Last week, another one of my clients overdosed. We found his body slumped against the wall next to his bed, an empty syringe still in his arm. I overheard the coroner on the phone when police called him. “Another overdose?” he asked with a tired lack of surprise, “I’ll be there in a while.”

I’m a frontline supportive-housing worker in Victoria. For me and the city’s emergency first responders, dealing with an overdose has become a routine part of our day.

Our governments’ primary response to the epidemic of overdoses has only been a Band-Aid solution. They have distributed naloxone-injection kits that temporarily cancel the effect of an opioid overdose. Naloxone kits have saved many lives, but I have seen clients revived from almost deadly overdoses two and three times in one week who then continue using. To resolve the crisis, our communities need to be treating addictions—not just overdoses.

One of the most effective interventions into an addiction crisis that the world has ever seen took place in Liverpool, England, in the early 1990s.

The situation in Liverpool at that time was analogous to our own. Cutbacks to social assistance and health care, combined with a lack of affordable housing, produced a large population of poor and underhoused people. Many of them used heroin to cope with the trauma of living in poverty and fell into a cycle of crime, addiction, and mental illness. The same context of austerity and poverty exists today in Canada, but our addiction crisis is worse because of fentanyl and other deadly synthetics being laced into street drugs.

To help people break the cycle of addiction, Liverpool took a unique approach: it legalized heroin. That’s right, it legalized heroin.

During the early 1990s, people who were addicted to heroin could go to a doctor, receive a prescription, and have the drug provided to them by the British government. 

The results were indisputable. Moving heroin addiction off the streets and into medical clinics resolved many of Liverpool’s social problems. The city’s drug dealers were put out of business almost overnight. With that, there was also an observable decrease in drug-related violence and petty crime. One of the doctors prescribing heroin reported a 96-percent decrease in thefts committed by his patients.

What’s more, prescribing medical heroin actually worked to promote recovery.

On the surface, providing drugs to cure an addiction sounds ridiculous. But a look at the factors behind addiction illnesses explains why prescribing heroin was an effective intervention.

The reality is that healthy, comfortable people do not get addicted to street drugs. Research shows undeniable correlations between mental illness, homelessness, poverty, and addictions, each one amplifying the other. In Liverpool, providing medical heroin was an effective way to interrupt that deadly cycle.

When heroin was provided free of charge in medical clinics, people with addiction illnesses no longer had to risk their safety in expensive back-alley drug deals. That meant they had money for food, for housing, or for trips to visit family members. They could stabilize and deal with factors beneath their addiction illness. What’s more, under a doctor’s supervision, they were provided with less harmful ways of ingesting the drug and could be gradually weaned off it.

It sounds counterintuitive, but the best way to help someone with a heroin addiction is to give them heroin. Medicalizing the drug and bringing it off the street and into clinics worked in Liverpool and in a number of other cities around the world. In British Columbia, it would eliminate the fentanyl crisis overnight and help our most vulnerable community members develop healthy, stabile lives.

I wonder how many more of my clients will die before our governments learn that simple lesson.