‘Ottawa’ Egan: Four Fallacies about Fentanyl and its Phantom Fix
One thing is becoming clear about the city’s opioid crisis: nobody has any easy answers.
As a consequence, we’re madly off in all directions, clinging to false hope, such as:
- All we need is more youth treatment centres.
Not really. The terrifying thing about the two latest high-profile deaths is that we’re likely not dealing with addicts, or even addiction. These were, evidently, young people experimenting with drugs, or only occasional users of pills.
How do 100 or 1,000 more treatment beds help a Teslin Russell, the promising 18-year-old who tragically died of an overdose Dec. 31, apparently the victim of “one bad pill”? There is no evidence, according to the account from her parents, of a pattern of drug use, let alone addiction.
And this is what makes fentanyl, in particular, so worrisome. Kids don’t become alcoholics with one drink, but they can die after one pill, 100 times more potent than heroin.
Similarly, was Chloe Kotval, who died at age 14 on Feb. 14, a candidate for a residential treatment centre, or the victim of youthful misjudgment and terrible luck?
Also, the snap response — “throw them in treatment” — sounds great in theory but, in practice, doesn’t work. The user has to be ready for help. So often, they aren’t. So often, they have to wait. So often, they relapse.
The Dave Smith Youth Treatment Centre has 24 beds, programs that run 45 to 90 days, and wait times that are weeks, if not months. Executive director Mike Beauchesne calls the whole sector “chronically underfunded” and says the number of addicts actually asking for help is as low as 10 per cent. So yes, more beds, but beds aren’t the whole solution.
“There’s no quick fix,” agreed Marion Wright, executive director of Rideauwood Addiction and Family Services. “The only piece that’s really changed is that things have gone from bad to deadly very quickly.”
- It’s a terrible problem from China we can stop at the border or the dealer’s den.
Not really. On the whole, Canada is awash in legally prescribed opioids, one of the highest prescription rates in the world. Should we be surprised that lethal, counterfeit pills can so easily knit their way into the existing fabric of pharmaceuticals that fill suburban medicine cabinets?
This, says Beauchesne, is how the problem manifests itself at the doorstep of Dave Smith: “(We’ve seen) the gradual increase in the number of kids reporting using opioids from their own prescription cabinets, their parents’ cabinets or of their peers.”
Indeed, opioid pain relievers are used by roughly 15 per cent of the population (even higher among seniors), down from 22 per cent in 2008. The Centre for Addiction and Mental Health in Toronto reported that 37 per cent of those seeking help were hooked on opioids from physician prescriptions. At Dave Smith, 31 per cent of clients (aged 13 to 21) reported at least weekly opioid use.
And underground? Internet-ordered ingredients, basement cooks, quantities so small they evade detection at borders. We shouldn’t count on the “war on drugs” to keep bootleg opioid off the streets. When did it ever work?
- Naloxone is the answer.
Not really. Obviously, it’s a critical tool for first responders and anyone who is a regular drug user and in danger of an overdose. But can we realistically expect there would be so much of the antidote available, at all the right times and places, to save anyone in danger? (We don’t even have naloxone in high schools.)
And what of young people who aren’t overdosing? Is not the greater worry for the legion of young people spending their days wasted?
- The schools are the problem.
Not true. Wright says counsellors from Rideauwood spend at least 14 hours a week in every English high school in Ottawa, a program stitched together with those exiting the Dave Smith centre. This on top of whatever awareness is spread through the regular curriculum and guidance systems.
Just this week, Wright and others in the addictions sector spoke to roughly 100 principals at a city-wide meeting. The goal is for a co-ordinated message from those third-parties regularly in the classroom: Rideauwood, Ottawa police, Ottawa public health.
She believes early intervention at the school level, more peer-to-peer help, the right parenting, and constant messaging and education are our best hopes at battling the crisis. She attended a meeting in Kanata this week where many parties, politicians and agency heads turned up to offer support to parents worried about the unknowns or themselves in the centre of an addictions storm.
“It must have been extremely unsatisfying for parents,” she said. Why? Did we not have all the experts in one place?
“Because they didn’t get any answers.”
To contact Kelly Egan, please call 613-726-5896 or email firstname.lastname@example.org