Fentanyl crisis echoes mistakes of HIV/AIDS response: Watt


[:en]Abuse of fentanyl, the highly addictive opioid pain medication, is taking a menacing toll across Canada.

Opioid-related overdoses killed 1,400 Canadians last year. To label the situation a coast-to-coast crisis is a massive understatement.

Fentanyl can be found in knock-off prescription painkillers, in party drugs and even in cocaine.

The fact that other drugs are being laced with fentanyl means that drug users often haven’t actively sought out the “thrill” of fentanyl and don’t even realize what they’ve done until it’s too late.

My firm, Navigator, has recently conducted a nationwide survey on public opinion relating to the fentanyl crisis in Canada.

Today, only half of Canadians say they are familiar with fentanyl-related issues. What’s more troubling is that those most vulnerable, those aged 16 to 17, are least familiar. Only 4 in 10 teens are aware of the crisis.

The impact has, to date, been uneven across our country and so, therefore, has awareness. For example, 70 per cent of British Columbians express awareness compared to only 49 per cent of Torontonians.

The fentanyl crisis has spread so quickly, the public hardly noticed it was happening. Government officials didn’t notice it either. As a result, it went largely unaddressed. And as so often happens, issues affecting the poorest or most vulnerable among us are the last to be noticed. It has only been as the crisis has transcended class lines and begun affecting suburban teenagers that the outcry has begun.

Also, problematically and mistakenly, the fentanyl issue has been seen primarily as a matter of criminal justice.

If it is to be dealt with successfully, it must be seen as a matter of public health. In a hospital, a person who dulls their pain with fentanyl is a patient. On the street, that same person is a criminal.

Fortunately, the current federal government has broken with its predecessor on this issue and we are starting to make progress in treating the fentanyl crisis as the public health crisis it is.

Perhaps the biggest challenge has been that the public at large has not felt, so far, that the fentanyl crisis affects them. They continue to believe it is a problem faced by addicts and drug abusers, who rely on illegal substances. There has been little public sympathy, and many people perceive fentanyl to be of little risk to them, far removed from everyday life.

It is a situation that has striking parallels to the HIV/AIDS crisis of the 1980s and 1990s, an indelibly tragic mark on Western society’s record of compassion.

The existence of a life-threatening public health crisis that has no prevention plan in place would usually cause moral outrage. The outbreak of SARS and H1N1 both saw heightened government action, panicked media coverage and widespread agreement to address the issues.

But, in both the HIV/AIDS and fentanyl crises, the general population has viewed the victims as foreign. HIV/AIDS was long dismissed as a gay disease, a consequence of living an immoral lifestyle.

Action was taken only once those ostensibly “moral” judgments were challenged.

Far too many people died an unnecessary death. Western nations sat idly by as a crisis ravaged a class of people they did not deem to be important enough, or moral enough, to be worth saving. Famously, President Reagan never even uttered the words HIV or AIDS even at the height of the pandemic.

A similar crisis is developing around fentanyl. Drugs are seen as taboo by large segments of the population, and drug laws provoke passionate political responses.

As was the case with AIDS, many people believe fentanyl will never be an issue for them personally. In public policy debates, the well-being of drug addicts is rarely of prime consideration.

But it’s becoming clear fentanyl is an issue that will affect all Canadians.

Moving forward, the issue requires immediate and formal co-operation among government agencies, law enforcement groups, elected officials at all levels, the emergency management infrastructure, educators, civil society, parents and families.

It is simply not enough to sit idly by while the most vulnerable among us die of a preventable situation. This is not the first time we have found ourselves in such circumstances and we must be vigilant that it not happen again.

The fentanyl crisis, an insidious one, threatens to undermine the lessons we learned from health crises of the past.

Canada can, and must, do better.

Jaime Watt is the executive chairman of Navigator Ltd. and a Conservative strategist.

(As published in The Toronto Star on May 21, 2017)