Our experience in Chatham-Kent aligns with Adam Zivo's message. Active drug users inform the former drug users. The former drug users lead a sanctioned group of public activists who are funded by many sources including the municipality. One of these activist groups were involved in writing the municipal drug strategy and further advise the municipality on encampment decisions, without input from municipal council or citizens impacted by these decisions.
Great piece. I fought this like a beast at our local crime prevention council and drug policy council and was predictably silenced at both. My very addicted adult son also thought this approach was a truly boneheaded idea.
Good grief, Adam, I don't know where you find all your powerful Canadian drug addicts controlling policy, but you sure do spin a tale about how things are going down in Canada now that we've given away the farm to people using drugs. I'll concede that in some pockets of the country, there are words on paper somewhere that do say something high-level about consulting people who use substances and bringing them to the table when things fundamental to their lives are being discussed. The reality is so very, very different. What troubles me the most is that I know you know that, but yet you write this fiction. The gap between policy and reality has always been a huge one, but I don't think you'd find a bigger one anywhere than the one between what we say about substance use and what we do. I can't even begin to emphasize enough for whoever is reading you (though I know they won't believe a word of it anyway) that there is so little truth in your exaggerated and hyperbolic descriptions of how drug policy is created and enacted in Canada. And in the scant places where there actually is policy that sounds humane and helpful toward people who use drugs, it's largely ignored on the ground anyway. So don't sweat it, little buddy. Your side is winning, and always has been. I know better than to pack in a bunch of facts, stats and reality checks here, because none of that makes a bit of difference to you or the readers who actually buy into what you write. I'd just be another one of those loathsome "progressive harm reduction advocates" trying to defend the powerful drug addict lobby (!!). But I do hope you wake up one day and realize your role in causing real harm to people with your stirring the pot to make sure that any tiny sliver of kindness and evidence-based practice is swept away on a tide of ugly politics and public opinion. You know the truth but make your living on lies. May that weigh on you.
To say Adam's 'side' has been 'winning as always' must come as a big surprise to one very brave journalist among a sea of cowardly parrots repeating the HR mantras --and paying very dearly for it. Adam's 'side' may yet 'win', but the cost of this one-pillar substance use approach (HR instead of and above all else) is measured in countless suffering addicted bodies and souls.
I absolutely agree that we've got some pretty messed up and deeply inadequate pillars. But that's not because harm reduction advocates are winning the day - it's because we have no policy, no planning, no evidence-based strategy, no accountability, as little public funding as can be gotten away with, a highly.politicized environment around health services, an unregulated and highly toxic drug supply, and just enough actual harm reduction to sustain people with problematic substance use in their misery indefinitely. Show me the harm reduction advocate who is happy with the state we're in. Harm reduction is about keeping people alive to fight another day. It's not meant to be the only thing we do, just the first thing. I don't see anybody on my "side" fighting to stop people from getting on to steps 2, 3, 4, etc. But the services aren't there. The barriers are huge. The costs are impossibly high, because so much has been given to the private and corporate sectors. The outcomes are a complete unknown, with treatment centres' duty to report ending as soon as a person walks out the door. People have been left to prove they're "ready" to access the scarce supports that do exist. The sickest, with the most complex stories underneath their substance use, are the least likely to get help. And when they can't manage it, well, there's a piece of street waiting for them in a community near you.
Killahkel replied to your comment on No, Addicts Shouldn’t Make Drug Policy.
To say Adam's 'side' has been 'winning as always' must come as a big surprise to one very brave journalist among a sea of cowardly parrots repeating the HR mantras --and paying very dearly for it. Adam's 'side' may yet 'win', but the cost of this one-pillar substance use approach (HR instead of and above all else) is measured in countless suffering addicted bodies and souls.
