“Make No Mistake, People Are Dying”: A Literature Review of the Opioid Crisis in Canada

Objective: Evidence has indicated that harm reduction practices aid in preventing drug overdose and provide social support for people who use drugs. However, less is known about the enablers and barriers to adopting such practices in public health policy. The purpose of this research is to investigate how social and political factors act as enablers or barriers to implementing harm reduction services, with a focus on the roles of activism and evidence-based research.

Design: A policy and history analysis of the opioid crisis in Canada, with a focus on British Columbia and Ontario.

Methods: I conducted a literature review of published literature, grey literature and Federal and Provincial government reports.

Findings: My findings demonstrate that activism is a stronger enabler for harm reduction than evidence-based research in both Ontario and British Columbia. A common barrier in Ontario is the difference in political values between the provincial and Federal governments. Also, limited funding and poor resource distribution resulted in equity concerns for Northern communities like Sault Ste. Marie.

Conclusions: My findings emphasize the need for a more equitable reallocation of Provincial funding for mental health and addictions health care. A shift in political values may enable Ontario to implement harm reduction services long-term. More research is needed to better understand the intersection of multiple social determinants of health.