorities urged rest and plenty of fresh air
  • Prompt reporting of cases by physicians and the general public
  • No involuntary hospitalization or strict quarantine of the infected

After all was said and done, public health authorities tended to agree that civil cooperation and education were preferable means of disease containment, and were more effective than compulsory measures such as placarding homes and the wearing of masks.

Chapter Two, “Winnipeg 1918: Social History and Public Health,” provides the context on what the social and economic situation was like. In 1916, Manitoba women were the first in Canada to be given the right to vote. Many people had come to Winnipeg not because they had money, but because they wanted to make money. There was no universal health care in Canada until 1961. Those with money were able to afford hospital care. Some immigrants were poor, and they lived mainly in the north end of Winnipeg. The southern end had more wealth. The Winnipeg General Hospital was the largest privately-run hospital in the city (now known as the Health Sciences Centre). In 1918-1919, community-based nursing care service provided a significant and essential component of the influenza response. The nurses treated many immigrant families of the Margaret Scott Mission.

Chapter Three, “Every Citizen a Health Officer: Influenza in Winnipeg,” describes how each citizen of Winnipeg was encouraged to feel as if they were a health officer. Fifteen sick soldiers were scheduled to arrive in Winnipeg on a military train on September 30, 1918. It was difficult to contain the flu during wartime, as the war took precedence over public health. The government was not able to contain the disease, so Winnipeg citizens were encouraged to help enforce health measures. The motto was, “Help the authorities to suppress the flu.” Military travelers were considered one of the main vectors in the spread of the flu – especially for the prairies, and for Canada as a whole. Nowadays, the leading carriers of the virus are travelers, especially those from China, the US, Italy, and Spain. Packed airplanes and congested airports are of concern as are any densely populated communities, including cities, cruise ships, hospitals, and long-term care facilities.

If you or anyone you know is on social media, such as Facebook, you will see many memes and posts by your friends and family telling people to “Stay home.” Many of us have become health officers and promoters of the “safer at home” and “stay home” guidelines to help reduce the spread of the COVID-19 virus, therefore “flattening the curve.” Some of us have even become enforcers of the physical (social) distancing rule of two metres. You may hear someone telling you to “wash your hands” or “just stay home.”

On Monday, October 7, 1918, two infected soldiers died in Winnipeg while two others lay near death.  The local paper, the Winnipeg Tribune, and the Free Press were publishing articles soon after, some more alarmist than others. In attempts to prevent hysteria, the news of the spreading illness was presented by using facts, reassurance, and even humour. The Liberal government, at the time, preferred to avoid the sensationalization of the outbreak. The first civilian death in Winnipeg was reported on Thursday, October 10, 1918. Eventually, the Free Press started to publish articles that were more alarmist in tone. Humour was used to help to make the crisis emotionally more manageable. But come mid-November, the appropriateness of comedic relief was long gone.

Winnipeg’s first public health response was to ask the ill (“victims”) to respect a period of quarantine in their own homes. Compulsory isolation in hospitals or placing a health department notice (“placards”) on the homes of those infected was not enforced. Reporting was instrumental in helping the authorities determine when the outbreak would peak, and they paid particular attention to poor and immigrant districts. It was soon realized that this was not a disease of the poor and that anyone was at risk. By October 12, 1918, there were 48 known cases of the flu in Winnipeg. On Friday, October 18, what has been called “Black Friday,” 20 patients were admitted to the King George Hospital. The next day, officials reported on October 19, there were 330 cases of influenza and eight deaths in total. Health authorities talked about the “crest of the wave,” whereas now we talk about the “peak of the curve.”

A vaccine was favoured instead of placarding homes, as it was thought that people would be less willing to report cases. A new aggressive vaccine campaign ensued, with no positive effect. At the end of October, the number of cases was doubling daily and then rose to over 300 cases and over ten deaths per day. City public health officials later announced they would commence the placarding of all infected houses on October 31. Strict quarantine measures were necessary, and differences in the spread of the flu in educated and uneducated districts became evident.

Unfortunately, it was difficult to enforce the placarding and quarantine measures, and on top of that, 25 members of the police force were down with the flu by the end of November. A balancing act was needed to generate enough concern by the public but avoiding too much concern that would evolve into fear and panic.

On November 7 and 8, the Free Press mistakenly announced that a World War 1 truce had been declared. Impromptu crowds of celebration sprung up all over the city, “dispelling the epidemic’s ‘sensation of gloom.’” On November 11, a “joy fest rage” swept the city, and Winnipeggers were celebrating the end of the long war. These celebrations were not broken up by the officials, as it was determined, “If the people were told what to do to avoid the disease and they don’t do it, it’s up to them.” (Douglas). Four hundred nine (409) deaths were reported by November 18.

