Everyday is International Overdose Awareness Day

Preventing overdose deaths

As mentioned in the title, for those who have lost loved ones to what we are now rightly calling the “toxic drug poisoning crisis,” the day of remembering is every day.

The daily grief that families carry is unimaginable. The most intense part of that grief is that this crisis can be resolved, but it seems like no one is listening.

Here is my take as a retired mental health and substance use clinician and now advocate for drug policy change.

The answer to the toxic drug poisoning crisis is not treatment as we understand it. It is harm reduction which must include the repeal of prohibition on the remaining substances that are considered illegal and to regulate the safe supply and distribution of said drugs.

Treatment as it is currently envisioned and structured is a separate issue and is designed for people who are needing, ready and able to make changes to their substance use. And harm reduction needs to be included throughout the treatment process as part of relapse prevention. Thus, harm reduction is actually a part of the treatment process.

Again it is the lack of harm reduction and its principals that contributes to toxic drug deaths. This is true among too many current treatment programs as they continue to practice treatment models that are very limited in scope. Thankfully many programs are beginning to recognize this lack of current best practices. However, treatment as we think we know it is not appropriate for everyone.

We do not require treatment for the legal distribution and use of alcohol, tobacco, caffeine and cannabis because the majority of people who use those substances use them recreationally. Other, just as dangerous, substances are prescribed and monitored. People don't typically die from overdose of substances that aren't prohibited because the supply is regulated and safe and because harm reduction principals are practiced from the distributors through the legal and medical systems and the individual. So the majority of Canadians do not suffer from substance use disorder, particularly from substances that are currently legal.

If people do progress to develop substance use disorders, then treatment should be accessible, evidence-based and monitored.

There is a mountain of evidence building that indicates the issues surrounding substance use disorder are based in the prohibition of these substances. As with the prohibition of alcohol in the early 20th century, crime has increased, substance use has increased, substance use disorder has increased and what we view as overdose deaths have increased.

The increase of deaths with the prohibition of alcohol, and the increase of deaths associated with overdose are very much alike and primarily due to what happens when substances are prohibited in a society.

To make a long story short, the “product” becomes more powerful when unregulated so as to maintain an increasing demand for that product.

So people are not really dying of overdoses, they are dying because the product is increasingly toxic. There are no labels indicating the level of medicinal or intoxicating ingredients such as there is now with alcohol. And most importantly, we are finding that many of the people who are “overdosing” are not necessarily “addicted”.

The repeal of prohibition will end the war on drugs, thus end the war on people who use drugs. Treatment should not be a mandated condition to the repeal of prohibition. It should be an informed, encouraged and easily accessible option for those who need it.

In the meantime, while we talk and debate and talk and debate, people are dying. Some of those people were struggling with substance dependence disorders, some were just kids experimenting and others were grieving the loss of their jobs or coping with overwhelming stress for various reasons. And families are endlessly grieving the loss of their loved ones, overwhelmed with the knowledge that their deaths were preventable.
So, first and foremost, harm reduction is the strategy needed to end the massive fatality rate of toxic drug poisoning. Ending prohibition is the overall answer. Talk about further treatment models can co-exist with harm reduction and the end of prohibition because harm reduction is a crucial part of treatment.

Ben Goerner is a resident of Lake Country, a father, husband, musician and retired mental health and substance use clinician with 31 years of service in the field. He is a volunteer advocate and a writer, focussing on drug policy and substance use treatment policy change.

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