Quebec Elections: the CAQ's inaction on overdoses is costing lives
More people died of an opioid-related overdose last year than were killed in motor vehicle accidents. This government's silence is allowing the epidemic to get worse.
Josée had just returned from Christmas shopping when she heard a knock at the door.
It was two young police officers, standing nervously at the entrance of her home.
“You could tell they were struggling to get the words out,” said Josée. “At first I thought maybe we’d burned a stop sign while we were shopping but the longer it took for them to speak, the more worried we got. Then one of them said, ‘We have some bad news. We have some very bad news. It’s your son…’
“They still couldn’t bring themselves to say it. So I asked ‘Is he dead?’ They said ‘Yes.’ I froze.”
Just moments earlier Josée had put her son Gabriel’s Christmas gifts down on the living room table. She bought him a juicer and splurged on a new set of clothes. Now he was gone, the victim of a drug overdose.
Josée was one of about 100 in attendance in downtown Montreal Wednesday at a vigil commemorating those lost to the overdose epidemic. In the past three years, nearly 2,000 Quebecers died of an opioid-related overdose but the crisis hasn’t even been a blip on the radar during this election campaign.
And while the drug crisis is ignored by our political class, it’s all people like Josée can think about.
“He was always so curious, he would lose himself in the search of knowledge and I really admired that,” said Josée, whose 26-year-old son died last December. “He’d take up a lot of space at the dinner table, he had an energy that would fill a room, the kind of person who breathed life into a party. Yes, he used drugs and it worried us but when you hear about overdose deaths, you always assume it’s going to happen to someone else’s kid. But it can happen to anyone.”
More Quebecers died of an overdose last year (450) than in traffic accidents (387) and homicides (87). Not a single political leader bothered to show their solidarity with the mothers and families who gathered to mourn Wednesday.
Québec Solidaire spokesperson Manon Massé sent someone from her office and she’s been a tireless advocate for sensible drug policy. But she is a voice in the wilderness.
“The message from our government is pretty clear. If you use drugs and you die, you’re not a priority, your grieving family isn’t a priority, your life doesn't matter,” said Jean-François Mary, executive director of CACTUS Montreal, a community organization that helps keep drug users from overdosing.
Quebec’s drug supply became tainted with fentanyl early in the pandemic, when there was a brief interruption in the province’s usual heroin smuggling routes. When that happened, major suppliers began cutting their product with fentanyl to keep from running out. That caused a massive spike in fatal overdoses.
“I remember my dealer told me he was having the hardest time finding good dope,” said Cinthiam, a harm reduction worker and drug user who attended the vigil. “After that, it was never the same.”
Quebec saw a 30 per cent increase in opioid-related deaths in the first year of the pandemic. Faced with a public health crisis that killed 571 people in 12 months, Coalition Avenir Québec chose not to allocate any new money to fight overdoses.
By comparison, the CAQ says it’s ready to pour an extra $250 million into the Montreal police’s budget to fight a rise in homicides on the island. Of course, it’s tragic that 36 people were murdered in Montreal last year. But the city already has more police per capita than any other police force in Canada and the homicide rate in Montreal — roughly 1 per 100,000 residents — is half the national average.
What’s equally concerning: the CAQ’s promise to add 450 more cops to the force might actually make the overdose crisis worse, according to Mary and a half-dozen street workers who spoke to The Rover.
“If you put more police on the streets, they’ll just make more drug arrests and push drug users further into the margins,” Mary said. “When people are too scared to use opioids at a safe-injection clinic, when they choose instead to use it alone, their risk of dying increases dramatically.
“Whenever there’s a big drug bust, the supply gets cut with more fentanyl and more people die. That happened earlier this year, there was a massive takedown of drug suppliers in Montreal. After that, we saw 52 people died of an overdose in March. That’s unprecedented.”
The solutions to Quebec’s opioid crisis are plainly obvious.
Give people a safe supply of drugs and a safe place to use and they’ll stop dying in such great numbers. Yes, it’s certainly not ideal that people use opioids. But drug prohibition has only exacerbated the problem.
Look at a place like CACTUS Montreal, for example. About 60 to 75 people use CACTUS’ safe-injection site every day. That’s almost 25,000 instances of people injecting dangerous opioids into themselves every year. Do you know how many of them have died while using the service? Zero.
“We see people overdose every day but because they’re surrounded by medical staff, they can be saved,” said Mary. “But there’s only a handful of safe-injection sites in Montreal and almost none outside the island. We know they save lives but it’s clearly not a priority.”
In fact, there has never been a fatal overdose at any of Quebec’s safe-injection sites. Still, almost all of then struggle to keep their doors open because there’s little funding, in Quebec’s budget, for harm reduction.