First, thank you for a balanced response to my response to you. So rare to *respectfully* disagree on some things in online forums. I 100% agree that we are failing those struggling with addiction in so many ways. You say "Show me the harm reduction advocate who is happy with the state we're in." No, you are right; they are not. I *can* show you, however, HR activists and advocates who want to (and do) go FAR further than safe consumption sites and clean needles/gear. I *cannot* show you many who are willing to listen to unintended consequences of so-called 'safe' supply, normalizing drug use, the immeasurable harm to parents and kids left behind, and acknowledging that we need an off-ramp from HR-only back to support for the other 3 critical pillars needed to address addiction (prevention, treatment, and yes, law enforcement). Portugal's astoundingly successful model addressed all of those- we here chose to prioritize the edgy, libertarian and cheapest one- harm reduction. When we look at the nearly miraculous decline in cigarette smoking, we see that 'stigmatizing' smoking (NOT the smoker), increasing cost, and reducing access did the job pretty damn well. Our current drug policy seems headed down a one way street the wrong way.
And thank you back for engaging! I am making a real effort to avoid let's-hurl-insults-at-each-other-until-we-bleed discussions on hot-button issues, and most especially this one. People are dying while we fight, and in truth I think all of us on the various "sides" want the same thing. We just disagree on how to get there. I'm going to (carefully) mention that I do think street drugs need to come under some kind of regulation. Let's not call it safe supply, because that's a controversial term and it's not like any of this is actually safe. You mention smoking, which is a great example of effective, thoughtful long-term policy across all pillars to reduce harms. But cigarettes were fully legal when that work started, and so all the research that had to be done to encourage people to quit could easily happen, along with the follow-up studies to see how things were going, patterns of use, ages most responding to the messaging, etc. Street drugs, on the other hand, are illegal and ever-changing. Any study of any length just can't happen in that environment, and every time a person buys street drugs it's a complete crap shoot as to what they're getting, how much it's been cut, etc. No meaningful studies are possible because the drugs keep changing, day to day, even hour to hour. So instead of being able to say "Hey, people, if you're going to do drugs (because they are, let's be realistic), at least make sure you aren't buying anything with fentanyl above x per cent," we have to say "Don't do any drugs!" even though there ARE drugs in the illicit supply that for the most part are considerably less harmful than our legal ones, like alcohol. Stigmatization is definitely a part of controlling use, but we are having to blanket-stigmatize everything, rather than being able to stigmatize and educate around the really bad stuff while acknowledging that there are significant differences between these things we lump together as "drugs." We can't really even talk about street drugs realistically, because we're hell-bent on saying that all are evil and can't have anything resembling a normal conversation about it. Made worse by all that blood-in-the-water fighting that all of us do. I was looking into Stats Canada numbers, albeit from 2019, and what you see is that overall, illicit drug use is generally not rising very much. What has changed dramatically, however, is what's in the mix. It's lethal in a way that it makes a person wish for the good old heroin days. (Out here in BC where there are projects analyzing substances, heroin now accounts for just 3 per cent of the "down" in street drugs.) Where you do see a significant rise, however, is in the number of people who are on an opioid prescription and go on to report problematic opioid use. That figure doubled between 2017 and 2019. There's a clear problem to jump on, because those problematic opioid users, who got started on it by their doctor, are soon enough going to fall into the illegal supply once their doc gets nervous and cuts them off. And we all know the risks once that happens. Here's my thought on where all of us with our many divisive opinions might possibly agree - what if we began a real effort to analyze street drugs? The technology is all there, and can be done from a distance. We start with educating people on the actual drugs of the moment. We start engaging people in evidence-based conversations about the illicit supply, and where the greatest dangers are. We shine the light, open some eyes, save some lives. And then we can move into the touchier subjects, once we all get the hang of getting along. The drug-testing is happening here in Victoria at a small scale, but here's where politics and public opinion make things weird: Our current government tolerates users bringing in their own drugs to have analyzed, but doesn't want sellers to bring in their drugs, because it's a criminalized environment. So you've got a seller who sells to, say, 100 people, and who actually wants to make sure they're selling something that won't kill people, but the logic of testing that person's drugs gets swept aside by the optics of looking like you're being tolerant of criminal behaviour. And people keep dying - 18,000 right here in BC in the last 9 years since we declared a public health emergency (and did almost nothing except declare it, of course). Apologies for the l-o-n-g response - this is a hobby horse of mine, to see all of us good people come together and get a handle on this crisis instead of using all our energy on fighting with each other about how it should be done. I really think we need to find small actions that we can all agree on, and grow out from there.