The turning point occurred on November 21. The crest of the wave had been reached, as only 195 cases of the flu had been reported the previous day—the lowest number since October 26. Deaths stabilized at nearly 30 per day. The public meeting ban had lasted 46 days, ending on November 25. The ban had caused “considerable unrest among businessmen.” By November 30, there were 122 new cases and 12 deaths.

The third wave of the influenza epidemic arrived in Winnipeg in mid-March. This time there was no placarding, no quarantines, and no public meeting bans. Two thousand three hundred forty-two (2,342) cases and 301 deaths were reported. I can only imagine the horror and grief my grandfather, his siblings, and his mother endured that spring on Home Street. Comparing to the fall wave, which took 915 lives, the third wave was milder but deadly for many. Most people died at home as there wasn’t sufficient accommodation in hospitals. I often wonder if the public health authorities had taken more measures as they did in the fall if my ancestors would have survived this last wave.

Chapter Four, “Volunteers and Victims: Women’s Relief and Social Order,” describes the volunteerism of over 650 mostly Anglo-Canadian women who provided help to those affected by the flu. These women were the faces of compassion and heroism, as hospitals and community nursing were not able to keep up with the demand. Many of these women did not have nursing training, however. Female teachers were highly sought after as volunteers. These volunteers were caring for the diseased. Providing personal care, feeding, comfort, and “easing the deaths” of the infected flu victims was a female role at the time. Men rarely stepped up to do this type of work. Unfortunately, many of the nurses and volunteers who cared for the ill became ill themselves. These women were seen as being courageous and brave. Sadly, “seven nurses in Winnipeg, some trained and others who were volunteers, died of the flu.”

In today’s pandemic, the volunteer call has not been made yet here in Winnipeg. I have seen it being done in New York, however. Here, I see acts of volunteerism springing up as women are making cloth masks (for example, my husband’s aunt made me some, and my friend received four homemade masks the other day from her female coworkers). Men and women are doing shopping for others. There is a new program in Winnipeg called the “Student-Senior Isolation Prevention Partnership,” where health professional students are providing weekly phone calls to seniors to help alleviate isolation. It is also important to note here that those 60 and older and those with underlying medical conditions are more at risk of dying from COVID-19 complications.

Chapter Five, “‘Men Cannot Be Allowed to Starve’: Influenza and Organized Labour,” explores the conflict that was generated by the disease. The working people, the public health authorities, and the state all experienced conflict because of the flu. Of note, it is possible to read about the Winnipeg General Strike of 1919 without knowing Winnipeg was confronting and had just endured a devastating disease. The Influenza of 1918-1919 came and went without much acknowledgment by the historians who covered the strike.

The bans on public gatherings and closures of businesses such as theatres and billiard rooms provoked opposition from the working class because of the economic hardship it caused them and their families. The modern-day Liberal Canadian government has pledged to financially support those who lost their jobs in the current pandemic, as well as businesses. This will hopefully help encourage people to stay home and help reduce the spread.

Chapter Six, “Influenza and the Construction of Collective Identity,” includes a look at the challenges to disease prevention and cure. Public health authorities believed that the flu could be avoided if people took the proper precautions and avoided panic.

THEN – For those who were stricken with the Influenza of 1918-1919, they were instructed to:

  • Go to bed at once and get rest and warmth
  • Take warm drinks, broths
  • Good nourishment
  • Good hygiene
  • Send for your physician as needed

NOW – Current guidelines on how to treat COVID-19 symptoms include:

  • Stay home
  • Rest
  • Drink frequently, 1.5 litres of warm or cold liquid/day
  • Protect your entourage by self-isolating in your room until you feel well
  • Use a separate bedroom and bathroom if available (don’t share towels)
  • Keep your environment clean, wash surfaces with disinfectant
  • Monitor symptoms and call your doctor or public health line for guidance
  • Seek help if needed
  • Stay informed

Workplaces were sites of contagion. People went to work even when they were ill. Many disobeyed the bans and quarantines. Those in public service and professional occupations – doctors, nurses, social workers, and child welfare workers – were undoubtedly at high risk.

Women were not only experiencing the ‘pains of war,’ but also the pains of the influenza epidemic as well. Then came the working-class strains and then the General Strike of 1919.

Influenza preventatives in 1918:

  • Camphor
  • Sulphur
  • Eucalyptus oil
  • Raw garlic
  • Poultices of hot bran
  • Lard mixed with camphor and chloroform or turpentine
  • Goose-grease

Sore throat remedies:

  • A sip of oil of cinnamon
  • A drink made of warm milk, ginger, sugar, pepper, and sugar

Alcohol was traditionally an essential prophylactic, and it was almost impossible to obtain unless a physician prescribed it. The officials stated that alcohol was not a treatment; however, pharmacists were accused of price gouging prescription medications that contained alcohol. Now the wine is pouring freely, and our liquor stores are deemed an essential service. Also, the current guidance is that any hand sanitizers we used should contain at least 60% alcohol!

