The drugs changed — our systems didn’t

A recovery-oriented system must connect housing, care, public safety and long-term community support.

Around 2016, something changed on Winnipeg’s streets. Methamphetamine became more prevalent. Fentanyl entered the supply. The drugs became more toxic, addiction more relentless and homelessness far more complex.

Our systems, however, largely remained the same.

For years, we have described Winnipeg’s homelessness crisis primarily as a housing problem. There is no question that we need affordable, supportive and transitional housing. But housing is only part of the crisis unfolding on our streets.

We will not house our way out of an addiction epidemic.

Many support systems predate today’s fentanyl-driven drug supply and struggle with its intensity, particularly for people living with trauma, mental illness, brain injury, poverty, homelessness and prolonged substance use.

We did not choose one disastrous policy. We allowed several incomplete policies to replace a complete system.

Housing First rejected the idea that people must prove themselves “housing ready.” Harm reduction recognized that people cannot recover if they do not survive. Rights-based approaches reminded us that homelessness does not strip a person of dignity. Each contains an important truth. But none, on its own, is a complete strategy for today’s crisis.

The consequences are visible. People cycle through encampments, emergency rooms, shelters, police interactions and correctional institutions. Residents are frightened, businesses are overwhelmed and public spaces are becoming unusable. Outreach teams, police, paramedics and hospitals respond repeatedly to the same people without having anywhere meaningful to take them.

Winnipeg is moving toward a supervised consumption site with a Rapid Access to Addictions Medicine clinic attached. The larger question is not whether one supports it. The question is what happens next.

What good is a doorway into care if we have not built the system on the other side of that door?

A supervised consumption site can prevent an overdose death. A RAAM clinic can assess someone, prescribe medication and connect that person with services. Both can play a role. But neither substitutes for withdrawal management, stabilization, treatment, mental-health care, Indigenous-led healing, recovery housing, employment support and long-term community reintegration.

Without those next steps, we have created points of contact without creating a pathway forward.

What Manitoba lacks is a recovery strategy connecting housing, health care, addiction treatment, mental-health services, justice, Indigenous-led care and community organizations into one accountable continuum. That system must be easy to enter, difficult to fall out of and responsible for what happens after the initial intervention.

Recovery is not a single event or a 28-day program. It is the gradual work of rebuilding health, relationships, purpose and community. For people who have spent years living outside, surviving violence and using highly addictive drugs, that work may require sustained support over several years.

Nor does recovery end when someone leaves treatment. Long-term, community-based programs allow people to practise sobriety while rebuilding routines, relationships, employment skills and a sense of belonging. If we invest only in treatment beds without investing in what follows, too many people will be discharged back into the conditions that contributed to their addiction.

A complete system must balance compassion with expectations. Protecting a person’s rights does not mean leaving that person in a tent while addiction, illness and exploitation consume their life. Harm reduction should reduce harm, not simply manage deterioration. Housing should provide more than an address when someone needs intensive support to remain safely housed.

Municipal government also has a legitimate — and unavoidable — role. Safe, managed encampment communities should be funded as access points to outreach, stabilization, treatment and housing, not treated as provincial projects the city may support only if someone else pays.

Winnipeg already bears the costs of an unmanaged crisis through emergency responses, encampment remediation and pressure on neighbourhoods. Investing in an organized pathway is not the city assuming the province’s responsibilities. It is the city fulfilling its own.

The goal should be movement: from the street to stabilization, from stabilization to treatment, from treatment to recovery housing, and ultimately to independence and belonging. We should measure that movement. How many entered and completed treatment? How many remained housed after one year? How many found employment, reconnected with family or no longer relied on emergency departments, police and shelters?

Counting contacts, visits, referrals and housing units tells us what systems are doing. It does not tell us whether people are getting better. A provincial strategy should establish shared outcomes, report them publicly and identify who is responsible when people repeatedly fall through the gaps.

We can keep debating whether housing, harm reduction, treatment, enforcement or recovery should dominate. Or we can recognize that all are necessary, applied intentionally and at the right time.

Housing can provide someone with an address. Recovery helps someone build a life. Winnipeg will ultimately need both.

Marion Willis is founder and executive director of St. Boniface Street Links.