In Plain Sight

Between May and August of 2019, Health Canada released an 8-episode podcast series on Apple Podcasts, Google Podcasts, and their own website that "explores the personal stories of people affected by the opioid crisis"; a crisis that is happening "in plain sight". Included in this series were people in recovery (Charlotte, Darryl, Mélissa, Kirk, Stéphane), a service provider (Elsa), and a family of overdose decedents (Amy, Donna). Three episodes (Mélissa, Elsa, and Stéphane) contain French audio with English transcripts.

2019-05/2019-08

"In Plain Sight" by Health Canada is licensed under CC BY-NC-ND.

Episode 1: Charlotte, abridged
*see full transcripts of all 8 episodes at Health Canada's "Audio series on opioids: In Plain Sight"

Charlotte:

Hi my name is Charlotte Smith. I guess my problems really started when I was about uh – I was almost 13 and my biological mother came to England, because she is British but she had moved to Canada and had gotten married, and uh, she but had never been in my life. I was adopted out when I was six months old.

When I was about 13 she wanted to find me and re-adopt me and take me back into her custody so she did. And she paid for my immigration to Canada. Sponsored me in. And, it was a pretty devastating transition for me. I was very homesick. I was ok for almost year and we were in our honeymoon phase, but after that, everything went downhill.

I started cutting my arm and avoiding my biological mother. I stayed out a lot with friends. I didn’t want to go home. I didn’t feel like I was wanted there.

I had found some recordings that my mother had done of her self-therapy and she was just sobbing into the recording saying how I wasn’t really like her daughter, and how I didn’t speak like her and I didn’t have the same values as her and she was clearly devastated by that.

As my mental health declined, her behaviour towards me also declined. She became very emotionally abusive.

Eventually, she dropped me off outside of a foster home where I had babysat. This was a few weeks before Christmas, when I was 15. I cried for about three days straight. After about a week of being in this foster home, where I wasn’t a ward of CAS (The Children's Aid Society), but my mother was paying rent to the parents to keep me there, which had been cleared by CAS.

I was so scared of being alone, you know. I didn’t have any family in Canada besides my biological mother and I thought if things don’t work out at this foster home, I’m just going to be completely alone in a country where I really don’t feel I belong.

So their marriage dissolved. The foster home was completely destroyed by that. I ended up living on my own on and off with that man and in and out of horse farms that I had also volunteered at when I was 13 and 14, since coming to Canada.

So horses, and that experience, really provided great opportunity for me for housing – because I had the experience mucking stalls – when I came back to these places I was a 16-year-old homeless girl. They would take me in and let me work there for a room. But I also started using a lot of ecstasy. I had never done any drugs before being kicked out of my house.

But after that, everything just seemed even more hopeless than it was before. It was just a way to cope. It was a way to cope with being homesick from England, and then it was a way to cope with the loss of my newly found biological mother.

Narrator:

So at just 18 years old, Charlotte left Canada and returned to England – with no life skills or experience living on her own.

But the ties she had to Canada began to tighten and she soon found herself leaving England to return to the only life she really knew.

Charlotte:

Then things went further downhill because I had failed at going back to my home. I had come back to Canada and now the farms were out of reach for me.

So I just started doing more drugs. I met some people who were prescribed OxyContin and I started to take that. And, at first I thought this was great, because it allowed me greater strength capacity. I got a job in construction, and I was able to keep up with the men. I was able to lift the drywall sheets – everything – and keep that energy going all day because of these pills. I didn’t realize that I was addicted to them.

They also gave me a lot confidence and I moved in with a woman who was addicted to OxyContin, and her son. And I taught her how to crush them up and snort them because that’s what I had always done with ecstasy. I didn’t realize that that would make her addiction – which I still, I didn’t realize that even she was addicted, but it took her addiction to prescription pills to the next level because she started going through them so fast because the high is more intense but it’s shorter. And of course you build up resistance too. So, then we started having to go through all of her pills and finding ways to buy more. And when I didn’t have them, I would be very sick and the whole world would be gray. Like, apart from the physical sickness.