The other interesting note here is that we have been encouraged to use household cleaners such as “Lysol wipes” or diluted bleach to help eliminate the COVID-19 virus. Back in 1918, they were “fumigating.” Not sure what they were using to fumigate with. Fumigating certain areas of hospitals, ships, planes, and trains sounds like a good idea if you ask me.

Chapter Seven, “Family Life after Influenza: Single Parents and Orphans.” Winnipeg lost many adults between the ages of 20 and 39. Like my grandfather, many were married and had children. Many single parents and orphans were left behind. Social supports, generosity, and community reciprocity helped these grief-stricken families get back up on their feet. The Winnipeg Children’s Aid Society and the Manitoba Mother’s Allowance provided resources and supports as needed. Men were more apt to remarry than women. Women were more prone to rely on friendships, family, and neighbours.

The “Conclusion” points out that the influenza pandemic of 1918 as the “best documented but least known pandemic in history.” Containment measures such as quarantine and placarding homes seemed to be ineffectual. The mask order, which lasted about a month, “had no apparent impact upon the increasing number of flu cases.”

Perhaps they could have considered adding the current guidelines:

  • Physical (social) distancing (of at least two metres/six feet)
  • Cover your cough and sneeze with a tissue or cough into your sleeve
  • Keeping groups down to 10 or under
  • Washing hands frequently with warm soap and water for at least 20 seconds and using alcohol-based sanitizer (at least 60% alcohol) if soap and water not available
  • Wearing cloth masks when out in public to help prevent the spreading of droplets to others
  • Staying home except when needing to get essentials such as groceries or medications
  • Working from home when possible
  • Self-isolating for 14 days after travelling or if feeling unwell

There was price gouging in the funeral industry, pharmaceuticals, and home remedies such as eucalyptus oil. Today, we see dwindling and high-demand supplies such as toilet paper and Tylenol. A positive side-effect we are experiencing for the average household is a decrease in the cost of gasoline – with prices currently at 66.9 cents per litre (CAD).

As the current pandemic days, weeks, and months ensue, we will be writing a new chapter in history. What will our “Pandemic 2020” book have to say about how our society handled this traumatic and life-changing event? How do we want it to go down in the books? Will it be discussed in the news and then disappear, much like the events of 1918-1919? What will happen to us? What will the world look like after the dust has settled?

If you are just as curious about your family tree as I am, check to see if you have any relatives who died in 1918 or 1919. They may have been a victim of the Influenza pandemic just like my great-grandfather and his daughter. Let me know if you find out anything, or you think I can help.

One can only hope our history will influence our future, and we can learn from it. Books like “Influenza 1918” by E. W. Jones helps shed light on our past and helps us cope in the present. Consider getting a copy of her book and see what you can glean from it. We will come together as a family, community, country, nation, and the world, supporting each other through this current pandemic.

You may also be interested in CBCNews (11 Apr 2020): How the Spanish flu compares to COVID-19: Lessons learned, answers still being pursued

Angela G. Gentile, MSW, RSW

















Free Book Promotion



“Caring for a Husband with Dementia: The Ultimate Survival Guide” by Angela G. Gentile, MSW, RSW was released 5 years ago, in 2015.

To celebrate and help dementia caregivers everywhere, Angela is offering her ebook (Kindle) for FREE, for a limited time.

Go to Amazon to get your copy Sat. March 28 – Wed. April 1, 2020 inclusive.

Download your copy: https://amzn.to/2WJzMXs



It’s a Different World


It’s a different world out there.

How do I know?

  • I didn’t feel comfortable having to remove my glove to enter my information on the touch screen at the drive-through bank machine. I’ve read there are lots of germs on those glass display monitors. Even touching the money made me feel uncomfortable. (Thankfully I have hand sanitizer in my car that I used before driving off.)
  • Gas is 69.9 cents per litre in Winnipeg, Manitoba.
  • I saw grown men walking around outside wearing medical masks.
  • Portage Avenue traffic was so sparse, it felt like it was a very early Sunday morning, when in fact it was 10 am on a Thursday.
  • My co-worker felt like she was doing something “bad” by handing me some office supplies through my car window. The office supplies included some disinfectant wipes that she didn’t feel were safe if she tried to send them via our interdepartmental mail system as they were coming from a different building in a different part of the city.
  • I was happy to be driving in my car, feeling safe from the corona-virus. My car felt like a safety zone.
  • I had to put a “6 Feet” “social distance line between me and my chair, so that my work space is safe.
  • The elevator has a sign stating, “Maximum occupancy  persons.”


These are just some of the reasons why I know it’s a different world out there. I am different, too. I am much more aware of the invisible enemy out there. The one who has claimed many, many lives in a short few months.  The first death related to COVID-19 was in China on 11 Jan 2020. Just 2.5 months later and the whole world is at war with something we can’t see. No amount of arms will protect us now.

Please be safe out there, everyone. And thank the essential services workers, especially those hospital staff on the front lines.

