Life's a mess for people on the streets. But at least they've got friends

Bianca van Djyk, Pixabay

I spent a bit of time on “the block” this past weekend, that stretch of Pandora Avenue that is currently one of the city’s most visible hot spots of social crisis.

I hope the city’s big plan works out well for all concerned, and sign me up for helping. But after three decades of watching so many variations of Victoria councils trying to get a handle on this issue, it's obvious that we'll just be moving street problems into someone else's neighbourhood unless we grasp what really creates these hot spots. 

There's a tough little core of maybe 70-100 people at any given point in time in our region who are youngish, hardy, and deep in a late-stage struggle with whatever substance has got them, generally with mental and physical illnesses taking an additional toll. Their chaotic and unpredictable lives place them far outside the many rules, online forms, waiting periods, and service restrictions they face when trying to get help.

Like anyone, they need to get their needs met. So they settle in areas where there's food, washrooms, and a shelter mat in bad weather or some shade when it's hot. The drug sellers follow, and in many cases are the same people, because how else does an impoverished person afford a $50-100 daily habit?

But there’s another factor at play in why this group of people find their way to each other. They are each other’s community. Most everybody else in town either hates them, fears them or views them with disgust, pity, or some mix of the two. On Pandora, the judgment stops.

Get talking to people on the block and it quickly becomes clear that as sad, rough and garbage-strewn that life on a sidewalk appears to be to people like me, there is community on that street. More than one person told me they would be so happy for housing, but that it would need to be big enough for all the people on the street who they consider to be their family.

If you are a sick, struggling person who is spat on, sworn at, and openly scorned pretty much everywhere in the region, it must be pretty nice to have one place you can exist where most people aren’t going to hate on you. Anyone who has known the feeling of being an outsider finally finding their “people” can surely relate.

Can we even fix the multi-pronged social disaster that has been created from decades of neglect? I don’t know anymore. But if we’ve got any chance, it hinges on recognizing that people living homeless don’t just need homes that accept them as they are, they need community. "Don't put us all two by two in a bunch of different buildings where nobody likes us," said one woman. "Let us stay together."

I first encountered this group (not the same individuals, of course) 25 years ago when they were living at Holiday Court, a rundown motel on Hillside Avenue. I was working as a journalist at the time. It was a crazy little scene at that motel, but you didn't have to be there for more than a few minutes before you saw that they were mostly glad for each other's company and assistance. 

Soon enough, the motel scene got too hot for the community to handle, and Holiday Court closed and was torn down. The group moved somewhere else, then somewhere else, then somewhere else, with new people falling into the group at roughly the same pace that others were falling out. They would stay until neighbours or police started howling, then move on.

Eventually there was no place where they were tolerated but the street, where a person has no choice but to live every moment of a problematic life out where everyone can see you. The rest of us make a lot of noise about having to see them, but reflect for a moment on what it must be like on the other side of all our loathing and intolerance.

So many things have changed since the days we dream of returning to, when Pandora's tree-lined boulevards weren't blocked off with ugly blue construction fencing lined with litter. Businesses used to operate side by side with social services that have dominated the block for many years. But that has all changed since the pandemic, when we fully lost control of our weakening social safety net.

Housing affordability, the job market, easy access to medical care, the mood in our communities - all that has changed since the pandemic as well. We definitely weren't doing great before 2020, but we've been doing so much worse ever since. 

Our jails have filled with people with mental illness. Our schools have more and more students who don’t fit into the way we’d like to teach them. Our child-welfare system pumps out half-grown “adults” into homelessness, poverty and substance use disorders. Our street drugs are toxic with fentanyl and more, causing death and chronic health problems at unprecedented levels.

Brain injuries abound, an unintended consequence of bringing people back from the dead in the toxic drug crisis. People with intellectual disabilities are falling into homelessness as “inclusiveness” becomes an excuse to cut services. Mental health issues are increasingly common, even while resources are increasingly scarce.

And now the City of Victoria is setting out to fix things once again with its Community Safety and Well-Being plan. The days of anything resembling an easy fix are long past. I don't want to be a wet blanket, but let's just say I'm moderating my expectations accordingly. 

If we truly want this time to be different, though, then we need to see the problem through the eyes of the people living it. There are many reasons why people end up on Pandora, and feeling like they're finally part of an accepting community is a pretty big one. Is that in the plan?

