The Sustainable Development Goals aim to improve the most important things about life on Earth. The prevention and treatment of substance abuse is targeted by SDG 3, Health and Wellbeing—but drug use is a shadow that cuts across the path of so many others, and therefore merits special attention. We talk about that

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"Drugs, drugs, drugs!"

In the early 1990s, someone thought this public service announcement was a good idea. Thirty years later, the accidental anthem has become a bemusing relic of the war on drugs—which was already decades old, and had proven itself interminable, when this first aired on Canadian television.

Puff, puff, pass

Two years ago, the Government of Canada ended almost a century of marijuana prohibition by passing Bill C-45, or the Cannabis Act. So far, the rollout of legal pot from coast to coast to coast has had its highs and lows. Most pointedly, the black market is still thriving, with Statistics Canada estimating that about three quarters of the country’s cannabis users are still getting high on an illegal supply. 

Meanwhile, the Ministry of Health’s earnest Cannabis in Canada website is chock full of educational resources, health information, travel tips, business requirements and more—including PSAs for the modern era.

The opioid crisis

In 1993, British Columbia’s chief coroner investigated an “inordinately high number” of drug-related deaths within the context of a “very real and very serious” problem with illegal drug use. At the time, there had been 330 such deaths in the province. That was the highest number B.C. had ever experienced, and the event is widely remembered as the country’s first overdose epidemic.

By three years ago, that same statistic had soared to 1,473 lives lost annually—an increase of more than 400 percent in a generation’s time. 

All the while, considerable attention has focused on Vancouver’s Downtown Eastside (DTES), a neighbourhood with inordinately high rates of mental illness and drug addiction among its homeless and housing insecure populations. 

Across the country, other urban centres have similarly troubled communities, but the current opioid crisis does not discriminate. Overdose deaths are unquestionably a national happening, with a body count of almost 14,000 between January 2016 to June 2019. Drug overdoses are currently claiming more Canadian lives than motor vehicle accidents and homicides combined. Today’s street drugs are incredibly strong, with scores of addicts at daily risk of their next shot being the one that will end them.

Last December, the Public Health Agency of Canada released this statement:

Many of these deaths are a result of the contamination of the illegal drug supply with toxic substances. Fentanyl and other illegal and highly toxic synthetic opioids continue to be a major driver of this crisis….

The opioid overdose crisis is a complex problem that we know will take time to turn around. To have a significant and lasting impact, we need to continue working together on whole-of-society changes. This includes addressing the stigma that surrounds substance use, implementing further harm reduction measures and reducing barriers to treatment. It also means continuing to work together to better understand and address the drivers of this crisis, such as mental illness, and social and economic factors that put Canadians at increased risk.

Crackdown

Crackdown is a podcast about “the drug war, covered by drug users as war correspondents.” Host and executive producer Garth Mullins is a journalist and radio producer who survived the DTES of the early ’90s, back when B.C. experienced that first wave of alarming deaths. He is a careful, empathetic interviewer who is wide open about sharing his own history of drug use.

We are embedding the show’s trailer from Mullins’ Soundcloud stream below, and recommend a visit to Crackdown’s website to hear the dozen episodes that they have made so far. Or just find and follow the show on iTunes, Spotify or another podcast provider. It tells stories you will not hear elsewhere, from a perspective you might not think to consider.

Marilou Gagnon

Marilou Gagnon (RN, PhD) is president of the Harm Reduction Nurses Association (hrna-aiirm.ca), a professional organization with a national mission to “promote the advancement of harm reduction nursing through practice, education, research and advocacy.” 

In practice, this results in actions including:

  • “Serving as a national voice for harm reduction and related nursing issues”
  • “Creating a dynamic network to support and mentor nurses across the country”
  • “Advocating for the rights and dignity of people who use drugs and their families”

Last summer, acting in a direct response to the opioid crisis, HRNA called for the decriminalization of people who use drugs in B.C.—which, notice, is different than the decriminalization of drugs. 

“This is a critical way forward to address the overdose crisis and to promote greater health, wellbeing, justice, and equity at an individual and population level,” the group’s statement concluded. “Additional steps include ensuring access to a safer supply of substances, housing, mental health services, treatment, support, and harm reduction services.”

Prisoners’ Legal Services

Nicole Kief, formerly of the ACLU, is a legal advocate for Prisoners’ Legal Services in B.C. This role puts her near another front line of the current crisis: federal and provincial prisons.

According to the Correction Service of Canada, overdoses and overdose deaths among prisoners more than doubled within a five-year period spanning 2012 to 2017. The Office of the Correctional Investigator’s 2017–2018 annual report includes the remarkable fact that there are now “more drug detector dogs working in federal penitentiaries than in the entire Canada Border Services Agency.”

During the past several years, Kief and her colleagues have fielded a growing number of pleas for assistance with a pair of drug-related issues: one, unbearably long waiting lists for Methadose and other “opioid agonist” treatments; and two, forced cold-turkey withdrawals from high-dose addictions.

Prisoners’ Legal Services appealed to the Correction Service on both fronts—and got nowhere. In June 2018, the group filed a complaint with the Canadian Human Rights Commission. That did something. Since then, Kief says there’s been a noticeable drop in prisoner reports about both issues. 

Closing words—and how to save a live if you need to

Near the end of this episode, host Vicky Mochama reads the following quotation from the United Nations Office on Drugs and Crimes:

Many of the communities and people caught up in the drugs trade, whether users, small-scale traffickers, producers or cultivators, often constitute the most vulnerable and marginalised segments of society, the “further behind” which the SDGs have endeavoured to reach first.

This, in a nutshell, is why we’ve made this episode.

And below, in six minutes, is how to administer a potentially life-saving shot of Naxolone to a person who is overdosing on opioids. These injection kits are widely—and freely—available in Canadian pharmacies, and offered with hands-on training similar to what’s depicted in this video.