I am listening, Jody! Sorry; less interesting business (that I get paid for, lol) distracted me from being able to respond. I struggle to understand how the evolving nature of the drug supply necessitates regulation. You are very right- newer street drugs kill swiftly and often. They also maim first, and often- we have an untold *sea* of people living on the streets who are literally brain damaged from the noble efforts to save them. (Hypoxia during OD's, often numerous.). We do not seem to be discussing unintended consequences; the few researchers who have tried were silenced/shunned (eg., Doleac and Mukherjee). On smoking, my understanding is that we didn't get people to quit- sadly, most will still die of smoking related illnesses *before* they quit- the miracle work was that we got young people not to START smoking. That's why numbers are down. So... to me, a key is to make drugs so unappealing (uncool, difficult, expensive, etc) that people don't start. Evidence suggests that harm reduction does the opposite... ok, gotta go to work. Thx for engaging!
We'll just keep the dialogue going when we can! I work in communications strategy around various social issues, so for me this is so useful in getting me thinking about how we can bridge our divides and get things done. I hear you on the need for a very different kind of drug education. I'm not even sure if there IS real drug education going on. There's a young woman here in BC who is going into schools Grades 8-12 to talk drug education, Naloxone, toxic drug crisis, etc, and her stats after speaking to 40,000 kids in that age range show that 51 per cent had never even heard there was a toxic drug crisis until she came to speak. That's pretty wild. And yes, the brain injury stuff post-overdose is a terrible unintended consequence of the crisis. Nobody has any kind of handle on any of that, at least not in BC - no stats, no process for diagnosis, no analysis of its impact on the street crisis, no adaptive services for people who now have a life-changing injury.
Our experience in Chatham-Kent aligns with Adam Zivo's message. Active drug users inform the former drug users. The former drug users lead a sanctioned group of public activists who are funded by many sources including the municipality. One of these activist groups were involved in writing the municipal drug strategy and further advise the municipality on encampment decisions, without input from municipal council or citizens impacted by these decisions.
God. Sounds just like us in our Region.
Great piece. I fought this like a beast at our local crime prevention council and drug policy council and was predictably silenced at both. My very addicted adult son also thought this approach was a truly boneheaded idea.
Good grief, Adam, I don't know where you find all your powerful Canadian drug addicts controlling policy, but you sure do spin a tale about how things are going down in Canada now that we've given away the farm to people using drugs. I'll concede that in some pockets of the country, there are words on paper somewhere that do say something high-level about consulting people who use substances and bringing them to the table when things fundamental to their lives are being discussed. The reality is so very, very different. What troubles me the most is that I know you know that, but yet you write this fiction. The gap between policy and reality has always been a huge one, but I don't think you'd find a bigger one anywhere than the one between what we say about substance use and what we do. I can't even begin to emphasize enough for whoever is reading you (though I know they won't believe a word of it anyway) that there is so little truth in your exaggerated and hyperbolic descriptions of how drug policy is created and enacted in Canada. And in the scant places where there actually is policy that sounds humane and helpful toward people who use drugs, it's largely ignored on the ground anyway. So don't sweat it, little buddy. Your side is winning, and always has been. I know better than to pack in a bunch of facts, stats and reality checks here, because none of that makes a bit of difference to you or the readers who actually buy into what you write. I'd just be another one of those loathsome "progressive harm reduction advocates" trying to defend the powerful drug addict lobby (!!). But I do hope you wake up one day and realize your role in causing real harm to people with your stirring the pot to make sure that any tiny sliver of kindness and evidence-based practice is swept away on a tide of ugly politics and public opinion. You know the truth but make your living on lies. May that weigh on you.
