I originally wrote this as a Facebook post, but was very quickly reminded that such a post will likely remain algorithmically buried. Being able to post content like this, without the censure of the social media platforms is one of the reasons I have this website, so figured I should post it here in hopes that may help people to see it. Please share it if you feel so inclined, and don’t let those lost be forgotten, bring these conversations out of the shadows.
Today is International Overdose Awareness Day. Over the past few years we have seen a steady increase of deaths from poisoned drug supply. Maybe if you aren’t a drug user or if you haven’t lost someone close to you, you don’t understand. I will try to break it down.
Many people use opioids. They are one of the only medication classes that can treat extreme pain, which is why we typically use opioids in hospital, following surgery, while treating broken bones etc. The medicine in the poppy plant, and the chemically synthesized look a likes, join onto receptors in the brain- altering the experience of pain. This has been known and used in practice for 100s of years.
The drug war began as a mechanism to criminalize racialized communities, like the Chinese who had brought opium traditions with them. Considering the sort of labour that Chinese immigrants were expected to perform for the colonial project (like building a railroad….) having access to traditional pain management is logical. But jingoism built fear around opium dens as corrupt places that were after the colonies white daughters and eroding the fabric of a “hard working” society and that flavoured the outcome. In the 1980s, Ronald Regan amped up the racial fear mechanism in the US and this spread to Canada. Crack cocaine mythology was created to fuel fear of Black folks; while crack was introduced in Black communities, largely to prey on the trauma induced desire to alter one’s state and to rationalize sweeps that would fill for profit prisons. Fear about “marijuana” was fuelled to ensure that latinx populations would also be subject to speculation from white communities and criminalization (again- filling the for-profit prisons with labourers).
As people are prescribed opioids, they may find that they have become habituated in their use, either because the meds work to treat the pain, or because they have developed a physiological dependence. Or a little from column A, little from Column B. And then the script runs out. Attempts to access more from legitimized means are not successful, a “drug seeking” label is added to one’s chart. All further health care access becomes stunted. Options for treatment are few, far between and often lack mechanisms for pain management.
So the search for effective treatments for the pain and/or the side effects of dependency (dope sickness) takes folks to the street. While getting opioids in the grey and black markets is possible, it is not like getting it from a pharmacist. Dosage, concentration and cuts(additives) are all unregulated in the prohibition drug market. Every time that someone finds a pill, or paste, or powder or or or or that may be a part of management of their pain and dependence symptoms- what exactly is in it and how strong it is becomes a crap shoot.
Ideally we encourage folks to get their drugs tested. But think about how hard that is if you are operating 5-10 steps behind on managing overwhelming pain and/or physical dependence symptoms. The deeper entrenched in this cycle someone is, you can start compounding barriers. The financial costs and/or stigma may lead to homelessness. The safety restrictions of the shelter system may mean you cannot have more than a single dose in your possession at once. Managing other things like self care, hygiene, interpersonal support relationship etc etc etc all get harder. Last check in I had with the folks at the local drug testing said that about 80% of the opioids they check have cuts including fentynal and carfentynal- which are 20-80x stronger than the opioids they were sold as.
So imagine if you will…. you go to a bar. And order a beer. But then you start to drink it and nearly instantly feel that this wasn’t JUST a beer. This was a beer, with a shot of absinthe and some under the kitchen sink chemicals. Luckily, you are in a bar. The other patrons see you drop from your stool and are able to give you a magic potion that grabs onto the undesirables floating around between your brain and liver, saving your life. They have seen this enough times to know the routine. The bartender knows. Sometimes they add things, but often their beer is already not beer before it ever gets there. The bartender isn’t trying to hurt people, but can’t get his hands on straight beer very often. Some folks who are dependent on what he can sell, will keep coming back even though, cause when they try and buy beer from the regulated beer store, they are treated like garbage and sent on their way.
Responses like granting safe supply to anyone who needs it, moving away from a criminal response to substance use, robust harm reduction including safe consumption sites, and cultural shifts away from stigma all make a difference. But these actions are happening too slowly, and while we wait, about 5 more people die in BC – EVERY DAY.
More people have died from this crisis than covid. Many of the people suffering are living in intersections of oppression. Veterans, Residential School Survivors, Mental Health patients, abuse survivors, trans folks, survival sex workers and folks with physical disabilities. Like covid we see that the least resourced people in our society are the most vulnerable.