‘Human beings have always used substances’: Overdose Awareness Day aims to end overdose

International Overdose Awareness Day is marked on August 31 around the world, with an aim to end overdose, remember those lost and acknowledge the grief of family and friends.

The campaign also promotes the de-stigmatization of drug use, which advocates say is at the heart of harm reduction philosophies.

“Human beings have always used substances either to relax, to enlighten themselves, to party, to toast around dinner. It’s the stigmatization that prevents people from talking about their substance use, seeking help where they need it,” says Colin Johnson, co-chair of Toronto Harm Reduction Alliance (THRA).

He says drug use is far more common than most people realize and a way of life for many.

“The majority of people who use drugs don’t have issues with the authorities, they’re not impacted by the paramedics or the medical system,” he says. “People who use drugs are just like everybody else. You don’t know who they are in many cases — they’re your brothers, your sisters, your fathers, your uncles.”

Johnson says often, those who do come in contact with authorities due to their drug use are also impacted by the lack of a myriad of other social determinants of health like housing, education and job prospects — each of which also need to be dealt with on a societal level.

When it comes to managing drug use, Johnson says there are four pillars: prevention, treatment, harm reduction, and enforcement.

“Most of the money goes to the police, it goes to arresting people, it goes to putting people in jail. What actually goes to harm reduction is less than a fifth of what’s actually given to enforcement. And similar numbers for prevention, and similar numbers for treatment,” he says.

“There are times when enforcement is going to be necessary, there’s no doubt about that. However, if we start putting more money into harm reduction, then you start getting people educated.”

Johnson says education about safely consuming drugs and facilities where people can do so makes overdose both preventable and manageable.

Toronto currently has nine safe consumption sites where people can use drugs in a safe and supervised environment, with help on hand in case of any adverse effects or overdose.

Councillor Chris Moise, chair of the Toronto Board of Health, says more of these types of facilities are needed province-wide.

“People need to go to a safe consumption site where they live, be it in Mississauga, be it in Brampton, not only in Toronto,” he says, acknowledging that such sites are not always welcomed by area residents, but necessary nonetheless.

“When we have safe consumption sites, it also reduces contamination — be it HIV or Hep C and all the things that affect people’s lives in other ways.”

Safe consumption sites and harm reduction must be part of a larger strategy to de-stigmatize drug use, and a critical part of that strategy is making drugs legal, adds Johnson.

“Criminalization is what puts people in jail. It messes up lives, families … it also disproportionately affects specific groups i.e. the African Caribbean, Black and the 2SLGBTQ+ community,” he says.

“There is no proof that criminalization actually prevents substance use. America alone has wasted something like a trillion dollars on the so-called war on drugs. Canada – I think it’s something like $500 million that we spend. It’s not going to go away.”

Moise agrees that drug use is a health issue, not a criminal one.

“I’ve reached out to the federal government to make sure that we [express the] need to decriminalize drug use,” he tells CityNews.

“This is now a pilot project in Vancouver, and so we’ve asked for a Toronto-centered approach as well. We’ve actually submitted the second application to the federal government so that we could actually start that process happening.”

He hopes to have a response by early 2024 to implement the pilot program in Toronto.

Johnson adds decriminalization will help create what’s called a “safe supply,” saying that part of the reason why opioid toxicity deaths have doubled since 2019 is due to adulterated drugs, making it difficult to judge their effects.

“One of the reasons why people are overdosing is because of a contaminated drug supply. What I mean by that is you can go to any bar anywhere in the world and you can order scotch — it’s going to be the same, it’s going to be 40 per cent [alcohol by volume],” he says.

“The supply of drugs – we are seeing fentanyl, it’s being mixed with benzodiazepines, all sorts of things. Nobody can plan what their usage is going to be — so that’s why we are having these overdoses.”

He says if currently illegal drugs are legalized, the drug supply would be safer and there would be fewer overdoses.

“The government would purchase the substances just like they do liquor. You’d go into a store, you know what you are ordering, you can look at the quantity, where it came from … you know what you’re getting. You know how your body deals with that,” he says.

In the absence of immediate legislative changes, both Johnson and Moise say understanding and compassion must be at the forefront of addressing the ongoing overdose crisis.

“Just remember that it could be any one of us that falls through the cracks — it could be your sibling, your parent, an uncle, anyone,” says Moise. “Just be supportive of those who need the support in a non-judgmental way.”

“Thirty-six thousand people overdosed between 2016 and 2023. Those are numbers. But for each one of those numbers, it’s a friend, a family member — it’s somebody, it’s a human being,” says Johnson.

‘Noise against overdose death’

To further these conversations on Overdose Awareness Day, cultural worker Steff Juniper organized a pay-what-you-can benefit concert called ‘Noise Against Overdose Death,’ featuring local noise-core bands at a small, private venue.

“We chose this cause because we feel that while mental health is often talked about, addiction is really pushed aside … I just think it’s something that really needs to be addressed in terms of how we talk about drug use,” they say, reiterating that the stigma surrounding it is a contributor to overdose.

“It creates shame and people use alone. People are less likely to call out for help when there’s an overdose. Whether that means call 9-1-1, call a friend, check on people on the street,” they say.

“So this stigma itself is what is part of the deaths. Overdose happens. It’s really important for us to talk about it as just a thing that can happen and something that can also be prevented [and reversed].”

Proceeds from the concert will go to Toronto Indigenous Harm Reduction.

“They’re helping our most vulnerable members of our community in Toronto on the front lines,” they say.