Angela G. Gentile, MSW, RSW


Three Sheets to the Wind: A Primer on Addiction


man holding black backpack

Photo by Oliver Sjöström on Pexels.com

There’s an old saying that when someone is “three sheets to the wind,” it means they are drunk. The original phrase was derived from sailing ships. It means that an intoxicated person is out of control and in danger of crashing, much like when the ropes of the sails on the ship are out of control. I have also had a few times in my life when I was “three sheets to the wind.” Now I am much more aware of my drinking habits, especially after all I have learned about addictions. What I have found after researching this topic has been eye-opening and informative.

Many people have lost their lives due to drugs, alcohol, or other substance addictions. People with behavioural addictions have lost their homes, families, and jobs. Multiple dependencies can also cause people to have problems in all areas and, ultimately, end in horrific or tragic circumstances. Many people addicted to illicit drugs end up in jail.

Over the past few months, I have completely immersed myself in learning about addictions and the abuse of substances. I have discovered many interesting facts and interviewed amazing people. I used to wonder why I didn’t see many of these issues with older adults. Sadly, I have discovered that many people who have addiction issues don’t make it to 65. I learned about a man who died at 72, from cirrhosis of the liver, even though he had been “sober” for 35 years. It appears that even after years of abstaining from drinking alcohol, it may not necessarily save one from the damage that is done years prior. It may extend one’s life, but the shortened lifespan is an unfortunate consequence.

I hope that by sharing what I have discovered, through my curious and caring nature, I can help someone seek treatment for what I now know is considered a chronic illness. Understanding more about alcohol, substance, and behavioural addictions, and providing you with heartfelt stories that some courageous people have chosen to share, will help shed some light on this stigmatized area of mental health. The more we talk openly about these issues, and the more we try to understand and support each other, the better off we will be.

What is Addiction?

My understanding of addiction is that it is a dysfunctional condition of the brain’s pleasure centre that affects one’s behaviour. What often starts as a harmless, casual, occasional activity, insidiously and slowly, can become a harmful craving or urge – escalating to emotional and physical needs. Cravings can be explained as intense, obsessional, emotional needs. Many say there are identifiable triggers. These needs cannot be resisted when our addiction is strong and deeply engrained. Our willpower is overcome by addiction cravings. Chemical and behavioural addictions fool our brain with large surges of dopamine, the pleasure hormone and transmitter. Our brain continuously seeks pleasure and what it needs to relieve stress. If this intense drive becomes dysfunctional and affects our daily living and health, it becomes an addiction. No addiction is positive.

A person with an addiction may have more than one substance or behaviour that they are chained to. For example, a person could have an alcohol addiction plus a gambling problem. The addiction often coincides with mental health problems such as anxiety, depression, and poor self-esteem. For some, the substance (e.g., drugs or alcohol) or behaviour (e.g., shopping, pornography, or gambling) becomes a way to help self- medicate. It could start with a prescription from the doctor for pain medication. Addiction is a chronic illness that has no cure that requires lifelong management and treatment.

We, as a society, have to be careful about the language we use when talking about people who have addiction problems. Calling someone a “drunk,” “wino,” or “pothead” are not acceptable terms. These are harmful labels that create negative stereotypes. The shame and stigma labeling invoke can prevent people from seeking help. Instead, we are encouraged to use “people-first language,” such as “a person who uses alcohol” or a “person who has a substance use disorder.” We also want to remember to use terms like “a substance a person is using” vs. a “substance of choice.” A person, who is not using substances or is reducing use, is a person “in recovery.”

Why Do People Become Addicted?

There are several theories, and I don’t think there is one clear answer. I understand there are common internal (within us) and external (outside of us) risk factors that are often referenced or referred to by the experts and those who have an addiction. They are:

  1. Genetics (e.g., a “vulnerable brain” inherited from parents, “Addictive personality,” “Disease of choice,” poor self-esteem or self-image)
  2. Social Conditioning – Family and Lifestyle (e.g., what you grew up with, how your family handled stress and other life situations, peers, workplace activities and norms, habits, loneliness, boredom)
  3. Past Trauma (e.g., PTSD, adverse childhood experiences, abuse, loss)
  4. Underlying Mental Health Illness (e.g., depression, anxiety)

A person does not have to possess all risk factors to develop an addiction. The addiction may be related to only one of the above-listed factors yet still be enough to ignite the disease process. Conversely, not all people who have any of these risk factors will develop a chronic addiction. One in five of us will develop an addiction. It could all start with a very innocent habit or hobby. Having a glass of wine with dinner every night can lead to two – and so on. I would say the process of addiction festers and brews for a while before it becomes a full-on substance use disorder (or problem behaviour). I think it is safe to say it is a combination of things that may cause one to develop an addiction – much like that “perfect storm” situation.

