CERB benefits contributing to spike in overdoses, outreach workers warn

'We've lost people .. and we don't know when it will end' - Anne Marie Hopkins, Ottawa Inner City Health

Image | Injection drugs

Caption: A discarded needle lies in a puddle at Richards Street and Georgia Street in Vancouver. People who work with the addicted say the CERB pandemic emergency benefit program is fuelling a surge in illicit drug use. (Rafferty Baker/CBC)

People who work with those struggling with drug addictions are warning that the Canada emergency response benefit program (CERB) — Ottawa's primary support for households left without income due to the pandemic — is helping to fuel illicit drug use and may even have contributed to overdose deaths.
"I just know that all of us front-liners are really scared. We're scared for our clients," said Anne Marie Hopkins, head of peer outreach services for Ottawa Inner City Health.
"We've lost people and it's been really devastating and we don't know when it will end."
Combined with the effects of physical isolation and an increasingly potent illicit drug supply, she said, the easy-to-access cash has led to troubling and even deadly consequences for some clients of Ottawa's harm reduction services.
Public health officials have been sounding the alarm in recent weeks about a rise in overdose deaths since the pandemic hit.

Image | Anne Marie Hopkins

Caption: Anne Marie Hopkins of Ottawa Inner City Health: 'We're scared for our clients.'

Spikes in overdoses reported across country

Based on preliminary results from the Ontario coroner's office, there was roughly a 25 per cent increase in overdose deaths in March, April and May of this year, compared to similar data for the previous year.
British Columbia saw a 39 per cent jump in overdose deaths in April compared to the same month last year.
In late May, Chief Public Health Officer Dr. Theresa Tam said the B.C. numbers represent "a worrying trend."
"Tragically, other jurisdictions across the country are reporting similar trends," she added, citing reported increases in "illicit opioid-related fatalities" in Toronto and Calgary. "There have also been clusters of overdoses due to unknown or unusual mixes of toxic illicit substances in jurisdictions, including Nova Scotia, Toronto and Guelph, Ontario."
Outreach workers attribute the death toll in part to the effect of physical distancing rules on people struggling with addiction and living alone; with no one watching out for them, and with no easy access to their drugs of choice, some are obtaining tainted street drugs and overdosing in isolation.
But many outreach workers also say the CERB benefit is putting too much temptation in the way of struggling users by providing sudden infusions of cash with few questions asked.

Dying alone

The benefit was introduced in March to help millions of Canadians left jobless by the pandemic by providing them with $2,000 every four weeks.
Hopkins said she knows of clients who received payments, rented hotel rooms and died alone of overdoses.
There is "no question" that the CERB program is contributing to an increase in overdoses, she said.
"I do see that it is causing some damage in our community," she said. "We have lost some clients who we loved dearly and that side of things has been really, really painful for us."
Bob Hughes is the CEO of ASK Wellness, which provides social housing and harm reduction services in the British Columbia interior. He said that while the CERB program was well intentioned, its ease of access is putting the addicted at risk.
"I've been in this field many years and I've never seen the amount of money on the streets that I've seen in the past number of months," he said.

CERB kickbacks

The federal government has said it made applying for the CERB as simple as possible in order to ensure Canadians in need get their payments quickly. Applicants are required only to answer a few questions and certify they are telling the truth.
Word that CERB money was easy to get "spread, as you can imagine, like wildfire through a population that is severely addicted," said Hughes.
He said his group has heard of multiple instances of people being pressured into applying for CERB and paying a "kickback" to those who coerced them. It's not an organized scam, he said — just the actions of people who wouldn't normally behave in a predatory way who are being driven to extremes by addiction.
"They're just literally trying to get money to sustain that level of dependency," said Hughes.

What happens when the payments end?

