Stigma kills, just as assuredly as a loaded gun wielded by an unthinking or malicious person. Can our approach to drug use hurt others? You bet it can!
Let me tell you a story — Vince’s story (not his real name) — about how people and their judgement of him and his mental health and drug dependence contributed to a catastrophic outcome . The tears shed by friends and family because of the undeserved judgement and stigma placed on people with drug dependence could fill an ocean.
When I met him, Vince was struggling profoundly with opiate dependence and a mental health disorder. His story tells us how living in a safe and comfortable space is paramount to recovery and life. It also helps show us that treating drug dependence as a behaviour, a choice and a crime has devastating consequences.
At one time Vince had everything — a lucrative job, a good relationship and a son. For many reasons, including unstable employment, a severe and unchecked mental health issue, and a violent, traumatic history, Vince ended up losing everything as he fell further into opiate addiction and mental illness.
Vince was referred to me, an addictions counsellor, by staff from the supportive housing where he lived. Staff complained that they were finding drug paraphernalia in his room. They were sincerely worried about him. However, their policy was zero tolerance of any substance use or paraphernalia, with violations resulting in immediate eviction. Rather than evicting him though, staff sought help for Vince.
Vince’s main goal was to reconnect with his son, and to maintain his housing. His substance use and unpredictable emotions were barriers in his relationships. Our main strategy was to work on his IV opiate dependence while developing healthier coping skills.
We focused on his love for his son. Motivation is the foundation of recovery and there is no greater motivation than love, in my opinion. Vince had no shortage of that. When he was well and stable, his love was overflowing.
Vince enrolled in a methadone program and eventually, his IV drug use ceased. Vince was given supervised visits with his son and got a part-time job. His enthusiasm and passion for life was growing in leaps and bounds until …
I don’t know what triggered Vince’s return to drug use. It was likely being laid off of work and the slow pace of progress with visitation with his son. Vince defaulted to his old familiar ways of dealing with his circumstances. He overdosed in his suite. (Overdose often coincides with a return to drug use.)
That was not the end. Staff found him on time, and Vince spent a few days in hospital. When he arrived back at his suite, the eviction letter was waiting for him. Vince was extremely upset and started to push everyone away. He lost his visits with his son. He ended up homeless and in our community’s shelter before he was able to find a small place with a roommate.
About four months after his eviction, Vince was found unresponsive by his roommate. This time, he did not make it. Vince fell victim to the poisoning of the illicit supply of heroin. He would never again see his son, nor would his son have the chance to have a dad. His family and his roommate were devastated. I was devastated.
The poisoned drug supply has claimed well over 25,000 deaths in Canada since 2016, when BC declared the opioid crisis a public health emergency. Thankfully, one response has been a change in policy at some supportive housing facilities. People have always used drugs in their rooms despite sanctions and consequences, often alone. They want to keep their use hidden, not only from the law but from the stigma and judgment of others. Unfortunately, this turned into one of the most dangerous practices possible for substance users – 84% of toxic drug deaths last year occurred within private residences.
Now supportive housing facilities follow a harm reduction approach. There is no longer a zero tolerance in most of the facilities. There is no longer a danger of losing housing as a result of using substances or having paraphernalia. Some buildings have safe consumption rooms where people will be monitored while using substances. There has been very little if any negative impact on communities. And people in these places, who now feel less stigmatized by sanctions and intolerance, have more opportunity to actively seek help when they are ready.
Imagine if this had been in place for Vince. His son might still have a father, despite his challenges. People like me could still be working with Vince and helping him stabilize his life. Stigma was a significant barrier to Vince getting the help he needed.
Many of the deaths that occur due to the poisoned drug supply can be prevented if we all saw drug dependence as a health issue, often in response to trauma. If we could only see the people first and not the drug dependence, we could save lives. Harm reduction works to save lives and preserve dignity and thus build confidence and motivation.
Let’s all try to follow this approach: Compassion, not punishment. Love, not hate.
Ben Goerner is a retired clinical counsellor of 30 years. He volunteers extensively with Moms Stop the Harm and the Kelowna Community Action Team. Special thanks to the Port Alberni Community Action Team for making this post available.