By: Kamalvir Pablay
How it began and still affects Canadians
The opioid crisis has been a long-standing issue in Canada, and even to this day, we are often subject to either experiencing it on our own or someone giving their experience of people using drugs on the streets across small and big cities. Why is it important for students not only at Queen's but also at post-secondary institutions across the country to understand why the Canadian government has had trouble solving this issue?
The problem of the opioid crisis started in the early 1980s when the selling of synthetic opioids to hospitals and pharmacies for prescriptions across Canada increased by upwards of 3000%. In 2016, Canada became the second-largest consumer of prescription opioids in the world, right behind the USA. By 2008, nonmedical prescription opioid use was the fourth most prevalent form of substance use, after alcohol, tobacco and cannabis. It had become more common to misuse a prescription opioid than to use heroin or cocaine.
How do people get their hands on opioids? A couple of ways, some of which may surprise you. Just to name a few, there is sharing with family members, seeing two doctors for the same prescription, prescription fraud and forgery, street drug markets, thefts/robberies, and purchases online. In 2017, Health Canada discovered that nearly one-third of opioid users in the year the study was conducted did not always have a prescription.
Strategies and initiatives to counter the problem
Many public health strategies have since been introduced in the 1990s to reduce the consumption of opioids across Canada. The first is supervised consumption sites (SCS), which opened in 2003 in Vancouver. Since then, numerous SCSs have been introduced to communities across North America. The purpose of these sites is to provide an area where individuals with substance use disorders can safely consume substances, such as opioids, and there is help on-site in the case of overdoses, helping to prevent deaths or complications caused by overdose. A second strategy has been the introduction of naloxone, an opioid antagonist, to various facets within communities. Naloxone is a medication used to treat opioid overdoses by reversing the effects of opioids on the body post-consumption. The effects of naloxone are delivered within 2 minutes. When I was completing my undergraduate degree at the University of Waterloo, I participated in a workshop by the UW Naloxone Advocacy Group to receive training and certification in providing naloxone in suspected cases of overdose. Various groups around Queen's have organized similar workshops and distributions of naloxone for students to become familiar with and have with them in case they run into anyone they suspect may be overdosing. In 2021, Camille Bains published an article with CBC communicating that more than one in four deaths among young people in Canada were opioid-related in the recent year of 2021.
Thirdly, many pharmacies also provide methadone, an opioid agonist, which functions to suppress opioid withdrawal. This substance is often provided in combination with juices, masking the bitter taste of the substance as well as discouraging injection of the substance, which may lead to opioid-like effects including overdose.
It is worth noting that despite public health interventions, the opioid crisis exists. In 2021, a study by Friesen et al. reported that in the first year of the COVID-19 pandemic, emergency medical services related to opioid use increased by 57%. Opioid overdoses across all age groups increased by 60%. On top of the surge in usage over the pandemic, persons using substances often face stigma from society in various forms, leading to unequal treatment of individuals with substance use disorders, and reducing their ability to recover from their use.
Often, social stigma results from the belief that those with substance use disorders have them because of a lack of willpower or moral flaws. This leads to discrimination and social exclusion of these individuals. In reality, addiction to opioid drugs is a highly complex disease, and willpower and good intentions are often not enough to escape from the harms of the disorder. There are also healthcare barriers, in which judgmental attitudes and resulting inadequate care incorrectly address individuals with substance use disorders as having an addiction rather than a chronic health condition. Therefore, even when seeking help, individuals with substance use disorders do not receive the appropriate care to address their disorder. These barriers often lead to continued use of opioids. The social stigma against use can lead to reduced function of the individuals, often leading to unemployment and exile from family and friend support groups, culminating in homelessness. Without a home, there is increased exposure to threats to health, and reduced access to avenues to receive health care.
As discussed it is important to understand how the issue of opioid use across Canada began, proliferates, and is neglected by various social barriers. We can look to reduce stigma and discrimination, address these issues and find solutions within our community to better provide social and health care to individuals with substance use disorders, which may also lead us to a safer and more productive society.
References:
https://wdgpublichealth.ca/your-health/opioids-and-naloxone/local-opioid-resources
https://www.canada.ca/en/health-canada/services/opioids/naloxone.html
https://www.canada.ca/en/health-canada/services/opioids/stigma.html
https://www.cbc.ca/news/health/opioid-young-people-1.7174098
https://healthsci.queensu.ca/opdes/cpd/educational-programs-opportunities/OpioidCrisis
https://www.instagram.com/queensustudentwellness/p/DBfQKjjxxju/?img_index=2
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