With one push on the piston of a syringe, crystal methamphetamine made Debbie Roberts’s world a darker place.
She thought she was taking another drug, Ritalin, the day she went blind. But someone must have swapped it out while she was in the washroom. When she pushed the needle into her vein, it was crystal meth that flowed into her bloodstream.
“All of a sudden I couldn’t remember anything after that. I just remember getting a headache,” she said.
“My mom said that I called her and my mom told me to go to the hospital and I woke up two weeks later in the hospital, blind. … My brother was dying in the next hospital from crystal meth, from his heart enlarging.”
Roberts and her brother were both meth users at the time, and both were HIV-positive. In their home province of Saskatchewan, the frequency of the virus is twice the national average and a large majority of cases are transmitted through injection drug use.
At the same time, crystal meth use has spiked in Saskatchewan, most dramatically since 2013. The number of people reporting crystal meth use when admitted to drug treatment services jumped by 200 per cent from 2015 to 2016.
Saskatoon police Chief Clive Weighill said the drug is driving crime in his city, which had the highest crime rate in Canada in 2015. Crystal meth is being blamed for everything from property crime to homicide, and the numbers are rising.
Although the prevalence of the drug has exploded in Saskatchewan in recent years, it wasn’t a sneak attack. Crystal meth was virtually non-existent in the province before the year 2000, but it was making headlines in the province by 2005.
Fears brought about by the drug’s devastating impact in the U.S. prompted policy changes in Canada, including harsher penalties for dealers. It was a response that draws parallels with today’s reaction to the fentanyl crisis.
But more than a decade later, crime and health statistics show meth in Saskatchewan is far from beaten. Actually, it shows no signs of slowing down.
Now, health workers say it is contributing to another public health crisis: HIV rates, which doctors say are of epidemic proportions. Unlike fentanyl, which can kill overnight, doctors say crystal meth is taking lives more slowly and under the radar.
Health workers say they’re doing everything they can to slow the momentum of a problem that’s already out of control.
But if Saskatchewan saw a crystal meth trainwreck in its sights, why wasn’t it able to put on the brakes?
Crystal meth nets new users quickly. The euphoria has such a powerful draw that it's believed about 10 per cent of people are addicted after their first try.
Roberts, a former crystal meth user who has been clean for several years, said addicts hankering for a fix will dig holes in their skin, picking to get at the drug as it comes out of their pores.
It leaves users with tunnel vision for their next high; whether people get hurt along the way is inconsequential. As Roberts describes it, “nothing matters.”
It’s the reason she said her friends left her at the hospital doorstep the night she went blind. It’s also why she stole when she was an addict, and the reason she said many addicts are sex workers.
“[Clients] pay you to go buy it because they get higher on the crystal meth, and then they’ll pay you not to use a condom,” said Roberts.
One of the ways meth impacts the brain is by causing psychosis, meaning users can become paranoid, delusional and manic.
A couple Roberts knows sleeps with a golf club under the bed to protect themselves if their son, a crystal meth user, breaks into their house looking for money.
“That’s how much it affects [you] — like, you’ll go after your own parents for money, for something to steal,” she said.
Roberts said she knows of someone killed over “one little baggie.”
The prevalence of the drug is encouraged by the fact that it is cheap and easy to produce.
Combined with the fact that it’s elusive to police, crystal meth has been able to chug away under the radar, gaining momentum.
The first wave
Jerome Engele, a retired Saskatoon Police Service officer of 35 years, was with the drug enforcement team when crystal meth started arriving in Saskatchewan.
He said police started to notice it in Saskatoon around the early- to mid-2000s, although there were a few isolated cases in the late-1990s.
While police had some success at the time, Engele said it had been difficult to target the drug because the “king pin” was always changing.
“You’re king of the mountain for a week, so to speak ... until you start using too much of it or your funds and product is all run out,” he said.
“And you become a high-end user and then you drop down to the bottom.”
Engele said there is no doubt crystal meth has increased violent crime in the city, saying different groups will try to steal drugs and money from each other through home invasions.
Although police were originally looking for labs around Saskatchewan, they now believe most of the drug is being brought in from Edmonton and British Columbia.
Engele said it became increasingly difficult to act quickly on information about crystal meth arriving in the city when the justice system started demanding more detailed warrants.
“As soon as it arrives [in Saskatoon] they’re going to split it up and leave. You’re looking at ... you got 10 to 15 minutes to get everything put together and set up and put a team on and prepare for the takedown,” he said.
“And it takes you two to three hours to do the paperwork? You’re missing a lot of opportunities and you’re letting a lot of product go on the street.”
By 2004, word was spreading about the new, highly-addictive drug and its disturbing effects. Newspapers started running headlines about the growing threat of the drug, pushing it to the forefront of political discourse.
