By ESG Analyst Anaelle De Serres
The Opioid Crisis in Montreal Across Minority Groups
Recently, there have been more and more tormenting videos that were posted on social media platforms showing an epidemic of drug addiction and overdose in Canadian cities such as Vancouver or Toronto. These videos depict homeless individuals that have been on the streets for years, with no apparent possibility of escaping addiction and poverty. Opioid-related drug abuse is a social issue that has had exponential growth in the past 5 to 10 years, and Montreal has not escaped its claws.
There has been a considerable increase of addiction to opioid-based drugs in Montreal that can be traced back to the pandemic. Indeed, before the COVID-19 pandemic, drugs were imported from other countries and sold on black markets in Montreal. Fentanyl has been on the market since 2014, but it did not have as big of an impact as seen today. With strict Canadian borders during the pandemic, drug supplies were almost impossible to get from foreign markets. The addicted individuals and dealers were left with no other choice than to turn to homemade mixtures of drugs that were often cut with much more dangerous substances, such as high doses of Fentanyl and carfentanil. A lot of the necessary information on how to create these dubious mixtures was available on the Internet, and the rise of cryptocurrencies made it easier for drug dealers to remain anonymous. It has become increasingly difficult to prepare correct dosages, thus leading to more overdoses. These synthetic opioids are hundreds of times more dangerous and addictive than more “common” drugs, such as heroin. For these reasons, the cases of addiction and overdoses grew at an unseen rate.
In Montreal, addiction is much more prevalent in minorities and marginalized ethnic groups. This issue stems from deeply-rooted stigmatization and can be traced back to colonialist mentalities. A vicious cycle can be seen across the various minorities affected by this issue; the lack of support and increased discrimination that an individual who uses drugs faces can make them turn to consuming even more. The racism towards Chinese people, for instance, was further emphasized by the immigration prohibition, during which the possession of opioids and any other type of drug was even more stigmatized. This ethnic group was more often targeted by police searches and enforcement, thus increasing their marginalization and isolation. Another minority that finds itself at the core of this issue in Montreal is the Autochtones community, some of whom live in remote communities in Northern territories that may not have sufficient infrastructure to support drug abuse, addiction or alcoholism. This problem has created intergenerational trauma, and families that move to Montreal may face exclusion from society. Indigenous people also account for 10% of overdose deaths, despite representing only 2.6% of the total population in Canada. Indigenous women are five times more likely to have fatal overdose than non-Indigenous women. Another minority that is more affected by this crisis is the LGBTQ+ community. This has been exemplified by the increasing amount of homeless addicts in the Village neighborhood, which has risen after a new shelter opened in that area. More and more cases of addiction are concentrated in that area, thus making residents feel threatened and making the neighborhood less popular, which has led to even more discrimination and homophobia.
What are NGOs doing to help this social crisis?
There are several not-for-profit groups that have dedicated their projects to helping with the opioid crisis. Indeed, many shelters have opened around the city of Montreal in the hope of limiting the amount of people outside, especially around winter time. There are also several rehabilitation centers, and a few of them offer their services free of charge. One facet of the issue highlighted by a trainer for overdose prevention is the stigma as addicts use alone in the streets with no support or supervision. For this reason, there are centers designed to limit drug harm and overdoses, including four supervised consumption sites that are run by both government and not-for-profit organizations. These facilities are designed to encourage users to access these centers to use drugs without stigmatization, and benefit from monitoring and intervention in case of overdose. These centers may also direct individuals towards other rehabilitation centers or other channels to help them overcome their addiction. Another type of center exists to test the drugs of individuals for free, which lowers the risk of consuming a mixture that is unknown or cut with more powerful drugs.
However, these centers experience many challenges due to the lack of support from the government. The organizations struggle to find locations to start operations, like the Maison benoit Labre site that is temporarily located next to an elementary school and is receiving backlash from worried parents that fear for the safety of their children. Moreover, shelters receives thousands of requests, and some only have around 40 beds, such as Vivalvi, a treatment center in Terrebonne. Finally, regardless of the $21million allocated funding from the federal budget to dealing with the opioid crisis, some centers have not yet received any funding, thus making the operations more difficult to run. Many of the workers in these organizations reflect on the urgency of creating new shelter spaces and increasing financial grants in order to have a measurable impact on this social issue.
Impact gap assessment: What is missing ?
The government has yet to allocate more funding to support the existing centers that are designed to help the marginalized communities combating drug addiction. The lack of available infrastructure also reflects the insufficiency of the government towards this social problem. The existing centers have helped with drug overdose management and provided a safe space that encourages addicts to use in a safer environment rather than using alone on the street. This has helped prevent some stigma and increase the amount of people saved from overdosing. However, there is a lack of awareness concerning the location of those centers, and how to get help; many of the homeless drug addicts have very limited contact due to marginalization from society and have no one to reach out to for help, or simply do not know where to start. This lack of communication and awareness is also a problem that reinforces the social crisis of opioids.
More specifically, the centers should be more inclusive and reflect on the cultural heritage of the individuals, especially for Autochtone communities. This will help create a sense of community or belonging and may lead to a decrease in drug use as the individuals may feel less alone.
Moreover, the majority of existing solutions can be perceived as controversial or ineffective at facing the opioid crisis in Montreal because they do not prevent the use of drugs but only prevent overdoses. Some may even consider the centers of supervision as incentives to start using drugs, but this is a claim that does not have any concrete evidence to support it. This social problem lacks an evident solution that tackles the root of the issue: how to combat the start of using drugs and becoming addicted.
There is evidence, however, that decriminalizing drugs may be beneficial to limit stigmatization of drug addiction and could help individuals seek help when they need it, rather than fearing that they will be thrown in jail if they seek help. It would also limit the challenges that criminalization and policing practices pose to existing harm reduction programs. However, there still needs better infrastructure to support these groups of marginalized people that seek help. Furthermore, it is very difficult for a government to justify the virtues of decriminalizing hard drugs without receiving backlash and being accused of promoting drug use.
What can individuals do to help ?
There are various programs existing in Montreal or online in which individuals may help at their own scale. Indeed, individuals can play a crucial role in increasing awareness of the solutions that exist, and help make sure that minority groups are not excluded from the centers. The Opioid Harm Reduction Project for instance has the goal of including everyone in options to be safer when using, as well as seeking help to overcome addiction. This program also offers training that individuals can take online which can help in promoting helpful behaviors, as well as encourage more volunteers to work in centers. With minimal training, volunteers may alleviate the excessive workload that employees in the organizations or centers have as they are struggling with labor shortages. Another great way to help on an individual scale is talking about existing stigmas with friends, family, coworkers, and peers in order to mitigate the taboo that exists around these marginalized communities who deserve to be recognized and have access to the same help as any other individual.
Additional links :
https://ici.radio-canada.ca/espaces-autochtones/2023874/itinerance-montreal-autochtones
https://addictionrehabtoronto.ca/addiction-rehab-price-much-drug-rehab-cost-quebec/
https://drugpolicy.ca/about/history/
https://www.cbc.ca/news/canada/montreal/drug-checking-service-at-laval-non-profit-1.6877396
https://www.cbc.ca/news/canada/montreal/quebec-funding-delays-for-drug-harm-reduction-1.6289882