The toxic standards that have shaped coverage of drug use in Canada

Writer and drug policy expert Matthew Bonn, a long-time fan of gonzo journalism, started out writing blogs while working in harm reduction organizations in Nova Scotia. The reporting style, typified by writers like Hunter S. Thompson, captured audiences with immersive narratives centred on first-hand experience and deliberately blurred the lines of more traditional reporting that favours a detached style based on third-party quotations and presumes an objective take on the news.

Though Bonn hadn’t been working in journalism for long, he said his work really picked up in the early months of the pandemic — around the same time that he started becoming more open about his own current and past experience with drug use.

He now produces regular pieces for Filter Mag — a New York-based nonprofit publication covering drug use and policy — where he also works as an editorial consultant, finding other writers with lived expertise to empower them to share their stories.

For Bonn and other journalists who use drugs, it’s clear that substance use isn’t just a social issue out in the field — it’s a reality that touches their own lives as much as a health issue that requires more robust, nuanced coverage than communities have tended to get. “A lot of people talk to me because I’m super open about my drug use,” Bonn said. When asked about the old stereotype of journalists as heavy imbibers, Bonn says “I’d even go further to say that there is even more recreational drug use in journalistic professions.”

A 2022 survey of media workers’ mental health and wellbeing in Canada shows that they are “at much higher risk of problem drinking than the general public,” with freelancers reporting the highest rates of alcohol consumption. A group within the small sample — fewer than a dozen respondents — reported using opioids, but “almost all (86 per cent) said they used them for work-related stress.”

Despite the prevalence of issues such as alcohol use among media professionals in Canada, the industry has been very slow to adopt compassionate standards of news framing around addiction, dependence and drug use in general. While coverage has slowly improved toward meeting the demands of the moment, a news culture that has historically de-valued lived experience and defaulted to criminal — over public health — frames means this workplace stigma affecting the industry’s workers has weighed heavily on the public record of a health crisis.

The state of a crisis

Between January 2016 and September 2022, 34,455 people in Canada died from opioid poisoning. Over 7,000 toxic-drug supply deaths occurred earlier in the pandemic, between April and March 2021, a 96 per cent increase from the same time the previous year. British Columbia, one of the provinces hardest hit, declared the overdose crisis a public health emergency in 2016.

Contrary to common media portrayals, these deaths aren’t exclusively among intravenous opioid users. Inhaled opioids account for an increasingly significant number of overdose-related deaths, with 18 per cent more overdoses in Ontario occurring after drugs were inhaled (33 per cent compared with 15 per cent for injection).

According to a 2018 government report, four million Canadians over the age of 15 reported trying an illicit substance (including marijuana) at some point in the last year. Not all who use legal or illicit substances have or will go on to have a substance use disorder, but it is estimated that up to 21 per cent of Canadians will experience addiction to drugs or alcohol within their lifetime.

Over the last 20 years, there has been a shift in how we talk about drug use in most media sources. According to a review of Globe and Mail coverage published by the Harm Reduction Journal in 2020, from 2001 to 2008, major news outlets most commonly framed issues relating to drug use as a criminal issue, with a notable shift towards public health framing beginning in 2011.

While the framing has started to improve over time, there is still a significant amount of harm caused by sensational and stigmatizing reporting.

Toronto-based writer and journalist Carlyn Zwarenstein explains that many cultural narratives around drug use often repeat themselves, ultimately becoming stereotypes recycled in news media. “I think part of the issue with media is this fascination with certain tropes – you have to say it in a certain way, you have to find a certain quote, a certain description that conforms to an existing way of talking about things. And that is not always empowering to certain groups.”

Zwarenstein reflects on many of the nuances around opioid use in her book, On Opium: Pain, Pleasure, and Other Matters of Substance, released in 2021, she traces the history of opioids and probes into uncomfortable questions around pain, prohibition and the current toxic drug supply crisis.

Zwarenstein has spent years writing on issues relating to social justice, poverty, housing, and drug policy. She has at times, like in On Opium, also incorporated in her writing her own experience using prescription opioids to manage chronic pain associated with an inflammatory disease.

She says that many of the narratives that the media have constructed and continue to use around drug use – prescribed and otherwise – are often outdated or incorrect. “Editors often come with the idea that (opioid use) is a very slow and endless spiral where people start with an injury and then get a prescription and then they’re injecting heroin … and it’s just a trope.”

“‘Most of what we write about drugs and alcohol is wrong.'”