My radio interview on - surprise! - the toxic drug crisis

Image by 愚木混株 Cdd20, Pixabay

Anyone else like a radio opportunity that gives free range to say whatever you want to sound off about,  but then you listen to it and think good grief, couldn't I have been more eloquent and organized in my thinking?

Ah, but then I wouldn't be me, right? Or that's what I like to tell myself. 

Here I am, blathering on People First Radio this month about the street scene in Victoria. For some reason, I'm listening to it for the first time today, 10 days after it aired. I think that might relate to my reluctance to not want to hear myself talking in random, wandering, no-key-messages fashion. That's my dealio, but that's not to say that I love that I do it that way. 

But all that said, thank you, Joe Pugh, for letting me sound off in my usual stream-of-conscious style, and for including some clips from the speaker series on the toxic drug crisis that I organized in partnership with Peers Victoria earlier this year. 

On the upside, illicit drug deaths in BC fell to 143 in March, from a monthly peak of 241 in December 2023. That's about where we were at in April 2020, though up from February 2025 when we saw "just" 132 deaths. 

But I note that figures on the BC Centre for Disease Control dashboard haven't been updated for  April and May, and I wonder what that means. My connections are telling me that BCCDC communications now have to be vetted by government first. I am really hoping that is not impacting the data they are able to put out. 

Just saw a Conversation piece from a US academic who specializes in communication strategies for resistant audiences. I sent her an email for any advice. All I see is people like me talking like crazy, and nobody listening. 

Sidney McIntyre-Starko was loved. So were the other 50,000 people who didn't get their stories told

Pixabay

I hope the inquest recommendations that have come out of tragedy in a University of Victoria residence really do lead to major change. What happened to Sidney McIntyre-Starko is very sad, and there were some major stumbles on a number of fronts leading up to her death at 18 from toxic drugs.

But if anyone is thinking that the terrible stigma that hangs over illicit drug use got eased by all the news coverage of this young woman’s death, just let that one go. If anything, the coverage deepened stigma.

Right to the final stories, we have seen photos of beautiful Sidney in all her active, “normal” roles, been reminded that this was the first time she’d ever used drugs. She was a good person, we have been assured many times by those quoted in the stories. She died because of system failures, the stories emphasize, not because she was a drug user.

And there it is. The stigma. The coverage is careful not to say out loud that Sidney was not like all the other drug users who are dying, but it comes through clearly. She was different – active and beautiful and loved, with a bright future. She even got her own inquest.

The lives of the other 50,000 lost souls who died the same way that Sidney did in these terrible nine years ended largely without comment, and certainly without government investing any scrutiny as to how systems may have failed them.

I mean no disrespect to Sidney or her family. Her death will change the way things are done, and that is a big deal. 

But this young woman’s tragedy has been put forward in a way that affirmed from the start that she was Not Like Those Other Drug Users. The coverage has confirmed - if not intensified - the terrible stigma that hangs over all the other active, beautiful and loved people with bright futures who also continue to die in the toxic drug crisis.

The irony is that in a way, Sidney was killed by stigma. If someone had said from the get-go that Sidney and her friend had just used random drugs someone had found in an abandoned case of wine coolers downtown, I expect things would have gone very differently.

But the young people who knew drugs were involved felt the stigma so heavily that they didn’t acknowledge it to any of the first people they asked for help even when two young women lay before them turning blue and having convulsions. That is some kind of stigma that can do that.

In a way, stigma likely led to those young women using the drugs they found in the first place. 

They went from age 9 to 18 in the years since BC declared a state of emergency over toxic drugs, which started killing so many people after the heavy-duty pain drug fentanyl and all its analogs started to creep into the street drug supply as a substitute for heroin.

How is it that two girls who literally grew up in the era of a horrendous toxic drug crisis in BC didn't know that using random drugs from an abandoned box of booze a friend found downtown was a dangerous risk to take?

I’m pretty dubious of that story if I’m being honest. But if it’s true, then that’s because of stigma too. And if it's not true, then there's the stigma again, getting in the way of these young people admitting that they'd actually bought the drugs.

If the conversations we have about street drugs were at all realistic, those young women would have known from years of education that just about the craziest thing to do in a toxic drug crisis killing 150-200 people a month was to take unknown drugs from a completely unknown source. At the very least, they'd have known to take them to the UVic drug-checking storefront first to see what was in them. 

