People who use drugs are facing barriers to treatment when seeking recovery - many have been around for years while others cropped up during COVID-19.

With over 2,272 suspected illicit drug toxicity deaths in British Columbia, 2022 had the second-highest illicit drug death rate ever recorded, .

The supply of illicit drugs is growing increasingly toxic as they are mixed with such compounds as fentanyl and etizolam - the latter of which is not responsive to naloxone, the medication used to block the effects of opiods.

These dangerous compounds lurking in an unchecked supply are only exacerbating the need for more harm reduction and better access to addiction care, says Guy Felicella, a who credits harm reduction like drug checking and safe-use spaces for saving his life.

The system, he said, isn鈥檛 keeping up with the toxic drug supply.

鈥淲e just need to give people the opportunity so that when they are ready, we are ready,鈥� he said. 鈥淭hat is the quintessential factor in people moving forward.鈥�

The things he said British Columbia needs more of - and less of - could save countless lives, giving people who are addicted to drugs a chance at a life that isn鈥檛 centered around using. Such problems as long waitlists, doctor shortages, medication stigma and payment processes, however, are holding people down, Felicella said.

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Felicella said getting on a waitlist for a detox centre is the first challenge people face.

In Victoria, that looks like going to Central Access and Rapid Engagement Services (CARES) for a referral. The front desk at CARES said the time it takes to move through that step depends on the circumstances, but can sometimes take a few days.

Fred Cameron, who works for SOLID Outreach Society, a non-profit organization which provides support services and harm reduction, said the referral process can be bumpy.

鈥淭he process to get into detox is not as smooth as it could be,鈥� Cameron said. 鈥淭he referral process is not open to the public - you can鈥檛 just do it online. Small NGOs (non-government organizations) aren鈥檛 able to do that either, so there are definitely some hoops you have to jump through to get there.鈥�

After the referral is sent to Island Health, patients go on a waitlist for a detox bed, which can take weeks, but more commonly, months. There are in the province and research shows there is an British Columbians with an opioid addiction alone, according to Kevin Hollett at the (BCCSU).

Hollett said the number could be higher, since many addictions are undiagnosed. Not everyone with an addiction needs to detox, and there are private facilities available, but they can be expensive. The government-funded bed-to-person ratio in B.C. is one of the barriers Felicella cites.

Abstinence-only programs that limit and stigmatize certain medications also pose problems, Felicella said, adding that some publicly funded treatment centres still don鈥檛 allow the use of methadone, a medication used in Opioid Agonist Therapy (OAT) to treat withdrawal symptoms, which Felicella said can last for months and decrease the likelihood of stabilization and ability to learn life and coping skills.

Additionally, shows patients are at a higher likelihood for overdose if they discontinue the use of methadone for OAT.

Cheryl Diebel, the director of in Victoria, said there are facilities that don鈥檛 allow methadone use during OAT, but many are moving away from this.

鈥淭hat鈥檚 a very, very purist view of abstinence - we absolutely allow OAT and we recommend that patients don鈥檛 do any kind of withdrawing from the methadone for at least the first two months so we know they are starting to stabilize,鈥� she said.

Evan James, who works with the , an organization in Victoria that provides addiction support, said income assistance requirements are one of the more frustrating barriers he sees every day. For publicly funded treatment centres, he said patients either need to be on income assistance or disability, but many don鈥檛 qualify for either.

鈥淲e have this huge slice of the population in between the two - they certainly cannot afford the expensive private paid treatments, but they are not eligible for income assistance because they haven鈥檛 lost everything, or they have assets, or they鈥檙e still working - whatever the case may be,鈥� James said.

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James said cost barriers, coupled with the fact that most patients need to go to the mainland for publicly-funded treatment, present challenges to recovery. Support systems during recovery are essential, James said, so when people leave Victoria to get treatment, they lose that. Then the support systems they build on the mainland during treatment are lost when they come home.

Accessing alternatives to detox and inpatient treatement such as group meetings is also limited, as Cameron said the recovery world fell apart when COVID-19 first hit.

鈥淎 lot of the events and public gatherings that took place outside of structured recovery groups were cancelled and put on hold, so a lot of the things that I look back to that helped me out currently don鈥檛 exist,鈥� he said. 鈥淭here is a place for professional recovery, but to imagine a system that is big enough and comprehensive enough to help everyone - I just can鈥檛 see it, which is why people are directed to 12-step programs. It is those kinds of groups that people are going to and getting support in the early days.鈥�

For a system to be successful in helping people recover, advocates say more of everything is needed.

Diebel said more beds, specifically women鈥檚 beds, are needed. Cameron said more harm reduction services and different outlooks on recovery would help. James said addiction treatment needs to be treated as a medical expense by the province and Felicella said in general, the process needs to be easier to navigate.

鈥淭here are people who want help,鈥� Felicella said. 鈥淪ociety often says 鈥榯hese people don鈥檛 want help, they鈥檙e not going to change,鈥� but they鈥檙e not changing because it鈥檚 hard to get access to change. Instead of pointing fingers and blaming people struggling with addiction, let鈥檚 start pointing fingers at the policies that hinder them from getting the help that they need.鈥�

hollie.ferguson@vicnews.com
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