In June 2005, then-Saskatchewan premier Lorne Calvert chaired a meeting of western Canadian justice and health ministers in Regina to brainstorm solutions.
The crystal meth response was also on the agenda at a premiers’ meeting in Banff, Alta., in August of that year. Speaking at the meeting, Calvert waved an issue of Newsweek with an ominous headline at a group of reporters.
“The Meth Epidemic: Inside America’s New Drug Crisis,” it read.
“I don’t ever want to see that kind of headline on the cover of Maclean’s,” said the NDP leader, speaking shortly after the federal government introduced a maximum life sentence for meth makers and dealers.
“We have the advantage in Canada of acting now to prevent this from happening," said Calvert.
Days earlier, the premier had announced Project Hope, a “three-year plan to strengthen substance abuse prevention and treatment services in Saskatchewan.”
And in the same year, Saskatchewan Party MLA Ted Merriman spoke out about his daughter’s nightmarish battle with crystal meth.
More conferences and meetings were called to prepare a response, including the Community Action Against Crystal Meth conference in Saskatoon.
Speaking to CBC Saskatoon in May of this year, Calvert said there was more public pressure to act at the time, adding that it was higher on the public agenda when most of the young people affected were middle-class youth.
He said he became particularly alarmed about the drug’s arrival in Saskatchewan after speaking with then-governor of North Dakota, John Hoeven, about the rapid growth of crystal meth in the U.S.
“Knowing the depth of addiction that surrounds crystal meth and that level of drug; knowing how quickly particularly young people could become addicted, it had an urgency,” he said.
Tracy Muggli, the director of mental health and addictions services at the Saskatoon Health Region, said the initial response in 2005-06 led to better supports for users. Project Hope in particular provided funding for youth and adult outreach services that are still in place in 2017.
The second wave
But Muggli said nobody predicted the drug’s second wave over the past five years. While other provinces were dealing with the beginnings of an opioid crisis, Saskatchewan was taking a hit from an explosion of crystal meth. From 2014 to 2015, the number of people who accessed Saskatoon Health Region addiction services jumped by 44 per cent.
“We’re not having the opioid crisis like Vancouver is,” said Muggli. “We’re having the crystal meth crisis. And who could have predicted that, you know, it wouldn’t have been fentanyl here, just like it is in Vancouver? And why drugs move the way they do?”
The Saskatchewan Ministry of Health also notes a jump in crystal meth use at a provincial level. It said reported usage stayed about the same from 2006 until 2015-16, when reporting at the point of hospital admittance jumped by 200 per cent. In the same year, injection use of crystal meth was reported in 1,040 admissions to alcohol and drug services. The previous year, the number was just 360.
When asked to explain its strategy for dealing with crystal meth, the province said it was monitoring the rise in injection use of the drug. It provided an info sheet about the drug’s effects, adding that crystal meth was the fifth most common drug reported at addiction services in 2015-16, behind alcohol, nicotine, marijuana and cocaine.
The province said its approach to addressing meth is also being considered by a new provincial drug task force, although its focus is on opioids such as fentanyl.
The task force comprises the ministries of justice, health, education, social services and advanced education, along with police and some health experts.
“These same partners also recognize the inter-ministerial nature of the crystal meth situation in Saskatchewan and are looking at options to address the growing harms related to crystal meth,” the province said in a statement.
Saskatoon doctor Peter Butt believes the provincial response is inadequate. He said the public profile of the crisis has downsized since 2005, despite the growing nature of the problem.
He agrees with Calvert — that the lack of attention is because crystal meth was affecting a different demographic in 2005: suburban, middle-class youth.
"It's a suburban demographic; it's a predominantly white demographic; it's a wealthier demographic. They go to the media; they know how to talk to the media; they know how to go to politicians; they know how to lobby; they're well placed,” said Butt.
Butt said it’s the same reason there is a strong parental lobby attached to fentanyl, and why it’s getting a bigger response and more press than meth.
A similar shift occurred in Prince Albert, Sask., where Sgt. Troy Dumont said middle-class youth from stable families were the worst affected around 2005.
“People that had never been in trouble — no criminal records, anything like that,” said Dumont.
His team was able to crack down on the drug to the point that it “dissipated” in his community.
That is, until a second wave broke in 2015.
Since then, Dumont said the city had seen a drastic increase in crystal meth use, and this time he said it is affecting everybody.
“We always had crystal meth present in our community and area but we started seeing a demographics change. And, you know, crystal meth has no barriers,” he said. “Race, gender, age, socioeconomic status: it’s all from younger kids that we’ve dealt with that are using to older people ...”
