'You don't deserve to live like this': 4 things a recovered drug addict says policymakers are doing wrong

"For those who currently use drugs, to their families and communities who care for them and spend sleepless nights worrying for them, I say I'm sorry. You don't deserve to live like this."

It's a message recovered addict Guy Felicella delivered following a report on illicit drug overdoses in British Columbia, saying he felt compelled to apologize because it's what he longs to hear himself.

On Wednesday, B.C.'s chief coroner announced, in a voice that wavered at times, that 2,224 people died last year of drug toxicity. It's a record in the province; 508 more deaths than the year before, which had also broken the previous record.

"To those who died, to their loved ones, I say I'm sorry. I'm sorry that you've become a victim to decades of failed policy. I'm sorry that you were casualties of the war on drugs that is decidedly one-sided. I'm sorry that your sacrifice has felt like it's been all for nothing," said the Vancouver Coastal Health peer clinical advisor, speaking after the coroner.

Felicella shared a bit of his own story, saying he lived in a cycle of addiction and criminalization for years.

"I used drugs to manage my own personal pain and trauma. I was repeatedly treated as less than a person, a disposable piece of garbage, simply because I used drugs," he said.

"I am one of the lucky ones, to escape the cycle alive when many of my friends did not. An apology is at least what we should expect from those we've elected at every level of government to protect us and our communities. They have failed us."

Felicella said that failure can be seen in the thousands of deaths that have occurred since public health officials in the province first declared a public health emergency over the overdose crisis.

He was notably frustrated, angry, by what he called a lack of progress during the nearly six years since the crisis began.

Efforts have been made in that time, of course.

The B.C. government and Vancouver municipal government are taking steps to decriminalize drugs including heroin, cocaine and methamphetamine.

Supervised consumption sites have been set up in some parts of the province, and no lives last year were lost at these locations.

Investments have been made to improve access to a safer supply and to treatment, but even government officials acknowledge there's still a ways to go when it comes to life-saving measures.

Felicella asked Wednesday, "Where is the apology? Where are our political leaders who should be standing here beside me, in Ottawa and in provincial legislatures across the country, to acknowledge their failure and to share what they're going to do to end this crisis? Why do we only hear from some of them once a month at best, simply acknowledging the number of people who've died, take a public flogging for a day and then move on?"

He blamed politicians, yes, but he also blamed the public for failing to demand more from elected officials.

"How is this possible? What kind of society are we that lets thousands of people die preventable deaths?" he said.

"How can we become so cruel to one another that we cannot even hold those who have the power to stop this to account? As much as I'm saddened over the lives we've lost and will lose, I'm saddened for this world that seems drained of every ounce of compassion and empathy."

He said there's been a failure by all levels of government to learn from the mistakes made so far in B.C.'s opioid crisis, calling those mistakes "wasted lessons" that are costing lives.

"One thing has become abundantly clear: some lives matter more than others. The lives of people who use drugs don't seem to matter all that much. Not to you, not to those who can ever stop this never-ending crisis."

There are four mistakes in particular that continue to be made, he said at Wednesday's news conference.

A BLOODY, EXPENSIVE WAR ON DRUGS

"Number one, we continue to wage a bloody, expensive war on drugs – a losing war," Felicella said, beginning his list with a critique that the drug supply in Canada has been left in the control of criminal organizations.

He said prohibition doesn't work; illegal drugs aren't all that hard to access, and instead, all the profit is made by criminals "whose job it is to make drugs easier to produce, easier to traffic and more addictive.”

The solution to an increasingly toxic supply, a major factor in the number of deaths last year, is not to rely on organized criminals to make that supply less deadly, he said.

"The coroners' toxicology report tells us that the drug supply is changing for the worse. Fentanyl is now not the only problem, now it's benzo-dope. Drugs are being cut with more and more highly addictive substances," Felicella said.

"We spend billions of dollars trying to keep drugs out of the country, and then spend billions more trying to reduce the harms of those drugs that make it in to the country. Tell me, does this make sense?"

Progress is, somewhat, being made on this front. As already mentioned, the provincial government has applied for a Health Canada exemption that would decriminalization of possession of small amounts of drugs including heroin and cocaine. But given how long it took for cannabis to be regulated in Canada, actual regulation of harder substances seems like it could be a ways away.

