Last Tuesday, Prime Minister Trudeau sent 60 armed forces service members to Nova Scotia to assist with the record-breaking number of Covid-19 cases in the province. That day the number was … 96. Cases. Not deaths, cases. Our government sent helicopters. Over the last year, 67 people in Nova Scotia have sadly died from Covid-19. In the same time frame 1,548 people in B.C. died of opioid overdoses. No helicopters, no extra doctors, no Red Cross, no daily press conferences with graphs, mathematical modelling, and a scrum of reporters. Trudeau said Ottawa made this decision to send in the military “because the situation requires it.”
I want to tell you how that feels.
It’s been almost six years since my son Holden died of an opioid overdose; five years since an official ‘crisis’ was declared in B.C. If my family’s loss were singular or even rare the lack of action would be easier to understand, but since then more than 7,000 other sons and daughters have also died. Often alone. Often without asking for help. Because the shame of admitting addiction is worse than the risk of dying. Does “the situation require it?”
This week, the BC Coroner’s Service announced that 498 people died of overdose in B.C. in the first three months of 2021. Chief Coroner Lisa Lapointe calls the situation a “toxic drug emergency.” Is it still defined as an emergency when the same scenario has been replaying every year for five years? Or have we simply decided as a society that some lives are worth more than others. Emergency – noun : a sudden, urgent, usually unexpected occurrence or occasion requiring immediate action.
I want to tell you how that feels.
Not sudden, not unexpected. Five people a day. Every day. For five years. Five mothers who, like me, will always be less than whole. Thousands left behind who, like me, aren’t contributing to society the way we used to. The collateral damage is enormous. It’s estimated that for every overdose death several close family members and friends will sub-perform for years. If we’re cold enough to talk dollars, I don’t pay as much income tax as I used to when Holden was alive. Then there’s the 7,000 dead, predominantly young men, who no longer work and pay taxes. How much do these deaths really cost?
Hours before my father died of Covid-19 this past December, I held his soft hand and told him he was loved. Family members said goodbye via FaceTime. While an expensive machine did his breathing work, I reassured my dad that he was strong but the disease was stronger. A doctor treated him, nurses brought ice chips, the Director of Care made sure he was comfortable and warm. Few knew how unwell his grandson was, how he suffered. It was a secret. Nobody directed his care. Nobody held his hand. Nobody told him that he was strong but the disease was stronger.
When my sister was diagnosed with colon cancer she was flown on a private jet from Trail, B.C. to Vancouver where she stayed intermittently for months at St. Paul’s Hospital while a team of highly-educated specialists cared for her. Surgeries, diagnostics, chemo, radiation, follow-up care for five years. What did that cost her? Nothing. Not one cent. What did it cost our medical system? I’m guessing hundreds of thousands of dollars. Was she shamed or made to believe she was weak because of her illness or her burdening of our medical system. No, she was given empathy and jello.
I want to tell you how this feels.
After my son died, I awoke one night in the dark with a deep, resonant throb in my chest. Thinking I was having a heart attack I went to my local hospital emergency room. It turns out my heart is broken but that’s beside the point. I was given blood tests, an EKG, a 24-hour Holter monitor, an appointment with a cardiologist, and a followup with my family doctor. When a person in overdose is treated by first responders or arrives in the ER they are saved (hopefully) with Naloxone and when they come around they are released. No protocol of care, no follow-up, no support. At this point they are very vulnerable to overdose again because though the Naloxone has in effect de-activated the opioids in their system, throwing them abruptly into withdrawal, whatever drugs they’ve ingested are still very much present.
Addiction, like other diseases such as cancer or multiple sclerosis, is a “relapsive” disease, meaning it comes back at times as part of its natural arc. Remission is not a cure. Nobody is shamed when their cancer recurs, but when a person in recovery relapses they are typically removed from treatment and deemed a failure, leaving them more wounded and isolated. This is a vulnerable time for overdose.
The other night during the Oscars, Travon Free, in his acceptance speech after winning Best Short Film for “Two Distinct Strangers” quoted James Baldwin, “The most despicable thing that anyone can be is indifferent to other people’s pain—Please don’t be indifferent to our pain,” he said, talking about police violence against black people.
Science tells us that people who use illicit drugs do so not for pleasure but to ease their pain, to mask their trauma, or to simply feel better.
I’ll tell you how it feels. It feels like despicable indifference.
One mother I spoke with, whose son is fighting substance use disorder, said it took five adults, multiple phone calls, emails and favours, driving through a snowstorm during a pandemic to get her son admitted to a treatment facility in Prince George. Her voice sparked with frustration, “There’s no way he could have pulled that off on his own.” Many families have re-mortgaged their homes to afford treatment for their children.
