Stop polarizing the debate. It took both harm reduction and drug treatment to save me

A fierce debate rages between drug treatment and harm reduction advocates in Alberta. But that misses the point, argues Chris McBain, a former injection drug user. He needed both to get his life back.

When I was at my most vulnerable, volunteers with a needle distribution service gave me hope

A man holds onto a large stack of books focused on treatment for drug and alcohol addiction.
Chris McBain was once addicted to crystal meth and is now a sociology student at Athabasca University. (Submitted by Chris McBain)
A banner reads, "The Way Out: Addiction in Alberta."

This story is part of a series called The Way Out: Addiction in Alberta. Join the discussion, or read more about the series here. It is the opinion of Calgary resident Chris McBain. For more information about CBC's Opinion section, please see the FAQ.

I don't vote conservative. But I deeply appreciate what the UCP government has done for recovery.

They opened more beds with free treatment and, in 2021, it saved my life. I'm a former injection drug user. Treatment gave me the chance to get off the street and on my feet again and make a fresh start with my life.

But harm reduction also saved my life.

When I was at my most vulnerable, volunteers with a needle distribution service in Edmonton gave me hope, and helped me navigate the complex road to recovery.

Without harm reduction I wouldn't have found the path to life.

There's a lot of anger and rhetoric around this today. Policy makers, advocates and many others are polarizing recovery versus harm reduction. But they're not mutually exclusive. They're both essential.

The inside of a supervised consumption site. They often resemble medical clinics, allowing people to take drugs in a monitored and hygienic place. (CBC News)

For the past four years, Marshall Smith — the premier's chief of staff and a former cocaine user himself — has been leading an effort to invest heavily in new treatment options while leaving supervised consumption sites in limbo and scaling back access to alternative treatments.

But I believe his problem is consensus bias — what happens when people see their own choices and assume their situation and experience is common. Smith was able to recover with treatment, so he assumes others can.

But drug treatment centres don't address the poverty, homelessness, lack of education or deep-rooted trauma that make recovery much more complicated for many. An employee at a treatment centre with a diploma in addictions isn't equipped to help someone recover from the trauma of rape, or a lifetime of fighting homophobia and extreme poverty.

The other reality no one is talking about is the efficacy of treatment. 

In 2017, the Canadian Centre on Substance Use and Addiction surveyed 855 people who had gone into treatment. They found 58 per cent did not complete the program, and of those who did complete it, nearly half returned to substance use.

Because if you can't get a job due to a criminal record, or therapy to address trauma, then how are you supposed to build a life worth staying sober for?

When the UCP government says harm reduction doesn't work, it points to B.C. But B.C.'s model is failing because there isn't a mass pouring of resources into mental health, housing and food security. 

We should look instead to Portugal. It decriminalized personal drug possession in 2001, but as part of a reorientation to a wider, health-based approach. And drugs were still confiscated with administrative penalties such as fines or community service.

I would have stayed lost and probably died by overdose on the street.- Chris McBain

In 2001, Portugal had the same overdose rates as most of Europe and they were climbing fast. The country still struggles with drug use, but its overdose rates are now a fraction of what some other countries are seeing. In 2019, for example, Portugal was at six overdose deaths per million residents, compared to the European Union average of 23.7 per million. 

As well, HIV diagnosis dropped from 1,287 new cases in 2001 to only 16 new infections in 2019. Prison rates also dropped and the government reinvested funds into mental health and housing. That's the piece we're missing in Canada.

My own substance use got out of control in 2012, when I was sexually assaulted and found out a month later I was HIV positive. Until this time, I was a pretty standard young gay man who liked to party. With my new diagnosis, the party went dark and substance use took over.

I lost my job, filed for bankruptcy more than once, became homeless and traded sex for a bed to sleep on. I lost the support of my family and friends, and even the spark that made me "me."

Had it not been for that needle distribution team in Edmonton back in 2016, I would have stayed lost and probably died by overdose on the street.

Two men stand holding each other's shoulders.
Chris McBain, left, stands with former Edmonton city councillor, Michael Phair, at an event about inclusive citizenship. The photo was taken about eight years ago, just before McBain's addiction to injection drugs began. (Submitted by Chris McBain)

The journey back has not been straightforward. I had been to treatment four times, detox 10 times, and always relapsed. But on December 24, 2021, I tried detox once more and it finally stuck.

I've been in recovery for 14 months now. Staying stable took getting housed, finding support groups, a psychiatrist, a social worker, and rebuilding my circle of loving friends and family. It took finding a meaningful role in society and a hell of a lot of faith.

I'm grateful to both harm reduction and treatment as they have helped give me my life back in a whole new way. I just wish we could all see the importance of these pieces working together. Treatment is essential for some — but how will people get there if they're dead?

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Chris McBain

Opinion writer

Chris McBain is a sociology undergraduate at Athabasca University. He was addicted to crystal meth and now draws on that experience to work as a harm reduction educator with a local non-profit. He is also a church member, a sci-fi geek, a dog lover and a proud member of the recovery community.