Interestingly, although a mental health problem may be made better with substance use in the beginning, in the long run, the mental health problems can get worse (especially depression and anxiety.) The other important thing to note is that addiction problems can increase the risk of mental health problems such as psychosis or depression.

Some experts like Craig Beck, The Stop Drinking Expert, don’t believe addiction is genetic. He believes alcohol is a poison. A person becomes a problem drinker when the “nice to have” becomes a “need to have.” He explains how there is an “evil clown” inside us that causes us to drink more than we should. Lack of willpower is also a big factor.

Any substance-use problem is not only a physical and mental health addiction, but it is also a behavioural problem. One would say, if you have a drinking problem, just stop drinking; but, it’s much more complicated than that. Unless the root cause of the problem is understood and acknowledged, and the desire to get the behaviour under control, there will be no recovery.

I believe addiction is an illness. It’s a chronic (lifelong) illness, just like any other disease. For example, let’s compare a person with alcohol addiction to a person with type 2 diabetes. If the person diagnosed with diabetes wants to get better, they have to change their lifestyle (diet and exercise) and perhaps take medicine such as insulin. In many cases, this is done and it is a positive outcome. Comparatively, if the person living with years of addiction is told they have to change their lifestyle, behaviour and take medicine, their brain’s ability to recognize and understand that there is a problem may have become damaged. Therefore, there is an aspect of not knowing – not even being able to know there is a problem – combined with denial and unwillingness to make changes. Dr. Kevin McCauley states, “Addiction is a disease of choice. It’s a disorder of the brain that affects our ability to make proper choices.”

Some people don’t want to change anything, as they feel “better” when using or acting in a harmful way. Harm reduction is one way that a person with an addiction can be helped. If the person is not able to completely abstain from the substance or behaviour, putting limits on it may be better than continuing as they are. Limiting access to the substance or behaviour is a significant first step in harm reduction and recovery.

Treatment for Addiction

Some people can recover from their addiction without the help of a doctor. They may find sharing their emotional issues with others helps them find healthier ways of coping. For others, there are medications that can help. There are even implants that can be effective for up to six months. These medications help control these cravings. Think back to the person with type 2 diabetes who needs to take medicine. A person with addiction may need to take medicine. Sometimes an antidepressant can help the person manage by helping stabilize their moods, therefore, making the person feel better without self-medicating with additional substances. Co-occurring mental health disorders have to be treated at the same time. For example, an addiction to opioids has to be treated at the same time the bipolar disorder is.

Groups and supportive communities are key factors in recovery. Connecting with others and being kind to oneself aid in a successful outcome. Groups and programs like Alcoholics Anonymous, Narcotics Anonymous, and Smart Recovery are popular and helpful for many. Individualized counseling programs can help one deal with past traumas and family issues.

Addiction treatment and recovery do not respond well to a “treat and release” approach. It takes a lot of effort, time, and ongoing management to ensure relapses don’t occur. And, if a relapse does occur, it’s important to keep in mind that recovery and moving forward is still possible. Being mindful of any system gaps is key to ensure a positive outcome. Detoxification, rehabilitation, and residential programs often have waitlists.

As we age, we must keep in mind that our bodies are changing. It takes a lot less of a substance to get the same “buzz” or “high” than when we were younger. The aging process affects our metabolism, which, in effect, changes the way our body reacts to drugs and alcohol. We may be on medications for other health conditions, which will also interact with our use of harmful substances.

Help is Available

If you or someone you know has an addiction, no matter how big or small, please get help. It is possible to get those sails under control. There are effective programs and treatments that can help you get better, and reduce the risks for unfortunate endings. Addiction is a chronic illness, just like type 2 diabetes and heart disease. There is nothing to be ashamed of.

Addiction recovery is ongoing; it’s a lifelong process. There is help. Talk to someone.


Angela G. Gentile, MSW, RSW




Social Distancing to Help Slow the COVID-19 Spread

man and woman near table

Photo by fauxels on Pexels.com

Many years ago, at the beginning of my career in health care, a community nurse told a few of my colleagues and me that she makes sure she washes her hands often, even after shaking hands with someone. I will never forget that moment, and the feeling I had when she said that.

I said to her, “Really? That sounds pretty extreme.” I was thinking, “Boy, that sounds odd. She must have obsessive-compulsive disorder or something.” I was comparing her to a relative I have that used to wash his hands a lot. My colleagues were just as taken aback by that nurse’s statement.

She was confident and very matter-of-fact. Her words left quite an impression on me. After some time passed, I thought to myself, “She is a nurse. She must know her stuff. Do we really need to be worried about germs when we shake someone’s hand? Everyone does it. I don’t see how that could be a public health concern.”

Fast-forward – 25 years later. That nurse was way ahead of her time.

On March 11, 2020, an announcement was made that the World Health Organization has declared a COVID-19 pandemic, and in order to control the spread, “social distancing strategies” have been recommended. One of the specific directives includes “avoiding greetings that involve touching such as handshakes.”