And the woman I was living with ended up going to detox because of that. And I felt very responsible. She ended up losing her child as well, for a period. But when she came out of detox, she came out with a boyfriend who used crack cocaine and I then fell into smoking crack with her and her boyfriend. And it was fairly easy because it wasn’t my first time seeing crack.

I used to use online dating sites to secure drives places to pick up these ecstasy pills. So I would tell guys that I was going to sleep with them if they would give me a drive so that I could go get my pills. And one time, the gentleman who was driving me around had offered me crack and I spent, I think 4 or 5 days in his apartment, just high out of my mind. Just not fun, paranoid, scared but lighting that pipe and taking the next hit, and the next hit and the next hit. Even though I was shaking and sweating and sketched out.

And I got out of that apartment and I thought, “wow.” And it took me a few days to recover. I thought, “I’m never going to ever do that again and I hope I never see it again,” and I didn’t think I would. But by the time when I saw crack again, when I was 19 now, things had gone so far downhill I really felt like that I had left nothing to lose. I had no family. I had no real future prospects. I had dropped out of high school. There was no hope of returning to my family in England.

I felt like I was a complete failure. So I smoked the crack for the next three years every day. The only times when I didn’t was if I was in jail or when I was working to try to get more drugs – which was through shoplifting or sex work. And of course during this time I also kept doing OxyContin but I also started injecting OxyContin and morphine and cocaine as well, which was a very terrifying experience actually.

Even though I did it, it’s not that it didn’t scare me. I would go into these houses where I would see people searching for veins for hours – just poking needles into their arms, just trying to find that hit. And having abscesses, and having seizures, and just using dirty needles, sharing needles, and as shocking as that was, I honestly just felt as if I was finished – that my life was never gonna be what it could been if perhaps, I hadn’t come to Canada or if my mother hadn’t kicked me out.

So I followed suit, and I and I used dirty needles, and I shared them and I did all of those things. And, uh, really the only reason that I got out of drug use was through pure luck. And that’s what’s so frustrating about the system as it is right now, is that there is no standardized state-sponsored help for people to get out of addiction or homelessness. There is no reliable solution.

Everybody, sort of, is left to find their own way, which I was lucky enough to do. Because one of the last times that I went to jail, I knew that if I got out of jail and I went back, picked up the pipe or the needle, that I was going to end up with AIDS or HIV. A lot of my friends at the time had one of those diseases or the other.

So I called a friend, and he agreed that when I got out of jail, that I could move in with him. So, I went out there and I didn’t come back into the city at all for probably almost a year. And in that time, somebody helped me get a job at a horse farm. And every day that I walked into that farm, I saw the horses and I knew that if I were to pick up a pipe, if I were to go in to Ottawa and to go downtown, I would lose everything. All the trust that I built up with these people and all the privileges I was given to take care of these animals. So I was able to stay clean.

Then I did a year of college. Which now I’m starting my masters in September. I’ve got – had many opportunities to conduct research on populations that I used to be part of – like sex workers, drug addicts and homeless youth.

So, finally I can sort of see a future for myself. And it’s a future where I believe that I’ll, hopefully, be able to help some of those people that I’ve left behind. Cause I definitely do have survivors guilt, PTSD from, uh, the experiences of being homeless and being addicted to hard drugs. So that’s something that I still struggle with. I have a lot of nightmares, where somebody will be overdosing and I can’t save them. And those happen all the time, and that’s something I have to continue to try to put behind me.

I also still struggle with active addiction. So, I’ve been sort of some what on the straight and narrow for 5 years. Addiction is very powerful and I seem to not be able to escape it – and I wish that something could take it from my mind. But so far I haven’t found a way to do that. And there are so many memories that I have of using in Ottawa – that wherever I go, it’s just constantly in my face.

And I know that addiction and drug use is invisible to a lot of people that have not experienced it. But when you have experienced it, it’s unavoidable. And wherever you go there’s reminders of it and there are triggers that cause you to have urges to use and they can be very hard to deal with and there’s not necessarily a lot of help for that beyond, you know, weekly meetings with counselors or group sessions with other former users like, NA (Narcotics Anonymous).

