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Addiction and Harm Strategies in Prince Edward Island

Naomi Byrne (0336076)

Department of Psychology University of Prince Edward Island

SAN-2560-2: 2022W Anatomy of Addictions

Professor Kerry Marsh

April 10th, 2022

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Addiction and Harm Strategies in Prince Edward Island

Drug addiction in Canada has become more prevalent in today’s society due to an

increase in adverse childhood experiences, including emotional, physical and sexual abuse, and

the legalization of cannabis, opening a gateway to other illegal substances. The population of

people addicted to drugs in Prince Edward Island (PEI) has increased over the years. It continues

to grow with people struggling with childhood trauma and mental health issues. Due to PEI

being the smallest province in Canada with a low population, there are limited opportunities and

resources in all areas. Therefore, there are no efforts to improve harm reduction strategies for

people who inject drugs (PWID). Due to a shortage of resources, the province is behind

compared to other higher populated regions with a higher demand for harm reduction strategies.

This means that things offered in other areas are not yet provided on PEI, and the resources

available are not up-to-date in terms of technology and efficiency. PEI has shown insufficient

resources to help PWID and addicts on the road to recovery, with limited access to sterile

equipment and treatment availability. The stigma attached to drug addiction has also significantly

impacted harm reduction strategies in PEI, due to being such close-knit communities all over the

island where everyone knows everyone and their dog, and dealing with uneducated and

disrespectful healthcare workers. These factors play a significant role in the shortage of resources

for islanders struggling with addiction.

Picture this: you are suffering from drug addiction due to unrelieved trauma, and are

homeless in a province with limited resources for the homeless. The one place you and other

addicts stay to survive harsh weather is taken away, because the look of homeless addicts

gathering is not something society is willing to accept. This is the reality for approximately 50

homeless people in Charlottetown, Prince Edward Island (PEI), who took shelter inside a
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concrete tunnel in the cold winter months for more than two decades. The Charlottetown police

blocked this tunnel's entrance in December 2020 due to the possible risk factors of those living in

“The Cave”. This tunnel was home to many vulnerable people who came together as a

community and felt they were not alone. If anything dangerous happened, such as an overdose,

there were many bodies to ensure they received medical attention if needed. Now that the drug

cave is blocked off, those who lived there have dispersed and put themselves in more danger of

being alone while using drugs, and taking the risk of possibly overdosing where no one may be

around to save them. This not only puts homeless people at risk of dying from overdosing, but

also puts them at risk of frostbite, hypothermia and freezing to death. A woman named Nanci

briefly spoke to a reporter for the Eastern Graphic “Through the Cracks” special about the

struggles she faces now that the drug cave is closed off, and what she has been doing to survive

through the winter months without any help from the government. Nanci noted that she made

sure to inject where cameras were in case she overdosed, so workers of whatever public place

she was near would help her.

“I thought that if something did happen, because there is no safe injection (consumption)

site , at least I’m on camera,” she said. “That way if I was to start to freeze to death or something

like that, or if I have a seizure then someone is going to see me” (Collier, 2022, p1).

PEI needs to step up and find solutions to the problems they have created after removing

the one place homeless people in the area stayed, to be away from society and stay somewhere

safe from the harsh winter. The police are only covering up the problem of harm reduction,

instead of solving it, because addicts are now at higher risk in multiple ways as they separate and

search for shelter.

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Although environmental conditions were unsafe within the cave, and health risks, such as

sharing used needles and transmitting diseases, were also a sheltered place that offered resources

such as water and food, because everyone helped with whatever supplies they had. It was a

tunnel of people in survival mode who were a family that looked out for each other because

society didn’t. To many, it seems the government prioritizes the safety and wellbeing of addicts

less than citizens who are not suffering (Lewis, 2022). The government lets the public know they

are always looking into ways to grow the island's economy and offer more community and social

services. Yet it is 2022, and we still do not have safe consumption sites for addicts. The demand

for this will only increase with more people addicted to drugs each year, especially with

coronavirus, which prevents many resources and services from working at full capacity or at all.

Coronavirus has also caused a spike in people suffering from mental health issues, and therefore

has created an increase in substance abuse and a higher chance of recovering addicts relapsing.

