Canada's drug crisis affecting newcomers, but lack of data makes it hard to know severity of problem
Pratyush Dayal | CBC News | Posted: February 25, 2024 9:00 AM | Last Updated: May 15
Experts call for better data collection, culturally sensitive care
This story was originally published on Feb. 25, 2024.
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Within 17 days of arriving in Canada, Ali was introduced to methamphetamine.
"I was lonely and was thinking of suicide," said the international student from Turkey.
Ali said he has been using crystal meth on and off since he moved to Saskatoon in 2022. Now, the 23-year-old is working toward recovery but said mental health services in his language and culturally specific health care are lacking.
Raza, a Syrian refugee who also lives in Saskatoon, has had a similar experience. The 32-year-old works odd jobs to send money to his family overseas.
"It's difficult to find work here. I don't speak much English and don't know many people," he said.
Wahda — the Arabic word for social isolation — is a "constant curse."
"Crystal is a good way to forget those problems," he said.
WATCH | The drug crisis is affecting newcomers — but it's hard to tell how much:
CBC News is safeguarding Ali and Raza's full names because of the stigma around drug use and mental illness in their respective communities.
There were 484 confirmed and suspected drug toxicity deaths in Saskatchewan in 2023. In speaking with community organizations, CBC News found that the effect of Canada's drug crisis on newcomers is under-examined, meaning we don't know how severe the issue is.
Now, experts are calling not only for better data collection, but also more attention to the realities that lead newcomers to use drugs, and culturally specific care that could help them escape it.
- 2023 the 2nd deadliest year for drug overdoses in Regina: police
- Prince Albert, Sask., wastewater has high traces of meth, cocaine, StatsCan data suggests
Surge of calls from international students
Truly Alive Youth and Family Foundation, which serves Indigenous, immigrant and other diverse communities in Saskatoon, has seen "quite a surge" of substance use among newcomers, especially international students, according to executive director Anthony Olusola.
He said international students sometimes arrive in Canada already dealing with trauma, only to face the anxiety of building a life here while trying to support their family.
"It's not just their life here," said Olusola, "it's also worrying for their folks in their country of origin. All of this leads them to a place where they are looking for some haven, some sense of how to deal with it. For coping mechanisms, unfortunately, substance [use] is what they gravitate toward."
He said inflation and rising international tuition fees rates are adding to their struggles.
Stigma and shame persists
Sultan Ali Sadat, director of human resources and operations at Saskatoon Open Door Society, said young people who move here alone "struggle to survive." He said many of them are older than 22 and unable to attend high school, or find their previous education not being recognized by Canadian institutions. Some also have low levels of English.
The expectation from many families when their children move to Canada, Sadat said, is to see them "successfully standing [on their own two feet] and at least helping the families who are back home right away," adding that those relatives might be in refugee camps or countries where jobs are scarce.
"That stress puts them in a position to use some substance and then they cannot come out of it," said Sadat, who is also the president of Saskatoon Afghan Community Association.
Sadat said newcomers might turn to drugs for a number of reasons, from self-medicating, to dealing with injuries sustained in their home countries, to coping with trauma, to combating isolation.
Many cultures have significant stigma around mental health and a reluctance to talk about it, said Sadat.
"If you have a sister, nobody will marry them thinking if you have mental health [issue], children of your sister may [develop] mental illness, too," he said, adding that "community shaming" is common.
When people do share, their whole family can be impacted, said Raza.
- Do you have a story you want to share? Get in touch. Email reporter Pratyush Dayal at pratyush.dayal@cbc.ca.ca.
Need to collect data to address the problem: prof
Geoffrey Maina, an associate professor in the college of nursing at the University of Saskatchewan, said that while it would be unwise to generalize the experiences of diverse immigrant groups, three factors tend to increase their risk of substance use.
First is the stress of actually immigrating to Canada; second are the challenges involved with settling in, like "racism, cultural shock, credentials not recognized, and the peer pressure to become Canadianized;" and third is the availability of drugs in Canada.
Through community based research conducted in 2021, Maina found health-care providers in Regina reported a "noticeable increase in substance use among immigrants."
Hard data on this issue — local or otherwise — is difficult to come by.
Statistics Canada does not collect race-based data on substance use. Neither the RCMP nor the Saskatchewan Coroners Service track immigration status in its drug use data. And the Saskatchewan Health Authority does not gather information that would identify which of its clients are new immigrants to Canada.
