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Face to face with Canada’s fentanyl crisis

I recently learned how to administer naloxone, the drug that helps reverse an opioid overdose, at a Toronto workshop on harm reduction strategies, drug policies and combatting the fast-growing number of opioid overdoses in Canadian cities big and small. 

There’s an opioid crisis in Canada. 

Stories of first responders and volunteers saving those who are using and overdosing have saturated the local and national news for most of 2016. Fentanyl overdoses occur every day in British Columbia, Alberta, Manitoba and Ontario, and the news media are full of tired paramedics telling horrifying stories of death and revival in the streets. There seems no end in sight.

Vancouver saw 159 overdoses in 2016, and on December 15, nine people died of fentanyl overdoses in a single day. Ontario’s numbers are smaller (165 fentanyl-related deaths in 2015, an increase from 86 in 2014) but rising.

I’ve been following this story with particular interest. My older brother has been a fentanyl user for the last few years, graduating from cocaine, ecstasy, crack, meth and other substances over nearly two decades of drug abuse. 

Each morning as I listen to another fentanyl-related story on the news, I scan multiple media outlets, wire services and police news releases looking for information about recently deceased males that match his description. So far I’ve had only one close call. Thankfully, it wasn’t him. 

The opioid epidemic is here to stay. And the efforts of grassroots groups who are taking matters into their own hands are important and necessary since governments seem powerless to do much about it. 

Among the problems complicating the current emergency are drug policies that criminalize users and the shortage of mental health services for marginalized communities. Arguably, these are the issues we need to hear most about right now if we’re to make any kind of systemic change. 

All these matters were addressed in the workshop I attended. 

But as inclusive as these spaces are meant to be, I felt like an outsider. Most of those in attendance were harm reduction workers on the front lines or people involved in the party scene. 

What struck me the most were the conversations about extending kindness to people struggling with drugs, and the language around shame. 

For me, it’s hard to accept my brother as simply a “drug user” and not an addict with mental health issues when his use of drugs has had serious financial and emotional consequences for the people around him. 

My retirement-age parents are the legal guardians of his two small children after a long legal battle, and his third and youngest child, whom I have never met, has recently been adopted into another family. Their mom is also an addict, or user, and usually nowhere to be found.

Every addict is different and needs to get clean on his or her own terms. I get that. But it’s difficult for me to accept letting people use drugs in hopes that they’ll eventually wean themselves off.

My brother has always refused counselling. After many failed interventions, countless rehab assignments – even after we’ve let him hit rock bottom, as we’ve been advised to do by professionals – nothing has worked. 

I doubt I will have to administer the anti-overdose drug I learned how to inject into a stress ball. I’ve seen my brother only once in the last four years. The last time was about a month ago, after four years of silence during which my parents and I weren’t sure he was alive. 

He claimed to have been clean for nearly half a year, after a stint in jail. He called me, wanting to reconnect, to turn his life around, take care of his kids and own up to a lot of the sadness he’s caused. 

We had a coffee. I listened to his dark tales of his own overdoses, friends lost, grief for his children and our parents. He told me of his daily battles around using, how it’s a daily choice not to, and when he feels the urge rising he goes to group therapy to unload the scary thoughts. 

I hugged him tight and looked into his eyes. They were crystal blue and clean. I told him I loved him. He was hopeful, and so was I. I chose kindness over scorn. We made plans to see each other again over the Christmas break. 

Then, a few weeks later, he scored again and almost died. I don’t know where he is now. 

I went to the workshop hoping to meet others who feel the way I do. I was looking for answers on how to get through and how to help. But they were in a different place. 

Maybe they understand something I don’t. Maybe I’m not strong enough or understanding enough to accept that drugs can be used responsibly. Maybe they still have hope. 

I can’t allow myself that any more, because the inevitable fall has become too hard to bear.


Fentanyl factsheet

Fentanyl is a powerful prescription painkiller about 100 times more toxic than morphine, according to the RCMP. 

Known on the street as Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Green Beans, Jackpot, Murder 8, Shady 80s, TNT and Tango and Cash.

Sometimes mixed with other drugs so it’s hard to detect – 2 milligrams of pure fentanyl (the size of about 4 grains of salt) is enough to kill the average adult. 

Canada is the second-largest consumer of prescription opioids (after the U.S.), with a 203 per cent increase in use between 2000 and 2010. 

Fentanyl-related deaths have been increasing in Canada since tighter regulation of OxyContin, another painkiller that’s popular among addicts. 

Between 2009 and 2014 there were 655 fentanyl-related deaths in Canada, an average of one death every three days, but frontline workers say the number is likely an underestimate. 

During the same period, there were 1,019 drug poisoning deaths in Canada where post-mortem toxicological tests indicated the presence of fentanyl. 

The Works needle exchange program in Toronto has distributed more than 7,000 doses of naloxone, which have been used in 570 overdoses, since 2011.

Sources: RCMP, Canadian Centre for Policy Alternatives, Canadian Centre on Substance Abuse, Toronto Public Health 

news@nowtoronto.com | @nowtoronto

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