The US Declared Opioid Overdoses a Public Health Emergency Before Canada

Unless you have been living under a rock for the last decade or so, you know that North America is roiling in the midst of an opioid epidemic. In Canada, nearly 2,500 people fatally overdosed in 2016, and that number is expected to rise this year. Over the last ten years, there has been a 53 percent increase in people winding up in the hospital due to an overdose (an average of 16 every day nationwide), and half that increase happened in the last three years. The situation in the United State is magnified due to its much-larger population; anywhere between 90 and 145 people a day die there from opioid-related overdose.

There are many causes behind this growing problem, not the least of which is the spectre of fentanyl creeping across the continent. The pharmaceutical industry itself bears the lion's share of the blame for the crisis—aided and abetted by Washington. (If you're looking to start untangling the opioid mess, this brutal and exhaustive report from Patrick Keefe in the New Yorker—which begins by noting that four out of five people trying heroin in America this year started out on legally prescribed painkillers—is a good place to start.)

Regardless of its sources, opioid overdoses are a growing national health crisis in both the United States and Canada. Both Prime Minister Justin Trudeau and President Donald Trump have repeatedly acknowledged it as such. But so far, only Trump has actually declared it a public health emergency, authorizing the money and resources needed to address the epidemic faster and with a wider reach. (Although he has not, so far, actually requested any additional funds.)

The NDP called for the Liberals to follow suit, but Liberal MP Bill Blair told the CBC that naming it a public health emergency would just be "rhetoric" and that it was being dealt with under the normal legislative procedures.

Not that we should get ahead of ourselves in praising Donald Trump. While declaring a public health emergency and promising to take aim at pharmaceutical companies and fentanyl imports is a step in the right direction, there are a number of predictably Trumpian problems with the president's approach. There are few details as to what the government is actually going to do (or how it's going to do it), and the president's plan to rehash the 'Just Say No' drug abstinence campaign from the 1980s is more than a little misguided. And all this is before you consider how, exactly, the Republican administration intends to treat the problem of mass opioid abuse at the same time as it tries to rob health insurance from the poor.

All the same, it should give the Trudeau government pause that they're being outplayed by the Trump administration on something that should otherwise fit squarely in the progressive wheelhouse.

For their part, the Canadian government has enacted a number of measures aimed at alleviating the drug crisis. The Liberals have worked to streamline the process for opening new supervised injection sites, and made changes to the Customs Act to crack down on fentanyl crossing the border. The federal government is also in the process of readying dedicated health transfers to the provinces meant to fund mental health and addictions services.

But despite the Trudeau government's rhetorical commitment to acknowledging the epidemic as problem, there seems to be little indication that they are granting it the seriousness it deserves. For one thing, we still don't even really know how bad the problem is: there are large gaps in the basic clinical data necessary to understand the scope and dynamics of opioid overdoses in Canada. Of the country's 16 opioid hospitalizations a day, there is no clear sense how many are due to prescription pills or illicit drugs—let alone how many people started with the former and moved to the latter through withdrawal symptoms and supply restrictions.

More safe injection sites and methadone clinics will be tremendously helpful, but that help will move at a snail's pace even with legislative streamlining while the problem continues to grow out of control. More frontline social and medical workers in especially hard-hit areas will be needed, as will the resources and supports for those workers.

This is where declaring the opioid crisis a public health emergency under the Emergencies Act would make a genuine difference: it would speed up the procurement of funds for treatment programs that would otherwise get bogged down in parliamentary procedure. As reported by Brennan Macdonald at CBC, this would enable the government to rapidly open emergency clinics, shelters, specialized hospital services, and supervised safe injection sites. It would go a long way to alleviate the most urgent symptoms of the crisis while the larger and more complex causes—poverty, alienation, addiction, unscrupulous pharmaceutical practices, etc.—can be sorted out through legislative and/or legal means.

If the Trudeau government is as serious about tackling the opioid crisis as it claims, now is the time to declare a public health emergency. Anything less—especially now that Donald Trump (!) has thrown down the gauntlet—is neglect for the 3,000 Canadians expected to die this year from opioid overdose, and the many more who will inevitably follow.

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