Content warning: this opinion piece discusses opioid substance use and abuse, and stigmatizing responses to the opioid crisis.
We know that the opioid crisis is at our doorstep in Peterborough. We know that our city has some of the highest rates of opioid related deaths per capita, according to provincial statistics. But who are the faces behind the statistics? Why have things gotten so out of control? What can we do about it? The answers to these questions may surprise you.
We have all been taught how to spot someone who has a substance abuse problem. They are probably poor, jobless, homeless, suffer from a mental illness, and is racialized. Well take that image and throw it away, because in reality, we all represent the face of the opioid crisis. Individuals may use prescription opioids like morphine or oxycodone, another person’s prescription opioids, or drugs like heroin from the illicit market. Either way, the Ontario Drug Policy Research Network found in 2017 that the face of the opioid crisis does not have an age, includes all income levels, affects all genders, and cannot be predicted by race. If opioid use does not have any demographic predictors, why do we think we know what drug addiction looks like?
We have been told that street drugs are dangerous and fentanyl is the reason for overdoses. While around half of opioid related deaths involve fentanyl (a highly potent synthetic opioid available as a prescription or produced and sold illicitly), there are just as many overdoses when fentanyl was not present. The panic around fentanyl is legitimate – particularly when fentanyl is being cut into other drugs without the consumer’s knowledge – but let’s think critically about how the panic around street drugs deflects from Big Pharma’s role in the opioid crisis. Prescription drug companies benefit enormously from the over-prescription of opioids. Does our approach to the opioid crisis take this knowledge into consideration?
I am working with two fellow Social Work classmates on a social action project to raise awareness about the opioid crisis at Trent Peterborough campus. As Social Work students, we are thinking about both the interpersonal level of this crisis, as well as big picture social implications. The reality is, individuals who use substances are pathologized and labeled as deviant which only works to further alienate them from society. After all, who would seek help only to be told you are bad? Broken? A leech on tax dollars?
It is important to see that the face of the opioid crisis is universal – that overdose is a risk any opioid user can face – yet people who are marginalized are disproportionately affected by the stigma around substance use. Therefore, we need new community services to address their needs as the crisis worsens.
You may have seen myself and my colleagues around the Trent campus with a clipboard to collect signatures for a petition created by local service agencies for a safe consumption and treatment site (CTS) in Peterborough. We are passionate about helping this come to fruition, as it would provide clean supplies, wound care, emergency services, and naloxone kits to users. Naloxone is a drug that briefly stops the effects of opioid overdose in the body, affording emergency responders more time before an overdose results in death. Wrap-around services would also be provided at the CTS, connecting individuals with housing, employment, and counselling services.
Harm reduction services for people who use substances (such as a CTS) are politically divisive. While local Conservative Member of Provincial Parliament Dave Smith supports a CTS for Peterborough, it has proven difficult to find a landlord willing to host the site. These sites are controversial because the stigma around substance use means that people think ‘not in my backyard’ when they hear about a CTS.
Perhaps you’ve heard that safe consumption or safe injection sites are ‘enabling’ people to continue ‘bad’ behaviour. Perhaps you’ve heard that naloxone allows people to escalate their dangerous use of substances. In reality, studies such as Expanded Access to Naloxone by Daniel Kim, Kevin Irwin, and Kaveh Khoshnood have shown that individuals who are trained in naloxone administration are more likely to stop consuming opioids rather than increase their doses. Once again, much of what we think we know about the opioid crisis is a misconception.
Dr. Gabor Maté is a doctor at Insite, the Supervised Injection Facility in Vancouver’s Downtown Eastside. He said in an interview, “all addictions are an attempt to soothe the pain. So, when I work with addictions, the first question is not ‘why the addiction?’ but ‘why the pain?’”. Maté supports people to be in tune with themselves and work through their pain in a nonjudgmental atmosphere. Isn’t this the kind of support we want for our city? If social isolation is understood to be the driving force behind addictions, a place where individuals can get well in a way that is best for them sounds like a step in the right direction.
The opioid crisis is more than just naloxone kits and safe consumption sites. In order for any initiative to work, we need to educate ourselves about the harms of holding incorrect and marginalizing beliefs around substance use. Our group is joining forces with Ethel Nalule, the Vice President of Student Health and Wellness at the TCSA, to try to debunk the myths surrounding the opioid crisis. We will be launching a poster and button campaign by early November. Our group will also collaborate with the TCSA and Peterborough AIDS Resource Network (PARN) in their initiative to have naloxone distributed on campus. Along with naloxone kits, we will advocate that the solution to the opioid crisis is #MoreThanJustNaloxone.
What can you about the opioid crisis in Peterborough? Organizations such as Question of Care have created community education opportunities like the free workshop Understanding Opioids, which we would highly recommend. You can join with us and the TCSA in our initiatives on campus and keep an eye out for advocacy work around the CTS. Most importantly, you can engage in critical self-reflection around why stigma is perpetuated.
The three of us working on this project see the opioid crisis as a collective obligation for our community to step up to the plate and create real change, both at the individual and systemic level. We need to label the opioid crisis as a social crisis, and the first call to action is to dismantle the stigma.