A poisoning crisis is raging in Canada and killing thousands of people every year.
It’s not about contaminated meat, lettuce or infant formula – the kind of safety issues that cause public concern, product recalls and accountability of officials.
It’s a very different response to Canada’s toxic drug supply, as more and more people – including children – are dying from what harm reduction specialists call preventable poisonings.
“If we had poison lettuce contaminated with listeria or something like that, they would pull all of that from the store, there would be warnings… but because the substances we use are not regulated, there is no regulatory response,” said Natasha Touesnard. , executive director of the Canadian Association of People Who Use Drugs, based in Halifax.
Touesnard is one of many advocates who say Canadians need to change the way we discuss drug use because on average 20 people die every day from toxic drugs. Many of these deaths are the result of drug dealers mixing fentanyl, benzodiazepines or other substances with drugs like heroin, cocaine, methamphetamine or MDMA to stretch their supply – without giving any warning to clients.
Between January and September of last year, at least 5,368 Canadians died of ‘apparent opioid toxicity’, which is how the Public Health Agency of Canada classifies addiction-related deaths involving an opioid. .
The death toll has soared during the pandemic as people have experienced further isolation, stress and struggle, and illicit drugs have become increasingly harmful.
But the problem is not new: since 2016, 26,690 deaths in Canada were attributed to opioid toxicity.
“This is a mass poisoning crisis unfolding across our country, and the government has the power to address it,” Touesnard said.
Physicians, policy experts, coroners and law enforcement continue to call on the federal government to enact drug reform to ensure the safety of people who use drugs, noting that models of abstinence and criminal penalties n didn’t stop people from using drugs – they only made it more dangerous to do so.
“We have to change, because the drug supply isn’t. It’s going to get more and more powerful,” said Guy Felicella, peer clinical adviser for the BC Center on Substance Use in Vancouver.
Changing perspective on drug use
Supporters say it shouldn’t take the deaths of thousands of Canadians for this change to happen – but they’re still waiting to see the widespread public outrage that will force the government to act.
“There doesn’t seem to be enough care when people are dying from a poisoned supply,” said Jonny Mexico, Winnipeg network coordinator for the Manitoba Harm Reduction Network. “I don’t know if it starts at the top because politicians don’t seem to care, or if it starts with the amount of stigma that surrounds people who use drugs.”
Part of the job is to change stereotypes about people who use drugs, said Leslie McBain, co-founder of Moms Stop the Harm, a network of families who have lost loved ones to substance use.
“It’s not just these marginalized and vulnerable people. It’s our brothers or sisters, our children.”
Some people use drugs for fun, some are addicted, and some die the very first time they try a drug, but “nobody who uses drugs wants to die,” Mexico said.
Therefore, in most cases, the word “overdose” may not accurately reflect why a death occurred. In many cases, the victim took a drug without knowing that fentanyl or another potentially toxic substance was mixed into it.
“[Overdose] suggests that if they had been more careful they would not have died, when we know for a fact [that] the market is so toxic right now that there’s absolutely no way for people to know what’s in the substance they’re buying,” said Lisa Lapointe, Chief Coroner for British Columbia. Britain, where more than 9,400 people have died from drug toxicity in the past six years.
In other cases, a person who intended to use fentanyl was unaware that they were taking a much more concentrated dose than they were used to.
“When I buy illegal drugs on the street, there are none of the ingredients. So you tell me what it is – it looks the same to me, I buy it, I die. It’s poisoning” , said Felicella. .
How to remove poison from supply
One solution to the toxic drug supply is to crack down on those who poison them, as happens on rare occasions in Canada. However, harm reduction advocates have said arresting individuals is not the solution to a much larger problem.
“It’s the mole thing – if you arrest ten drug dealers, there’s 100 who will take their place in two days,” McBain said.
“Removing the market is the way to impact these people and removing the market means putting in place a safe supply.”
Again, however, these words – secure supply – mean different things to different people.
The federal government has signaled its willingness to try a medical model, funding a limited number of “safer supply” pilot projectswhere people can access prescriptions for pharmaceutical grade opioids, stimulants and benzodiazepines.
However, many advocates say a bolder model is needed, where drugs are decriminalized or legalized, and regulated like alcohol or cannabis, to keep people safe and disrupt the trade in toxic drugs.
As part of this approach, British Columbia, Toronto and Montreal have all sought federal exemptions to decriminalize personal possession of small amounts of drugs. The Canadian Association of Chiefs of Police supported this decision.
There are also signs of growing public support: in an Angus Reid poll last year59% of respondents said they supported the decriminalization of all illegal drugs, while the remaining 41% opposed it.
But there is still resistance from other quarters. Alberta Police Chiefs said earlier this year that it is too early to decriminalize drugs, especially without more health supports and treatment services in place.
Prime Minister Justin Trudeau has also voiced his opposition to decriminalization, saying it would not be the “silver bullet” suggested by advocates.
Lapointe, BC’s chief coroner, supports decriminalization and policies to make the drug supply safer. She said there was evidence that drugs can be used safely if the drugs themselves are safe.
“For my office, it’s not an ideology. It’s very practical,” she said.
“We are looking at what could be done to prevent deaths, and the only way to prevent the number of deaths we are seeing in our communities is to stop their reliance on toxic drug supplies.”