I work in the community as a social worker. I have been greeting and shaking hands with my clients and their family members for years. Over time I learned that in order to prevent getting sick it is important to have clean hands and to not touch my face. Washing my hands before and after contact with my vulnerable and older clients became part of my “routine practices.” (I use hand sanitizer when soap and water aren’t available.)

However, having clean hands isn’t even enough now in this pandemic situation. Little did I know how risky this simple, well-meaning gesture can be. Getting too close is even risky.

Perhaps a friendly smile, head nod, and “Nice to meet you” is all that is needed for now.

And lots of handwashing.

Let’s help slow the spread of COVID-19 and keep a respectable and safe distance from each other. That nurse from 25 years ago knew her stuff.


Angela G. Gentile, MSW, RSW



Eat Less Often, Live More – Book release


Eat less often

The beginner’s guide to intermittent fasting. For health and weight management.

Intermittent fasting is becoming one of the most talked-about and researched weight loss and health management tools. In this short ebook, Angela G. Gentile explains what it is, how it can benefit you, and how it helped her and her husband lose weight. IF can enhance any diet and it can also help make you feel better. In this easy-to-read book, you will be inspired and motivated to try this safe and healthy way of eating (and not eating!).

Eat Less Often, Live More: What one year of intermittent fasting taught me,

by Angela G. Gentile

Buy the ebook (for Kindle) on Amazon.


Addicted to Anti-Anxiety or “Nerve” Pills — Benzodiazepine use disorder and what to do about it


Image by Pete Linforth from Pixabay

Many people, especially women, develop feelings of anxiety and worry. Some call it “bad nerves.” This predisposition to feeling anxious can cause problems with everyday living, coping, and sleeping. I have assessed and interviewed many older people with a range of problems with anxiety. Feeling anxious is a completely normal reaction to stress or a situation where you may feel fearful. However, being in a continuous state of feeling afraid can cause problems both mentally and physically. Some say they feel like they are “trembling inside.”

Anti-anxiety medications (also known as “nerve pills”) are used by many people. These pills come from the family of “benzodiazepines.” Some of the commonly prescribed anxiolytics in Canada or the United States include (but not limited to):

  • Clonazepam (Rivotril)
  • Alprazolam (Xanax)
  • Lorazepam (Ativan)
  • Diazepam (Valium)

A commonly prescribed non-benzodiazepine that acts like one is Zopiclone (eszopiclone in the USA). It is commonly used as a “sleeping pill.”

Generally, benzodiazepines end in “pam” or “lam.” Use of these medications can initially improve symptoms by offering a sedating effect, however, they can also be addictive. Side effects of these drugs include increasing the risk of cognitive impairment, confusion, delirium, falls, fractures, drowsiness, and motor vehical accidents. They are not recommended for use by older adults. In fact, older people are recommended to gradually reduce their dosage (a slow and steady decrease is recommended over a sudden discontinuance due to withdrawal symptoms). Always talk to a doctor about any changes to your medication. As the dose is gradually reduced and preferably stopped, it is important to identify and optimize alternatives to managing any underlying issues. These alternatives are preferably not other medicines.

Sometimes these medications are used on an “as needed” basis. For example, if you are afraid of flying, and you need to go on an airplane, you can take one of these medications (prescribed by your doctor) to use in specific situations. Or, if you have claustrophobia and you need to go for a scan such as an MRI, taking this medication may make it more bearable.

I have also seen where these medications are prescribed for help with sleep. People who have an anxiety disorder may be prescribed this classification of medications to see if it helps reduce anxiety or panic attacks. In older people, antidepressants are the preferred class of medications to help with anxiety.

Some other key tips to remember:

  • Avoid taking benzodiazepines with opioids or alcohol.
  • These medications are more often prescribed to women (Almost 1 in 5 Canadian women report to have used in the past year).
  • Almost 1 in 10 Canadians in Quebec have been reported to have an addiction to benzodiazepines.
  • If a benzodiazepine addiction is present, consider there may also be other substance use disorders or behaviours present (e.g, alcohol, opioids, marijuana, gambling).
  • If you are older, it’s best not to start taking benzodiazepines.
  • If the addiction is getting worse, an admission to a treatment facility may be necessary.

If you are finding yourself feeling “addicted” or “dependent” on these medications (or other substances or behaviours), you are “craving” these drugs, or you are needing to increase your dosage, you may want to see your doctor to discuss alternatives. Reducing the risk of harm is key.

For more details, The Canadian Coalition for Seniors Mental Health has published the Canadian Guidelines on Benzodiazepine Receptor Agonist Use Disorder Among Older Adults (2019) and is found online: https://ccsmh.ca/wp-content/uploads/2019/11/Benzodiazepine_Receptor_Agonist_Use_Disorder_ENG.pdf

Angela G. Gentile, MSW, RSW

OK Boomer – A passing fad?


