Can storytelling help us respond to the opioid epidemic? Since 2016, more than 9,000 Canadians have died from opioids. Countless others have experienced health complications and adverse side effects, including a reversed overdose. The Canadian opioid epidemic shows little sign of slowing. It’s time we start exploring new approaches to the problem.

A 90-day consultation

In Canada, the Public Health Agency of Canada works with the federal government to create policies and institutions to support people living with an addiction. This work is referred to as the Canadian Drugs and Substances Strategy (CDSS). Divided into six parts, the overarching strategy looks for ways to prevent and treat problematic substance use. Policies focus on both the enforcement of existing laws and innovative approaches to harm reduction. The stated mandate claims that its policymakers make “[u]se of timely, comparable, national-level data to help develop effective drug and substance policies,” and seek “[f]unding programs available to support activities under the pillars of the Canadian Drugs and Substances Strategy.”

As part of their efforts, the CDSS organized a 90-day national consultation in September 2018. Reaching out to the public, including individuals with lived experience of addiction, the organizers claimed that the purpose of the consultation was “to gather ideas on potential next steps under the Canadian Drugs and Substances Strategy.”

More than 1,600 responses were recorded. Many of the responses came through “a ‘tell us your story’” tool “which allowed Canadians to share their personal experiences with drug and substance use.”

Storytelling

After the consultation, the policymakers of the CDSS reported that:

stigma and discrimination towards people who use drugs act as barriers to effectively addressing substance use issues in Canada[;]
there is a need to improve our understanding of problematic substance use by strengthening the evidence base and conducting more research on underlying causes

and that

there is no ‘one-size fits all approach’ to addressing substance use and that services need to be better tailored to meet the needs of individuals and groups.

What remains unclear is how the collected stories were used to generate these conclusions, or how they will inform any new policies under the CDSS.

The report seems to merely summarize any major themes that emerged from the storytelling that took place. And, in fact, if I were less charitable, I would say that the findings merely replicate what the organizers previously suggested were key concerns. Take a look.

On the consultation website, the CDSS policymakers list the following topics as “key areas for discussion,”

taking action on the root causes of problematic substance use
reducing stigma around substance use
supporting Indigenous peoples
addressing the needs of at-risk populations
grounding substance use policy in evidence.

And, in the consultation report, the table of contents list the following categories,

stigma and discrimination
understanding problematic substance use
services that better meet the needs of individuals and groups.

What this tells me is that, even after a year after the consultation finished, no new approaches to treating drug addiction in Canada has been developed.

Political judgment

In her work on political judgement, Hannah Arendt argues that it is important to consider a multiplicity of perspectives. Only when we do so can we have collective understanding – and make judgments on matters. In fact, on Arendt’s account, we need a multiplicity of perspectives to form our own considered opinion. Both at the collective and individual level, Arendt thought that judgement requires an “enlarged mentality,” that is, we must imagine the viewpoints of others so that we can think about our beliefs and attitudes from new perspectives.

Arendt seems to have thought that we can acquire an enlarged mentality all on our own. We need only imagine the perspectives of others and nothing more. For example, on Arendt’s account, it is sufficient that I imagine what it might feel like it to be in that other’s situation. We only need to visit these perspectives. In the words of Lisa Disch, Arendt only wants us to tell ourselves “the story of a situation from the plurality of its constituent perspectives” (p. 163, Hannah Arendt and the Limits of Philosophy). Then, I can make a judgement. Then, I can share my judgements with others and, finally, then, we can all refine our views.

The CDSS

The CDSS policymakers fail to visit the perspectives of people with lived experience of addiction, however. They appear to make a judgement and share it with the public, but there is no opportunity for genuine interaction and, therefore, refinements to their judgements. Rather, they use the stories of Canadians with lived experience of addiction to make what Arendt might call a pre-judgement about the future of the CDSS, failing to fully address others’ views, and merely publicize their intentions. Thus, there is little truth to their claim that the stories they heard through the consultation will be used “to update the CDSS to more effectively and compassionately address substance use in Canada.” Canadians should brace themselves to see the CDSS updated to reflect what the policymakers judge to be important next steps for the CDSS.

From stories to policies

What the CDSS policymakers have done well, perhaps, is that they have actually reached out to Canadians with personal experiences of addiction. Unlike Arendt, who implicitly suggests that this step is unnecessary, I think that reading actual stories will help policymakers to visit the perspectives of those whose lives will be most impacted by the CDSS. Nevertheless, this isn’t enough. While reading the stories of others and having a conversation with them can both be considered a form of visiting, I think the former is not as effective as the latter. Having the chance to interact with the other, to have them correct our interpretations in real time, is incredibly valuable; it helps to ensure that we are indeed visiting a new place (and not just imagining that they are).

Part of what makes Arendt’s account of political judgement pluralistic is that she leaves room for judgements to be revised by new perspectives and the judgements of others. The CDSS’s public consultation, however, doesn’t allow for this. The consultation is now closed. And the policymakers, we can consequently assume, are no longer soliciting new information. The report has been published and no updates are forthcoming. And so, again, we can consequently assume, there are no more opportunities to refine the policymakers’ judgements on the future of the CDSS. To follow Arendt, however, is to say that there is no final word. While these particular policymakers may have finished this particular policy, this doesn’t mean that others won’t take up their work in the future.

The infographic for this post has been taken from the CDSS’s report, “What We Heard: Strengthening Canada’s Approach to Substance Use Issues”.