The government needs to stop ignoring all the signs that are pointing towards innovating more

resources and services into harm reduction resources on PEI (Lewis, 2022). McCutcheon and

Morrison state in their Harm Reduction Journal on PWID in PEI that, “In terms of the treatment

options for PWID in PEI, the primary location is the Provincial Addictions Treatment Facility,

located outside the capital city of Charlottetown. The Provincial Addictions Treatment Facility

offers a detoxification program for drug, alcohol, and gambling addictions and contains 25

detoxification beds. The Provincial Addictions Treatment Facility is also the location for the

province's methadone maintenance treatment program. As well, PEI's provincial government

offers preventative services through their four syringe exchange centers.” Since this statistic,

there have been two more exchange sites, but the needle exchange program still has flaws that

need to be addressed.
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The barriers that prevent PWID from going to needle exchange sites in PEI are their

available hours to go, only three hours in the afternoon on specific days of the week, and each

location has different available days. If you live in Souris, for example, they are only open for

three hours one day a week, and the same goes for other less populated areas. There are not

enough days open for the exchange sites to be helpful for PWID. The people located in areas that

they are only open one day a week have to either go into another city where they may not have

transportation to do so, or risk injecting used syringes that are dull and not sterile, and even

worse, using other PWID needles where they are risking the transmission of Hepatitis B,

Hepatitis C and Human Immunodeficiency Virus (HIV) (Prince Edward Island, Canada, 2021).

The shortage of sites and availability limits how safe PWID can be, and staff do not treat them

properly. Based on research interviews with PWID, staff do not properly treat them. Islanders

addicted to drugs feel they are a burden to staff, and that people in the healthcare system are not

educated enough about the psychology of addictions and why PWID are vulnerable and

traumatized. This goes hand in hand with the stigma associated with entering a needle exchange

site. PEI being a low populated place creates more anxiety due to the high chance of seeing one

or more people you know, whether they are staff or drug addicts, coming in to exchange their

needles. Although healthcare staff must keep confidentiality in and out of the workplace and

cannot tell people who they saw come in to exchange needles, there is always fear that PWID

will be crossed, and they will tell people, which in turn causes many addicts on the island to go

to pharmacies and pay for sterile needles out of pocket. With the needle exchange programs

limited availability and uneducated and disrespectful staff, it is not hard to see why people feel

such a stigma attached to addiction.

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Stigma has been attached to drug addiction since they were introduced to society. It is

something that islanders who suffer from addictions struggle with constantly and feel more

judgment when using and needing help on the island than in other provinces, because of the low

population rate and seeing people you know more frequently than seeing people you don’t know.

It is something that makes drug addiction that much harder, because it is not a lifestyle anyone

wants to live. Addicts are suffering so much emotionally due to childhood trauma, and the

stigma attached with addiction adds to their mental health issues, causing addicts to feel isolated

and less of a human. Stigma creates discrimination for those who suffer the most, and makes

them feel less than and do not deserve the same respect as people who suffer from mental health

issues and addiction. It is a cycle that never ends due to society's refusal to educate people on

addictions. It makes it extremely difficult for addicts to open up about their trauma and gain

enough support to feel like they can conquer their addiction. If the stigma in Prince Edward

Island was not so obvious, or better yet, removed from society, there would likely be more

programs and resources for addicts, and a decrease in the percentage of diseases transmitted from

injecting used needles, as well as a higher chance of people seeking help. Addicts feel helpless

and trapped in a world where they cannot escape stigma, because addicts are too anxious to go to

places specifically meant for PWID. Addicts have been discriminated against and mistreated at

needle exchange programs, detox units, hospitals, pharmacies and majority of public settings in

PEI. For example, a participant in a study in 2014 talked about her experiences as an addict when

purchasing sterile syringes, and noted that he had a pharmacist track him down in the pharmacy

before leaving to ask him to never enter the store again because of his purchase (McCutcheon, J.

M., & Morrison, M. A, 2014, p.12).

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The government has done little to help break the stigma and silence on addiction in PEI,

up until the publication of “Through the Cracks”, which has brought attention to the problems

PEI has ignored for too long. After Through the Cracks published their first article on CBC, the

premier Dennis King announced the government would fund methadone treatment to islanders

who need it as quickly as possible. The government makes many promises that are added to a list

of addressed issues that need fixing, but hopefully this promise will not fall through the cracks

and be implemented quickly. Dr. Stewart, a medical officer at the provincial addictions facility in

Mount Herbert, who has practiced medicine for 45 years, has made it clear that implementing an

opioid replacement therapy (ORT) would help so many islanders live a fulfilling life while on the

road to recovery, and is worth the costly investment to save lives. Stewart says he has reached

out to the government multiple times, but has heard no response in return until Through the

Cracks (Collier, 2022). This announcement from the Premier was not surprising in response to

the new efforts by The Eastern Graphic to spread awareness of the island's flaws in terms of

addictions PEI. The government of PEI does not want to be known for not having sufficient

resources for those in need. Through the Cracks shedding light on the issue and better change for

PEI, it is becoming a reality slowly. What an ORT would do for people on PEI who want to

recover from their addiction is prevent withdrawals from 24 up to 36 hours, and slowly decrease

the craving of drugs including heroin, oxycodone, hydromorphone (Dilaudid), fentanyl and

Percocets until they are no longer dependent. (The drug methadone slows the high down and

stops that initial craving to get high again when they come down from their last high. This helps

people addicted to opiates take more control of their lives and become better physically. The

treatment is also recommended to be taken while also taking other therapies, such as one-on-one
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or group counseling for addictions. This is a great opportunity for many islanders who are not

capable of paying out of pocket for the costly therapy.

