A plea to our community members, our province and our country: A response to the BC Coroners Reports on Overdose Deaths in BC
I need to talk about our view of what is called the opioid crisis, the overdose crisis and what is really the toxic drug poisoning crisis. I need to stress this over and over again to everyone, to those who have lost a loved one to the toxic drug poisoning crisis and those who are struggling to support a loved one experiencing negative impacts due to substance use disorder; To those who are in recovery; To those who are living the experience. I need to stress this to business people, to lawmakers and politicians loud and clear! Most importantly I need to stress this in our conversations amongst friends around the kitchen table…..
While it seems that focusing on treating addiction is the common sense answer to saving lives in the toxic drug poisoning crisis, it is not. At least it is not a complete answer and not an answer at this point in the crisis.
I have lived experience with substance use. Most of us do if we truly look at our lives.
I also have developed and facilitated various approaches and treatment programs for over 30 years in my career as a mental health and substance use clinician. I have experience working in many of the models for treatment from 12 step abstinence only, to SMART, to various psychotherapies and pharmacotherapies; inpatient, outpatient, outreach, individual and groups with varying success.
But there is only one approach to the toxic drug poisoning crisis; and that is to stop the poisoning of the illicit supply that is killing hundreds of thousands of people across North America let alone in other countries as well.
We do this by putting the supply of illicit substances into the hands of regulated bodies and ensure access for all who are using substances. This requires the complete unsanctioned decriminalization of all substances so that an infrastructure of safe supply can be legally created and safely accessed.
Though addiction plays a role in the overdose crisis, it is not the cause. The cause is the toxification or poisoning of the illicit supply of opioids and stimulants by organized crime for profit. It is done to increase demand and increase the value of the supply.
Cracking down or intensifying the war on drugs has only increased property and violent crime, increased drug toxicity, increased overdose from drug toxicity and now deaths from drug poisoning. Toxic drug poisonings now have overtaken car accidents, homicides and suicides as the leading cause of death in BC.
The only approach that has been guaranteed to save lives at this time has been harm reduction. Without naloxone, without opiate agonist therapy, without opiate replacement therapy, without supervised consumption sites and overdose prevention sites and strategies, the death rate from this would at least be one and a half times, if not more than it is now. In BC that would be closer to 9.75 people dying each day instead of 6.5.
We see this exemplified in the US where harm reduction is only just beginning to be considered: And in states like Hawaii, nonexistent. They actually have one and a half time more deaths per capita than Canada. The US has not progressed beyond an abstinence only based mindset. Canada, though still struggling through this change, has embraced harm reduction to the point where it has been effective. But again not enough. And somehow, unbelievably in my professional opinion, still a controversy for too many.
Where do we draw the line? How many deaths per day is enough? Or do we just not care about some people in our society. So much for all lives matter hey.
While many folks have attended detox and residential treatment programs that were abstinence only based, success (measured as abstinence only) has been limited. It is always wonderful and encouraging to hear the success stories of those that made it and those programs can work for some. It was validating to hear about it in my job. This kind of success with this disorder is difficult. But those programs do not work for everyone. And for the vast majority, they do not work the first time!
This is where we run into a now deadly debate. As a clinician, I have seen far too many people who did not succeed with abstinence only, after their first shot at treatment or detox and relapse. This is one reason people are dying. This is one reason that treatment only, as we understand it traditionally, does not work to save all lives. There are also a disturbing shortage of resources for those who would like to access treatment despite its limited success. They have to wait and are dying from the poisoned supply.
People, the majority being men, are dying in their homes far, far more than they are dying in the streets. This is a large portion of the population not accessing resources for many reasons. Not the least of which is the criminalization and stigmatization of substance use.
So I strongly submit and advocate that putting the supply of decriminalized substances into the hands of regulating bodies and made accessible is the first and foremost approach to this toxic drug overdose poisoning crisis. Even the Chief Coroner, Lisa Lapointe, in her address regarding the worst month and now worst year in history for overdose death has expressed her support for this very approach as the first response to the crisis.
She’s tired of it. Imagine how it feels for the parents and friends, and in my world, all of the front line workers struggling to go to work everyday and face another 6 people dying and hundreds overdosing!
Dead people do not seek help.
Providing more beds will only minimally make services available and will not address the long wait lists for inpatient or outpatient. And as we see, it will not guarantee abstinence post treatment and in fact put people at higher risk of toxic drug overdose post treatment. Abstinence only detox puts people at even more risk, as well over 90% of people relapse post detox. Every service provider with experience knows this! How is it that politicians and decision makers don’t know this?
I am a recently retired professional social worker and counsellor with over 30 years experience in the substance use treatment field and my own lived experience. Consultation with others in this field with experience and education supports my argument. Widely available research and study in this area supports my argument. The only immediate answer to the toxic drug poisoning that is causing so many deaths is to stop the poisoning.
STOP THE POISONING!!! STOP!YES I’M YELLING!! WHAT THE HELL IS IT GOING TO TAKE
We can do this by changing drug and criminal policy. We need the policy to reflect that people, not criminals, are being poisoned for profit. We need a policy that will help build a safe infrastructure that will put all substances in the hands of regulated bodies. We need to stop the poisoning.
In the meantime, the only approach that shows the most impact on saving lives is harm reduction. Further treatment options are certainly necessary but as is very evident, will not save lives from the poisoning of the illicit supply of substances.
I am extremely confused and confounded as to why this is not being understood by our decision makers. I’m even more confused why this is not understood by the so called consultants from the treatment field! Why information and education about this is being ignored and political will is taking precedence over the lives of everyday people.
Why are frontline workers, people with lived and living experience, families, clinicians and scientists not getting through? I don’t understand why politicians and lawmakers are not pushing for unsanctioned decriminalization and regulated safe supply to save lives and create safety for people to seek out help when they decide they are ready!
I don’t understand Why 6.5 more people will die today in BC, why 396.5 more people will die by the end of New Years Eve this year. Is that somehow okay?
Not for me it isn’t and not for thousands of others. Know this. We are growing. We need this desecration to end. We are pissed and will not go quietly into the night!
As always, or as often as I can, I choose a music video produced by my brother Karl and I at BeeK Productions that fits for the topic. Here is “Light Up”, a song of protest and taking action. I include the lyrics as well:
Light Up:
Ben Goerner, Karl Goerner
Copyright 2018
legalize decriminalize
another war with too many lies
over consumption greed and corruption
feed the machine to satisfy our addiction
Light up, light up, light up your soul
Light up light up, let’s rock and roll
Occupation, colonization
So out of touch with the human nation
We have become so unimportant
We have become senseless and numb
Light up, light up, light up your soul
Light up light up, let’s rock and roll
won’t see the future won’t see the answer
when we close our eyes we feed the cancer
don’t lose your voice or give away your choice
Stand up Stand up
Let’s make some noise
You can reach me at bengoerner.bg@gmail.com or leave a comment below.
https://www.bccsu.ca/wp-content/uploads/2017/08/Safety-Bulletin-Withdrawal-Management.pdf
http://www.bccdc.ca/health-professionals/data-reports/overdose-response-indicators
https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm
Lewis Marc Dr, (2015) The Biology of Desire, Public Affairs Perseus Books New York
Boyd Susan et al (2016) More Harm Than Good: Drug Policy in Canada, Fernwood Publishing Nova Scotia.
Mate Gabor M.D., (2008) In the Realm of Hungry Ghosts, Vintage Canada Toronto.
Alexander Bruce Dr, (2008) The Globalization of Addiction, Oxford University Press