A focus on mental health could help end Canada’s fentanyl crisis

Posted on June 30th, 2017

Jessica, a homeless heroin addict, shows her kit of clean needles, mixing cap and tourniquet in the Kensington neighborhood of Philadelphia, Pennsylvania, on April 14, 2017.

In North Philadelphia, railroad gulch as it is known, is ground zero in Philadelphia's opioid epidemic. 80 percent of us want to get out," said Jessica, before outlining the numerous ways she has tried to get treatment for her addiction. In one case, she said, there weren't any available beds. In another, a treatment provider required a positive drug test before delivering aid, meaning if she hadn't used recently she'd be denied. Instead of getting treatment, she spends her nights trying to keep warm on a mattress under a bridge, the very spot where she was raped and infected with HIV.  People come from throughout the city, and some as far away as the Midwest, for heroin that is remarkably cheap and pure at the largest heroin market on the East coast. / AFP PHOTO / DOMINICK REUTER        (Photo credit should read DOMINICK REUTER/AFP/Getty Images)

We are in the midst of an unprecedented health crisis, with fentanyl-related overdoses causing the death of thousands of Canadians. I believe this crisis is due, to a great extent, to the wilful blindness of all levels of government to the inadequate resourcing of mental health care.

Whether due to stigma, poor insight, hopelessness or lack of access to care, many people who are mentally ill suffer in silence, sometimes for years. For some, this leads to a reliance on “self-medication” to cope with their symptoms. This term refers to the use of inappropriate or unhealthy measures to relieve the distress and pain of a mental illness. Self-medication can take many forms: alcohol and cannabis are most common, but other illicit substances, food, or other forms of escape are also common.

“Dual-diagnosis” is the term commonly used to describe those diagnosed with a mental illness and an addiction. Not everyone who has an addiction has a dual-diagnosis, but a substantial proportion do, and many are unable to access timely, appropriate mental health and addiction treatment. Untreated mental illness drives addiction, and addiction drives mental illness, creating a vicious cycle that too often is broken by death, not recovery.

Why are so many people falling through the cracks? Actually, we don’t have mental health care “cracks.” We have a mental health care “Grand Canyon,” resulting from the negligence and/or ignorance of governments, health-care providers and society as a whole. Ultimately, the most vulnerable members of society pay the highest price.

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