Introduction
I have been trying to get this essay right for quite some time. It has been a difficult one to write, being so close to home. I have lived in Vancouver for almost a decade, and even in the short time I have been here, I have witnessed Vancouver's addiction epidemic grow, spilling over from the Downtown Eastside into the rest of downtown Vancouver. The problem just keeps growing, with no end in sight.
This essay is an attempt to start answering the question: why? Why does Vancouver host the worst addiction epidemic in North America? Why, despite spending one million dollars a day on the problem, does it continue to get worse? I certainly do not have the answer, but I hope that, in a small way, this at least gets us thinking about some of the contributing factors.
Thanks so much for reading!
Part One: The Downtown Eastside, Following the Money
Vancouver hosts the most severe addiction, homelessness, and mental health crisis in North America, making it an epicentre of intertwined social issues that demand urgent attention and effective intervention. Despite the many efforts and substantial funds allocated to help, the situation worsens. Why does this crisis continue to grow? This essay presents a hypothesis: hidden financial incentives might be playing a role in keeping these severe problems from being solved. By exploring the possible influences of pharmaceutical companies, government policies, unions, and non-profit organizations, we suggest that monetary and financial interests could be obstructing real solutions. Understanding this hypothesis can help us consider whether these unseen economic factors are making it harder to fix the issues in Vancouver and remind us of our shared responsibility to make a change. The influence of financial interests is evident in the actions of Purdue Pharma, which lies at the core of Vancouver's worsening addiction crisis.
At the heart of the worsening addiction problem is Purdue Pharma, the pharmaceutical giant notoriously linked to the North American opioid epidemic (Van Zee 2009). Purdue’s aggressive marketing of OxyContin in the late 1990s and early 2000s led to widespread misuse and addiction. This created the foundation for the opioid crisis, deeply affecting communities like Vancouver that are now struggling with long-term consequences. In Vancouver, programs providing a 'safe supply' of opioids aim to reduce harm by offering regulated substances to those struggling with addiction (BCCSU 2020). Purdue Pharma plays a direct role in supplying opioids for Vancouver's safe supply program, which is intended to offer these substances in a controlled manner to reduce harm (BCCSU 2020). However, this involvement has sparked significant concerns among critics, who argue that the program may serve corporate and political interests more than it serves public health goals, potentially perpetuating addiction instead of alleviating it. Purdue's role is a clear example of how corporate interests can interfere with public health initiatives, prioritizing profits over genuine solutions to addiction.
Critics argue that supplying free opioids to people with drug addictions can inadvertently sustain the addiction rather than alleviate it (Wright et al. 2016). There are reports that most recipients sell these opioids on the black market to fund the purchase of even more potent drugs, like fentanyl (Buxton and Dove 2008). This not only perpetuates their addiction but also introduces others to these dangerous substances. The cycle of addiction continues, potentially benefiting pharmaceutical companies' profits. It raises a critical question: Are corporate interests being placed above human lives? This question becomes even more pertinent when considering how government funding is being allocated to tackle these issues.
Both provincial and federal governments allocate over \$1 million per day to tackle Vancouver's addiction crisis (Statistics Canada 2021). Despite these vast financial resources, the effectiveness of this spending is highly questionable, especially when we consider the influence of unions in shaping how these funds are used. Unions often push for funding to be directed towards maintaining jobs rather than implementing innovative programs that could yield better long-term results. While the funding is intended to address homelessness, addiction, and mental health issues, a significant portion of this funding supports a vast, unionized workforce in social services and healthcare roles (Vancouver Coastal Health 2018). Critics argue that this funding model prioritizes employment stability for workers over meaningful, transformative change for those in need, ultimately creating a system more invested in maintaining the status quo than solving the crisis.
Unions in British Columbia wield significant influence over provincial politics, a power that has been entrenched for decades. Through substantial lobbying efforts and political contributions, unions have cemented their control over policy-making and funding decisions, ensuring that their interests remain at the forefront (Ross and Savage 2013). This immense political clout enables unions to shape how critical social issues in Vancouver are handled, often prioritizing their own agenda over the needs of the community. 
This position of power leads unions to prioritize job security and organizational growth over the effective resolution of social problems. Unions have a vested interest in maintaining the status quo in Vancouver to keep union members employed. Studies have highlighted instances where unions focus on preserving jobs, even if it means supporting programs that are less effective in solving underlying issues (Freeman and Medoff 1984). This potential conflict of interest hinders progress and contributes to ongoing challenges in Vancouver. Similarly, non-profit organizations, which also benefit from public funds, face significant scrutiny regarding their financial priorities.
Non-profit organizations provide many essential services in Vancouver, but their operations are not above scrutiny. Despite receiving vast sums of money—benefiting from tax advantages, generous public donations, and a portion of the \$1 million per day government expenditure on Vancouver's addiction crisis (Pivot Legal Society 2010)—serious questions have emerged about how these funds are actually used. Investigations have revealed that a significant portion of their budgets often goes to administrative costs and executive salaries, with far less going toward direct aid for those in need (Saunders 2017). This raises concerns that some non-profits may be prioritizing their own growth and operational comfort over truly addressing the crisis in Vancouver. This misalignment of priorities further complicates the challenges faced in the city.
