A Vancouver Island addiction expert says stamping out stigma against addicts is a crucial step to stemming the tide of drug-related deaths, just as activists did during the HIV/AIDS epidemic once seen as a "dirty disease from dirty people."
CBC's examination of treatment and recovery in the wake of a rash of fentanyl-related death has inspired an outpouring of concern and a backlash of judgement.
CBC Radio's Talk Back line has gotten many comments from listeners blaming addicts as the cause of their own problems and questioning why taxpayers should pay for their treatment.
'No longer a choice'
Dr. Patricia Mark, who works at the AIDS Vancouver Island methadone clinic, says this opinion is common and based in ignorance. It is also part of the reason the overdose crisis continues as addicts are left out in the cold, blamed for their illness and not offered resources that could help.
People believe addicts are "bad people making bad choices," she explained.
But when it comes to illicit drug use, the problem is not that simple.
"After the first initial few uses, it's no longer a choice. It's a brain disease which alters the brain and these most unfortunate people are stuck with something they just can't control," said Mark.
She pointed out that many illnesses that cost society money start with "choices" and are completely "self-inflicted."
"Let's look at smoking ... what about alcohol misuse? Let's talk about obesity ... these [also] cost the taxpayer a lot of money," she said.
Addiction and trauma hand in hand
Mark described the men and women she treats in the B.C. Corrections system and at the methadone clinic where she works.
They are not "bad people," she said.
Instead, she describes them as victims of trauma — often horrific abuse as children.
"They've had horrible lives — unbelievable abuse they endured as children that I don't even want to describe," Mark said.
"These are damaged people that use drugs and alcohol to blot out everything that is horrible in their lives."
Despite the trauma they have survived, many end up blamed for their addiction and victimized again, she explained.
Mark said many hardcore addicts are almost impossible to fix, and will never be able to walk away from the illness that has changed their brain's wiring.
Is there progress in helping addicts?
Not as much as Mark would like to see.
The political impetus to fund evidence-based care and support is lacking, she explains.
"[Judgmentalism is] rampant at all levels of society — and that includes political levels," said Mark.
The thinking reminds her of how long it took before people joined forces to fight the HIV/AIDS epidemic that was overcome with groups of individuals who demanded people see past the stigma to the lives being lost.
"That was considered to be a dirty disease from dirty people ... until a very courageous group of men and women got together from Vancouver and they took this head on," she said.
"And look what happened! We have got this illness, this disease pretty well under control in B.C. now."