From the Toronto Star, by By Manisha Krishnan, Contributor –
Dr. Jess Wilder never thought of being a doctor as an inherently political job.B ut as she found herself confronting a dozen cops and security guards trying to stop her from opening an unsanctioned overdose prevention site outside the hospital she’s worked at for six years, she had to reckon with a stark fact. She was no longer just a physician, but an activist.
“It felt extremely unnatural to me,” she said. But “when you’ve been doing this work and you see the suffering and the injustice and the political turning of a blind eye that results in the death of an entire group of your community, there’s just something that happens that is bigger than you.”
Wilder and around 20 other Vancouver Island doctors have formed Doctors for Safer Drug Policy, a group that opened two unsanctioned sites outside the Nanaimo General Hospital and Victoria’s Royal Jubilee Hospital in late November. The splashy demonstrations aimed to pressure the province to fulfil its promise of opening overdose prevention sites at three Vancouver Island hospitals, allowing patients who use drugs like illicit fentanyl to do so safely.
Both pop-ups were met with police, forcing Wilder and her colleagues to contend with drug and trespassing laws at their own workplaces and threats of being violently arrested.
It feels counterintuitive for doctors, professionals who rely on objective scientific evidence, to be activists. Having interviewed dozens of doctors and scientists while working on stories about drugs and public health over the years, they often come across as measured, quiet, and sometimes detached about their work, even when it’s controversial.
But as both Canada and the U.S. deal with the rise of populism and a backlash against scientific expertise, doctors who work in politicized fields like addiction treatment, harm reduction, gender-affirming care, and abortion access, are finding themselves thrust into the spotlight — and forced to take a stand.
While necessary, that work is made harder by the fact that it must counter some of the most powerful voices in Canadian politics. In July, Conservative leader Pierre Poilievre began referring to safe drug consumption sites as “drug dens,” vowing to shut some of them down and drop federal funding for them if elected.
After Ontario Premier Doug Ford announced the shuttering of 10 supervised consumption sites in the province, Poilievre’s spokesman derided registered nurse Doris Grunspun as a “wacko” with “23 letters behind her name” because she, along with dozens of other experts, said closing the facilities will drive up drug deaths.
Ford has ignored his own government’s reports recommending leaving overdose prevention sites open and stated that his “personal opinion” is that rehab and “good paying jobs” will work better. But when it comes to life-saving health interventions, why does his opinion carry more weight than people who actually work with drug users?
Ford is currently trying to push through legislation that would close the sites and stop new ones from opening without including public hearings, fast-tracking some have rightly criticized as anti-democratic. Even if you’re against these sites, the lack of due process should be alarming.
Ford said he’s closing the sites in the interest of public safety, though his government has failed to prove that the sites directly increase crime. While people are understandably upset by visible poverty and drug use, eliminating places where people can use drugs safely and privately will only force more of them onto the street. It will do nothing to address the wider issues of poverty, homelessness, and untreated mental illness.
Both Ford and Poilievre have also been highly critical of Canada’s safe supply programs, which provide people with substance use disorders access to pharmaceutical opioids as an alternative to the unpredictable, often toxic illicit drug supply that has already claimed at least 47,000 lives since 2016.
Ford has called the federal government “the biggest drug dealer in the entire country.” Poilievre’s attacks are more disturbing in nature. His party went as far as to name safe supply doctor Andrea Sereda in a news release, accusing her of being a liar and calling for her medical license to be revoked. Sereda’s license, thankfully, is governed by the College of Physicians and Surgeons of Ontario; but it is nonetheless terrifying to be targeted with baseless accusations by a federal party.
The war on scientific expertise saw its clearest expression at the height of the COVID-19 pandemic, which saw protesters dubbed the “freedom convoy” protest vaccines and lockdowns outside Canada’s parliament for weeks, beginning in January 2022. Similar protests were held in the U.S. Now, Donald Trump is set to return to power and has named Robert F. Kennedy Jr. to lead the Department of Health and Human Services, and who has fueled conspiracies linking vaccines to autism; Stanford University physician Jay Bhattacharya, who opposed COVID-19 lockdowns; and Mehmet Oz, who used his daytime talk show to hawk shady supplements and “miracle” cures, to lead public health.
“I genuinely think RFK Jr is one of the most dangerous men in America . . . I suspect he will indeed try & jail researchers who criticize him,” Dr. Gavin Yamey, director of the Center for Policy Impact in Global Health at the Duke Global Health Institute, recently posted on Bluesky, a relatively new alternative to Twitter. It was in response to a news story revealing that Kennedy had called the CDC “fascist” for its vaccine program.
While America’s culture war against experts has clearly spilled over into Canada, it still feels surprising to see the anti harm-reduction movement gain a strong foothold in B.C.
Despite decades of being a bastion of progressive drug policy in North America, the province, led by an ostensibly left government, gutted its drug decriminalization pilot program earlier this year and is expanding involuntary treatment for people with addictions — a policy that can actually increase the risk of overdose.
“We as experts have been too complacent,” said Dr. Ryan Herriot, who led the Victoria pop-up safe drug consumption site. “It looked like we’d won or were winning, and we have allowed other non-experts to fill that void.”
In April, B.C. Health Minister Adrian Dix said all hospitals in the province would be outfitted with safe drug consumption sites (some already have them), but he walked that back ahead of the provincial election.
Wilder and her colleagues were tired of waiting. When they rolled up to Nanaimo General Hospital last month, armed with donated medical supplies, tents, hand warmers, and snacks, they were met with guards who said they were willing to use “physical force” to remove them if necessary.
Wilder was surprised to find that all of her fellow doctors were willing to be arrested. Ultimately, they set up off of hospital property so that they could help people.
“It just goes to show that these people who have their entire lives been completely law-abiding and law-upholding citizens, just how exhausted we are by continuing to fail our patients and to lose patients because our government refuses to give us the tools that we need to save lives,” she said.
The death of a Nanaimo patient, beloved by staff, during their demonstration laid bare why they were taking such a drastic measure.
The man, who used fentanyl and meth, safely smoked drugs at the site on the Monday it opened, while he was in the hospital’s care. The site closed that evening. At around 4 a.m. Tuesday, he was found dead in a bathroom in the emergency department, having used drugs alone.
Wilder had known the patient for three years and said he was “gentle” and “very well loved.” He’d been doing better recently, as he’d landed housing. Every time Wilder saw him, he would ask her to buy him red velvet cheesecake from the hospital’s cafeteria and they would sit down and chat while he ate it.
She laughed trying to recall how many pieces of cake she’d bought him.
“This is why we’re fighting,” she said. “When people have a safe place where they know that they can have life-saving medication or resuscitation if they go down, of course, they want to use those sites.”
Since the demonstration, the province has said it is still figuring out how to regulate overdose prevention sites across B.C. — a bizarre deflection, considering that these sites have been around, and operated by the province, for years. The dawdling is even more damning when you consider that a small group of doctors and volunteers set them up in half an hour.
Wilder, Herriot, and their fellow doctors are now planning to teach interested physicians and even civilians across the country how to replicate their pop-up sites.
“I have a bias. I have a bias that’s powered by science and evidence,” said Herriot.
They may not have set out to be activists, but it’s a role some doctors aren’t backing down from.
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