“It’s a price the majority of patients cannot afford, says Dr Stewart. The issue is

compounded because not all are able to complete funding applications or wait for bureaucratic

processes necessary to access funding through other avenues. . . Dr Stewart estimates it would

take $250,000 per year for the government to cover treatment for all those patients currently

paying out of pocket for their care.” (Collier, 2022)

Although treatment costs each year are high, the government has to look at where their

priorities lie, and the health and safety of islanders suffering from addiction should be one of

them. If you look at areas where the government spends money annually on boosting the

economy through tourism, for example, at least six to seven thousand dollars is spent separately

each year for big red number sculptures bought to make the year it is at Queen’s Wharf

(Goodwin, 2020). If almost thirty thousand dollars can be spent on four big number sculptures

each year, and each year needs a new number, then money spent to help save lives should be

easily given to implement new and better resources. Not only would this help save lives, but

would also cut down the waitlist of the detox units in PEI, which has gotten as high as 300 in

2014, and has been even more difficult with the Coronavirus and not being able to run at full

capacity, which is a limit of 14 beds in the first place. Waiting periods can last up to 2 years

before people are checked into the provincial addictions therapy facility, and if you put yourself

in an addict's shoes who is in a vulnerable state, wanting to receive help and begin their recovery

with the help of our healthcare system, be told they have to wait for a bed to open up, which

takes a long time. Playing the waiting game when it comes to your health is not something to
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take lightly. The government needs to fix this waitlist problem before the population gets bigger

and more people suffer from addiction.

Sometimes problems that are prevalent in society and are on the rise to more serious

issues do not become a concern enough for the government to make changes until statistics grow

too high or the news steps in and makes the government look bad. It should not have to come to

a certain amount of drug-related deaths, or for a news article series to come out for the

government to actually help citizens. If the government took action before waitlists got to 400

people, then we would not see a spike in numbers and would have more opportunities for addicts

to recover, which could prevent the rate of addiction from going up. Change in our system would

not only slow down the rate of addiction in PEI, but also reduce the transmission of diseases

from injecting other people’s needles. The more resources and services there are to offer people

with addictions, the more chances of saving lives, and I think that should be our main goal. No

matter why a citizen of PEI is unhealthy, I think it should be taken equally seriously, whether a

person is slowly dying of cancer or dying from drugs, and it should always be a priority to keep

everyone safe and healthy as best as possible. It is evident that we are not doing the best we can

yet, and that many changes and improvements can be made to improve the province's healthcare

system. I believe the island has a lot of potential to be resourceful and maintain various services

for PWID. Implementing more needle exchange sites with better hours and more days open in

the week, funding an opioid replacement therapy, cutting down detox waiting periods, and

spreading more awareness on addiction will serve islanders much better and create a change in

how addiction is viewed in society.

More research is needed on addiction in PEI both qualitatively and quantitatively,

because although I found enough resources to complete this paper, I could have used more
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statistics on addiction in PEI, more experiences of addicts living in PEI, and the limitations PEI

has resource and service wise. The last qualitative report done on PWID in Prince Edward Island

was 2014, and I would like to see another report done and compare where we are now in terms of

service needs and stigma on PEI with addiction. I have a sister who has worked at the provincial

addictions treatment facility in Mount Hebert for over five years now, and she knows how far

behind we are in terms of services within her workplace and others based on their files. But this

is something that is not announced anywhere to the public, and we need to stop hiding and

ignoring the signs that show improvements need to be made. The island is a wonderful place to

grow up, and I am so fortunate to have lived somewhere with low crime rates and is a safe place.

But this low populated province has been good at keeping their flaws in the system away from

the public eye, and from my own personal experiences, I can justify that problems such as

addiction services here in PEI are not publicized often, and therefore you can easily go through

life not knowing unless you are forced to research it. I am fortunate to have access to the

Robertson library where I learned many new things about our healthcare system and where we

need to step up our game. I can now see why my sister, for example, does the job she does

because she understands how big of an issue addiction is and should be taken seriously. She sees

the world of addiction second-hand and knows how vulnerable they are, which makes this topic a

soft spot for me, as I cannot imagine the emotional and physical pain addicts go through while

using and recovering. It is so important that they can reach safety if they need to and recover

properly with the right medications, while professionals are on watch to ensure they come down

safely from drug use.

In conclusion, PWID are equally important in society, as those who are not addicted to

drugs, and the care PWID needs, should not be negotiable, but immediately implemented in the
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province of PEI. While we are still behind in harm reduction resources and services, we are

gradually making our way in the right direction by funding methadone to citizens on the road to

recovery. Improvements in addictions PEI is becoming a higher priority on the government's

long list of promises, and this can only lead to greater things.
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References

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Collier, Rachel. “Through the Cracks: Doctor urges equal ORT treatment access”, The Eastern

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