October 22, 2020

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No quick fix

Crucial questions about Canada's opioid crisis continue to linger

Darryl Dyck / the Canadian Press files</p><p>Countering the damage done to individuals, families and society, author Benjamin Perrin finds that safe injection sites are among the factors that can save lives in the opioid epidemic.</p>

Darryl Dyck / the Canadian Press files

Countering the damage done to individuals, families and society, author Benjamin Perrin finds that safe injection sites are among the factors that can save lives in the opioid epidemic.

Hey there, time traveller!
This article was published 11/4/2020 (194 days ago), so information in it may no longer be current.

As coronavirus stories and issues have blown up Canadian culture, it would be easy to forget those who have suffered, tragically, with other public health problems.

University of British Columbia professor Benjamin Perrin reminds his readers that the opioid crisis — which was declared a public health emergency in 2016 — is still a serious problem, one which social distancing and sheltering in place will not help.

In his engaging and matter-of-fact chronicle of interviews and research conducted in the first half of 2018, mostly in British Columbia, Perrin cogently lays out a great deal of relevant information about the cost of opioid use in human lives and social consequences.

In 2012, Perrin was "at the heart of Canadian politics as Stephen Harper’s top criminal justice adviser."

Returning to UBC, his investigation resulted in what he calls "a complete 180-degree turn. I was convinced: the misguided war on drugs was not only a total failure, it was actually making things worse."

The book’s 14 chapters reflect questions which kept cropping up in his interviews and conversations, such as "Why Do People Start Using? Why Can’t they Stop?" "Can We Prosecute Our Way Out?" and "Don’t Supervised Injection Sites Enable Drug Use?"

Each chapter contains anecdotes about those affected by opioids as well as frank information from over 40 experts: medical personnel, law enforcement officers and medical, legal, government and social workers. Perrin walks the reader through this largely question-and-answer format clearly and dispassionately.

He introduces people who have suffered various kinds of stigma associated with addiction, and traces much "opioid use disorder" to the various kinds of pain people have suffered, including the shame of addiction itself.

Perrin traces Canada’s drug war to 19th-century prohibitions against opium: frankly racist attempts to discourage Chinese and other Asians immigrant workers.

The stigma of drug use — especially from those who dismiss and disdain addiction as low-class, personal choice, or both — ignores trauma from childhood experiences, inadequate health care, or, in Indigenous communities, ordeals associated with colonialism and racism.

Canada’s drug laws have resulted in stronger and stronger drugs which are easier to hide, just as Prohibition a century ago resulted in more hard liquor and less beer.

Feelings of failure, disgrace and despair from such stigma drive many users to hide, where drugs such as fentanyl and carfentanyl result in solitary overdoses and the rise in opioid deaths.

Even detox and rehab of various kinds can end tragically; as a person’s tolerance for drugs decreases, making formerly "safe" amounts more deadly.

Countering the damage done to individuals, families and society, Perrin finds that safe injection sites, widespread use of naloxone as well as opium substitutes such as methadone and suboxone can save lives.

"Supervised consumption sites literally have a perfect record in saving lives," Perrin writes. Some of those sites were in a legal grey area, but many experts have come to see them as essential tools in harm reduction.

Decriminalization, however, still faces political resistance from the current government. One expert says Justin Trudeau in 2017 expressed sympathy, "But do you know how much trouble I’m having legalizing marijuana?"

By the end of the book, Perrin’s writing begins to show his emotional commitment to strategies and policies he would have rejected a decade ago.

He ends with the legal-sounding but stirring "Vancouver Declaration on Responding to the Opioid Crisis," which he wrote to sum up the passion of a convert.

Like Overdose as a whole, it’s an excellent place for Canadians to begin considering new ways of treating addiction — and the people often formerly dismissed as merely addicts.

Bill Rambo teaches from The Laureate Academy in St. Norbert.

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