The 180

Why the opioid crisis hits men the hardest

For all the stats you've heard about opioids in B.C, there's probably one you haven't: 80.7% of the opioid deaths in 2016 were men. Psychiatry professor Daniel Bilsker says men are more likely to abuse substances, and more likely to take their own lives, and the real crisis is how little attention that gets.
Of the 914 illicit drug overdose deaths in B.C. in 2016, 80% of them were men. (Chris Corday/CBC)

"Why is it mostly men?"

That's the first question Daniel Bilsker asks when he thinks about the fact that 80% of all of B.C.'s illicit drug overdose deaths were men.

But it's not the only question he has.

"What does it say about men's mental health and psychological safety? What is the issue between genders in terms of the frequency of this happening?" says Bilsker —an assistant clinical professor of psychiatry at the University of British Columbia— in an interview with The 180's guest host, Michelle Eliot.

Daniel Bilsker, a UBC clinical assistant professor in psychiatry, says more attention needs to be paid to the gender disparity in overdose deaths. (Manusha Janakiram/CBC)

When he looks at the numbers, Bilsker sees parallels between the opioid crisis and male suicide in B.C.

"One of the key things that has to happen is to understand the patterns underlying it. Just to say someone is an opioid addict doesn't say who they are and it really obscures the things we need to know. You really want to know how do those men, in this case, get into that terrible, hopeless, and despairing state, where the only option they saw — to relieve the suffering of their life — was to escape into this really terrible drug world or drug experience. We have this phenomenon now of recurrent overdoses — where someone who nearly died and has been rescued — is doing it again. So we need to understand how do those men become that addict, become that person, so willing to trade all of life for that moment. How did they become that?"

While 2016 may have been the worst year on record for illicit drug overdose deaths in B.C., years after year for the last nine years, men have made up anywhere from 72-80% of the fatalities.

According to Bilsker, the fact that trend has continued, with little attention or scrutiny, is indicative of two problems.

The first, Bilsker says, is that men themselves are taught to neither talk about their emotional suffering nor reach out for help.

Bilsker recalls attending a military health conference recently, and speaking with a soldier who viewed himself as a "mobile weapon system."  He says after that conversation he realized the man/machine metaphor held true outside of the military as well. 

"As a man, my job is to deliver, perform, meet the requirements; not to complain about my suffering, to talk about my emotions," he says, "so it's essentially viewing yourself as a kind of technology, and not as a full human being. And that is a kind of violence, a cultural violence, that has been done to men."

Reflecting on the fact that 738 of the 914 deaths in B.C. last year, were men, Bilsker says the second issue is that society takes male mortality for granted.

"It hasn't really received as much attention as it warrants when you look at the numbers, where you think it would emerge as a key priority in the way we think of men's health, or health in general."