This mismanagement raises a harrowing concern: Do some non-profits have a financial stake in the continuation of the very crises they aim to solve? If the problems were resolved, their funding would diminish, threatening their existence. This paradox creates a situation where the suffering of vulnerable populations in Vancouver—including those struggling with addiction, mental health challenges, and homelessness—inadvertently sustains these organizations. This underscores the broader issue of how financial incentives can obstruct real solutions, ultimately prioritizing institutional survival over meaningful change. This reality should provoke outrage, yet few consider the extent of this influence on Vancouver's worsening addiction and homelessness crisis.
Adding to this, many individuals residing in Vancouver are not originally from British Columbia. Reports indicate that some provinces provided one-way tickets to Vancouver for individuals struggling with addiction and homelessness (Eberle et al. 2001). By offloading their social challenges onto Vancouver, other provinces shirk their responsibilities, leaving the Vancouver and BC governments to struggle with this issue. This situation puts immense pressure on the healthcare system, which already faces significant challenges in addressing the needs of those impacted by widespread drug use. This neglect exacerbates the crisis, overwhelming local resources and burdening the BC taxpayer with expenses other provinces should bear.
The healthcare industry in BC receives massive funding to manage the consequences of widespread drug use, yet the impact remains questionable (Martinez 2018). While hospitals and clinics are essential, the current funding structure largely emphasizes treatment over true prevention and long-term recovery. This reactive approach traps patients in an endless cycle of emergency services, continually treating symptoms without tackling the underlying causes of addiction. The economic implications are staggering, with funds being exhausted on repeat visits rather than genuine solutions, while the human cost—lives lost or left in despair—remains beyond measure. These interconnected challenges reflect the broader systemic failures that perpetuate the crisis, making it not just a local issue but a national concern.
The crisis in Vancouver is not merely a local issue; it’s a national concern that reflects our collective challenges. The entanglement of corporate interests, governmental policies, union influences, and non-profit operations has created a situation where financial considerations consistently overshadow human needs. Recognizing these interconnected influences is crucial if we hope to confront and resolve Vancouver's deepening crisis. We have to consider whether financial incentives are hindering real solutions and perpetuating a cycle of addiction, homelessness, and despair.
It’s time to confront these shadowy contributing factors with courage and conviction. Awareness is the first step toward change. By acknowledging how these financial incentives might hinder real solutions, we can begin to demand accountability and advocate for policies that prioritize people over profits.
References
Van Zee, A. (2009). The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy. American Journal of Public Health, 99(2), 221–227. ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/))
British Columbia Centre on Substance Use (BCCSU). (2020). Safer Supply Information. ([https://www.bccsu.ca/about-safer-supply/](https://www.bccsu.ca/about-safer-supply/))
Wright, N., D'Agnone, O., Krajci, P., Littlewood, R., Alho, H., Reimer, J., Roncero, C., Somaini, L., & Maremmani, I. (2016). Addressing misuse and diversion of opioid substitution medication: Guidance based on systematic evidence review and real-world experience. Journal of Public Health, 38(3), e368–e374. ([https://academic.oup.com/jpubhealth/article/38/3/e368/2239846](https://academic.oup.com/jpubhealth/article/38/3/e368/2239846))
Buxton, J. A., & Dove, N. A. (2008). The burden and management of crystal meth use. Canadian Medical Association Journal, 178(12), 1537–1539. ([https://www.cmaj.ca/content/178/12/1537](https://www.cmaj.ca/content/178/12/1537))
Public Health Agency of Canada (PHAC). (2022). Federal actions on the opioid overdose crisis. ([https://www.canada.ca/en/health-canada/services/opioids/federal-actions/overview.html](https://www.canada.ca/en/health-canada/services/opioids/federal-actions/overview.html))
Statistics Canada. (2021). Health characteristics, annual estimates, by age group and sex, Canada, provinces, territories, health regions. ([https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310009602](https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310009602))
Ross, S., & Savage, L. (2013). Public Sector Unions in the Age of Austerity. Fernwood Publishing. ([https://fernwoodpublishing.ca/book/public-sector-unions-in-the-age-of-austerity](https://fernwoodpublishing.ca/book/public-sector-unions-in-the-age-of-austerity))
Freeman, R. B., & Medoff, J. L. (1984). What Do Unions Do? Basic Books. ([https://scholarship.law.nd.edu/cgi/viewcontent.cgi?article=1358&context=jleg](https://scholarship.law.nd.edu/cgi/viewcontent.cgi?article=1358\&context=jleg))
Eberle, M., Kraus, D., Pomeroy, S., & Hulchanski, J. D. (2001). Homelessness — Causes & Effects: A Profile, Policy Review and Analysis of Homelessness in British Columbia. BC Ministry of Social Development and Economic Security. ([https://homelesshub.ca/sites/default/files/sqebtrix.pdf](https://homelesshub.ca/sites/default/files/sqebtrix.pdf))
Pivot Legal Society. (2010). Cracks in the Foundation. ([https://www.pivotlegal.org/cracks\_in\_the\_foundation](https://www.pivotlegal.org/cracks_in_the_foundation))
Plant Nerd
Iboga: The Sacred Healer of Central Africa
Iboga, known scientifically as Tabernanthe iboga, is a small, shrubby tree native to the rainforests of Central Africa. Revered for its powerful psychoactive properties, this plant has held a significant place in the spiritual practices and cultural traditions of the indigenous peoples of Gabon, Cameroon, and the Congo. Iboga is not only renowned for its striking orange fruits and thick green leaves but also for its deep connection to ancestral rites and its use as a powerful tool for physical and psychological healing.