But really it’s something that’s always there inside you. And even I’ve watched my friends die and people are dying every day in Ottawa from opioid use. And as painful as that is for me to see those people dying, it’s still not enough of a deterrent for me to not use when… when that urge strikes me. And that makes me feel disgusted at myself. And I don’t know what the solution is.

Narrator:

Fifteen minutes. That’s all it took for Charlotte to take us on a life journey.

She then shared reflections on her life, how the world came to treat and perceive her – how she began to see herself differently too.

Charlotte:

One thing I noticed when I was using crack and heroin and OxyContin and morphine on the streets, was that you are no longer treated like a young girl. You become seen as responsible for yourself, as an adult who is making – conscious of their decisions – and just simply choosing the wrong path. Which I very much felt like I was not an adult and that I still had the mentality of when I was 15.

So to be treated like an adult was difficult, because when you go, say to your social worker for a welfare cheque and they are very unsympathetic that you’ve been using or that you can’t find a place to live it’s very damaging. And… it’s awful because you so badly want people to see that you are a 19-year-old or 20-year-old girl, and that you need help.

But they tend to view you like just the way they see any other street user and that it’s your fault for the position that you’re in. And it’s very uncomfortable to ask for help because you don’t feel like you deserve it, because you start to think that, “I am the cause of my own demise here and I did do this to myself.” Which is to a point true, but there were also a lot of other complicated issues that played into me taking that choice to use drugs.

And I think that that barrier that comes up between you as a young drug user and the rest of society – it causes you to look for belonging in other ways outside of the mainstream. So you become very close to the older people on the street the older addicts who are around you and you forge some sort of community with them. But it’s certainly not a healthy community and that’s not because of the individuals themselves. They may be very nice people and they’ve also come from so many different backgrounds, but the lifestyle associated with drug use on the street is very toxic.

So I met people who were actively engaged in sex work and who were not honest about that when I first came on the scene. So they would set me up on dates with men who I honestly, naively, stupidly thought were, maybe wanted to date me. And they were not. They were paying the people I knew to have sex with me and I had just had no idea, and that’s what I mean by that I was a child even though people were treating me like I was an adult.

I was very naïve and people wouldn’t believe me when I said I didn’t know they were pimping me out. They would just think that oh you’re a slut. But no, I really didn’t know and I when I did realize, I tried to kill myself.

The girl that I was staying with, who was an IV drug user, she ended up being all I had. I felt safe with her and then when I realized that she was selling me to men and that she really didn’t care or that she did care about me, but her need for drugs was so powerful that she was willing to risk my life or my safety to get those drugs, I was devastated and I stabbed my arm multiple times with a carving knife and she had to call an ambulance. And because of that, she wouldn’t let me go back to her place. Because I was a heat bag then.

Because of me she had to call 9-1-1. Which is a serious offense in this subculture of drug use and homelessness and sex work because police are pretty awful to drug users, in my experience. And it’s very hard, even if you’re watching your friend overdose, you do not want to call 9-1-1, because you don’t want to get in trouble. You also don’t want to call 9-1-1 because you know that the person laying on the ground does not want to wake up and see the police in their face and be taken to jail because of their addiction. And that is a call I have had to make. And I tell you that I did leave my friend on the floor until her lips were blue before I called 9-1-1 because I was scared of the police.

And the time that I tried to kill myself when I was first realizing that I’m in this subculture, where people can only care up until they get their next hit.

When I was released from the hospital in Quebec, I was covered in blood. This is another example of how you’re not treated like a young girl – when they took me in, they were basically laughing at me. They weren’t taking it seriously that I had tried to kill myself and they told me that I just, you know, I was just in drugged-induced psychosis, basically and that I was jonesing and that I just needed another hit, and that’s why I was acting out.

