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Perrin - Overdose: heartbreak and hope in Canadas opioid crisis

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Perrin Overdose: heartbreak and hope in Canadas opioid crisis
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An astonishing and powerful look at the ongoing opioid health crisis--the only book of its kind in Canada.
North America is in the middle of a health crisis. The word Fentanyl only recently entered common usage, and yet it has become a looming presence in news reports and conversations across Canada. It is an opioid more powerful and pervasive--and deadly--than any previous street drug.
Often those suffering are marginalized people. Consider that in 2003, the SARS epidemic killed 44 people in Canada and launched a massive mobilization of public funds and resources to contain the outbreak. Over 100 times that number have been killed between 2016 and 2017 during the opioid crisis in Canada. Yet, the response has been far from proportionate. In fact, our policies are making things worse.
The victims are many, and as we learn here, not only who we might expect. They are our neighbours: professionals, students, parents, and even health care workers. Despite the thousands of deaths, these victims remain largely invisible. But not anymore.
Benjamin Perrin, a law and policy expert in Vancouver, BC--ground zero for the crisis--shines a light in this darkest of corners. What he finds challenges many assumptions about the people who use opioids, and the factors fuelling the crisis. Why do people use Fentanyl, where does it come from, and why cant we stop it? These questions, and many others being asked by all Canadians, are answered here in this urgent and humane look at the worst health crisis in recent history.

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Also by Benjamin Perrin Victim Law Invisible Chains VIKING an imprint - photo 1

Also by Benjamin Perrin

Victim Law

Invisible Chains

VIKING an imprint of Penguin Canada a division of Penguin Random House Canada - photo 2

VIKING

an imprint of Penguin Canada, a division of Penguin Random House Canada Limited

Canada USA UK Ireland Australia New Zealand India South Africa China

First published 2020

Copyright 2020 by Benjamin Perrin

All rights reserved. Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, recording or otherwise), without the prior written permission of both the copyright owner and the above publisher of this book.

www.penguinrandomhouse.ca

L IBRARY AND A RCHIVES C ANADA C ATALOGUING IN P UBLICATION

Title: Overdose : heartbreak and hope in Canadas opioid crisis / Benjamin Perrin.

Names: Perrin, Benjamin, author.

Identifiers: Canadiana (print) 20190141921 | Canadiana (ebook) 2019014193X | ISBN 9780735237865 (hardcover) | ISBN 9780735237872 (HTML)

Subjects: LCSH: Opioid abuseCanada. | LCSH: FentanylCanada. | LCSH: OpioidsOverdose. | LCSH: FentanylOverdoseCanada.

Classification: LCC RC568.O45 P47 2020 | DDC 362.29/3dc23

Ebook ISBN9780735237872

Book and cover design by Andrew Roberts

Cover image by Julius Reque / Getty Images

v54 a Disclaimer Nothing in this book should be construed as providing - photo 3

v5.4

a

Disclaimer: Nothing in this book should be construed as providing legal or medical advice. If you or someone you know is using substances and needs help, please contact a healthcare professional.

For Douglas Little Doug Nickerson

Most people are more comfortable with old problems than with new solutions.

Anonymous

CONTENTS
FOREWORD

If they ran a dog as the candidate Id still vote Conservative.

Growing up in Calgary, I heard that saying more than once. And even though I love dogs and thought of myself as a conservative, it bothered me. It summed up my fears of party politics: at some point, youd have to shut your mind off and blindly surrender to loyalty and ideology.

I first became interested in politics when I was 14. A federal election had been called for October 25, 1993, and my social studies teacher asked us to keep a scrapbook about it.

I dove into the project. I got copies of each partys election platform and read them voraciously. This was pre-Internet, so I had to clip out newspaper stories with scissors and watch the evening news to learn what each political party leader had said. Even though I couldnt vote, I was fascinated by the tough issues and tried to make up my own mind about them.

In 2012, two decades later and with that election scrapbook sitting in my parents basement, I found myself at the heart of Canadian politics as Prime Minister Stephen Harpers top criminal justice advisor. Id taken a one-year leave of absence from my job as a law professor at the University of British Columbia to pursue this once-in-a-lifetime opportunity. I was eager to use my position to help the plight of victims of crimean area Id spent most of my professional career working on.

In Harpers office, I also had a front-row seat to Canadas war on drugs. His tough on crime agenda had already increased jail time for drug offences and fought unsuccessfully to shut down Insite in Vancouver, at that point the countrys only supervised injection site. Since illegal drugs were viewed as bringing disorder and devastation, stamping them out was Conservative dogma. Having never spent much time thinking about drug policy, I figured it made sense. I had shut my mind off.

A few years after moving back to Vancouver with my young family and resuming my job at UBC, I started hearing seemingly isolated media stories about illicit drug overdose deaths in the city. It struck me as a tragic yet senseless loss of life.

As the death toll mounted and a public health emergency was declared in BC in 2016, it was clear that the status quo wasnt working. It bothered me that I was just carrying on with my busy life as people continued to die every day in my city and across the country. Id been spending time seeking God in dealing with challenges in my own life, so one afternoon I prayed a simple prayer: I asked him to give me a heart of compassion for the people who were being affected by the opioid crisis. I had no idea where it would lead me.

I began asking around the law school to see whether any of my colleagues were conducting research on the opioid crisis. Nope. I checked at the other law schools and posted an appeal on Twitter. It turned out that there wasnt a single law professor in the provinceand quite likely the entire countrywho was doing any work to address the crisis at the time.

How could I just stand by as people continued to die? I felt a moral responsibility to try to help if I could, and also a personal responsibility to do something. After all, Id worked for a government that set up Canadas current approach to dealing with illegal drugsa modern-day war on drugsand it was clearly failing to address this crisis. I was a law professor with experience in government and had helped change laws and policies before. I had contacts in law enforcement and the community. I knew how to get a message out through the media and had contacts with a major publisher. And with tenure, I could take controversial positions based on my research. It was time to act.

I set out to investigate the opioid crisis without any team or funding in place. That would come later. It was a leap of faith. My aim was to find out why the crisis was happening, what was being done about it, and what more could be done to save lives. I would follow the trail of evidence wherever it led.

I dropped everything to kick-start my research. And given that this was a public health emergency, I didnt want to wait a year or two to apply for traditional research grants; instead, I proposed raising the money Id need via crowdfunding. The law school put the brakes on that idea. Fortunately, an individual donor stepped up to cover the costs of a research assistant, travel, and transcription services for the interviews I needed to do.

Within a month or two Id read all the current reports on the problem and gotten ethics approval to launch the study. Then I hit the streets. I quickly learned that BC is the epicentre of the opioid crisis in Canada, and that Vancouver, Surrey, and Victoria have been hardest hit. So thats where I focused my investigation.

I interviewed 42 leading experts with over 500 years of combined professional experience. I met with police chiefs, drug squad investigators, undercover police agents, border guards, intelligence analysts, firefighters, prosecutors, defence lawyers, judges, healthcare officials, medical doctors, addiction specialists, community-based service organizations, Indigenous organizations, activists, advocates, and organizations representing people who use drugs.

I criss-crossed the BC Lower Mainland and travelled to Victoria to see firsthand what was happening. I filed Freedom of Information requests to get access to government records. I analyzed and wrote up my findings as soon as I received interview transcripts back, working from early in the morning, before the kids were awake, to late into the night. Burning the midnight oil, I felt like I was back in law school again, except now I needed to take a 15-minute nap in the afternoon.

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