Many people wrongly assume that opioid addiction only impacts certain people. Understanding the facts is a critical step in trying to find solutions to our city’s toxic drug crisis
EDITOR’S NOTE: This article is part of an ongoing SooToday series — ‘Turning the Tide’ — that explores potential solutions to our city’s toxic drug crisis. You can read more about our project HERE.
If you believe the stereotypes, opioid addiction only impacts certain people in our community. But in reality, anyone can get hooked. Opioids do not discriminate.
“An opioid addiction can cross all socioeconomic barriers,” says Jessica Kent-Rice, an emergency physician and medical toxicologist who grew up in Echo Bay, studied at Northern Ontario School of Medicine University and now works at St. Michael’s Hospital in Toronto.
You can be poor or wealthy, but the amount of money you have will not protect you against addiction, she says.
“If you use an opioid like fentanyl for a few days at a time, that can be all it takes to become addicted. No matter who you are.”
Kent-Rice says the reason drugs like fentanyl are so addictive is because the human brain has receptors that are stimulated by opioids.
“That receptor does a bunch of stuff, including relieving pain,” she says.
When people go to the hospital with an injury, fentanyl is a great way to treat pain.
“It acts quickly on that receptor. However, the other thing that receptor does is trigger a euphoric feeling or a high, which is obviously why many people tend to misuse fentanyl,” Kent-Rice says.
Last year, 38 people died in Sault Ste. Marie from apparent opioid toxicity, amounting to a mortality rate of 48.36 deaths per 100,000 people, the second highest in Ontario.
In 2024, 7,146 people died across the country from apparent opioid toxicity.
Opioid use has been popular for hundreds of years, but it has only turned into a crisis in the last three decades, driven in part by large pharmaceutical companies, Kent-Rice says.
“Initially, when people were becoming addicted to opioid medications, it was prescribed opioid medications like oxycodone.
“However, over time doctors stopped prescribing as much of these medications as they learned one of the harmful things was they can cause addiction,” she says.
There are a few reasons why people get more addicted to opioids compared to other drugs.
“One reason is the drug’s ability to hijack the brain’s reward system. Opioids powerfully trigger the brain to elicit this pleasurable, euphoric response,” Kent-Rice says.
Another reason is how fast the drug can get a person high.
“Fentanyl is something where if you take it, it works within seconds.
“Drugs like fentanyl work right away and then just as quickly they fade off.
“That rapid contrast between your normal and all of a sudden you get this euphoric high and then it fades back to normal . . . that rapid cycling of on and off is also a property that makes a drug addictive.”
One reason people die from fentanyl is it can suppress the brain’s drive to breathe.
“Every breath that we take is controlled by unconscious signals from our brain stem and opioids via that receptor slow your breathing.
“At high enough doses you’ll stop breathing altogether,” she says.
Another reason people die from fentanyl is due to isolation, which is why deaths increased during the pandemic.
Algoma Public Health reported that between 2022 and 2023, the vast majority of toxic drug deaths in Ontario — 82 per cent — occurred in a private residence.
Health professionals encourage anyone who uses drugs to not use alone.
“If you are using drugs by yourself, there’s not going to be anybody around to call for help, provide naloxone, or do rescue breathing,” Kent-Rice says.
She says it can be extremely difficult to quit opioids. It takes a lot more than just willpower.
“You have to have the motivation to want to stop using the opioid, but you need help to do that.”
Patients will often receive opioid agonist therapy, which are medications that stimulate the opioid receptor to prevent withdrawal but don’t cause euphoria.
“It can literally be dangerous to stop using opioids on your own. It can cause effects to the heart and other organs. You need to be engaged in treatment,” Kent-Rice says.