Janet Jones challenges the idea that the 2018 Canadian Drugs and Substances Strategy public consultation will lead to innovative approaches to addressing addiction in Canada.

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The Canadian opioid epidemic shows little sign of slowing. Since 2016, more than 9,000 Canadians have died from opioids. Countless others have experienced health complications and adverse side effects, including non-fatal overdoses. To save lives, new approaches to the crisis need to be considered.

Under the Canadian Drugs and Substances Strategy (CDSS), the Public Health Agency of Canada works with the federal government to create policies and institutions to support people living with addiction. The purpose of this strategy is to prevent and treat problematic substance use. To do this, CDSS policies focus on both the enforcement of existing laws and the development of innovative approaches to harm reduction. Its mandate is to use “timely, comparable, national-level data to help develop effective drug and substance policies.”

In September 2018, the CDSS organized a 90-day national consultation. Reaching out to the public, especially to individuals with lived experience of addiction, the consultation organizers sought “to gather ideas on potential next steps under the Canadian Drugs and Substances Strategy.”

Anyone interested in participating in the consultation was asked to read a background document provided by the Government of Canada. The 35-page document is a comprehensive introduction to the problem of drug addiction as a health crisis. It outlines what the government and federal agencies consider key topics for discussion. The online survey, the main form of participation in the survey, only became available after individuals scrolled or clicked through the document.

Photo Credit: Lisa Blankenship. Image Description: An image of three people having conversation.

The consultation recorded more than 1,600 responses. The majority of those responses, however, came not through the online survey but, rather, through “a ‘tell us your story’” tool, which allowed participants “to share their personal experiences with drug and substance use.” This tool was separate from the online survey, though, to access it, participants had to read the same background document that preceded the online survey.

What is worrisome is that the post-consultation report seems at odds with the intention of the “tell us your story tool.” The report boasts an overview of the major themes that emerged from the storytelling process and, at some points, even includes direct excerpts from the stories to corroborate the reported concerns, but nowhere does it include the actual responses or stories. And, even more troubling, nowhere is there any indication of how the collected stories will inform future plans of the CDSS.

In fact, the key points of the post-consultation report are near duplicates of what the CDSS policymakers listed as “key areas for discussion” before the consultation took place:

The following points were identified as key areas for discussion on the consultation website:

• taking action on the root causes of problematic substance use
• reducing stigma around substance use
• supporting Indigenous peoples
• addressing the needs of at-risk populations.

 The following points were identified as common themes in the post-consultation report:

• stigma and discrimination
• understanding problematic substance use
• services that better meet the needs of individuals and groups.

Duplication may suggest that the participants echoed the organizers’ concerns, but Appendix B of the post-consultation report lists that there were other noted themes in participants’ responses, including “moving forward with prevention; increasing access to evidence-based treatment; law enforcement and justice, alcohol policy, and addressing methamphetamine use.” Yet none of these are cited in the main body of the report. It is evident that only some stories were heard; only some made the cut.

Reading case studies or hearing the experiences of others open up our horizons to new perspectives, encouraging us to inhabit spaces differently and feel from diverse points of views. However, if we simply take the narratives of others and fail to meaningfully work with those others, then narratives – no matter how poignant – will matter little.

Storytelling, on its own, is not enough. Both stories and storytellers need to be heard. As researchers and policymakers, we need to engage with storytellers beyond their narratives. They must be offered the chance to correct our interpretations and challenge us when their stories conflict with ours. We must recognize that expertise doesn’t always look the same and that these other experts must both participate in and steer joint initiatives like the CDSS for them to be effective and innovative.

Participants of the CDSS, unfortunately, were only able to submit their stories according to the format that the policymakers offered. There were no opportunities for engagement or interaction between the two parties. Consequently, stories and personal lives became mere data to be sifted through and there was nothing to ensure that stories were interpreted correctly, voices were heard, and lived experiences honoured. For that reason, I doubt that the consultation will push the CDSS in genuinely innovative directions. But, for now, we can only hope.

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Janet Jones is a Ph.D. student in Applied Philosophy at the University of Waterloo. Invested in the philosophy of addiction and harm reduction, she asks us to consider how storytelling can inspire and inform innovative approaches to the Canadian opioid crisis. @thejanjan88