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The Hidden Toll of Overdose in Canada

August 31st is International Overdose Awareness Day, and this year’s theme recognizes the unseen grief and loss of the people who are left behind.

Losing someone we love is one of the hardest things we go through in life. While nothing takes away the pain, sharing the experience of loss with others can go a long way toward helping us heal. But every year, thousands of Canadians who lose a loved one to an overdose are denied this comfort because of the fear, stigma, and blame that swirl around drug use. This year’s International Overdose Awareness Day is bringing this issue into the light and acknowledging the people whose suffering goes unseen.

The overdose crisis in Canada

Worldwide, opioids account for the majority of drug overdose deaths (69%). In Canada, between January 2016 and June 2022, there were a total of 34,442 deaths by apparent opioid toxicity—a number greater than all other major causes of accidental death combined. That’s an average of 17 Canadians lost to an overdose every day. And every individual loss creates a ripple effect that touches many more people whose lives will never be the same, including family, friends, community members, first responders, and healthcare providers.

It’s an issue that Abby Gardiner understands all too well. As a Therapist, Addiction and Mental Health for Homewood Community Addiction Services (CADS), Gardiner has seen the far-reaching effects of the opioid crisis on those who care for and love the people who overdose. CADS provides community outpatient addiction and mental health treatment services in Guelph and Wellington County, Ontario, as well as support to individuals who have been impacted by someone else’s substance use. 

“We’re seeing so many families, friends, and communities that are experiencing the grief and loss that’s resulting from a contaminated and toxic drug supply,” said Gardiner. “In Guelph alone, we have seen 12 accidental deaths from opioids in the past six months.”

The impact of stigma and fear

When we ignore the issue of overdose or assign blame to it, it doesn’t make it go away. In fact, it can make it worse by negatively affecting both the experiences and outcomes of the people at risk and those who love and care for them. 

“Our fear and our unconscious biases influence our thinking, and that leads to an ‘othering’ mentality, a ‘not me’ mentality,” Gardiner explained. “But that judgment and stigma are primary barriers to accessing help. It stops people reaching out because they feel shame. And these issues impact more than just that one individual. They impact everyone who loves them and cares about them.”

This even extends to the unseen healthcare workers and first responders who care for people who need mental health and addiction treatment. 

“Stigma takes a toll on healthcare providers,” Gardiner said. “We witness the lack of compassion and kindness every day, and it can be exhausting. There’s a different level of grief that can be experienced when we, as service providers, lose clients to drug or alcohol poisoning.”

The experience of this type of grief among healthcare providers is called moral injury or moral distress, and it can lead to depression, anxiety, and post-traumatic stress disorder (PTSD) for healthcare professionals. One-quarter of Canadian healthcare workers have actually considered leaving their profession due to moral distress, and an equal number meet the criteria for PTSD. (Learn more about the impact of moral injury on healthcare providers in this blog post.)

Break the stigma, change the outcomes

When we question the stigma around overdose and make an effort to see it as a health issue like any other, it can have a powerful ripple effect on the people who need help the most. For people at risk of overdose, it could mean seeking mental health and addiction treatment. For friends and family, it could mean finding space to grieve loved ones and celebrate their lives. For healthcare providers and first responders, it could mean practicing self-care or being appreciated for the vital work they do. 

On International Overdose Awareness Day, here are three things you can do to bring awareness to the hidden toll overdose takes on thousands of Canadians and their families, friends, and caregivers.  

See the ‘unseen’

Take the opportunity to engage and learn more about how it affects your community. For example, Gardiner visited a local farmers market last summer with her family, and her children were drawn to a table covered with stuffed bears. It was run by a mother who lost her son to drug poisoning. 

“The bears were her way to honour him, raise awareness, and create safe or brave spaces for anyone to talk about anything.” Gardiner explained. “It’s one example among many of how important it is to have that opportunity to grieve.”

Making space for these conversations humanizes the issue and gives the people left behind an opportunity to process and talk about the experience.

To see the human face of overdose and hear stories of how it has affected communities, watch these videos on the International Overdose Awareness Day.  

Change the language

When you see overdose as a health issue like any other, it’s easier to destigmatize it and treat the people affected by it with empathy and compassion.  

As a way to fight stigma, Gardiner and her colleagues have begun changing the language they use. Instead of talking about a “drug overdose,” they describe it as “drug poisoning” to highlight the fact that people don’t intentionally take a higher dose of dangerous drugs. Instead, they overdose when the drug has been tainted or the dosage is higher than expected or their tolerance is unexpectedly lower. 

Carry naloxone

Naloxone is accessible, easy to use, and effective in saving lives that might otherwise be lost to overdose, yet many people choose not to carry it because of the stigma that surrounds drug use.   

Available in a nasal spray or injection, Naloxone is used to quickly restart the breathing of someone who has overdosed on an opioid. As of 2019, Naloxone kits were estimated to have reversed as many as 61,000 overdoses in Canada. 

Kits are available for free in most pharmacies and no formal medical training is needed to administer it safely. A kit can be added to your first aid supplies and kept in your car or handbag so it’s always there if you need it. These short Youtube videos show you how to use Naloxone in the nasal spray and injection versions.  

From stigma to dignity

When someone in our community is sick, we surround them with compassion and care. If they are diagnosed with cancer, for example, we might drop off a food parcel, sit with them during their chemotherapy treatments, or organize a fundraiser. But if the issue involves mental health, addiction, and overdose, our instinct is to turn away. 

We need to rethink the way we see and respond to these challenges. People at risk of overdose are equally deserving of the community’s help and understanding, as are their families and caregivers. Their stories deserve to be heard, their loss acknowledged, and their perseverance in seeking life-saving mental health and addiction treatment supported and celebrated. 

For Gardiner, the benefits of treating this population with dignity don’t just flow one way. Approaching the issue of overdose with openness and empathy helps the whole community learn and grow. 

“Asking for help is rarely easy,” Gardiner said. “I feel really honoured to have the individuals that I work with sit with me and be willing to share their challenges and allow me to witness their change journey.”

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