A commentary by a retired mental health and substance-use treatment provider, and counsellor who advocates for drug policy change, based on his 32 years’ experience in the field.
We’ve made many huge mistakes when it comes to the overdose crisis in B.C. We are at 14,398 beautiful souls dead, as of February, since the declaration of a public health emergency in 2016.
Numbers have decreased nominally over the past couple of months compared to previous years. But they are obviously horrendous even still.
The province has responded. Up to $2.6 billion has been budgeted for prevention, harm reduction and treatment.
Yet somehow the numbers of dead pile up.
The issue we are facing is the misinformation that is being politicized by politicians vying for votes and power on the backs of those who struggle and on the backs of those who have died.
There is a growing popular belief that abstinence-based treatment is the only answer to the overdose deaths. It is not the answer, or any kind of silver bullet.
The expansion of treatment so far, both in Alberta and in B.C., have not made any impact on the number of dead.
There is a growing belief that harm reduction has somehow contributed to all the deaths. It has not. In fact, harm reduction is the reason the number of dead are not double or perhaps even triple what they are now.
And as we are seeing in Alberta with the repeal of many harm-reduction programs, the number of dead are increasing.
We also see this most clearly in the U.S. where harm reduction is just now being considered a viable response as more than twice as many people per capita have died from overdose deaths than in Canada.
From my experience and my consultations with other colleagues in the field, the answer is multi-faceted.
The answer includes better evidence-based treatment programs that are flexible to the needs of the people who participate. They must include medically assisted therapies that are proven to be effective and life-saving to those who suffer with opioid use disorder.
Cold-turkey withdrawal has a deadly high relapse rate and without lifesaving medications. I have seen people die who were directly out of abstinence-only programs.
Thus, due to long wait lists for reputable (and some not-so-reputable) treatment programs, due to high relapse rates post treatment programs, and due to recreational and experimental use that has nothing to do with addiction, people are dying, not just from lack of proper treatment, but primarily from the poisoned toxic supply of illegal street drugs courtesy of prohibition and organized crime.
In the end, I have seen people thrive with the right medication, including a safer supply. Crime disappeared for many.
Many were able to treat other mental health concerns as well as substance use. Many were able to gain housing (something that is becoming extremely difficult if not impossible for many). Many gained overall stability in their lives.
So when you are listening to the populists trying to convince you that there is only one answer, please know that they are just plain wrong.
They do have one part of the answer, that’s true. But it is far more complex than the simple way populists are portraying it through their propaganda.
And we have learned through the decriminalization pilot that expecting complete outcomes from half measures is pretty much insanity.
Just like with alcohol, we need safe consumption sites. We need a safe regulated supply that doesn’t drop you dead unexpectedly.
We need realistic prevention programs that prepare youth and others. Scared straight has always failed miserably.
And we absolutely need a regulated, evidence-based program based not just on lived experience but on education that provides context and expansion for that lived experience.
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