But a safe place to use is only a part of the solution. Increasingly, experts point to drug checking as a way to make sure users don’t unwittingly inject poison into their bodies. Christina Kiriluk is the coordinator of Checkpoint, a service that uses lab equipment to test people’s dope for contaminants.
But she says it’s much more than that.
“We take the time to discuss people’s consumption habits, we take a list of the prescription drugs they use to make sure there’s no additional risks, we treat them like people,” said Kiriluk. “People don’t usually have a place they can go where they can be open about their drug use. But we’ve found that if they feel safe, if they feel like they can be honest, they can open up about their traumas and the root cause of their drug use. That’s a much more productive discussion than just casting people into the shadows.”
In the past seven months, Checkpoint has helped about 500 people use drugs in a safer way. But they only have enough funding to be open 32 hours a week. And they’re one of just two permanent drug testing sites in Montreal.
There are signs of progress in the province. Pharmacies across Quebec are now legally required to carry the life saving drug Naloxone and hand it out free of charge. In addition, more first responders are being trained to use Naloxone and intervene during an overdose.
Another positive: drug deaths haven’t yet overwhelmed our system as they have in British Columbia and other parts of the country. Some 4.6 people per 100,000 die of an opioid-related overdose in Quebec compared to 46 per 100,000 in B.C. For years, Quebec had been spared the worst of the crisis because our ports had access to a steady supply of heroin from Mexico and overseas.
The arrival of fentanyl in the drug market has changed that reality and, as a result, Quebec’s opioid death rate will likely keep rising.
“Once you’ve started using fentanyl, you can’t go back to heroin,” said Cinthia. “Fentanyl is so much stronger that your body develops an immunity to regular dope. But because the supply is so inconsistent, it’s really hard to know how you should dose it.
“Picture dope cut with fentanyl like a batch of chocolate chip cookies. The chips aren’t distributed evenly. One cookie might be bursting with chocolate while the other has like two chips. Unless you test those drugs, you can’t know exactly what’s going into your body and most people don’t have access to testing.
“I live in Villeray (Montreal’s north end) and we don’t have access to 24 hour services for harm reduction. And when you use drugs, you’re not exactly operating on a 9 to 5. You might have something awful happen to you and you need to use. But without a safe place and a safe supply, you’re on your own.”
Cinthia is one of the rare habitual users who hasn’t OD’d. She uses home testing kits, she calls a friend before using and she tries, as much as possible, to never use alone.
“In a perfect world, no one would use these drugs but that’s not the world we live in,” Cinthia said. “The way it works now is, if you want to quit, you need a good doctor, a good pharmacist and a good plan. Those are hard to find. Have you ever stood in line at the pharmacy, going through withdrawal, sweating and trying not to puke while you wait for a small dose of methadone? It’s fucking dehumanizing.”
Ultimately, the easiest way to stop overdose deaths is by ensuring a safe supply of drugs. Two years ago, when the crisis took off, Québec Solidaire tabled a motion in the National Assembly to decriminalize possession of narcotics like fentanyl. It was rejected by the CAQ. That’s despite a growing body of research that shows decriminalization and increased testing leads to fewer deaths.
Of course, that sort of thing doesn’t play well with the CAQ’s base.
At first, Josée wasn’t sure who she could talk to about losing her son.
It’s not easy to deal with the stigma of having lost your kid to drugs. So, far too often, people like Josée grieve alone. Events like Wednesday’s memorial help.
“It’s good to know there are others like us,” she said. “Because, when it first happened, it’s so hard to have to explain yourself, to have to justify your grief. Yeah, my son died because of drugs but that doesn’t mean he wasn’t a good kid. It doesn’t mean he wasn’t a person who deserved to be treated with dignity.”
Just then, her eyes began to well and Josée put on a pair of sunglasses to keep herself from bawling. Gabriel was her son, she carried him inside her womb and rocked him back to sleep when he’d wake up at night. She put band-aids on scraped knees and watch the joy in his face when he’d tear through his presents on Christmas morning.
He was her boy, he was her world and now she can only see him in fading memories.
Just then, I thought about my own daughter and what would happen if she ever went down the same path as Gabriel. Would anyone in this government care if she died? Would they bother showing a trace of solidarity with her or would they take the easy way out and do nothing?
I still have hope that, one day, this government will be there for people like Josée and Gabriel. But for now, their lives aren’t a priority.
A note about the elections…
Nora Loreto and I will be hosting a twice-weekly call-in show on Twitter throughout the campaign. Wednesday’s episode featured interviews with Québec Solidaire candidate Maïtée Saganash and policing expert Ted Rutland. You can listen to it here.
Today’s show will feature Quebec City mayoral candidate Jackie Smith and our very own ambulance guru Hal Newman. You can tune in on your mobile phone or desktop.