To say Adam's 'side' has been 'winning as always' must come as a big surprise to one very brave journalist among a sea of cowardly parrots repeating the HR mantras --and paying very dearly for it. Adam's 'side' may yet 'win', but the cost of this one-pillar substance use approach (HR instead of and above all else) is measured in countless suffering addicted bodies and souls.
I absolutely agree that we've got some pretty messed up and deeply inadequate pillars. But that's not because harm reduction advocates are winning the day - it's because we have no policy, no planning, no evidence-based strategy, no accountability, as little public funding as can be gotten away with, a highly.politicized environment around health services, an unregulated and highly toxic drug supply, and just enough actual harm reduction to sustain people with problematic substance use in their misery indefinitely. Show me the harm reduction advocate who is happy with the state we're in. Harm reduction is about keeping people alive to fight another day. It's not meant to be the only thing we do, just the first thing. I don't see anybody on my "side" fighting to stop people from getting on to steps 2, 3, 4, etc. But the services aren't there. The barriers are huge. The costs are impossibly high, because so much has been given to the private and corporate sectors. The outcomes are a complete unknown, with treatment centres' duty to report ending as soon as a person walks out the door. People have been left to prove they're "ready" to access the scarce supports that do exist. The sickest, with the most complex stories underneath their substance use, are the least likely to get help. And when they can't manage it, well, there's a piece of street waiting for them in a community near you.
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On Tue, Sep 16, 2025, 1:39 p.m. Killahkel <forum@mg1.substack.com> wrote:
Break The Needle
Killahkel replied to your comment on No, Addicts Shouldn’t Make Drug Policy.
To say Adam's 'side' has been 'winning as always' must come as a big surprise to one very brave journalist among a sea of cowardly parrots repeating the HR mantras --and paying very dearly for it. Adam's 'side' may yet 'win', but the cost of this one-pillar substance use approach (HR instead of and above all else) is measured in countless suffering addicted bodies and souls.
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First, thank you for a balanced response to my response to you. So rare to *respectfully* disagree on some things in online forums. I 100% agree that we are failing those struggling with addiction in so many ways. You say "Show me the harm reduction advocate who is happy with the state we're in." No, you are right; they are not. I *can* show you, however, HR activists and advocates who want to (and do) go FAR further than safe consumption sites and clean needles/gear. I *cannot* show you many who are willing to listen to unintended consequences of so-called 'safe' supply, normalizing drug use, the immeasurable harm to parents and kids left behind, and acknowledging that we need an off-ramp from HR-only back to support for the other 3 critical pillars needed to address addiction (prevention, treatment, and yes, law enforcement). Portugal's astoundingly successful model addressed all of those- we here chose to prioritize the edgy, libertarian and cheapest one- harm reduction. When we look at the nearly miraculous decline in cigarette smoking, we see that 'stigmatizing' smoking (NOT the smoker), increasing cost, and reducing access did the job pretty damn well. Our current drug policy seems headed down a one way street the wrong way.
And thank you back for engaging! I am making a real effort to avoid let's-hurl-insults-at-each-other-until-we-bleed discussions on hot-button issues, and most especially this one. People are dying while we fight, and in truth I think all of us on the various "sides" want the same thing. We just disagree on how to get there. I'm going to (carefully) mention that I do think street drugs need to come under some kind of regulation. Let's not call it safe supply, because that's a controversial term and it's not like any of this is actually safe. You mention smoking, which is a great example of effective, thoughtful long-term policy across all pillars to reduce harms. But cigarettes were fully legal when that work started, and so all the research that had to be done to encourage people to quit could easily happen, along with the follow-up studies to see how things were going, patterns of use, ages most responding to the messaging, etc. Street drugs, on the other hand, are illegal and ever-changing. Any study of any length just can't happen in that environment, and every time a person buys street drugs it's a complete crap shoot as to what they're getting, how much it's been cut, etc. No meaningful studies are possible because the drugs keep changing, day to day, even hour to hour. So instead of being able to say "Hey, people, if you're going to do drugs (because they are, let's be realistic), at least make sure you aren't buying anything with fentanyl above x per cent," we have to say "Don't do any drugs!" even though there ARE drugs in