The most recent survey of Duty challenges preconceived ideas regarding drug consumption, giving us the image of a society incapable of adequately naming evil and ensuring equal treatment of people in a situation of dependence. It is the story of indifference that is playing out before our eyes, at the risk of human life.
After going through 405 coroner’s reports across Quebec, our journalists Améli Pineda and Stéphanie Vallet came to the conclusion that when it comes to fatal overdoses, the epidemic is not what we think. Since January 2022, crack, cocaine and crystal meth are the deadliest drugs in Quebec. They have killed seven times more than opioids, where attention and resources are directed.
Stimulants claimed 162 lives between 1er January 2022 and April 5, which represents 40% of overdose deaths over this 15-month period. Cases of polyintoxication come in second among deaths (32%), and opioids far behind (6%).
This evidence, which the authorities neglect even though it is at hand, calls for a reframing of the public debate. “Using the term “opioid crisis” does not describe the current situation,” says the DD Élisa Pucella, medical advisor to the overdose control team at the Regional Public Health Directorate (DRSP) of Laval.
Moreover, the National Institute of Public Health of Quebec (INSPQ) refuses to qualify opioid overdoses as a “crisis”, even though this terminology is used by the DRSP of Montreal and the Minister responsible for Social Services, Lionel Carmant. Taking note of this is the first condition for change… This also applies to the media, intoxicated by the North American narrative ritual, which places opioids at the top of consumption issues.
This vacuum is evident at all stages of the care of people struggling with stimulant dependence. Thus, there are only three supervised inhalation centers in the entire province: in Laval, Gatineau and Quebec. The opening of a fourth center is planned in Montreal, in Saint-Henri, but the project faces stubborn opposition from residents who consider it too close to a primary school.
The mayor of Montreal, Valérie Plante, shines brightly on the international scene for her commitments in the fight against climate change. It is a success that inspires pride. On a local level, she sometimes gave an impression of defeatism, as if the deterioration of the city center, where many problems linked to drug consumption are concentrated, was not her responsibility. This delay is denounced by organizations such as Dopamine, which is toying with the idea of opening an inhalation center. Montreal must assume greater leadership to finally declare a state of health emergency and decriminalize drugs on its territory. The measure would make it possible to reduce the stigmatization of drug users and act more effectively in prevention.
There is another source of annoyance in our investigation, and that is the indifference with which we accept preventable tragedies. Of course, abstinence is the best possible choice from a personal health perspective, but a world without drugs is a utopia. Let us instead return to our duty of assistance and fair treatment, from a public health perspective.
The coroner’s reports are written in the imperfect tense of the tragedy. All substances combined, four out of five fatal overdoses occur alone. This risk factor arises from a stigma phenomenon that must be broken. It is Karina who dies in a parking lot. It’s Pierre found lifeless by his owner after two days. It’s Priscilla found by her mother, collapsed forever at the foot of the bed.
A common thread connects these reports and it is that of the indifference of the coroner’s office as an institution responsible for ensuring better protection of human life. In 99% of reports, coroners make no recommendations; the fatal overdose was relegated to the rank of a banal and common news item. In its defense, the coroner’s office states that it does not produce recommendations in 95% of all the files under study. The deputy coroner, Luc Malouin, calls for the formation of a national committee and collective awareness of fatal overdoses. The institution could participate more actively in the reflection instead of disengaging in this way.
Finally, the investigation returns the buck to Minister Carmant and the national director of public health, Luc Boileau, who refused to comment on our investigation. It is their responsibility to improve the service offering, without taking anything away from the resources that deal with the issue of opioids, in order to increase access to health services for all drug users.