Botanical Overview
Iboga is a perennial plant that typically grows to a height of about 1.5 to 2 meters. It is characterized by its glossy, elongated leaves, which are arranged in an opposite pattern, and by its bright orange, oval-shaped fruits. The plant flourishes in the shaded undergrowth of tropical rainforests, thriving in humid environments with rich, well-drained soil. Its resilience and adaptability to the rainforest ecosystem make it a vital part of the biodiversity in these areas.
Ecological Role
Iboga plays an important ecological role in the Central African rainforest, contributing to the complex web of life within its native habitat. Its flowers attract pollinators such as bees and other insects, supporting local biodiversity. The bright orange fruits are consumed by birds and small mammals, which in turn aid in the dispersal of its seeds, allowing the plant to propagate across the forest floor. This symbiotic relationship highlights Iboga's integration into the ecological cycles of the rainforest, supporting both plant and animal life.
Traditional and Modern Uses
Iboga has been used for centuries by indigenous communities, most notably by the Bwiti religion in Gabon, where it is regarded as a sacred plant. The root bark of Iboga contains powerful psychoactive alkaloids that are used in initiation ceremonies, healing rituals, and spiritual exploration. For the Bwiti practitioners, consuming Iboga is a profound rite of passage, intended to facilitate communication with ancestors, gain spiritual insights, and bring about deep psychological and emotional healing.
In recent years, Iboga has gained attention in Western contexts for its potential therapeutic applications, particularly in treating addiction. The alkaloid ibogaine, derived from Iboga root bark, has been found to reduce withdrawal symptoms and cravings in individuals struggling with substance dependence, offering hope as an alternative treatment for opiate addiction. Despite its promising potential, the use of Iboga and ibogaine is carefully regulated in many countries due to safety concerns and the intensity of its effects.
Phytochemical Properties
The primary psychoactive compound in Iboga is ibogaine, a potent alkaloid that affects the central nervous system by interacting with a variety of neurotransmitter systems. Ibogaine is known for its ability to induce intense visionary experiences, often described as dreamlike or hallucinatory, with a strong introspective quality. These visions are believed to facilitate psychological insight, providing users with an opportunity to confront past traumas and explore their subconscious minds.
In addition to ibogaine, other alkaloids such as tabernanthine and ibogaline are present in the root bark, contributing to the overall effects of the plant. These compounds are thought to work synergistically, creating a complex psychoactive experience that can vary greatly depending on dosage, setting, and individual sensitivity. Current research is focused on understanding these interactions and exploring the potential therapeutic uses of these compounds in treating mental health disorders.
Conclusion
Iboga is a remarkable plant that embodies the intersection of botany, culture, and healing. Its role in traditional spiritual practices and its emerging potential in addiction therapy illustrates its profound impact on both individuals and communities. As interest in plant-based therapies continues to grow, Iboga remains a symbol of the deep knowledge held by indigenous cultures and the potential for natural substances to facilitate healing and transformation. The story of Iboga is one of resilience, both ecological and cultural, reminding us of the powerful connections between humans, plants, and the intricate balance of the natural world.
Hey Ivan,
I love your writing. This piece looks really comprehensive—thank you! I’m going to dig into it more thoroughly when I have a moment. However, after a quick skim, I didn’t see any references to the dynamics of the toxic culture of hyper-capitalism and prohibition itself as causal factors in the addiction crisis.
If we’re truly going to analyze the nature of the problem and its intractability, doesn’t that require us to highlight the root causes in order to find effective solutions? For me, this issue arises in the debate between the abstinence-only crowd and the harm reduction crowd. I believe it’s not a real debate because all of these approaches are part of the treatment spectrum, yet prohibition expenditures consume the vast majority of public funds. This creates a false dichotomy designed to benefit the powers that be.
I also wanted to acknowledge that, with such a quick skim, I might have missed the places where you refer to the disconnecting and dislocating forces of hyper-capitalism as trauma incubators and the true source of dysfunction that we see played out through the addiction crisis. I think incorporating perspectives on how hyper-capitalism contributes to trauma and how prohibition policies might exacerbate the crisis could provide a more comprehensive understanding of the issue. Discussing these root causes might help in formulating more effective, holistic solutions.
What are your thoughts on this?