A series of complex factors, including but not limited to the over-prescription of opioid-based painkillers like Oxycontin in the early 2000s, have played their part in today’s overdose epidemic. But experts point to other factors such as the introduction of synthetic opioids, the steep reduction in prescribing and a number of under-examined social and systemic causes such as prohibition, that all act to fuel the current crisis.

Similar patterns tend to reappear in headlines. Researchers from Western University, the University of Toronto and McGill University examined over 800 news stories in Canadian media published between 2000 and 2017. After what they found was a marked increase in coverage in 2016, 28.9 per cent of coverage pointed to unsafe prescribing as the cause of the problem. Seventeen per cent pointed to the pharmaceutical industry specifically, researchers Fiona Webster, Kathleen Rice and Abhimanyu Sud reported. Only 15.7 per cent pointed to government policies, while  fewer than 6.7 per cent acknowledged poverty and stigma.

“Editors encourage writers to produce a certain story and you just got a whole bunch of people who don’t know anything about what addiction means, how it occurs, why it occurs, what it is, if it is about drug use, the history of prohibition and don’t know the medical facts,” Zwarenstein says. “You’re just going from very culturally superficial inherited knowledge that’s wrong and it just gets repeated over and over again. Most of what we write about drugs and alcohol is wrong.”

News coverage has often lacked nuance, particularly when focusing on some of the root causes of issues relating to the overdose epidemic. Some coverage has been guilty of conflating concepts such as substance use, addiction and substance dependence even when the scientific community has updated their clinical definitions for these terms. Many of the exact definitions of these concepts within addiction medicine are also not without contention, further complicating how these issues are then  presented to a broader audience. How these topics are handled in new media can have potentially devastating impacts on public opinion, messaging around health and drug policy and obstruct solutions.

The Globe study, which examined coverage between 2000 and 2018, found that many of the sources of drug overdose were largely ignored in coverage, stating that “Only few articles (1.8 per cent) mentioned the root causes of high-risk drug use, such as social inequity, socioeconomic disparities, pain and unresolved trauma.”

Many major media outlets have made moves in recent years to reduce drug use stigma by adopting style guides that favor the use of person-first language (e.g. people who use drugs) in lieu of more stigmatizing terms like “addict.” But there are still a number of inconsistencies in the adoption of this language. The Globe study showed that individual reporters have inconsistently adopted less stigmatizing language in their coverage.

The Associated Press and other major news media style guides have updated their recommendations in an effort to humanize people who use drugs. But these recommendations haven’t been taken up universally by major publications in North America.

When it comes to images, the way in which story narratives are framed and who is chosen to speak all influence what kind of story is being told. What news media chooses to highlight shapes what audiences are told to think of as the problem, and consequently the solutions to that problem.

News media’s evolving stake in prohibition

When it comes to coverage of overdose victims, there are notable differences in both the framing and even awareness that some overdose-related deaths receive. Many have pointed to the relative erasure of racialized people as the victims of overdose death in Canadian news media, with racialized overdose victims all too often stripped of the hallmarks of innocence generally afforded to younger and whiter victims.

“We’ve been sort of coddling patients treating them as morally pure innocents that were tainted by the evil drug companies. Whereas we previously treated Black patients in exactly the opposite way … It’s certainly true that there’s a double standard,” says Zwarenstein.

These discrepancies far predate the current crisis.

The news media have historically played a role in amplifying prohibitionist causes against certain substances. As prohibitionist sentiments grew over the early years of the 20th century and more substances, including cocaine and morphine, became illegal, so too did law enforcement’s role in penalizing drug use.

Marijuana was added to the prohibition list in 1938 but it wasn’t until the 1960s and ‘70s that major media outlets began to change their stance on prohibition and reflected the growing desire among predominantly white college students for the legalization of cannabis.

“The mainstream media, such as Chatelaine, Life, and Time Magazine, rallied behind the white middle-class youth by writing stories critical of the harsh prison sentences handed down to them,” writes Susan C. Boyd in her 2017 book Busted. For Boyd, this stood in stark contrast to how media had portrayed Chinese men “as the foreign ‘other,’ vectors of immorality, and a threat to social cohesion,” during the wave of immigration beginning in the 1880s.

A 2019 media analysis by Genevieve Johnston published in the Sociological Inquiry journal found significant differences in media coverage of opioid overdose deaths among Indigenous people and settlers in Canada — the number of stories featuring individual stories and images of white victims as compared to Indigenous victims was nearly 30 to one. 

“Indigenous people are three times as likely to be the victim in an overdose-related death than non-Indigenous people.”

