When Sheldon Houtman broke his arm 17 years ago, he left the hospital with a three-month supply of Percocet.
“You don’t need that much. No, your arms healed after a month, right?” Houtman says.
The Calgary man had no intention of becoming addicted to drugs, but once his three-month supply to painkillers was finished, the addictive nature of the drug took over, and Houtman turned to the street.
Canada has one of the highest opioid prescribing rates in the world. In 2016, more than 20 million opioid prescriptions were dispensed nationwide, according to a 2018 study. This research also found Alberta and British Columbia experienced the highest rates of opioid-related deaths and hospitalization.
Opioid use in Canada
Stricter prescribing rules curtailed the number of opioid drugs available, but overdoses continue to kill thousands of Canadians. Recent data suggests overdoses in Alberta dropped between 2023 to 2024
Houtman turned to the street supply after his prescription ran out. This is not uncommon, and according to Statistics Canada, among the people who used opioid pain relievers, 9.7 per cent engaged in problematic use.
“This is not a problem,” concluded a 2018 academic review of Canadian opioid use. “Restricted to persons who use illegal or street drugs; rather, this is a national public health crisis that affects people in communities across Canada, across all ages and across all socioeconomic groups.”
Turning to harm reduction
Six years ago, Houtman’s friend took his own life after heavy drug use. This tragedy led Houtman to harm reduction.
“I was just sick of seeing people dying. That changes you,” Houtman says. “When I was first getting off the crack, the meth, and the coke, it was hard being out there for sure, at the beginning, but, you know, harm reduction was a community.”
Harm reduction supports those struggling with substance abuse by reducing associated risks. Strategies include supervised consumption sites, naloxone distribution, safer alternatives such as clean needles, clean pipes, and drug testing kits.
In addition to what is already being done in the harm reduction community, experts in the field believe an expansion in opioid alternatives is a critical next step in the drug crisis.
“I wish that more individuals would be able to prescribe methadone and suboxone,” says internist and addiction specialist Dr. Monty Ghosh. “I wish pharmacists could prescribe suboxone, especially because it would be very helpful.”
Reducing the opioid addiction
Methadone and suboxone reduce cravings and withdrawal symptoms.
Dr. Ghosh says only physicians and nurse practitioners with specialized training from the College of Physicians and Surgeons of Alberta can prescribe opioid agonist treatments. A support system is needed for those who cannot access these services.
“You kind of have to approach it through a very holistic lens,” says the Calgary physician.
Houtman says he found a community when he turned to harm reduction. That support, he says, was crucial for seeing progress in his recovery.
“It keeps me grounded by going out every Sunday and doing harm reduction,” says Houtman. “It reminds me of where I came from and how far I’ve come, and how I can’t go back.”