A Beautiful Life

Every five or ten years Ontario puts out another forward-thinking report. New framework. New strategy. New language. They talk about the unique challenges, the constraints, the road ahead. What they almost never talk about is what we already tried, where it went wrong, and who's accountable for it going wrong.

If everything was running smooth, fine. Nobody would care. But anyone with eyes knows this country has been poisoned from the inside out, and addiction and homelessness are two of the clearest places you can see it.

I wanted to learn how to build a website once. Before any of that, I needed a computer. Before I could really use the computer, I spent months learning to touch type. You can't skip the foundation and expect the building to stand. That's what Ontario keeps doing with addiction. Every new framework is the website. Nobody is buying the computer.

How I got to Ottawa

I showed up on a bus, dope sick, with warrants, from Guelph. I had a ticket to Montreal with a layover here. I never left.

That's the whole origin story. I didn't choose this city. I got stranded in it. And I've been seeking treatment in Ontario since 2011 — Guelph mostly, then Ottawa — through OxyContin, the reformulation, hydromorph, fentanyl, purple down in 2018, carfentanil and the analog soup, then benzos in the mix, now tranq. Sixteen years. On and off methadone since 2010 or 2011. Honestly surprised I'm alive.

I got clean in 2023. The detoxes I went through that year are part of why I'm writing this. I went into psychosis more than once coming off the dope. I'm still waiting on a freedom of information request from OCDC about what happened to me in there. I remember some of it. A lot of it I don't. What I do remember is being more scared of what my own brain was doing than of anything I'd ever felt using. That fear is part of why I haven't gone back. I know what's waiting on the other side now.

That's the part nobody in a policy meeting understands. People aren't choosing dope over recovery. They're choosing dope over unmedicated withdrawal in a shelter cot next to someone else in active use, with no one watching to make sure they don't seize, with nowhere to go when the psychosis hits. Given those two options, the dope is the rational choice. It's the only one that stops the suffering right now.

The inventory, fifteen years in

Here's what's actually changed and what hasn't.

More methadone clinics. The Royal exists in a way it didn't before. We have rapid access addiction clinics now. Those are real, and they matter.

The shelters are more or less the same. There is more homelessness. There are more sick people. There are the same number of detox beds. There are the same number of rehab beds.

That's the math. Demand has gone up by orders of magnitude. The actual front door — a bed where a sick person can stop being sick safely — has barely moved. You can build all the rapid access clinics you want, but if the person walking in needs a bed and there isn't one for six weeks, the clinic is a referral to nowhere.

The only two things I'd say this province has genuinely gotten right in fifteen years are clean needles and rapid treatment of Hep C. That's it. Two wins. And we're now actively walking back the first one.

Scrapping the only thing that worked

Pulling clean gear is the kind of decision that tells you everything about who's making decisions and what they actually know.

When clean needles aren't available, people don't stop using. They share needles. They try to clean them with bleach if they remember to and have it. Hep C reinfection goes up. HIV goes up. Endocarditis goes up. Abscesses, sepsis, soft tissue infections, the whole list. Then those people end up in the ICU, and the province pays ten times what a box of syringes costs to treat what a box of syringes would have prevented.

This isn't a debatable point. It's arithmetic. The same government that won't fund harm reduction will fund the ICU bed. The money gets spent either way. The only question is whether it gets spent on prevention or on cleanup, and whether a person ends up alive or dead in the meantime.

Scrapping clean gear is one of the few addiction-related decisions in the last fifteen years that's actually going to kill more people who would otherwise have lived. That sentence should be a scandal. It barely makes the news.

The drug changed. The response didn't.

The drug supply has mutated underneath everyone's feet. Each wave is harder to treat than the last. Naloxone doesn't bring someone back the same way when there's benzos in the mix. Tranq wounds don't heal in a shelter. Withdrawal from this stuff isn't what withdrawal looked like ten years ago.

Ontario's response, on the ground, mostly didn't change shape. Same shelter beds. Same waitlists. Same 21-day program if you're lucky and you call at the right minute on the right day. Same discharge to nowhere when it's over. The drug got stronger and weirder and the system stayed exactly as undersized and uncoordinated as it always was.

Meanwhile we've juggled new policies, new pilots, new task forces, new consultations. We can't even nail down the actual drug problem in front of us, which is poly-substance, contaminated, and neurologically brutal, and we're rolling out fresh frameworks on top of a foundation that was never built. That's a double failure. Skipping the basics, and pretending the new layer of paint is progress.

