This is the final feature in a three-part series diving into aspects of the opioid pandemic, the overdose crisis, whatever you wish to call it. It is a public health crisis which became exacerbated by the COVID-19 pandemic.

According to Canada’s Public Health database, there was a 95 percent increase in apparent opioid toxicity deaths from April 2020 to March 2021, with a total of 7,224 deaths, compared to 3,711 deaths from April 2019 to March 2020. Since then, deaths have remained high.

These statistics were published in March 2022 and only went as far as September 2021, but by that point, 5,368 apparent opioid toxicity deaths had occurred. This is approximately 20 deaths per day. For a similar timeframe in the years before the pandemic, there were between 7 in 2016 and 12 in 2018 deaths per day.

Several factors may have contributed to a worsening of the overdose crisis throughout the pandemic, including the increasingly toxic drug supply, increased feelings of isolation, stress and anxiety, and changes in the availability or accessibility of services for people who use drugs.

Joe Amero is a social worker in the Toronto shelter system, but he says he was a straight-up heroin addict for ten years. At the latter end, it was opioids like morphine due to availability and geographical location.

“I lived in Peterborough, so I couldn’t get heroin unless I drove to Toronto and brought back treats for everybody,” he said.

He’d do odd jobs in Peterborough to get the morphine.

“I used to clean up dogshit in the back yard of this strange lady on a sleep apnea machine, and she used to pay me in morphine,” said Amero. “I’d get extra if I would shoot up her daughter.”

He heard how his words sounded, laughed and qualified his statement.

“She was not a minor,” he said. “She already had an established habit and was a sex worker and doing her own thing. She was quite grown, but I’d get extra if I would shoot up her daughter in her kitchen while they watched Judge Judy in the living room. It was surreal.”

A guy Amero referred to as Old Michael would trade pills if people would shoot him up.

“He was a cancer patient, so he would have all the good reds and all the strong morphine, so he’d hook you up,” he said. “He’d want company too. He was a lonely old dude and gay, so some of the guys would get a lot of extra pills. I would just shoot him up.”

Amero laughed at the absurdity of his following words.

“Heroin is a gateway drug, so you’ve got to be careful,” he laughed again. “But through that, it’s an introduction to a well-established underworld, so you’ve got all the drugs.”

He preferred the down associated with heroin.

“I liked that buzz.” Said Amero. “I could maintain that, and I was functioning. I never worked more in my life than when I was a drug addict. I had three jobs because I liked to do a lot of drugs, so I needed a lot of money. It was motivating.”

Eventually, he found the realm of the stimulants like cocaine and methamphetamine.

“I couldn’t get my dope one day, missed my methadone, so my dealer only had coke,” he said. “I had never even sniffed it before, but I was a full-fledged professional IV drug user.”

Amero took some coke to pass the time until he could get methadone the following day.

“I shot the coke, and ten months later, I was sleeping in the park,” he said. “So you’ve got to be careful if you are going to do heroin because it might have some negative side effects.”

He considers himself lucky because he managed to maintain all his faculties.

“I did a huge hallucination acid test for years and years and years.” Said Amero. “I think I’m a bit of an anomaly in that respect because I know I’ve done more acid than I’ve ever heard of anybody doing. I’m not talking about bathtub strychnine blotter acid. I’m talking about Crystal 50 and the real LSD liquid in mass quantities. I’ve seen people do a lot less, and they are fried. We call that fried. They fried their brain. They are fucked. They are old acid burnouts.”

He also spoke of people who have stopped using opioids but remain fried.

“We don’t say clean anymore because you weren’t dirty,” said Amero. “I mean free from it. But what replacement therapy have they been on for it? Have they been on methadone for 20 years? Are they just walking with methadone in all their bone marrow? Or are they on antidepressants and antipsychotics? They tried to prescribe me Seroquel when I was coming off the drugs, and I know that’s an antipsychotic that would change my brain chemistry permanently if I took it for too long. It’s good to come down after a bender, but I wasn’t going to refill my prescription.”

He laughed.

“Especially when I could sell it and get more dope,” he said.

Amero is a survivor who is a fully functioning professional in his field with a car, house and family.

“I started working in the field and then kind of went back to school to get the credentials to do the job I was already doing,” he said. “I don’t know why. It was a personal thing for achievement.”