They didn’t give me even any bus fare. They let me – they released me to a place where, you know, outside of the hospital where I had no idea where I was and I had to find my own way back to this girl’s house… not knowing that she would also reject me from there. But just the lack of compassion… I know to them, I was wasting their time because they had real people with, what is considered real health issues – that aren’t addiction – to deal with. But I really did need their help. And if an adult, I feel like would have treated me like I was a young girl who needed help, things could have been different. But they didn’t even try. And that all contributed to me just giving up more and more.

I was worthless. I, uh, walked all through the streets of Ottawa in those bloody clothes and nobody offered me any help. Except a bus driver let me on for free eventually. And the only places that I could go were crack houses… and I call them crack houses but these are houses where there is a lot of prescription drug use. It's not all crack. It’s all kind of drugs, a lot of opioid use, a lot of needles… and those are the people that ended up taking care of me and letting me sleep on their couches with their bed bugs until I was healed enough to get my stitches out and carry on about my business.

And by then there was no other options outside of sex work because – I was too awful looking to get away with shoplifting. So, when you go into shops when you’re looking clean and tidy, they don’t notice you and you can get away with a lot more than when you walk in in dirty clothes and scabs all over your face and arms. You get noticed very quickly. So sex work becomes one of the only options because men, and not all men, but a lot of men don’t seem to mind if you are dirty and if you have scabs and if you are sick.

Every other part of your identity beyond drugs and prostitute and homeless are erased and that’s what people see. They see an addict and they can justify many actions against you by that. They can justify throwing you in jail, or kicking you out or having sex with you when you clearly are in no shape to be doing that because you’re just an addict – and you’re no longer a young woman who was scared, who needs help, who was a new comer to Canada. You’re just seen as disposable.

I don’t think that people treat young girls who are not homeless addicts the way that they treat homeless young addicted girls and I wish that is something that could be changed. I know a lot of men that have done terrible things to me, have daughters at home that they would kill somebody for doing the same thing to. But because I made the choice to put a needle in my arm I lost all the privileges that many humans in Canada do get. The rights over their own body – to not be touched while they are sleeping.

And just because I made the choice to sell my body or because I made that choice – because it was the only choice that was left to me…doesn’t mean that I can’t be raped. Because I did get raped and there are a lot of other girls who are out there getting raped too. There’s just no respect for addicts.

Narrator:

As far as she has progressed in life, sobriety is still a source of shame for Charlotte and she is always aware what the world expects and what is realistically possible.

Charlotte:

People do tend to think that when you stop being an addict, you’re supposed to at least stop doing all drugs and I think that’s taught in a lot of these recovery practices. But for me, that’s not the case and I think it is a dangerous misconception.

Because if you tell me that I can’t smoke pot or drink alcohol for the rest of my life, I’m going to be very anxious and panicky just the thought of that to not have that kind of safety net of more socially acceptable drugs.

When I first got off the streets, marijuana really helped me stay away from going back to the hard stuff. It also helped me sleep at night. I find that I have less nightmares. I find that I have less reoccurring traumatic thoughts about my past when I’m smoking marijuana. And I’m ashamed of that pot use to a certain extent because… while it is legalized and there is a lot less social stigma around it, I think or I feel like in professional worlds, that it might delegitimize me in the field of research because I use it so often. I feel like people may think that I am not a serious professional or they might worry that I’m conducting research stoned. I don’t use it for the day to day activities. I use it as a crutch at night.

What I hope to do is transform the research process into one that can be actually part of prevention and intervention for youth homelessness and addiction. So by helping to facilitate positive, meaningful youth engagement with youth who are at risk of homelessness and addiction, or who are experiencing those things. And trying to send the message that when we’re in places of privilege, like I am now, like, each interaction that I have with a youth who is experiencing hard times, can be a positive one.

It can be more than just a simple interview where I’m siphoning knowledge from them about their experience, to publish towards my own career. I can try to offer them resources, I can try to offer them hope, and at the very least, I can ensure that I’m giving them cash dollars for their participation in my studies, rather than gift cards, which are not a form of harm reduction, the way that I see cash is.