The HIV connection
Butt sees the results of daily urine testing of addicts through his work as an addictions consultant for the Saskatoon Health Region’s methadone and suboxone program. He, too, noticed a dramatic increase in crystal meth use among his clients, starting around 2013-14.
“We have a problem here — a crisis, quite frankly — in terms of drug addiction,” said Butt, “and fentanyl has received a lot of attention and certainly the mortality is significant, but what's being missed here is the mortality associated with crystal meth in part due to HIV/AIDS.”
Butt said crystal meth users are not psychologically or physically stable enough to take HIV medication consistently, meaning people are dying needlessly when their condition deteriorates into AIDS.
“HIV is a chronic disease. It's something that can be put into remission and they [patients] can have a normal lifespan but they have to be able to take the medication each and every day," said Butt.
AIDS Saskatoon executive director Jason Mercredi sees what happens to people with HIV who stop getting treatment because of their addiction.
Graphic: Steven Silcox/CBC News
He said some of his clients have been hospitalized for months by endocarditis, an infection that causes inflammation and deterioration in the valves of the heart, the spine and the brain. Others developed serious abscesses that had to be removed.
Mercredi said crystal meth users who were taking their HIV medication every day were the exception, not the norm.
“If somebody isn’t stabilized it’s hard to get them on HIV treatment, because even if they want to stay on it but their addiction causes them to miss a lot of doses, they become resistant to that strain of medication,” said Mercredi.
In 2015, HIV rates in the Northern Inter-Tribal Health Authority region, which services 33 First Nations in Saskatchewan’s North, were 3.5 times higher than provincial rates. (Those, in turn, were twice as high as the national rate.)
“The implications are huge, particularly when you look at the fact that crystal meth itself affects the way the body handles the antiretroviral [HIV] medication,” said Dr. Nnamdi Ndubuka, a medical health officer in the region.
When Debbie Roberts was using meth, she said her HIV almost progressed to the advanced stage of AIDS.
Roberts’ doctor at the time gave her a warning.
“[The doctor said] your train is crashing. It’s up to you to keep that train going or it’s going to fall off the rail. And lucky for me I took the next medication and it’s been working ever since,” said Roberts.
“My brother, he took another route: he chose not to take the medication, and now he’s gone and he left four beautiful children.”
Roberts believes stricter enforcement of the people trafficking the drugs would help stem the flow of addiction in Saskatoon.
But Det.-Sgt. Robin Wintermute from the Saskatoon Police Service’s integrated drug unit said police are still facing an uphill battle when it comes to tracking down traffickers.
His team of 12 officers works with confidential informants to gather information to build a case against the people bringing meth into Saskatchewan.
“Groups operating out of B.C. or Eastern Canada, they know the drug trade is lucrative in Saskatoon right now,” said Wintermute.
“We see a lot of groups that will move in here, set up an apartment or a house, just for the sole purpose to sell drugs, and they’ll do that until detected or they are caught.”
He said as soon as they are gone, a new group will move in.
He also said traffickers found “ingenious” ways — he didn’t elaborate — to transport the drug, which he said was valued from about $900 an ounce and between $10 and $20 for a “point,” which is 0.1 grams. By comparison, the cost for an ounce of cocaine ranges from about $1,400 to $2,200.
The drugs often arrive through organized crime groups and gangs before being dispersed to lower-level dealers to be sold on the street. A recent bust co-ordinated by a combined municipal and RCMP unit netted drugs that had been transported by courier.
He estimates about 50 per cent of people going through the city’s courthouses every day are facing drug charges.
Wintermute said police had some successes with significant seizures in 2016, but it was a frustrating pursuit, partly because he sees the devastating impact the drug has on people’s lives.
Wintermute added that it’s not uncommon to see people seek help through treatment programs, some of which can be expensive, only to fall back to the drug.
In the past five years, the Saskatoon Health Region has had to adjust its treatment and detox methods to meet increasing demand from crystal meth users, whose detox and rehab needs are unique.
Meth users can be more violent, aggressive and disruptive to others when they arrive at the health region’s Brief and Social Detox Centre, said Muggli.
Relapse is also more common because the depression that follows detox can last months, increasing the need for suicide prevention supports. There’s no secondary drug, such as methadone for heroin users, to help wean people off crystal meth.
Even after Roberts lost her vision, she still wasn’t able to shake her addiction. She said users are chasing an impossible goal to get the same high they did when they first started using.
She tried to seek treatment through a 28-day rehab program but she said she was thrown out when they accused of her being under the influence, which she denies.
It often takes longer for crystal meth users to decide to pursue longer-term residential treatment. If they decide to do so, adults can wait up to eight weeks for a bed at the Calder Centre in Saskatoon.