He graduated from the Humber College social service worker program, and then he had kids coming into his life, so he couldn’t afford to go on to university.

“I never needed it because I had a Ph.D. already in lived experience, and it went a long way because I could talk the talk and walk the walk,” said Amero. “I could read all the books and get a piece of paper that tells me I’m a master of the universe, but we already lived and died that life a hundred times.”

He looked thoughtful and backtracked on his previous statement about presenting as fully functional.

“What you don’t see is Post Traumatic Stress Disorder, Survivor’s Guilt and these things you carry with you,” he said. “They are invisible. They present in their ways, but you never know what someone is going through.”

Harry was his little brother and his best friend in life.

“We were partners in crime,” said Amero. “He died of a fatal overdose of Fentanyl in his heroin.”

Harry was living in Alberta, working on the pipeline.

“We had a bit of a falling out a little while before he died,” said Amero. “Luckily, we reconciled and were speaking again, but I knew he was dipping into this Fentanyl with his girlfriend. They were trying it because that’s what it is now. People don’t even want heroin. They want Fentanyl, so I was warning him against that, but what he ended up dying from was buying heroin, smoking it, and there was Fentanyl in it. It was a lethal dose. He overdosed and died.”

Amero believes clean drugs are the answer and the work Drug User Liberation Front DULF is doing to distribute a safe supply to users is the best action Canada has ever seen. 

“It’s a no-brainer, and they were just fucking bold enough to do it,” said Amero. “Just give them clean drugs, and they did it. As they say, they can’t afford to do it on a national scale, so they do it as an action and say this is an example of what you can do … and their actions will echo through history as the best action I’ve ever seen in my life.”

DULF is focused on the Main and Hastings area of Vancouver, perhaps the neighbourhood hardest hit by the overdose crisis in Canada. Amero encourages people to support their actions wherever they live.

“Buy a hoodie,” he said. “You can donate to the compassion club because it is the real deal.”

When Harry died, Amero saw the stigma attached to an overdose immediately.

“My mom didn’t want anyone to know right away – don’t tell anybody what happened,” he said. “So, you respect that because it is Mom, but When I was trying to deal with the aftermath of his death, in my grieving process as an artist, I started to write it down and build my story and a one-person show called Blood.”

He wouldn’t perform it without his mother and sister’s permission.

“I showed them they don’t need to be ashamed that it was an overdose that killed him,” said Amero. “You should tell everybody. Everybody should know. Fight the stigma. Just own it. I got their blessing, so I was able to do the show, and it helped a lot of people. Especially me, just to tell the story.”

Blood went over well with two sold-out the Bad Dog Theatre in Toronto. Amero was a featured player in the Bad Dog Theatre, so he had an in.

“It was about Harry, and he was a bit of a bad dog, so what better place to do it,” he said. “I worked with amazing people. Dana Puddicombe, she was directing it.”

Puddicombe and Amero were friends from the Second City Training Centre Conservatory. She started working on Blood to help hash it out and refine it into an hour theatre show. Then she received an offer for a job she couldn’t turn down, and Kate Fenton stepped in as director.

“Kate is amazing, and she really finished it off,” said Amero. “It was a cathartic experience for me. The whole process of working with them, putting my feelings on paper, and then bringing them to performance … I don’t know how I did it, but I pulled it off. People loved it, and people messaged me for years.”

There were plans in the works for more performances in Hamilton. Toronto and New York, and then COVID hit. Plans fizzled and a year passed, working away in the Toronto shelter system, but he wasn’t fulfilled creatively, so Drugs! The Musical! The Telethon! was created.

Amero’s follow-up to Blood was going to be Drugs! The Musical! And it will be his story with drugs but in a musical form.

“If you know me, it’s hilarious because although I played in bands my whole life, I’m not a musical person,” he said. “Then, of course, before I did that, I had to give back and do the telethon.”

Amero is in no hurry to complete the musical.

“The tagline has become. ‘When it happens, it happens,’ much like drugs,” he said.

His creative focus is currently on editing Drugs! The musical! The documentary!

“It’s about the whole process of creating the telethon and the musical and everything that has happened because it has turned out to be quite a story,” said Amero. “Then the musical will come out after or never. Who knows? Who cares? It doesn’t matter. There is more important work to be done.”