In Winnipeg, the head of a charity that provides housing, emergency shelter and addictions supports also said CERB is contributing to a recent rise in illicit drug use.
"I don't have data or statistics to tell you from here, but I think it is a logical connection," said Rick Lees, executive director of the Main Street Project.
The money has helped some addicted individuals obtain better housing, he said — but he worries about what will happen when the payments dry up and they can no longer cover rent.
Hopkins said she struggled with raising the issue publicly because she believes people on low incomes are too often unfairly scrutinized when it comes to personal spending.
"But I do feel like in our setting, maybe it's a little bit irresponsible to hand it out so freely to our folks," she said.

'Sheer agony'

Hughes was alarmed enough to write to the federal minister of national revenue and three B.C. provincial ministers asking for more rigorous efforts to make sure those getting the CERB are eligible for it.
"Our hope is that there is more diligence and scrutiny to the actual review of these applications," he said.
He said he also worries that those using CERB to fund their addictions could experience crippling withdrawal effects when the benefits end. He said they're going to need government help managing that transition, "to ensure that we don't have people literally dying of withdrawal or just in absolute sheer agony. The humanity of this needs to be considered."
He's getting some support from former B.C. health minister Terry Lake, who ran unsuccessfully for the federal Liberals in the last election.
Back in 2016, Lake took part in the provincial government's move to declare opioid overdose deaths in the province a public health emergency.

Gasoline on a fire

Lake said he reached out to political contacts at both the federal and provincial levels to warn that CERB payments and other financial supports could be playing a role in the spike in overdose deaths. He said he's seen no public evidence of action by either level of government on his criticisms of the CERB program.
"I really haven't seen a reaction publicly to say, 'Yes, we're aware of this problem, yes, these are some of the steps we're going to take to try and ensure we're not adding gasoline to [the] fire," he said.
Lake pointed out that B.C. has seen more people die of overdoses than of COVID-19, but the pandemic has provoked a far stronger government response than the opioid crisis.
"It clearly appears that some lives matter more than others," said Lake.
He said he'd also like to see more attention paid to screening out CERB applicants who don't qualify for the benefit. He's calling for more dramatic action as well — such as decriminalization of personal possession and a safe, uncontaminated supply of narcotics for users.

Image | Dr. Bonnie Henry

Caption: B.C. Provincial Health Officer Dr. Bonnie Henry called on the province to decriminalize possession of illicit drugs over a year ago. (Mike McArthur/CBC)

Dr. Bonnie Henry, B.C.'s chief public health officer, called on the province to decriminalize possession of illegal drugs for personal use more than a year ago, noted Lake.
Officials in British Columbia forwarded CBC's request for comment to the B.C. Coroners Service. An official with the service said new data on overdose deaths will be available Thursday.
Asked about claims that CERB is driving overdoses, B.C. Minister of Mental Health and Addictions Judy Darcy responded with a statement that suggested much of the blame actually lies with the illicit drug supply.
"Hundreds of thousands of British Columbians immediately lost their source of income due to the pandemic. They needed emergency relief," she said in the statement.
"We are dealing with the devastating impacts of two simultaneous public health emergencies. People are dying because of an illegal drug supply that is more toxic than ever before. It is dangerous to ignore that and it fuels stigma at a time when people need compassion, not condemnation."
The statement didn't say what the province might do to address the issue.

'No simple solution'

Federal Employment Minister Carla Qualtrough said the question of CERB contributing to overdoses is on her radar.
"I've been aware of this absolutely for some time," she said.
She said her government has worked with community groups to try to address issues like housing through a $350 million Emergency Community Support Fund, set up to help organizations working with vulnerable populations.
She suggested, however, that she's not interested in making changes to the way CERB is handed out.
"For me, that doesn't in any way make me pause to think about how important the CERB is," said Qualtrough.
In a statement, her office said millions of Canadians need the benefit to pay for groceries, rent and medication.
The federal government is still working out the future of the CERB benefit. For those who applied for the first instalment, the payments could end July.
Corrections:
  • This correction has been updated: A previous version of this story referred incorrectly to overdose statistics from March 2019 to May 2020. In fact, this period should have been stated as March to May of this year, 2020. June 11, 2020 5:37 PM