Canada is currently facing an overwhelming opioid crisis, with staggering numbers of overdoses and overdose-related deaths. For those of us who work with marginalized populations, this crisis and the inaction of politicians are all too familiar.
We have seen this crisis before. We have seen hundreds of sex workers being abducted and killed in Vancouver. We have seen thousands of missing and murdered Indigenous women across Canada. And now, we are seeing people who use drugs overdose and die at an alarming rate. In BC, 800 people are expected to die this year alone. Every day, new numbers are being reported: record high numbers of 911 calls, record high number of overdoses, 2 people dying every day, 7 deaths last week in Vancouver alone. But these numbers do not seem to matter to politicians. Why?
We know from previous crises that they tend to impact marginalized populations disproportionately; populations who are socially disenfranchised, who are busy trying to survive, and whose disappearances and deaths often go unnoticed, unreported, and undocumented by authorities. We also know that politicians tend to ignore issues affecting the most marginalized populations and get away with it because these are unpopular issues to begin with: sex work, gender-based violence, racism, drug use, poverty, housing have low political capital and mainstream appeal. As a result, they take longer to act and often only do so when it is already too late.
In the face of inaction, communities organize, monitor, and respond. This is what we are currently seeing across Canada and more so in Vancouver where the community is providing naloxone training to peers, issuing warnings, deploying outreach teams on bikes, implementing unsanctioned (pop-up) supervised injection sites, and keeping track of overdoses and deaths. Like sex workers and Indigenous women, they are coming up with their own solutions to keep their friends, relatives, neighbors, and communities safe. And they are doing so without the support of health authorities, relying solely on donations (money and supplies).
In both inquiries conducted on the preventable deaths of sex workers and Indigenous women, the same questions were asked over and over again: What took so long? Why the inaction? Months into the opioid crisis, we now have to ask the same questions. Failing to learn from the past and letting people who use drugs die at an alarming rate is gross political negligence, especially when we know how to prevent overdoses and overdoses-related deaths. Unless rapid and concrete measures are taken to address this crisis within the next weeks, we are heading toward the deadliest overdose epidemic ever recorded in Canada – one that will go down in history as yet another failure of government to protect the lives of its citizens.
A note to those who may think this critique is unfair or that governments are taking actions to address this crisis. Developing a national action statement without proper consultation is inadequate – and potentially dangerous. Waiting two years for a supervised injection site to open while people die is not action. Training people with naloxone but not supporting those who actually use it and save lives in the community is not acceptable. Collecting data and monitoring the crisis means nothing if concrete actions are not taken based on that information. Not allocating additional funding for all frontline workers or hiring more staff is irresponsible. Not using research evidence to inform policy and programs is ineffective. Politicians are out of touch, they are slow, and they need to be held accountable for their decisions (or lack thereof).
Actions that should be taken:
- Action = Life: A Call for an Immediate Response to the National Crisis of Opioid Overdose Deaths (published on August 31 2016)
- Civil Society Statement to the National Opioid Summit (Published on November 18 2016)
Marilou Gagnon, RN, PhD, Associate Professor, School of Nursing, Faculty of Health Sciences, University of Ottawa, Founder, Coalition of Nurses and Nursing Students for Supervised Injection Services. Follow her on Twitter: @mlgagnon_XVII and Instagram ml_gagnon