Because if I’m giving cash to my participants, then and they need drugs, then it’s my line of thinking that they’ll have to do one less awful thing to get those drugs because they have that $20. And I think that there is a perception, that when you’re giving addicts money, you’re enabling them. I think you need to respect people’s wishes too. If somebody is asking you for money, it’s because they need money. And it’s not up to you what they do with that money. And I think that you can provide some semblance of safety by giving them that money, rather than a gift card – which will not help them get the drugs they need... in which will mean that they will still have to go walking down the streets trying to catch the eyes of drivers who will stop and ask them if they want a date.

I hope that in all the research that I do I can engage meaningfully with youth, I can get them excited about the possibility of returning to school or following dreams outside of school that are off of the streets and away from drugs.

And I think from the youth that I have worked with so far, they do appreciate that I come from a background similar to their own and they do seem to be more willing to talk to me about more intimate details of their experience because of that. And they’ve told me that. And they seem also to be excited that I’m doing so well, and I think it gives them a sense of hope that, well maybe, you know, the future doesn’t have to look homeless and addicted.

Episode 3: Mélissa

Mélissa:

I had a good job as a client care attendant for people, uh ... who had terminal bone cancer. I had a great condo, a nice new car, a sports car, Tiburon, manual. My family didn’t think I’d get it, but I got it. It was a point of pride for me. I had lots of good friends, and I used coke occasionally. And my family relationships were going really well.

When I was 14, in high school, I hung out with some guys from Ottawa, and we did speed. When I was 18 I met a guy, a serious relationship that lasted 7 years. We broke up because of cheating, and then I started to work as an escort because it paid well. I started putting ads in the newspaper. I did some porn, and that led me to organized crime. I felt safe with them: if ever anything happened to me, I just had to call them and they’d take care of it.

That’s when one of them moved in with me. I wanted to help him out—little did I know what that would involve. After he OD’d, I saved his life. And by way of thanking me, he paid my rent and introduced me to heroin, which he bought for me. I was 24 years old at that time.

I realized things weren’t right when I was 28. I was doing heroin, crack, speed, oxys and fentanyl. It all fell apart when I lost everything: my boyfriend, my apartment, my friends, my furniture, my clothes and my personal hygiene. I was ashamed of myself. It got to the point where I was squatting in abandoned houses with no heat and no running water. I owed money to the drug dealers and the government.

I defrauded the banks by putting empty envelopes in the ATMs. I had about 20 different credit cards, with limits from $100 to $5,000. I lost my driver’s licence. I now have a criminal record, and as everyone knows, when you have a criminal record you’re stuck with minimum wage jobs for the rest of your life. My car was repossessed by the company because I couldn’t make the payments anymore. I was 28 years old, I went bankrupt, and I was on probation for the next three years.

So here I was at 28, on the street, no housing, tons of debt, no car, tons of family problems. I didn’t know what to do. My instinct went into survival mode. Rule number 1 was using. Every hour, every minute, and every second of the day, I had to get my fix. I’d stay with one person, then another for a few days at a time. Sometimes I had no place to sleep, so I’d sleep on a park bench, in any old park.

I had no hygiene, and I weighed 80 pounds. I’m 5’ 6”, so technically I should weigh 125 pounds. I was literally skin and bones. When I had no money for drugs, I turned to prostitution, or easier yet, I slept with the dealers in exchange for drugs.

Using is truly a demon that thinks for you, acts for you, and controls you in an incredibly cruel way. It literally tears you apart. I used with several people. And people will steal from you, they’ll manipulate you to get your stash. When you live on the street, your life is in constant danger. I got into even more trouble with the law—another probation, for one thing—and had even more family problems.

I lived on the street for three years. After three years, I was literally exhausted, both physically and mentally. In January 2018, I started therapy for the first time in my life at the CRDO [Centre de réadaptation en dépendance de l’Outaouais]. I stayed for two weeks, because I thought I’d be cured when I finished therapy. Therapy is really hard when you’re using. You’re scared, you don’t know what to expect. It’s change, and sometimes you’re not ready to change.

