She’s lost two brothers to opioids. Amid record deaths, she and others are pleading for change

The night before Dawn Girard's brother Michael died from an opioid overdose, they stayed up all night talking.

She had picked him up at a hospital where he was recovering from another overdose and took him back to her place in Brantford for some comfort and a meal. As they chatted into the early hours, she promised him she would never stop advocating for drug users. It was the last conversation they would ever have.

Girard has lost two brothers in three years to opioids. After her brother Harold died in 2017, she joined the Brantford Substance Users Network, a group that supports drug users and advocates for policy that treats drug use as a public health issue, not just a matter of law or morals.

Final official numbers aren't in but a recent public health report projected that 2,271 people - a 50 per cent jump from 2019 - would die last year from opioid overdoses in Ontario. Girard's brother Michael was one of them.

While the world has focused on COVID-19, Canada's opioid overdose crisis has worsened in its shadow. Public health measures such as border closures, physical distancing and lockdowns were accompanied by a dramatic spike in opioid overdoses across the country, most notably in Ontario, B.C. and Alberta.

This April will mark five years since British Columbia, the province hardest hit by the opioid crisis, first declared the rising tide of deaths a public health emergency. Since January 2016, more than 17,602 people have died from opioid overdoses in Canada. Just between April and June last year, 1,628 lives were lost to opioids - Canada's deadliest quarter on record. Advocates say Canada needs to do more to protect drug users from a toxic drug supply and crushing stigma that costs lives.

There has just not been the emergency response or urgent response that is required if we are to turn the tide on the deaths," says Donald MacPherson, director of the Canadian Drug Policy Coalition. He says Canada is still treating drug use as a criminal rather than a health issue, and implementing policy that does more harm than good.

Nick Boyce, director of the Ontario Harm Reduction Network, shares MacPherson's frustration. It's just becoming so apparent - and it's so tiring - that all levels of government are not listening to people who use drugs and frontline harm reduction workers about what we have to do to put a stop to this."

The spike in overdose deaths is driven by a drug toxicity crisis made even worse by COVID-19. Border restrictions have disrupted the flow of illicit drugs, further contaminating the already-dangerous drug supply and putting drug users at greater risk of overdosing. In Ontario fentanyl, a highly potent synthetic opioid often laced into to other drugs, was found in 87.2 per cent of opioid-related deaths during the pandemic, compared to 79.2 per cent pre-pandemic.

The effects of contaminated street drugs are compounded by the reality that most drug users are overdosing alone. Because of physical distancing requirements during the pandemic, drug users are more frequently taking unreliable drugs alone when no one is there to call emergency services or administer naloxone, the antidote to opioid overdose.

COVID-19 has also made it harder for drug users to access harm reduction services and treatments. Toronto's busiest safe injection site, the Works, closed for a month early in the pandemic. Post-mortem toxicology reports in Ontario show use of methadone - a treatment for opioid dependence - dropped from 13.3 per cent to 9.2 per cent during the pandemic, suggesting drug users may have challenges accessing prescriptions.

We know the impacts of the COVID-19 outbreak have been challenging for many people and families across Ontario, especially among those living with mental health and addictions challenges," Ontario Health Ministry spokesperson David Jensen wrote in statement to the Star.

The province referenced its Roadmap to Wellness" plan, a $3.8-billion, 10-year investment in support for mental health and addictions, introduced in early March. The plan includes $31.3 million in funding for as many as 21 supervised injection sites (The government has capped the number of supervised injection sites in the province at 21, a limit critics say harms drug users.)

While provinces can mitigate the toll of the crisis by offering harm-reductions services, treatments and social supports, advocates say these are Band-Aid" fixes, and the elephant in the room" is Canada's federal drug policy, which continues to criminalize drug users.

Harm reduction advocates, public health officials (including Toronto's Eileen de Villa) and Canadian police chiefs have all called on Ottawa to follow jurisdictions such as Portugal and, just recently, the U.S. state of Oregon, and decriminalize all drugs for personal possession. Experts say lifting criminal sanctions for small drug offences will encourage people to seek help and reduce the stigma that pushes drug users underground, where they are at increased risk of overdosing. In November, Vancouver voted to seek an exemption from federal drug laws to decriminalize the personal possession of all illicit substances - the first city in Canada to make such a request.

Critics of decriminalization warn it could increase drug use by removing a key deterrent: criminal sanctions. Prime Minister Trudeau has repeatedly said he will not decriminalize, and Ontario Premier Doug Ford has vehemently opposed a harm-reduction approach to drug use, cutting funding for safe injection sites. We need to put more money, more support into addiction (support) ... not encourage people to do more cocaine, more heroin," he said in a November press conference.

Because of drug prohibition, Boyce says, We view people (who use drugs) as bad people doing illegal things. That shapes our values, the attitudes, the language that we use and our approach to it. People have grown up with this idea that if you do drugs, you're a bad person, and you should be punished for it and go to jail, or that you have to stop using all drugs. ... We know that a lot of that stuff does not work and if anything, it actually makes things worse."

Girard says the social prejudice against drug users meant her brothers suffered in silence."

A lot of people turned their backs on my brothers because they used."

Being involved with the Brantford Substance Users Network changed Girard's perspective on drugs, which have taken so much from her. Rather than demonizing drug use, she says, we need to focus on keeping drug users safe by offering a low-barrier safe supply of illicit drugs.

Tackling this crisis will require both immediate solutions, such as safe supply, and longer-term efforts to reshape Canada's approach to drugs, MacPherson says. Ottawa's swift and expansive response to COVID-19 shows that with political will, big interventions are possible.

We're watching quite an amazing public health response unfold with regard to the coronavirus and we're not seeing very much of a public health response in terms of something that's taking the lives of a significant number of Canadians."

Girard says many dismiss the deaths of drug users. But as the toll of the opioid crisis grows, she doesn't want her brothers reduced to statistics.

Michael Saddler, who died last March, was a go-getter" who dreamed of owning his own business one day. He had two sons, whom he lived and breathed for." He was big on teaching his boys that it was OK to cry and it was OK to express your feelings."

Harold Saddler, who died in August 2017, was a father and comedian with an infectious smile" who lit up any room." He was the one that I would turn to," Girard says, He wore his heart on his sleeve."

Lex Harvey is a Toronto-based newsletter producer for the Star and author of the First Up newsletter. Follow her on Twitter: @lexharvs