If we hadn’t criminalized and cast shame over drug use (well, other people’s drug use, never our own), then we would acknowledge that lots of people use drugs, and that it’s actually in everyone’s best interest if people find their way to a regulated supply.

I don't know about you, but I really appreciate going to liquor stores knowing that none of the bottles has been topped up with methanol. I haven’t minded giving up the strange lengths I used to go to for acquiring cannabis now that it’s just in a store, with a label and everything.

I’m glad that when my nurse practitioner gives me a prescription, I know what’s in that drug, who made it, and that I’m taking the recommended dose.

People seek drugs. So why have we put this stigma around a very narrow little group of them, and told ourselves that we are protecting our children by doing that? And how is that working out for us, what with toxic drug deaths now the No. 1 killer in BC from age 10 up?

We are paralyzed with fear that regulating illicit drugs will put our children at risk through easier access. But that's like drawing a comparison to some dream world we aren't living in. The reality is that our children are at tremendous risk right now - never more at risk than now, in fact, and still we dither over our political opinions and our support of tactics that have failed us for decades.

That’s one tough stigma, locking us up like this so completely and for this long.

Sidney, you died far too young. I feel sure you were growing into as beautiful a person as all the photos of you in the media depicted.

But the families of all those other people who have died have those beautiful photos too, and there were so many system failures for so many of them as well. If something good can come out of your death, Sidney, I hope it’s a realization among all of us that there’s no difference between you and them.

What might we learn if we listened?

Image by Couleur: Pixabay

Nobody knows the challenges of getting out from under harmful substance use like someone who has actually done it. The third event in the Peers Victoria speaker series on the toxic drug crisis brought together a powerful panel of six past and present substance users to talk about their journeys with frankness, wisdom and so much insight. (I was the lead organizer of the series.)

But while we've got a complete video of the event, it's a rare devotee of the subject who would watch the whole thing, clocking in at over two hours. So I made a "greatest hits" compilation, if you will - 40 minutes all in, with clips reordered and with a bit of categorization that helps bring more focus to the panelists' comments. 

Here it is for your viewing pleasure. If you have people in your circle who are still saying stupid nonsense about substance users not wanting recovery sufficiently or being content to exist in a state of oblivion, please share it with them. 

What kind of systems for substance disorders might we have if we just listened to the people who have already been through this toughest of life challenges? 

As these six voices remind us, of course, we would be foolish to just listen to ONE voice when designing approaches (Marshall Smith, you're on my mind). The path to healing is so very distinct and different for each person, and the underlying pain and trauma that lead up to harmful substance use are highly individual as well. But if we genuinely wanted to address this crisis, the experts are all around us. 

Don't buy the snake oil

ChatBox AI image created by me

I generally stay out of the fray when it comes to commentary on politicking, so much of which is about as reliable as a snake-oil pitch.

But having caught Pierre Poilievre’s promise of addiction treatment for 50,000 Canadians, paid out of the money that will be saved when safe-supply programs are cut, I just can’t let that blatantly misleading statement stand unchallenged.

First, let’s start with safe supply. That’s the term used for when people are able to swap out their completely unregulated opioid-based street drugs for a prescription opioid from a health professional. It’s the most obvious immediate strategy to stop a toxic drug crisis that has killed 50,000+ Canadians – more than a quarter of them in BC - in the decade since the anesthetic fentanyl began dominating the street drug market.

That Poilievre actually thinks there’s enough money in the country’s teeny-weeny safe-supply response to pay for a major expansion of treatment beds and the cost of putting people into them for three, four or more times through – totally predictable with a relapsing health condition – well, that’s the first glaring sign that this promise is pure snake oil.

Here in BC, we have an estimated 100,000-125,000 people with opioid use disorder. A mere 4,600 of them are on the safe-supply program that BC launched at the start of the pandemic. That’s four per cent of the people who could actually benefit from safe supply.

Elsewhere in Canada, 10 other cities launched pilot safer-supply programs during the pandemic, nine of them in Ontario and one in Fredericton, NB. Federal funding ran out for most of them already.

In the few short years since, the mercurial public mood has shifted toward a view of safe supply as having “failed,” even though it actually barely got a start. So good luck grabbing all that big money invested in safe supply into treatment, Mr. Poilievre.

What really gets me with stuff like this is that a politician's comments are rarely challenged by reporters, leaving the public to assume that there really is some massive government investment in safe supply that can be transferred over to treatment.