Felicella's argument to policymakers and voters who might be hesitant to regulate the sale of these substances to think about who benefits from the current laws.

DRUG USE MISUNDERSTOOD

Another major issue, according to Felicella, is that drug overdoses are often tied in the minds of politicians to addiction, but in many cases, those who've lost their lives are more casual users.

He said the way we look at drug use needs to change. Initially, it was seen as a moral failing, he said.

"That led to prohibition and criminalization, which have only made drugs more dangerous."

Then the thinking was more toward addiction, but this is something Felicella described as a misconception. He said that thinking led to investments in the health-care system to solve the issues, but did not provide solutions for those who don't have a substance use disorder.

Many associate drug use with alleyways in communities such as Vancouver's Downtown Eastside, but outdoor deaths made up only a small percentage of fatal drug overdoses in 2021. Most people were indoors, in private residences, according to coroner data.

"For those people, drug use isn't the issue, it's actually drug policy that's the issue," he said.

But he acknowledged that while addiction may not be the proper diagnosis for all users, it is a problem, and for those who do have an addiction, getting access to treatment and recovery is a challenge.

This is something acknowledged by politicians and public health officials, all of whom have said that more needs to be done. Speaking before Felicella on Wednesday, Chief Coroner Lisa Lapointe said she knows people are dying while waiting for placement in treatment programs.

REFUSING REALITIES: 'WE NEED HEROIN'

Felicella said there are efforts being made to allow access to a safer supply, but that some of those efforts don't take into account the situations of people who use drugs.

"Safe supply is being crammed into a prescriber model despite it being obvious it won't meet the needs and demands of people who use substances," he said.

He said the issue with the model that allows nurses to prescribe safe supply is that their patients have to be diagnosed with a substance use disorder first, excluding "tens of thousands of people."

And there's also a problem with what's actually given out, as many programs offer alternatives to illicit drugs.

Bluntly, he said, "We need heroin to be accessible and central to safe supply."

'TIME TO ADMIT YOU HAVE A PROBLEM'

Lastly, Felicella said politicians and other officials are great at recognizing verbally that things need to change, but in his view, the follow-through has been an issue.

"For someone with an addiction, they're often told the first step is admitting that (they) have a problem. To those in charge of creating policy, I say the same thing. It's time to admit that you have a problem," he said.

He said promises are made, but rarely are they delivered in a timely manner.

"Where are the treatment beds for people outside the Lower Mainland?" he said.

"You hear about the new investments in beds, but how many are sitting empty right now, and how many aren't accessible to people in rural communities?"

For its part, the Ministry of Mental Health and Addictions issued a news release Wednesday outlining what actions were taken in 2020-21, made possible through a $500-million investment over three years in mental health and substance use initiatives.

Of that amount earmarked in the 2021 provincial budget, $132 million will go toward treatment and recovery services and $45 million will go to overdose prevention services, increased nursing care and outreach teams over the three-year span, the NDP pledged.

The NDP promised 159 new substance-use beds but, underscoring Felicella's point, the timeline in Wednesday's statement is "as soon as possible."

The ministry said work is underway to train up to 450 new nurse prescribers by March 2023, but it's unclear how many are actually practicing as of February 2022.

The ministry mentioned that 24,540 people were given opioid agonist treatment (OAT) – alternatives to illegal opioids such as methadone – in the month of December, but it's unclear how many were denied the treatment because they weren't diagnosed with a disorder. And Felicella said the substances provided aren't what users are looking for anyway.

The ministry said that more OAT options are being made available in injectable and tablet forms, but did not give any specific numbers.

It said more than $2 million was sent to 53 residential treatment and recovery service providers where budgets were impacted by the pandemic, seven new and nine expanded substance-use teams were added across the province and that access to overdose prevention services has been expanded.

A free app, called Lifeguard, was launched that automatically connects users to first responders if they become unresponsive and thousands of take-home naloxone kits have been shipped across the province.

Read more on the province's description of its actions here.

Ultimately, Felicella's message was that drug users' opinions and lived experience should be taken into account as new initiatives are taken into account, and that they should not be, as he said he was, "treated as less than a person."

"You should not have to be drug-free to receive proper health care."