Photo source: https://dailyillini.com/opinions/2019/12/02/ok-boomer-is-an-ok-trend/

The end of the decade brought forward a new catchphrase: “OK Boomer.” It’s meant to be humourous, but its real meaning is dismissive and insulting to the older generation. It is something a younger person would say to an older person in a sarcastic and mean way. It pits the younger generation against the older generation. This term exploded on the social media video clip site called TikTok and is now sweeping the nation.

I have been reading up on the term, and it seems that there continues to be quite a divide between generations. The older generation is known as the Baby Boomers (and those older than the Boomers are the Silent Generation). The younger generation is known as the Millennials, or Generation Y or Z.

In between the Boomers and the Millennials is Generation X. That’s my generation. Those who are Gen Xers now are around 40–54-ish. Generation X is often forgotten about. It seems like we are invisible. Not young, but not “old.” It is kind of like the middle-child that often gets forgotten.

Each generation tends to point fingers at the next. I say we need to embrace each generation. Learn from what each has to offer.  Boomers are those born between 1946 and 1964. They are aged 55-73.

In order to move forward in a united front, we have to stop saying “OK Boomer,” and instead say, “I hear you. I see you. Let’s talk.” We have so much to learn from each other. Gen Xers now approaching that magical 55+ age. That age when we get a senior’s discount. We are almost there. I don’t want to be dismissed with “OK Gen Xer.” Just as much as the younger person doesn’t want to be dismissed with “OK Kid.”

So, what do you think of the term, “OK Boomer”? Is it just a recycled and new way of dismissing the older generation? Ageism rearing its head? Or is it nothing new and harmless?

I hope it’s just a passing fad.


Angela G. Gentile, MSW, RSW


Cannabis and the Third Age: How Can Older Adults Benefit From This Plant?

Image from Pixabay

Image from Pixabay

This guest post is written by Bojana Petkovich. 

Cannabis (also known as marijuana) has suffered a fair share of stigma throughout the history of humankind. Even though plenty of its medicinal benefits have been known and tested for a long time, most of the world’s countries still keep cannabis illegal. Fortunately, Canada is not one of them any longer.

The Silent Generation and Baby Boomers clearly remember cannabis as illicit and all the stigma that went with it. One would think this mindset is perhaps the most difficult to change when it comes to fully embracing cannabis products, but this couldn’t be further from the truth. 

Why Are Seniors So Attracted to CBD-Based Products?

The answer is rather simple: older age comes at a price — your body is not the same as it used to be when you were younger, and cannabis helps a lot. Your skeletal, nervous, and muscular systems have aged, and there are several age-related diseases seniors are prone to. 

Some of these diseases can, however, be mitigated and battled using cannabis and its major constituents, cannabinoids (CBD). Such substances are diverse, and thus can help with plenty of symptoms and negative side effects.

The main reason a lot of older people lean toward cannabis and its products is that it is not like other heavy prescription drugs. It has hardly any worrying negative effects on your body, and it can benefit you greatly. These products do not harm your gastrointestinal tract and your nervous system, as opposed to prescription drugs for various pains, inflammations, and diseases.

Still, cannabis is also offered as a prescription drug and should be treated as such; this means that its abuse can result in cannabis use disorder that leads to severe side effects.

The National Cannabis Survey conducted by the government of Canada revealed that there has been a rise in cannabis use in seniors. Statistically, just over 40,000 people aged 65 and older used cannabis in 2012. As of 2019, the number rose to more than 400,000 people from this age group who consumed cannabis.

Age-Related Diseases and Cannabis

Diseases such as arthritis, glaucoma, dementia, osteoporosis, and adult-onset diabetes are some of the most common ones that come with old age. Cannabis is, however, known to help with all of them and many others.

Osteoporosis and bone-weakening diseases are some of the most common ones for older adults. They cause severe pain, limited activity and mobility, and overall weakness of your bones. Cannabis use is especially helpful when it comes to such diseases, as it speeds up the healing process of your skeletal system through osteoblast stimulation. These cells act as rebuilders and repairers of your bones, making them up to 50% stronger once the CBD treatment is finished.

Dementia is difficult to deal with, both for the one suffering from it and the person’s loved ones. Other than forgetting crucial things about your life, such as close family members and places, many people with dementia experience severe agitation, aggression, depression, and similar. The neuron cells saturated by excessive amounts of amyloid protein get inflamed, causing this vile disease. Luckily, tetrahydrocannabinol (THC) is there to reduce the amount of this protein, while inducing calmness. 

Diabetes is a problem for a growing percentage of the world’s population, especially in adults and the elderly. Diabetes statistics show people who use cannabis have around 16% lower fasting levels of insulin compared to those who do not use it, and type two diabetes is rather uncommon in cannabis consumers.

