Despite soaring death rate from opioids, Alberta steers away from harm-reduction approach

Vee Duncan relapsed a few weeks ago.

They had managed to stay away from opioids for a year and a half, but the disease of addiction reset that calendar. They know it's not a moral lapse or failure on their part — addiction is complex, and most people's journeys don't follow a straight line.

Duncan, a two-spirit Secwepemc outreach worker who runs a non-profit group called Nék̓em, has grappled with addiction since being prescribed Vicodin as a high school athlete.

"I really like how I felt from Vicodin, and it progressed into harder drugs and street drugs," they say. "I was often on the streets up until five years ago."

When Duncan relapsed most recently, they were glad to have access to pharmaceutical-grade opioids. They don't want to use drugs and, after seeing many friends and acquaintances die recently, they know the risks posed by the adulterated drugs on the street.

Duncan worries what might happen if they relapse again and a safe supply is unavailable to them.

"The pharmaceutical route is safer because I know where it's coming from," says Duncan. "I know that it's not put together in someone's basement in the bathtub."

Thousands of Canadians continue to die from drug poisoning each year, with more than 20 lives lost each day, on average.

Researchers and front-line workers prefer the term "drug poisoning" to "overdoses," in part because of the nature of the crisis: with an unregulated and adulterated supply, people can't know the true strength of the drugs they take, or what's really in them.

"Our [opioid] prescribing levels are way down and yet our deaths are way up," says Elaine Hyshka, an associate professor at the University of Alberta's School of Public Health.

"That to me is very strongly indicative of how it's really that the supply has changed, and not that all of a sudden we have way more people using drugs. It's just that the supply is fundamentally more dangerous."

In other words, it's not an addiction crisis; it's a toxic drug-supply crisis.

Alberta and British Columbia are the hardest-hit provinces in terms of accidental opioid deaths per capita. B.C.'s approach to the crisis includes some harm reduction and a decriminalization pilot, though many observers say neither goes far enough to have real impact.