AT THE INTERSECTION of London Road and Victoria Street, otherwise known as Highway 2 and Highway 21, lies Thamesville, Ontario, population 928. This tiny burg is part of the sprawling municipality of Chatham-Kent, about an hour from the Windsor-Detroit border. There are few people on the streets, and only a handful of businesses: a Mac’s convenience mart, a small consignment store, the Schmid Jewellery and Gift Shop, and the John C. Badder Funeral Home. Thamesville shares its name with the nearby Thames River, a placid waterway that continues southwest, cutting a line through the middle of Chatham-Kent. A network of small places with a combined population of about 104,000 people, Chatham-Kent is, mostly, a verdant mass of farming plots. If you follow the path of the river, you’ll pass the Thamesville Maize—a corn maze shaped this year in the likeness of astronaut Chris Hadfield—until you get to Chatham, a community of 44,000. In some places, Chatham is postcard pretty, its downtown core filled with red faux-cobblestone sidewalks and the kind of jaw-dropping Victorian brick homes that dot southern Ontario. Mostly, though, it is dominated by one-storey, vinyl-sided houses and low-density commercial strips—bars, pharmacies, pawnshops, and car dealerships.
The fortunes of Chatham-Kent have risen and fallen with those of southwestern Ontario’s automotive and manufacturing industries. Recently, they have mostly fallen; in its latest forecast, the Chatham-Kent Chamber of Commerce described the prospects for the local economy as “not promising,” citing a shrinking population and the exodus of heavy industry. The symptoms of that gloomy portrait are evident in the fabric of the place; although it’s designed for strolling and shopping, downtown Chatham feels almost abandoned when I visit. Meanwhile, back up the road in Thamesville, the only business that seems to be prospering is the Westover Treatment Centre, an addiction-recovery facility. Its massive front lawn is healthy and green, the august grounds evoking a well-to-do rural university. When I arrive, some clients are out for a walk; others sit on benches, gazing at the impressive converted mansion that serves as the centre’s main edifice.
According to those on the front lines of drug treatment, Chatham-Kent’s communities have, like much of Ontario, seen a steady rise in prescription opioid misuse over the past two decades. In 2007, almost 30 percent of high school students in the Erie St. Clair Local Health Integration Network, an area that includes Chatham-Kent, admitted to having used prescription opioids for non-medical purposes at least once in the previous year, according to the Ontario Student Drug Use and Health Survey. Although the survey documented a drop in prescription opioid misuse among junior high and high school students across the province between 2007 (20.6 percent) and 2013 (12.4 percent), it found that prescription opioids are still the fourth-most commonly used drug, after alcohol, highly caffeinated energy drinks, and cannabis.
There are many potential reasons for Chatham-Kent’s high rate of opioid misuse, perhaps including the region’s recent economic downturn. According to Ron Elliott, the executive director of the Westover Treatment Centre and a pharmacist by training, the spread of prescription opioid addiction is also due to a shift in prescription patterns over the last several decades. It’s gotten to the point, he says, that doctors are expected to provide the most efficient pain management available—even if it means putting patients at a higher risk of becoming addicted. As a pharmacist in the 1990s, Elliott saw physicians start prescribing huge amounts of painkillers, such as OxyContin. “It wasn’t unusual for someone being discharged from hospital to get a hundred doses of a pain reliever, rather than twenty or twenty-five to see how they do,” he says. “And so people became accustomed to having those larger orders on hand. We had some docs who wrote inordinate amounts. I was getting scripts at one pharmacy for five, six, even seven hundred doses of Oxys and that kind of stuff. And every time I challenged them—and I went through the system to challenge them—I was reassured that this is what’s always done.”
Elliott’s experiences were symptomatic of a larger trend. Between 2000–02 and 2010–12, according to data from the International Narcotics Control Board, Canadians’ consumption of prescription opioids—that is, opium-derived drugs like OxyContin and Percocet—more than tripled. That is a faster climb than in the United States, and one that turned Canadians into the second-highest per capita users of prescription opioids in the world, after Americans. Some observers say that this is a side effect of Canada’s robust universal health care system, though it can also be traced back to our historically poor regulation of painkiller dispensation. Pharmaceutical advertising targeted at physicians also slowly skewed the medical landscape, such that the over-prescribing of these addictive drugs became increasingly commonplace.