"We don't know the scope of the problem, but I'd say the problem might be bigger than we think," said Maina.
CBC News spoke with a dozen community based organizations and resettlement agencies who said they are seeing this issue to varying degrees. While some are getting direct calls, others said they are worried drug use might be more prevalent than they're aware of, but hidden.
Maina would like to see better data collection and research in this area, saying that a lack of adequate numbers can serve to perpetuate stigma.
"Correcting that data also creates space for people to come forward because a lot of the immigrant population might be coming from a shame-based culture."
It would also help to inform culturally appropriate services, Maina said.
"Because we have not wrestled with the perversity or the scope of substance use within the immigrant population, as a society and as policymakers, we have not caught up with this particular need."
Sask. not recognizing 'immigrants would actually be at risk'
Maina said Saskatchewan in particular is still not recognizing "that immigrants would actually be at risk."
His research paper, published in January 2023, says, "A cursory review of Saskatchewan's mental health and addiction action plan revealed that there are no explicit policies on substance use prevention for immigrants in the province."
We have an opportunity because we haven't reached an explosive phase where we have a huge crisis that's unmanageable. We are still at a tipping point where we can change direction. - Geoffrey Maina, University of Saskatchewan
In an email statement, the provincial Ministry of Health said the Saskatchewan Health Authority "continues to implement cultural support for patients and families, and a culturally responsive framework related to health care."
Maina said the COVID-19 pandemic brought to light the importance of collecting race-based data, as it offered a good grasp of the determinants of health specific to the immigrant population, like working in lower-paying, more precarious jobs — many of which were deemed essential.
He said data can also help make the case for funding to address an issue.
"We live in an evidence-based society, right? And so whenever you are advocating for a community … if you can't be able to show this evidence, then you're going to say, 'Well, I don't think there's a problem.'"
Calls for culturally specific care
The Truly Alive Youth and Family Foundation in Saskatoon has two counsellors, which Olusola said offer a "cultural lens to providing clinical support." He'd like to see more diversity in the field, stressing that it's important for clients to see themselves reflected in those helping them.
That's the idea behind Punjabi Community Health Services in Calgary. Executive director Sherri Shergill said the organization's seven counsellors understand the cultural piece around substance use, like the experiences of some people living in multigenerational households.
"There's actually a really big stigma in the South Asian community about seeking help and taking the conversation out of your home."
Shergill said there is "absolutely a gap" on the Prairies and much of Canada when it comes to providing culturally savvy care and preventive measures. She wants to see provincial governments fund more such initiatives.
"We have very large immigrant populations, but then they're heading into agencies where they don't see anybody that looks like them or speaks their languages," Shergill said.
The counsellors at Punjabi Community Health Services offer assistance in that language. They are "always at max capacity," said Shergill, and had their busiest two months in the organization's history in October and November last year.
Counsellors at Truly Alive Youth and Family Foundation are also "getting really stretched," said Olusola.
"We see that as great that people are seeking help, but we're also concerned that there's a lot of people who are falling through these cracks needing this kind of support."
He said change begins with data collection and an acknowledgment of the problem.
"We should be more preventative than responsive. We need to make people feel not only to get by, but that they belong so that they can't stop believing in their Canadian dream."
Explore the key issues and solutions Geoffrey Maina heard from stakeholders during his 2021 research:
The Saskatchewan government hopes the province can reach 1.4 million people by 2030 — and it will need a serious influx of immigrants to get there.
That's why some experts say it's a critical time to act.
"We can choose to be proactive rather than being reactive. And part of being proactive is to say we know what's going to happen — that these people are going to come with pre-existing proclivities to substance use coming to a country where diverse substances are easily available and accessible and using them is socially acceptable," said Maina.
"We need to start developing prevention interventions.… We have an opportunity because we haven't reached an explosive phase where we have a huge crisis that's unmanageable. We are still at a tipping point where we can change direction."
If you or someone who know is struggling with substance use:
- To find services near you, visit www.saskatchewan.ca/addictions. You can also call the Province of Saskatchewan's HealthLine, 811.
- The Government of Saskatchewan offers take-home naloxone kits free of charge around the province. Find out where you can get one.
- The Government of Saskatchewan also offers take-home fentanyl and benzodiazepine drug checking strips. Find the closest location to you.