The privatization of addiction: Regina’s drug crisis

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Contact the Aids Program South Saskatchewan for access to naloxone kits. Holly Funk

As deaths from toxicity and overdoses skyrocket, policy responses continue to tank

Margaret Thatcher, Prime Minister of the United Kingdom from 1979 until 1990, once famously quipped in an interview: “There’s no such thing as society. There are individual men and women and there are families.” Although her words have often been misinterpreted and taken out of context – I may be doing it right now – her words still reveal an erroneous and commonplace belief. Namely, the insidious lie that certain problems are individual, atomized, and disconnected from a larger and intelligible context. 

In particular, the problems of mental illness and drug addiction are considered, for the most part, individual problems. You’re depressed? Your brain chemistry must be out of sorts. You struggle with addiction? You have made bad decisions and developed a dangerous coping mechanism. 

Obviously, these are not adequate explanations for the causes of these problems. The causes of mental illness and substance use disorders can’t be located solely within individuals, families, or small social circles. Undeniably, these problems also have causes within a much larger formation: that thing called society, which certainly does exist. But if we misunderstand the causes, we have no hope of finding the solutions.

The late Marxist critic Mark Fisher identified a grave by-product of the pervasive deregulation and privatization of Western economies beginning in the 1980s – of which, politicians like Thatcher and Reagan were at the vanguard. This by-product is what he calls the “privatization of stress.” In his 2009 book Capitalist Realism: Is There No Alternative?, Fisher argues that the privatization of the economy also entails the privatization of social problems. 

Specifically, it entails the utter privatization of mental illness. Fisher writes, “Instead of accepting the vast privatization of stress that has taken place over the last thirty years, we need to ask: how has it become acceptable that so many people, and especially so many young people, are ill? The ‘mental health plague’ in capitalist societies would suggest that, instead of being the only social system that works, capitalism is inherently dysfunctional, and that the cost of it appearing to work is very high.” The same thing can be said about the proliferation of substance use disorders. When we individualize and privatize addiction, we imperil ourselves and, especially, those made most vulnerable in our society.

There is no question that mental illness, trauma, and substance use disorders are reinforcing and interconnecting problems. The Saskatchewan Health Authority (SHA) also understands the connection between mental illness and substance use disorder. On the SHA’s website, it states that the most common method of coping with depression and suicidal ideation is increased alcohol and/or drug use. Trauma, and especially childhood trauma, significantly increases the chance an individual will develop a substance use disorder. Homelessness is also demonstrated to seriously increase the chance of developing a substance use disorder. In 2018, the Canadian government found that, among unhoused people, “the proportion of individuals who reported addiction or substance use increases with time spent homeless, from 19.0 percent at 0-2 months to 28.2 percent for those who reported over 6 months of homelessness in the past year.” In 2015, unhoused people numbered about 232 in Regina. By the end of 2021, that number rose to 488. 

In Saskatchewan, the number of deaths by drug toxicity have grown inexorably over the past few years. In 2019, there were 179 deaths. In 2020, 322 deaths. And in 2021, that number rose to 376. As of July 4, 47 people have died of an overdose in Saskatchewan this year. The vast majority of these deaths are accidental. 

Accidental death by drug overdose is a dire problem in Saskatchewan, and especially in Regina. In 2021, 187 people died of overdoses in Regina, compared to 106 in Saskatoon – remember that Regina’s population is about 40,000 fewer than Saskatoon’s. Accidental overdoses also disproportionately affect Indigenous and Métis people. Out of the 294 people who died in 2021 by accidental overdose, 156 of them were Indigenous or Métis. Indigenous and Métis people accounted for 53% of accidental overdoses in Saskatchewan; these groups only make up about 16% of the province’s overall population according to Statistics Canada’s 2016 census.

Opioids are, by far, the drugs most likely to cause an accidental overdose. Specifically, the opioid drug fentanyl and its analogues: para-fluorofentanyl and acetyl fentanyl, among others. Since 2016, the number of accidental overdoses on these drugs in Saskatchewan has exploded. In 2016, fentanyl caused eight accidental overdoses. In 2021, it caused 252. There were no accidental overdoses of para-fluorofentanyl in 2016, but in 2021, there were 65. The same goes for acetyl fentanyl: in 2016, there were none; in 2021, 196.

The conclusions to be drawn from these grim numbers are numerous, but a few predominate: Regina, more so than any other Saskatchewan city, is in crisis; the drug supply is becoming increasingly unsafe with the introduction of fentanyl and its analogues; and, Indigenous and Métis people are being disproportionately affected by the crisis. The numbers are intolerable. That accidental overdoses affect Indigenous and Métis people so disproportionately bespeaks this province’s unceasing commitment to white supremacy. Each and every accidental overdose indicates a failure in policy, in stewardship, and – most importantly – our responsibility to one another. By definition, every single death by accidental overdose has been, is, and always will be preventable. 

Thankfully, there are people and organizations responding to this crisis. The Nēwo Yōtina Friendship Centre provides a safe consumption site near downtown Regina. The centre began operation in June 2021. Despite a slow start, more and more people are coming to the centre for supervised consumption. In June 2021, the centre saw fewer than 50 supervised consumptions. In February 2022, that number had risen to 224. The provincial government has provided the Friendship Centre an exemption to allow its operation, but this expires in September 2022. Beyond that, the future is uncertain for safe consumption sites in Regina.

What is certain is that safe consumption sites and other harm reduction programs work. With the proliferation of fentanyl, it is more imperative than ever that drugs are tested. Needles need to be used, exchanged, and discarded properly. People may need help or supervision while they consume in order to prevent fatal overdoses, and people need to be reminded that they are not alone, to have access to consistently available help. Addiction in Saskatchewan is not a private matter. It’s a public health crisis.

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