I figure that whichever party ends up elected at the end of this month, we’ll get a few more treatment beds. That’s a good thing, because we really need them, along with government funding to support people accessing those beds without having to come up with tens of thousands of dollars multiple times to buy their way into a largely private system of care.

But any new beds will barely make a dint on the actual issues that are troubling the public - one of which is an unregulated drug supply managed in the shadows by international drug cartels that is killing their children, grandchildren, employees, partners, siblings and neighbours; and the other being a multi-faceted crisis of poverty, homelessness and mental illness manifesting ever more ferociously on the streets of our communities.

Substance use is definitely layered into that latter problem. But the main driver of the tragedy unfolding on our streets is poverty, mental illness and a housing crisis. Until we deal with those underlying causes, we’re going to be living with the soul-searing visibility of enormous suffering no matter how many treatment beds come into play.

Safe supply is an easy scapegoat for politicians, I suspect because we’ve been convinced over many decades to view the kind of drugs that end up on our streets as evil. BC’s tiny safe supply program was dealt a very hard blow recently when Premier David Eby got fussed about the supply being diverted into the illicit market, and withdrew people’s right to take their prescription drugs in the privacy of their own home.

Picture how that would go for whatever prescription drugs you might be taking, if suddenly you had to visit your local pharmacy twice a day, within their operating hours, to take your heart drugs, for instance, or use your asthma puffer.

Your job, your family time, your recreation activities – all of that would have to fit around getting yourself to the pharmacy twice a day, every day, to swallow your pills or inject your insulin in front of a health professional. How long would it take any of us to be looking for alternatives on the black market to spare us such misery?

Yes, diversion happens. An issue with safe supply is that it decrees what drugs you can swap onto, and fentanyl isn’t one of them. So some people on safe supply sell whatever drug they’ve been given to get the money for the fentanyl that they actually want.

You can look at that as a failure, I suppose. But toxic substances laced with unknown quantities of fentanyl and fentanyl analogs are now the No. 1 cause of death for British Columbians ages 10 to 59, exacting a massive impact on our collective productivity that is second only to cancer. What could possibly be a bigger failure than that?

So now let’s consider treatment as a “cure” for that failure, as Poilievre wants us to do.

First, the obvious: Many of the people dead in the toxic drug crisis weren’t in need of treatment. They were just average people using drugs for fun – not aberrant behaviour in a country where three-quarters of us consume alcohol regularly. They died because a toxic drug supply doesn’t differentiate between whether you’re a first-time user or an “addict.”

Then there’s also this tricky truth: Treatment for any chronic, relapsing condition is a long, hard slog. Whether it’s Type II diabetes, hypertension, or this thing we call addiction, 40-60 per cent of people will relapse after treatment. They will need many passes through treatment to reach a state of recovery, and some will never get there. Getting to where we need to be in terms of quick access to treatment is going to be expensive, just as it is for any other long-term health care interventions.

People using opioids are particularly vulnerable to dying during a relapse, as their tolerance falls significantly after a period of abstinence. Add in that little ongoing problem of a toxic drug supply - any hope of accessing safe supply during a relapse having evaporated under Poilievre’s plan - and it’s clear that expanding treatment alone will not get us out of this crisis.

And one more tricky truth: Treatment for this thing we call addiction is almost completely owned by the private sector – and increasingly, by multinational corporations and private-equity firms interested in consolidating many small community treatment centres into one big entity that will attract investors. (As is happening with veterinary services, lab services, mental health services, employment training, etc.)

Treatment for substance use problems is outside of the Canada Health Act. Private treatment centres are free to set their own rates and their own methods. If they report on their effectiveness at all, the data collection stops the moment a person leaves the centre. A person could relapse within hours of “graduating” and still be counted as a success.

The lack of transparency and absence of meaningful data collection leaves us with scarce knowledge to prove or disprove the effectiveness of any treatment approach. Nobody can actually say what’s working, or what happens once someone leaves a treatment facility in a state of abstinence and walks out into the big world where all their troubles await.

We simply don’t know how many times people relapse, because we don’t measure or track. We don’t know how long an individual stays abstinent after a round of treatment. There are no national standards for treatment. No followup.

So yes, let’s talk treatment. It’s a pillar of any health-care approach, as is access to regulated medications. But please don’t buy the snake oil.