What "back to basics" actually means

I'll say something that's going to make some people uncomfortable. I think we need involuntary detox for the sickest people. Not as a punishment. Not as a sweep. As medicine.

Hear me out before you decide what I mean by that. The "voluntary" system we have right now is a lie anyway. Someone in active psychosis, going through unmedicated benzo-fent-tranq withdrawal, sleeping outside in February, can't meaningfully consent to anything. They're not choosing freely between treatment and the street. They're picking between hell and a worse hell. Calling that voluntary is how we let ourselves off the hook for leaving them out there.

What I actually want is a system where someone that sick can be held safely. Medically, with dignity, with people watching them so they don't die or hurt themselves or go into psychosis alone, long enough to get through the worst of it. Some of it should be voluntary, with low barriers, walk-in, no waitlist. Some of it, for people who genuinely cannot consent because their brain isn't online, has to have structure and constraints. Both can exist. Both have to exist. Right now, neither really does.

If people knew there was a real place to go, medically supervised, not a mat on a floor, not jail, not a six-month wait, I think a lot of them wouldn't go back to dope. I'm scared of what happened to me in 2023. That fear is doing more to keep me clean than any program ever did. Imagine if people didn't have to nearly die to learn that lesson.

That's the basics. That's the computer before the website. Stabilization before treatment. Treatment before housing applications. Housing before job training. A coherent thread instead of a dozen disconnected programs with different intake forms and waitlists that all expire before you can use them.

To say it the way a ministry would understand it

Strip out my voice for a second. Here is the same argument in the language a deputy minister reads in:

Harm reduction saves lives but does not stabilize acute, high-acuity addiction states. The system lacks a medically supervised, rapid-access stabilization capacity for people who are actively psychotic, in severe withdrawal, or unable to function in community settings. Without that layer, both voluntary treatment and outreach interventions fail to connect the sickest individuals to recovery pathways. — The gap, in their language

That's the whole gap, in one paragraph, in their words. There's no ideology in it. There's no left or right. It's an operational description of a missing layer in a healthcare system. A serviceable response to it would not require any new philosophy. It would require beds, staff, and a clear clinical pathway.

That's how I know the failure isn't intellectual. The argument is simple enough to fit in three sentences. The failure is political. Nobody wants to own the cost, the optics, or the legal architecture of holding someone safely against their will, even when "their will" is a brain in active psychosis that cannot form a coherent preference.

On the civil liberties question

I know what some people will say to involuntary detox, and I take it seriously. There is a real history of locking up people who weren't dangerous, who weren't sick, who just didn't fit. I'm not handing the state a blank cheque to pick up anyone they want off the street and call it medicine. That's a legitimate fear and the safeguards have to be real.

But here's where I push back. The loudest voices on civil liberties around this issue are almost never the people sleeping outside in February with tranq wounds and no shoes. They are not the families burying someone who died "voluntarily" because the system politely respected an autonomy the person no longer had. The current framework is not protecting anyone's freedom. It's protecting the system from having to act.

There is a difference between autonomy and abandonment. Autonomy assumes a person has the cognitive capacity to weigh options and choose between them. A brain in unmedicated benzo-fent-tranq withdrawal, in active psychosis, hypothermic, sleep-deprived for days, does not have that capacity. Pretending it does isn't respect. It's a dodge. We're using the language of rights to justify doing nothing, and the people whose rights we claim to be protecting are dying on sidewalks while we do it.

The right answer isn't to throw out civil liberties. It's to build the safeguards properly. Clear medical criteria. Time-limited holds. Independent review. Real treatment on the other side, not a holding cell. The work is hard, but it's been done in other healthcare contexts and it can be done here. We've just decided not to do it, and we hide that decision behind a principle we don't actually apply consistently anywhere else in medicine.

What I want from the next report

When the next forward-thinking Ontario report comes out, and it will, on schedule, I want to see something I've never seen in one of these documents. I want a section on what we tried that didn't work, and why, and who decided to keep doing it anyway. I want names. I want numbers. I want the honest accounting of how many people died waiting for a bed that the last framework promised. I want someone in writing to explain how scrapping clean needles is going to save anyone anything.

Without that, the next report is just the last report with a new cover. And the people who actually live this, who have lived it since the bus pulled into Ottawa, who are still living it tonight, already know it.

It's a beautiful life, the song says. I'm not so sure. But I think it could be, if we stopped skipping the foundation and started building one.