Pain is linked to many diseases and is the most common symptom. Cannabis is known for its ability to reduce different types of pain. Factually, 62.2% of cannabis users choose this plant and products based on it so they can relieve chronic pain.

Arthritis, a disease that attacks joints, tends to trouble 1in 2 older people. The feeling of stiffness and pain, followed by fatigue and swelling are some of the most noticeable symptoms. A 2018 study from the International Journal of Geriatric Psychiatry reports a strong bond between arthritis and depression, and seniors have been using cannabis to fight this disease. Not only that, but in 2018 they were up to 20 times more likely to admit they used marijuana in comparison to statistics from 1984. 

Bottom Line

As we enter an era where many symptoms, illnesses, and diseases are becoming a part of a blurry past due to technological advancement, older people can finally start experiencing a painless and easy day-to-day life. Cannabis is already making a massive change, as people opt for CBD-based products more and more every year, and we cannot wait to see this plant’s full spectrum of benefits in the future.


About the author: Bojana Petkovich is always on the lookout for new adventures and creative drives. Bojana is currently mesmerized by the fast-paced cannabis industry and providing the internet community with valuable information via LoudCloudHealth. The information on LoudCloudHealth is backed up by scientific studies. The articles on diseases and conditions treated by cannabis or CBD have sources to scientific research in their links. The statistics pages have their sources listed at the end of each article.

Low-Risk Alcohol Usage Guidelines for Older Adults – Know your limits

depth of field photography of woman in pastel color sleeveless shirt and white sunhat

Photo by bruce mars on Pexels.com

Most adults enjoy drinking alcohol on occasion. Sometimes, though, this occasional drink turns into a daily habit. One drink turns into two or more. If a person is not mindful, this habit could turn into an addiction. Addiction is also known as dependency or substance use disorder.

People can become addicted to not only alcohol but drugs, including prescription drugs (such as benzodiazepines and opiates). For example, nicotine, the drug found in cigarettes, is very addictive. Addictive behaviour can also be problematic, as in gambling, sex, or online gaming.

Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequences. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems. Yet a number of effective treatments are available and people can recover from addiction and lead normal, productive lives. – American Psychiatric Association, retrieved 03 Dec 2019.

For a number of reasons, it is essential to keep in mind that as we age, it is recommended we reduce our consumption of alcohol. For adults aged 65 and older, it is important to be aware of the low-risk guidelines.

Canada’s Low-Risk Guidelines (DrinkSense for Seniors) which is provided by the “Canadian Centre on Substance Use and Addiction”, states that limits for adults (not older adults) who drink alcohol should be 10 drinks a week for women with no more than two per day, and 15 drinks a week for men with no more than three drinks a day on most days. There is no specific limit for older adults, but one of their “Safer Drinking Tips” includes the advice of “Always consider your age, body weight, and health problems that might suggest lower limits.”


Standard Drink Portions:

      • Beer – 341 ml (12 oz.) of 5% alcohol content
      • Wine – 142 ml (5 oz.) of 12% alcohol content
      • Cider/Cooler – 341 m. (12 oz.) 5% alcohol content
      • Distilled alcohol/80 proof liquor (rye, gin, rum, vodka, etc.) – 43 ml (1.5 oz.) 40% alcohol content

Note: Not all wines are created equal. Some wines start at 5% alcohol content, some go as high as 18%!

I attended an “Aging and Addictions” course in November 2019 which was held by the Addictions Foundation of Manitoba, and they supported the drafted recommendations entitled “Prevention: Low-Risk Drinking Guidelines” for those 65 and older (noted below).

Low-Risk Drinking Limits (65+)

    • Women: No more than 1 standard drink per day, with no more than 5 drinks in total per week.
    • Men: No more than 1-2 standard drinks per day, with no more than 7 per week in total.
    • Non-drinking days are recommended every week.

Source: Canadian Coalition for Seniors’ Health. Canadian Guidelines for Older Adults. Prevention, Assessment, and Treatment of Alcohol Use Disorder, 2019.

These drafted guidelines are more in line with what I would recommend. I have seen what alcohol dependence can do to people and it is heartbreaking. And as noted in a previous post here on my website, to help preserve cognitive health, experts recommend no more than 2-4 drinks per week (see my Memory Rescue book review.)

For those who have a drinking problem, there is often stigma and shame attached. Many people can’t abstain or reduce their drinking behaviour on their own (harm reduction) and need help. If you or someone you know has a drinking problem, addiction or dependence, please contact the Addictions Helpline in your area.

> Addictions Helpline Canada 

> Addictions Helpline USA

AA 12-Step (https://www.aa.org/) or Smart Recovery (https://www.smartrecovery.org/) are peer support options to consider as well.

If you are considering getting on top of your drinking problem and need someone to talk to, please contact me and I can assist you in finding the help you need.

Angela G. Gentile, MSW, RSW










“A Standard Drink” image source: https://studentaffairs.lehigh.edu/content/what-standard-drink