It feels like some people are offered more help than others. While I was hiking one day in North Vancouver, the sound of a safety whistle pierced the still green air. A deep voice calling, a name, a name, a name. Boots on the gravel path ahead. We’re looking for a man, 42, distraught, he may be injured. Or unconscious. We found his car. A search and rescue team has been activated. We’re doing a sweep. I walked the snaking trails I used to walk with my son. A name, I called, a name, your family loves you, your family wants you. A name, I called, a name, whatever is going on I promise it will get better, I yelled to the canopy, the rushing river, the low cloud, a name, a name, they love you, they want you, they will miss you forever. They don’t care what you’ve done.
It feels like no search, no rescue, no team deployed to fan out and comb the bushes.
Under our current system, one way a person in active addiction can access a government-funded recovery bed is to phone in, every day, at the same time, for two weeks, thereby proving they are dedicated to the process. I have a mobile phone plan, reliable internet, secure housing and food, and I’m not sure I could pull that off. For anyone struggling with addiction, existing in uncertain conditions, this protocol asks way too much. When was the last time you had to prove you were ill, or prove you wanted to get well, before your doctor would treat you?
My father-in-law was given elaborate cancer treatment over a period of several years, even though he continued to smoke and drink heavily until the end. An end which was dignified, in a peaceful hospice, surrounded by family. You could say he was addicted to both nicotine and alcohol, and undoubtedly the choices he made to consume those substances contributed to his disease, but not once were his unhealthy choices mentioned in relation to his care.
Another requirement for addiction treatment is that a person demonstrates their worthiness by detoxing first, before a recovery bed will be offered. The daughter of a close friend was told she needed to be clean for 14 days before she’d be admitted, a notion which in retrospect, is as chicken and egg as it sounds. Imagine being informed you need to be free of diabetes for two weeks before you can be treated for diabetes. We know addiction is a complicated riddle. We know the true long-term success rate is low. But we still need to respond in the moment of opportunity. Being able to offer a detox bed immediately when a person, who has likely just overdosed or experienced some kind of negative impact of their illness, decides they are ready for change is a worthy goal. Inside addiction, the exit doors are few and far between, can we find a way to pull our loved ones through them whenever that opportunity arises.
The recent B.C. provincial budget includes a pandemic contingency fund of $3.25 billion for the current fiscal year, $900 million for COVID-19-related health measures. Fantastic. When the citizens need it, the money appears. But some citizens have needed it long before now. There is some good news. Finance Minister Selena Robinson announced the largest investment in mental health and addictions in the province’s history: $500 million over three years to expand youth mental health programs, add 195 treatment and recovery beds for substance users, and expand programs that respond to the overdose crisis. That includes $330 million for treatment and recovery services for substance users, $152 million of which is dedicated to opioid treatment.
Provincial Health Officer Dr. Bonnie Henry said she is “very, very pleased” the province has allocated these funds and hopes the federal government will respond quickly, “as it has shown it can with the parallel COVID-19 health crisis.”
As it has shown it can.
Knowing the government can find the dollars when lives are on the line, and has made the decision not to, is what hurts. $500 million sounds like a lot of money, and it is, and it’s welcomed. The optics are promising. But I want to tell you how it feels. Here are some rudimentary figures. There have been 1,581 Covid 19 deaths in B.C. since the beginning of the pandemic. The amount of government spending to keep that number low is incalculable—it’s in the billions. At the same time nearly 2,000 people have died from ‘toxic drug poisoning,’ so by comparison the $500M over three years represents a small fraction.
The opioid crisis, or parallel pandemic as Dr. Henry calls it, was actually here first—Holden riding the crest of the first wave in 2015—and though it is arguably more deadly, it is overshadowed by the cleaner, more presentable one—Covid-19. Holden was just one kid, one stat, one privileged white young man who had all the advantages, except his pain was just as real to him as anyone’s pain is to them. His confusion, his fear, his illness, just as valid.
It feels like a clear distinction is being made about which lives are worth saving, based on dollars in government funding, and which are not. Addiction is complicated. It’s slippery. There are many qualified opinions about how to approach this long-term devastation, and none of them are easy. All I’m asking for is equity. All I’m asking for is that my son’s life and the lives of other smart, sensitive people who are stuck in substance misuse be considered with the same weight as those we are currently protecting from Covid-19. Even when their illness mutates and proves uncooperative.
That would feel a lot better.