He spoke about the network of harm reduction resources across Canada, something he became familiar with when he was putting together the telethon.

“It’s a small world after all, and harm reduction is just a small town in that small world,” said Amero. “Everyone is connected, and you’ll see these key players popping up repeatedly. The same people are doing the work because they are essentially screaming into a vacuum … I reach out to people that I met through the telethon professionally for advice and guidance in my job. I did a job interview for a Street Health overdose prevention site. It was a panel interview online on Webex, and they had seen the telethon. ‘Oh, you are the telethon guy. I love it.’ Then I was in.”

Discovering that harm reduction network solidified his passion for the work he does.

“There are so many people out there who have been doing it for much longer,” said Amero. “I hid from it for years because I was on drugs, and then I hid from it for years because I didn’t want to divulge my entire history while trying to get into the field.”

He had pride and didn’t want to be known as “the Junkie.” Then after Harold died, he hid further from it.

“I didn’t want to think about drugs, although that’s all I was thinking about,” said Amero. “I remember after I cremated him and brought his remains to my mom, I had to go to work the next day. I was at a stoplight, realizing that I was heading up the harm reduction program and what I had to do on my first day back to work was to make 100 crack kits and 100 needle kits … I looked to the right, and on the electrical box somebody had put some crude graffiti of HA which spells “ha.” It was laughing at me but also my brother’s initials, Harold Amero. I could hear him laughing at me, and I was like, that’s not funny, but then I could hear him say, “that’s kind of funny,” and I realized yeah, it is kind of funny. Then I went to work.”

His lived experience connects directly to his work in the Toronto shelter system.

“Unfortunately, I know what a bereaved mother looks like,” said Amero. “That’s something you never want to see, and you definitely don’t want to see your mother go through it. Once you know what it looks like and how deep that is, you don’t want anyone’s mother to go through it.”

He feels those heartbreaking experiences give him an extra push when working in overdose prevention sites.

“If I can stop that from happening, that’s huge, and I’ll fight for that because nobody needs to see that,” said Amero. “These people who live on the streets are no different than anyone else, and they have mothers and families who love and care for them and will be broken when they are ripped away. So that’s a big drive for me.”

He knows all the experiences of addiction inside and out, from dope sickness to dealing with doctors and “scripts.”

“I’m a pretty good advocate for people in that way because I’m a little more relatable,” said Amero. “I don’t even have to give too much self-disclosure about my own story. People just know. The real will recognize the real. When I talk to a guy, he knows I’m not bullshitting. He knows that I know. There is relief in that alone and maybe even hope for some.”

He knows it can be motivating when people see they are getting help from someone who has experienced addiction.

Amero quoted Fred Hampton, deputy chairman of the Black Panther Party until his assassination in 1969, who said, “Theory is cool, but theory with no practice ain’t shit.”

He said he is not knocking theory or academia.

“They are fantastic, but I mean, if you haven’t been there, sometimes people don’t want to hear it,” said Amero. “I’d rather talk to someone who knows what it is in their soul.”

He noted that the overdose crisis has become so drastic that it is only a matter of time before everyone will know somebody that has been touched by it.

“If you haven’t been affected by this personally yet, statistically, you will,” said Amero. “That’s why it’s in the news because judge’s kids are dying now. It’s not just population control in the ghetto. Your little war on drugs. It’s cop’s kids and cops, not just robbers … A lot of organizations are faith-based and are not keen on harm reduction. A lot of people say they don’t believe in harm reduction. I’m a Christian. That’s the funniest thing I have ever heard because I say, well, you know all about the golden rule. Then I let them percolate on that for a drip. It’s the same in every religion. Just fucking help people, asshole. A little help helps a lot and if you can help, help. That’s my motto – help, don’t hinder, because help doesn’t hinder. That’s what my mom always said. If you can help someone, then you help them.”

Amero firmly believes people need to fight the stigma of overdose and addiction and make it part of the daily conversation.

“If you lose someone from it, fucking own it and let it be heard,” he said. “Don’t be ashamed. Tell it on the mountain. Everybody’s story is going to help someone else.”

Amero finished the conversation by encouraging people not to give up on their dreams, battles, or lives.

“Just keep going,” he said. “Be the last person standing. It might be lonely, but you won’t have given up. Live and tell your tale. It’s worth it. We want to hear it. We want to hear your story.”

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