Dr. Patricia Caddy: We have all been wounded by B.C.'s overdose crisis. Deepening community divides is not the answer

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Last week, without warning and without fanfare, the provincial government mandated the removal of a vending machine that had stood outside of the emergency department of Nanaimo Regional General Hospital. A vehicle came in the early morning hours, and workers whisked the machine away.

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That machine, the “harm reduction kiosk,” had just become the subject of a viral video created by an MLA candidate. In the video, the candidate says, “Let’s go get a free crack pipe and cocaine smoking kit.” She shows that a video was available that provided information on how to reduce disease risk when snorting cocaine. She concludes the video by showing the variety of safer-use kits she was able to obtain, and comments that the crack pipes were out of stock because they can be “traded for drugs” (which in itself is debatable, as drugs cost money and the pipes were free).

The machine helped people avoid catching communicable diseases or giving themselves infections when using drugs. After all, we know people are using drugs; six to seven people in B.C. are dying daily from drug use. And there is clear, longstanding evidence that access to clean pipes and needles reduces rates of HIV and hepatitis C in the communities where they are provided. These diseases, once in a community, can be passed to people who do not use drugs, too. The machine dispensed condoms and gave information on safer sex practices. It dispensed testing kits to check for the presence of fentanyl. And the only drug it dispensed was naloxone, to reverse an opioid overdose. Everything in the machine was free. Ironically, before the video, many people did not even know it existed.

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The comment section below this video is a storm of outrage, disgust, grief, and hate — as comment sections often are. But it represents the most outspoken facet of a much deeper feeling. Our collective, deep, and gut-rending fear.

The fear that our communities are dying in the midst of an unregulated drug crisis.

The fear that our children will fall victim to despair, poverty, addiction, and death.

The fear that we are not doing enough, or not doing the right things, to prevent our own collective spiral downward into darkness.

The fear that no one knows what we should do.

By now we have all, in some way, been wounded by the overdose crisis that is ongoing in B.C. and beyond. I am a mother. People I love are among the dead. I am afraid of where all this is going, too.

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But I am also a doctor who works with people who use substances. I grew up in a “just say no” household. I drink caffeine daily, alcohol rarely, and I’ve never used any other drugs. But I have interviewed thousands of people, from all walks of life, who do use drugs and struggle with that in one way or another. Some of my patients and former patients are living lives of total abstinence now. Some have died. And the majority are living in between, still walking their own journeys. If there is anything I have learned in this work, it is this: If screaming at one another about our pain and sorrow, our grief, our fears, and our hate was going to work, it would have worked by now. Just like our drug policies.

I have never been convinced of anything because someone yelled it at me, and I suspect you never have either. We must reach across aisles. We must, in good faith, talk to the people who disagree with us. We must seek to understand, not to convince.

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Just like there is research to back harm reduction measures, research has been done on what keeps communities healthy, and what lowers kids’ risk of developing addiction. The answer is not: Keep screaming at each other. Escalate the hate. Deepen our community divides.  Youth who are housed, fed, safe from abuse and neglect, and armed with the facts they need to make good choices about what they put into their bodies are less likely to develop addiction. Communities of people who feel seen, heard, and empowered to respectfully voice disagreement with one another without fear of mockery or scorn are stronger, more peaceful, and more resilient.

When governments do not hold themselves accountable to these basic terms of civility, ethics, and evidence, then it falls on citizens to do so — election year, and every year. I am interested in hearing from and voting for candidates who care about evidence more than rhetoric. I am interested in parties that foreground problem-solving over outrage on social media.

Dr. Patricia Caddy is a family medicine and addiction medicine physician from Snuneymuxw (Nanaimo).

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