How to fight Quebec's toxic drug problem? A former user says change the conversation
This is the second of two articles looking at the issue of drug overdoses in Quebec, where the situation is heading and what needs to be done to curb this trend.
You can read the first article here.
The turning point in Martin Rivest's recovery from a crystal meth addiction came when his doctor, in an attempt to provide comfort, told him: "Martin, addiction is a disease."
"It gave me a sense of relief. I was like 'OK, I'm not a bad person,'" said Rivest, looking back at his struggles from about 15 years ago.
"A lot of people that are affected by the drug crisis, a lot of it is due to shame, stigmatization, judgment from others and a lack of respect."
Rivest now does outreach work with the Association québécoise pour la promotion de la santé des personnes utilisatrices de drogues (AQPSUD), a group in downtown Montreal that advocates for safe drug consumption and is run by people who use drugs or did so in the past.
The stigma, Rivest believes, doesn't just come from friends, family or strangers. It comes from people in power.
Rivest and others believe that too much of the discussion around Quebec's opioid crisis ignores the perspectives of the people who, according to him, are the most knowledgeable about the issue: drug users and those who work with them.
Advocates say overcoming the crisis is complicated, but it starts with an openness to ideas they've been pushing for years: having a real conversation about decriminalizing simple drug possession and ending the stigmatization of users.
And with fatal overdoses in Quebec occurring at an unprecedented frequency, those advocates say decision makers need to finally listen up.
"Frankly, we feel abandoned. We don't feel heard or taken seriously. We get the feeling they view us like children," said Rivest.
"We like to say in French, rien sur nous sans nous, So nothing for us without us. We are part of the solution because we are the users. We know the problem."
'We shame them every day'
As far as fatal drug overdoses are concerned, 2025 is not off to an encouraging start: 153 deaths between Jan. 1 and March 31, according to the province's public health institute, the Institut national de santé publique du Québec (INSPQ).
In 2024, Quebec recorded 645 confirmed or suspected fatal overdoses, by far the highest total ever recorded in the province. The numbers have been trending upwards over the last decade.
That same year, B.C. Premier David Eby rolled back the province's historic decriminalization project and recriminalized drug use in public spaces after facing intense scrutiny.
Governments dealing with a toxic drug problem often appear to be trying to walk a fine line: getting people with drug addictions the help they need while not angering the broader public.
"While we are caring and compassionate for those struggling with addiction, we do not accept street disorder that makes communities feel unsafe," B.C's premier said at the time.
Last month, when the Coalition Avenir Québec government tabled Bill 103 — which would prohibit supervised drug consumption sites from being located within 150 metres of a school or daycare — Social Services Minister Lionel Carmant had a similar message.
"The overdose crisis is at the heart of our concerns," Carmant said. "But we also have the responsibility to ensure that these places are safe for everyone."
If Bill 103 becomes law, Maison Benoît Labre, a facility with a safe drug consumption site located about 143 metres away from a school, would eventually need the move.
Andréane Desilets, the executive director there, said Bill 103 and the controversy that's followed Maison Benoît Labre has taken a toll on staff and clients.
"A lot of people are hurt. A lot of people feel ashamed," said Desilets. "Because this is what we do, right? We shame them. We shame them every day with these laws. We exclude them from being a part of our community because we failed to provide acceptable support for them."
Desilets says she understands concerns about Maison Benoît Labre, but adds that the conversation could use some reframing: more of a community perspective and less of an "us and them" attitude.
"What should be very scary is the fact that people are dying on the streets and we're not doing anything," she said.
"If we just continue on with this vision that it's a personal problem or an individual problem, then we will not get better and will not see any action and will not see numbers that are going down, only going up."
Quebec has 14 supervised drug consumption sites. If Bill 103 is adopted, Maison Benoît Labre is one of two sites that would need to move. The other one is in Gatineau.
Maison Benoît Labre has said moving the centre, which is currently seven metres too close to a school at the moment, would cost about $6.6 million.
Quebec's plan for drug overdoses
Quebec's Health Ministry says dealing with drug overdoses in the province is a priority, but it's also become increasingly challenging.
"The situation is changing rapidly and is made more complicated by the fact that there are numerous substances contributing to the overdoses," wrote spokesperson Marie-Christine Patry in a statement.
"The illicit market is evolving rapidly, with drug contaminations that are not just limited to opioids."
The Health Ministry says it's putting a lot of effort into flattening the overdose curve, pointing to its 14 safe consumption sites and 34 drug verification sites, the widespread availability of naloxone in pharmacies and recent ad campaigns.
WATCH | Quebec government tries to raise awareness about overdoses:
It also highlighted the province's 2022-25 strategy for overdoses, which focuses on seven areas:
Raising awareness.
Prevention and harm reduction.
Public policy.
Monitoring the issue.
Research and training.
Addiction treatment.
Pain management.
Overdose deaths in Quebec are on the rise, and the problem could get worse
When asked about the province's plan, Desilets stressed the need to invest "massively" in prevention, but she also paused to reflect about how complex the drug overdose problem is.
"You know, it's never this one solution, right?" she said, before bringing up a broader but, according to her, necessary approach.
"We need to rethink how we see people that are using .... We have to address the fact, that maybe, just maybe, having safer substances going on the streets instead of letting criminal organizations create stronger and stronger and stronger substances."
'It's hell out there'
For many observers, providing safe supply of drugs goes hand in hand with decriminalizing simple possession.
Sarah Larney, a researcher and associate professor at the Université de Montréal with an expertise in drug-related harm, is favourable to the idea, but she acknowledges it can be a tough sell to the general public.
She said the pilot project in B.C. and its failures didn't help.
"It's really unfortunate," Larney said. "How do you move that needle to make that a conversation that can even be had in a way that is productive?"
When asked about decriminalization, Montreal police Chief Fady Dagher said it's not a "miracle solution" and was a failure in B.C.
"Decriminalization, when you think of it, it's not a bad option, it's not a bad orientation, but the system has to follow," Dagher told CBC Radio Noon host Shawn Apel.
"The problem is you decriminalize but nobody's taking over. The health system is not there to do the follow-up and the partners are not there to do the follow-up."
A spokesperson for Health Canada told CBC News that B.C. remains "the only jurisdiction that has been granted a time-limited exemption related to personal possession of small amounts of certain illegal substances" and it does not have any other similar requests.
"As the first exemption of its kind in Canada, there was always an understanding that all levels of government, partners and stakeholders would need to work together to closely monitor impacts in British Columbia, learn from the implementation and make adjustments as needed," the statement reads.
For the Quebec government, decriminalization is a non-starter.
IA spokesperson for the province's Justice Ministry said the risks associated with opioid consumption are significant, "so are the implications of a decision" on decriminalization.
"For now, we're focused on doing everything possible to accompany people in the most humane way possible," said spokesperson Cathy Chenard.
WATCH | How to use naloxone to help someone:
How to administer naloxone if you witness an overdose
2 years ago
Duration 2:28
Larney says tackling the toxic drug crisis requires several layers of intervention, such as decriminalization, addressing the housing crisis and supplementing people's income.
"It's quite radical, I'll admit that," she said. "But everything else we've tried doesn't work and I'm not sure that continuing down this path is going to work either."
The Quebec government's current path involves likely adopting Bill 103 and restricting where safe drug consumption sites can be located.
Desilets, the executive director for Maison Benoît Labre, says the proposed legislation "will not have any impact on what's going on."
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