I had relapse after relapse—you always return to your old patterns of consumption. In May 2018, I went back into therapy and successfully completed a 38-day program. You’re safe in therapy. I succeeded and I’m proud of it. You learn a lot of things in therapy, but the most important thing when you come out is how people react when they see you: you’re healthy, you’ve gained weight, you don’t have dark circles under your eyes, it’s all wonderful. I’m fine now, but I relapsed on the 75th day. Why? Because I fell back into my old patterns of consumption.

What I’ve learned about myself is that I’m beautiful, that I can be happy without drugs. I have to think of myself before others. It’s important to talk to someone when things start to go wrong. I got my independence back. Now, at 32, I have my own apartment, I cook for myself, I’m important, and it’s true that sleeping on something often brings a solution. I weigh 115 pounds. I haven’t used in 2 months and 2 days. It’s hard work, but it’s worth it. Being happy and not using is the best gift I could have given myself.

Another thing I learned is that when I was using, I had lots of friends, and now my old friends think I’m boring—and that’s normal, I’m not using anymore. I’ve built a new circle of friends, I have confidence in myself and that’s the important thing. To society, since I have a criminal record, I’m labelled a criminal. People are too quick to judge: when you’re using, people call you all kinds of names—slut, cow, junkie, bitch, etc. Now that I’m sober, people see me as a good person who knows what she’s doing, and also, importantly, a responsible citizen. I also belong to L’Addict, an association for current and former drug users.

I’m leaving on December 30, 2018, for a three-month therapy program in Ottawa, and I’m proud of it. This will be my challenge for 2019. I’d like to say that yes, it’s hard, and no, it’s not easy, but take the time, it’s worth it. I’m doing really well and I want things to get even better. After my three months are up, I’d like to get my driving licence back, finish paying off my debts, and be very happy and especially smiling. Don’t be afraid to ask for help—it’s worth it. Good luck, everyone. My name is Mélissa C.

Episode 7: Donna

Donna:

She suffered from, from symptoms of anxiety and mental illness for years before she was finally diagnosed. She self-medicated with OxyContin that she was prescribed. And she was very honest about it, she was, “This works, this works with my social anxiety.” And in my naivety I said that’s great, you know, let’s have you stay on that, and you’re functioning! You’re functioning well, you’re perfect, you’re easy to get along with. And then the doctor cut her off of course when she said to him, you know, “this is what I’m using it for”, and he said, “well I won’t prescribe it for that”, and actually fired her from his practice. And then she turned to the street drugs and that was the downward spiral to the point where she lost everything. Her children, her home, her relationship, everything, and ended up living on the streets, and becoming your stereotypical substance user, you know, the one that you want to cross the street to avoid.

You know, and my experience with her was to just practice tough love, and that just pulled her down ever further. By the time I realized how dangerous what she was doing was, it was already too late, and I couldn’t get to her to try to turn anything around. And then like I said, it was a matter of, you know, getting the phone call from the hospital saying you better come, we don’t know if she’s going to get up off the operating table. We’re going to amputate her legs to stop the necrotizing fasciitis. And, and by the time I got there, they had finished the surgery itself and said, you know, there’s nothing that we can do to stop the infection. It had already gone into her internal organs, and she was going to lose her life from it. And then it was just a matter of her saying to me, you know, you really need to know what addiction is really all about. And, for the remainder of her days that’s what she did with me, is she talked to me about what her issues were, the underlying causes of her needing to take drugs.

And, it was an eye-opener. When she first died, I, you know, her wish was for me to go out and to be able to help other moms and dads to understand what their children are really using drugs for. And it’s not for pleasure and it’s not for fun, it’s not for, you know, just – keeping up with your peers. Once, once you get started on something it’s very difficult to turn away from it especially when it comes to opiates, and the differences that it makes in a person’s body. That’s been my biggest challenge, is to let parents know that it’s not just a willful behavior, and something that they can stop. We really need to work hard to unders