I’ve spent the week contemplating the number 4,000. I have gone to sleep trying to to picture what 4,000 of something might look like: 4,000 grains of rice; 4,000 cans of pop; 4,000 golden retrievers; 4,000 body bags. Could you fill a hockey arena with 4,000 body bags? A football stadium?
What would the 4,000 dead junkies inside those bags look like? And why does it matter?
On Tuesday, the federal government released data showing that nearly 4,000 Canadians died in 2017 as a direct result of the opioid epidemic. This is the same epidemic that has made the occasional headline, many of which charge our health care system with negligence, or worse, indifference.
As a junkie myself — proudly reformed but never fully repaired — this number is received like a punch in the gut. These theoretical body bags theoretically contain people I know: friends, clients, other people’s children, parents and spouses. As someone who works in the mental health and substance use field, and who is a recovering substance user herself, this number is more than just a series of zeros at the bottom of some document.
Counting preventable deaths
Numbers are meaningless when it comes to stuff like this. I don’t believe we need a calculator in order to know that we have blood on our hands. When it comes to preventable death, one is too many.
Fully feeling the grief of this national loss, I hesitantly look to my supports — peers in recovery, most of whom subscribe to the 12-step modality — for comfort. I hesitate only because the number 4,000 makes me think about a kind of adage I’ve heard time and time again; when someone walks out of rehab prematurely, we hear it. When someone from your homegroup relapses, or overdoses fatally, we hear it:
“Sometimes, one addict has to die in order to save another addict’s life.”
Addicts say this. To other addicts. And somehow this is okay.
Every single time I’ve heard it, it has stung like a million paper cuts. Not just because it’s entirely crass, but because it’s fundamentally incorrect.
If there’s one thing we know about addiction, it’s that fear fails consistently as a form of deterrent. We cannot be scared straight. If we could, there would be no need for support groups, or rehab, or jail, in many cases. We’d all be just fine after our first blackout or bad fix. No addict or alcoholic will tell you that this disease isn’t scary. It’s terrifying, and we know it.
But does that stop us? Many of us would sooner die than surrender to the frightening reality that we’re killing ourselves quickly, or slowly. Exhaustion, ultimately, is what did me in. Not fear.
What’s also scary is the act of challenging these age-old sentiments held fast and close by many people with long term recovery. Personally, I’ve always been afraid to challenge this idea that we can and will learn from others’ errors, so I just bite my tongue, because I wouldn’t dare claim to know everything there is to know about addiction. Or recovery, for that matter.
I am many things — an addict, an alcoholic, a counsellor, an advocate — but I haven’t been ready to take on the title of a heretic as well. Until now.
Trying to make meaning out of chaos is just a waste of time. 4,000 Canadians died from accidental overdose last year. 4,000!? Using the logic of the aforementioned platitude, one might reasonably expect that in the wake of these deaths there’s been a return on investment.
But have 4,000 been saved? Did 4,000 get treatment beds faster, and for free? Did 4,000 get initiated into opiate replacement therapy programs, without having to wait two months for an intake? Did 4,000 people get revived by prepared passers-by who had taken time out of their busy schedules to be trained on Naloxone, even though they don’t use drugs themselves? Where are the reports on this karmic phenomenon in which we 12-Steppers so fastidiously believe?
An imagined altruism has no place here. Not with one death, and certainly not with 4,000. The things we tell ourselves to pacify anxieties around tragedies too terrible to comprehend might make for a momentary relief, but it does not leave room for eventual improvement. It’s ideas like this that allow governments like ours to continue to do nothing, do little, or just not do enough.
The best advocates for change are those who require it, and yet many of us choose to keep our heads in the sand because we think, “if I could quit, so can they.”
But back when the program of Alcoholics Anonymous was founded, we were not dealing with fentanyl. We were not calling for crisis status to be enacted nationally, and we were not carrying ampules of a potent reversal antidote in our purses just in case we found someone dying in the bathroom stall next to us.
Things have changed. We were once fighting a battle, but this is now chemical warfare. The very people who should be speaking up for change are posting about “heaven’s newest angel” on their Facebook pages, and sitting in circles when they should be marching in mobs.
I will always love the 12-step program for what it has given me. Sobriety, confidence, friendships and peace. But it also is responsible for giving me a conscience, and a voice, and the courage to say without shame that we have failed. As a community, and as a country, we have failed.
Proposing to restrict marketing practices on pharmaceutical grade opiates — which was the government’s bookend to the report containing this figure — is great. But it isn’t enough.
It’s not even close to enough, and 4,000 is just way too many.
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