HARM REDUCTION
A GLIMPSE OF THE
Canada’s opioid
crisis may be
less reported
than that in
the US, but the
effects have been
devastating. Is
this where we
are headed, asks
Jussi Grut, and
if so what can
we learn from
the country’s
response?
8 • DRINK AND DRUGS NEWS • FEBRUARY 2020
B
ritish Columbia, the
province in which
Vancouver is the
largest city, totalled
1,155 opioid related
overdose deaths
in 2018. This was the highest in
Canada despite having a population
less than half the size of Ontario,
Canada’s most populated province.
Almost 400 of the British Columbia
deaths occurred in the City of
Vancouver, with most of these
people residing in an area called the
Downtown Eastside.
The Downtown Eastside of
Vancouver is a place that can seem
intimidating to outsiders, with
people openly taking illicit drugs
alongside makeshift markets
where residents lay out their
few possessions on blankets to
sell for a bit of extra cash. These
misconceptions about this relatively
small community could not be
further from the truth, but before I
go into further detail some context
needs to be provided about North
America’s battle with drug addiction
as a whole.
While the opioid problem in the
US continues to make headlines
across the world, a similar but
contrasting crisis is taking place
above its northern border. Canada,
a country that for many conjures
images of snow-capped mountains,
never-ending forests and a history
of peace and inclusiveness, is the
last place many outsiders would
expect to have a drug problem
comparable to that of the United
States, but the country is struggling
to deal with serious problems
of addiction. The origins of the
situations are different, despite
having a very similar outcome.
The USA’s problem started with
the over-prescription of opiates
such as OxyContin – with doctors
reassured by pharmaceutical
companies and medical societies
that the risk of addiction with these
pain drugs was very low – and was
exacerbated by pharma companies
promoting use of these drugs for
non-cancer patients. After attempts
by government to limit the amount
of prescription opiates being
distributed, without putting in place
proper infrastructure to help those
now addicted, the amount of readily
available drugs accessible through
diversion decreased. This effectively
forced those who developed an
addiction to turn to illicit sources
such as street heroin, and deaths
due to heroin-related overdose went
up by 286 per cent between 2002
and 2013.
Top left: Residents lay out their
few possessions on blankets
to sell for extra cash. Top:
The Downtown Eastside in
Vancouver is a place that can
seem intimidating to outsiders,
with people openly taking
drugs. Above: Insite, Vancouver’s
first government sanctioned
supervised consumption site.
Credit: Jussi Grut and Insite,
www.phs.ca
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