Advocate for harm reduction in Alberta, drug addict challenges government’s emphasis on abstinence

CALGARY — A Calgary woman says she felt happy for the very first time as an opioid passed through her body in a hospital.

“When they gave me this intravenous hydromorphone, all the horrible things I was feeling went away,” says 21-year-old Ophelia Cara.

“I felt like I could breathe again for the first time in a long time and, in a way, for the very first time.”

The discovery of hydromorphone, marketed under the Dilaudid brand, would change everything for her.

While stories of opioid use are often tragic — with thousands of deaths attributable to Canada in recent years — Cara says their use has saved her life.

Cara is not going by her first name for fear it could threaten her prescription, as tensions mount in Alberta over how to respond to the overdose crisis.

As the provincial government focuses on a recovery-based approach, while reducing harm reduction services, Cara has become a well-known advocate in Calgary for services that support people who use drugs.

Not only does she fight to keep the city’s drug site from closing, but she points out that abstinence doesn’t work for everyone.

“I tried everything to stay sober. None of it worked,” Cara says. “I’m still very addicted, but I’m also more recovered and mentally healthy now than I’ve ever been.”

Sipping tea on a couch in her southwest Calgary home, Cara recounts a lonely childhood where she often chose the comfort of a school book over making friends.

From an early age, she faced significant mental health issues, such as depression, which continued into adulthood. Cara says her life hit an all-time high during the COVID-19 pandemic.

Her job at a nightclub was suspended and her relationship with a man she loved was difficult. An unrelated sexual assault landed her in the hospital in the summer of 2020, and that’s when she received the hydromorphone infusion.

After that visit, she turned to street drugs, cocaine and fentanyl. She suffered numerous overdoses, one of which resulted in a massive seizure that Cara says left her unconscious for an hour.

Her father tried to force her into sobriety by taking her to a small town in Mexico. It did not work. She overdosed almost immediately after returning to Canada.

“I don’t recommend anyone to use drugs,” Cara says, speaking specifically about illicit drugs. It scarred her life, she says, with hospital visits, toxic relationships, unbearable pain and broken ties with family and friends.

It was at the Calgary drug use site that staff helped her realize that there was an option to be “safer with drug use without getting sober”, and she started making research.

There are opioid agonist treatment programs in Alberta where strong opioid medications, such as methadone and suboxone, are prescribed to treat substance use disorders. Safe supply programs, which provide alternatives to prescription drugs, are also becoming more widely known across Canada.

Cara says she was rejected by several doctors before finding one who would prescribe Dilaudid.

Along with the therapy, she says the prescription medication is helping her improve her mental and physical health. This gives her stability so she can study and work while pursuing her passions, such as cross stitch and advocacy.

“Usually the reason we say people have to get sober is because there’s this idea that someone who uses drugs can’t live a balanced life…that whatever they’re interested in is getting high,” says Cara.

“But I’m more productive now than I was when I was sober, because now I’m actually stable. I’m not in survival mode anymore.”

She carries a medicine kit containing naloxone, sterile equipment, vitamin E oil for her skin and contact cards for local agencies, among other supplies to promote safer drug use. A pin attached to its mesh interior reads “cannot recover if dead”.

While abstinence may work for some people, says Kinnon Ross, a harm reduction nurse in Edmonton, recovery should instead be viewed as any step that improves a person’s quality of life.

“If that means having a less chaotic outcome from your drug use, then that’s a step towards healing,” says Ross.

In some ways, Cara is still like her younger self and can often be found with her head in a book. She plans to earn a doctorate in chemistry and pharmacology to delve into how drug use can be made safer.

Cara says she chose the name Ophelia after reading William Shakespeare’s Hamlet, where a noble young woman of that name dies by suicide after suffering many wrongs from men in her life.

“I wanted to give her a better ending than the one she chose for herself.”

This report from The Canadian Press was first published on April 17, 2022.

Alanna Smith, The Canadian Press

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