This year, the health region created a client advisory committee, which recommended that people coming down from crystal meth have a quiet place to sleep off their extreme exhaustion. The health region has since implemented that change, and it also started extending treatment periods for crystal meth users who are still benefiting from the program.
Muggli said health regions across the province are dealing with the same problems.
Muggli wants to see a crystal meth-specific approach to detoxing, including a separate physical space for coming off the drug. She said another problem is that the Brief and Social Detox Centre is only staffed by paramedics at night and on weekends, so there is no physician on-hand to order medication needed to help a person through withdrawal.
For that reason, they sometimes have to be turned away.
“I think having broader medical support might help us to move people in and you want to be able to take advantage of the moment when people walk in the door,” said Muggli.
“[Otherwise], yeah they change their mind or you go back onto the street and you get high again and then, you know, that motivation that you had in that moment may be gone.”
Police Chief Clive Weighill said there simply aren't enough policing or treatment services in his city to cope with rapidly increasing demand.
“I think we really have to get serious about addiction services — period — in the province,” he said.
Wintermute and Sgt. Troy Dumont, from the Prince Albert Police Service, believe more resources will help combat the problem. But they said solving it requires a more collaborative approach to health, policing and education.
Dumont said the Prince Albert Police Service worked with addiction services to start a program that helps police connect meth users with treatment.
At the start of April, it combined resources with the RCMP and the Prince Albert Parkland Health Region to deliver three information sessions on crystal meth and fentanyl.
Dumont, who chaired the sessions, expected about 75 people to sign up across the three sessions. In the end, 600 people went to the talks. Park rangers, prison workers and police officers from remote detachments were among those who travelled from across northern Saskatchewan for the sessions.
Dumont said the idea was to combine the knowledge of those working with crystal meth users to help everyone become more informed.
“There is no real training on crystal meth for any agency; it’s just more learning from experience, learning from dealing with people,” said Dumont.
All parties seemed to agree that prevention and treatment alone cannot beat crystal meth in Saskatchewan.
Addressing root causes like trauma, poverty and disadvantage will need to be part of the solution in the long term.
In northern Saskatchewan, Ndubuka believes addressing social issues should be a higher priority.
He also wants to see better engagement with First Nations so they can play a bigger role in identifying and implementing solutions.
“There’s a lot of potential that they have and they have the ability to heal themselves,” said Ndubuka.
The next new drug
Former premier Lorne Calvert said it’s disappointing that the drug was able to reach crisis-point in Saskatchewan despite having prior warning from the U.S.
Speaking on the same day that Saskatoon police announced a fatal fentanyl overdose in the city this month, he said there are lessons to be learned from crystal meth in the response to fentanyl.
As Saskatchewan police ramp up their efforts to thwart fentanyl, which has become a crisis in B.C., Calvert added that it’s important to avoid a pattern of failing to maintain the response to new drugs over the long term.
“It may be typical of us, as humans, that the urgent always gets attention and then the important gets sometimes forgotten,” said Calvert.
“While this is an urgent issue, we hurt ourselves and we hurt others if we do not maintain the importance of it.
“And so, if there is a lesson … when the issue is arising, then let us commit to keeping it in front of us, and over the long term you begin to make a real difference.”
When the people affected don’t have a voice, he said it’s up to elected and community leaders to get the issue back on the public agenda.
It was guilt that eventually helped Roberts beat crystal meth for good. When she went blind, she couldn’t access the drug by herself, so she started taking family members with her.
“I had friends that would hit me but I had to always bring somebody along with me, right?” she said.
“I felt guilty. I felt bad. I don’t want them seeing me doing this. I don’t want this for them.”
After losing her three children for eight years — something she said was a misunderstanding unrelated to her addictions — Roberts has built a new life for herself.
She hopes education from people with lived experience, like herself, can help end the cycle.
Roberts recently underwent an intensive training program to help her teach others to overcome challenges, and she has been recruited to speak about her experiences at schools and women’s jails.
Originally from Sturgeon Lake First Nation, Sask., she’s also encouraging Indigenous people to turn to their culture for guidance, and she believes spirituality can help beat addiction.
The fallout from crystal meth is all around her, in the friends that are still using, the nephew fighting chemical burns and kidney failure, the brother that is still in jail, and the people she lost.
Although Roberts’s life didn’t turn out the way she had planned, she said her role now is to educate others through her experience. The most important thing, she said, is to not give up on people.
“Today it’s even hard to get people to sit down and have a dinner together because of the drugs, you know, and it’s sickening I guess. It’s hard,” she said.
“But that’s what I’m hoping to help with, is to show them if I could go through this and keep moving, then you can, too.”
Story editing by Natascia Lypny
Graphics by Steven Silcox, CBC News Graphics