the illicit supply that for the most part are considerably less harmful than our legal ones, like alcohol. Stigmatization is definitely a part of controlling use, but we are having to blanket-stigmatize everything, rather than being able to stigmatize and educate around the really bad stuff while acknowledging that there are significant differences between these things we lump together as "drugs." We can't really even talk about street drugs realistically, because we're hell-bent on saying that all are evil and can't have anything resembling a normal conversation about it. Made worse by all that blood-in-the-water fighting that all of us do. I was looking into Stats Canada numbers, albeit from 2019, and what you see is that overall, illicit drug use is generally not rising very much. What has changed dramatically, however, is what's in the mix. It's lethal in a way that it makes a person wish for the good old heroin days. (Out here in BC where there are projects analyzing substances, heroin now accounts for just 3 per cent of the "down" in street drugs.) Where you do see a significant rise, however, is in the number of people who are on an opioid prescription and go on to report problematic opioid use. That figure doubled between 2017 and 2019. There's a clear problem to jump on, because those problematic opioid users, who got started on it by their doctor, are soon enough going to fall into the illegal supply once their doc gets nervous and cuts them off. And we all know the risks once that happens. Here's my thought on where all of us with our many divisive opinions might possibly agree - what if we began a real effort to analyze street drugs? The technology is all there, and can be done from a distance. We start with educating people on the actual drugs of the moment. We start engaging people in evidence-based conversations about the illicit supply, and where the greatest dangers are. We shine the light, open some eyes, save some lives. And then we can move into the touchier subjects, once we all get the hang of getting along. The drug-testing is happening here in Victoria at a small scale, but here's where politics and public opinion make things weird: Our current government tolerates users bringing in their own drugs to have analyzed, but doesn't want sellers to bring in their drugs, because it's a criminalized environment. So you've got a seller who sells to, say, 100 people, and who actually wants to make sure they're selling something that won't kill people, but the logic of testing that person's drugs gets swept aside by the optics of looking like you're being tolerant of criminal behaviour. And people keep dying - 18,000 right here in BC in the last 9 years since we declared a public health emergency (and did almost nothing except declare it, of course). Apologies for the l-o-n-g response - this is a hobby horse of mine, to see all of us good people come together and get a handle on this crisis instead of using all our energy on fighting with each other about how it should be done. I really think we need to find small actions that we can all agree on, and grow out from there.
I am listening, Jody! Sorry; less interesting business (that I get paid for, lol) distracted me from being able to respond. I struggle to understand how the evolving nature of the drug supply necessitates regulation. You are very right- newer street drugs kill swiftly and often. They also maim first, and often- we have an untold *sea* of people living on the streets who are literally brain damaged from the noble efforts to save them. (Hypoxia during OD's, often numerous.). We do not seem to be discussing unintended consequences; the few researchers who have tried were silenced/shunned (eg., Doleac and Mukherjee). On smoking, my understanding is that we didn't get people to quit- sadly, most will still die of smoking related illnesses *before* they quit- the miracle work was that we got young people not to START smoking. That's why numbers are down. So... to me, a key is to make drugs so unappealing (uncool, difficult, expensive, etc) that people don't start. Evidence suggests that harm reduction does the opposite... ok, gotta go to work. Thx for engaging!
We'll just keep the dialogue going when we can! I work in communications strategy around various social issues, so for me this is so useful in getting me thinking about how we can bridge our divides and get things done. I hear you on the need for a very different kind of drug education. I'm not even sure if there IS real drug education going on. There's a young woman here in BC who is going into schools Grades 8-12 to talk drug education, Naloxone, toxic drug crisis, etc, and her stats after speaking to 40,000 kids in that age range show that 51 per cent had never even heard there was a toxic drug crisis until she came to speak. That's pretty wild. And yes, the brain injury stuff post-overdose is a terrible unintended consequence of the crisis. Nobody has any kind of handle on any of that, at least not in BC - no stats, no process for diagnosis, no analysis of its impact on the street crisis, no adaptive services for people who now have a life-changing injury.
It’s the drugs that are causing the harm, little buddy.