In Canada, Indigenous people are three times as likely to be the victim in an overdose-related death than non-Indigenous people. Data from 2022 show that First Nations community members comprised 16.6 per cent of overdose deaths in British Columbia last year, but 3.3 per of the population. Yet, despite these figures, First Nations, Métis and Inuit overdose deaths are less likely to be given a proportional amount of media attention or the same type of media attention as white overdose victims.

Johnston’s research, which looks at coverage between 2014 and 2018, also raised questions around the characterizations of the influx of fentanyl from outside of the country. “Mainstream media coverage, particularly from the National Post, the Globe and Mail and the Toronto Sun, often presented white (and especially middle-class white) victims as innocent and virtuous, while demonizing foreign drug manufacturers of illicit fentanyl,” Johnston wrote.  

White victims of the overdose crisis are more often featured in articles that interview grieving families, the study noted, stating “White middle-class overdose victims (were portrayed) as ‘doubly duped’ both by unethical doctors who over-prescribed opioids and the cruel dealers who lace other street drugs with fentanyl … Meanwhile, a CBC headline for a story about a 23-year-old man with a Hispanic name labels him a ‘fentanyl addict who returned from the dead.’”

Webster, Rice and Sud found that those depicted as affected are overwhelmingly young and deemed “legitimate users,” a term used by researchers to describe those who overdosed after being prescribed opioids for pain management.

Their study cited “media stories that report on the numbers of Indigenous overdose deaths without giving space to their families and stories are similar to those that construct racialized youth as dangerous and criminal and confirm a dominant (and racist) cultural narrative that Indigenous communities are always-already plagued by addiction.” Under this assumption, the study argues that opioid use is “not a public health emergency, nor overdose deaths a newsworthy tragedy, but simply a continuation of an ongoing and irresolvable problem rooted in a dysfunctional culture.”

Zwarenstein says that a lot of coverage has largely focused on the often false narrative of the slippery slope of addiction from prescribed pain medication to illicit drug use because of the demographic groups that over-prescribing has impacted. “The prescription opioid crisis has been covered in a sympathetic way. Because people who have suffered from over-prescription resulting in dependence and addiction have largely been white, upper class, or middle class people.”

Journalists, workplace trauma and substance use

Thanks largely to activists, a lot of media coverage of drug use has improved somewhat in recent years, bringing concepts like harm reduction and decriminalization into mainstream conversations, says Manisha Krishnan, a senior editor at Vice News reporting on subjects such as racism and drug policy in North America. But, like our coverage, attitudes towards substance use in and outside of the newsroom still have a long way to go.

“I think having problematic substance use is still very stigmatized within society at large. It is often viewed as a personal failing or it becomes fodder for gossip. There can be a real lack of empathy there and I think that newsrooms are certainly not immune to that,” says Krishnan.

“‘There can be a real lack of empathy and I think that newsrooms are certainly not immune to that.'”

When asked about the relationship between drug coverage, occupational stress and supporting journalists who use substances, Krishnan says: “It’s complicated but I think all of these things are very connected. I think now we are starting to talk more about some of these issues … but traditionally (newsrooms) are not really a place where you want to show a lot of weakness, and I think that substance use would certainly fall into that category.”

Krishnan says that vicarious trauma, tight deadlines, competition and long hours are baked into the demands of the industry, and all contribute greatly to burnout among journalists. Social drinking is a convention that’s subtly enforced. She remembers regularly going to the bar with colleagues after work during an internship.

“It was very normalized. In hindsight, that was not the healthiest way to blow off steam,” she says. But despite the high pressures of the industry and ways that certain journalists may be using substances to cope, openness around these issues is still limited.

In a 2020 literature review on the emotional well-being of journalists, professor of psychiatry Anthony Feinstein and other researchers found that journalists can be adversely affected by emotional stressors and that most journalists are exposed to potentially traumatic events at least once in their career. These psychological consequences are expressed in forms ranging from PTSD, to major depression to alcohol and illicit substance abuse. Rates of mental illness, or psychopathology, among journalists also appear to be higher than in the general population and are particularly high in war journalists.

According to Cliff Lonsdale, former chief news editor for CBC Television and now president of the Canadian Journalism Forum on Violence and Trauma, when journalists are treated as an unaffected all-seeing eye, journalists themselves suffer.

Lonsdale is a lifelong journalist with conflict experience and also lived with alcohol addiction for a number of years. “Not only are (journalists) not separate but we’re among the professions that have the highest incidents of it, we are probably above average for getting addicted but that has a lot to do with the stuff we deal with every day,” Lonsdale says.

‘It’s time for the coverage to mature’

Despite the shift in mainstream framing drug use as a matter of public health, the “solutions” in our news coverage continued to overwhelmingly involve law enforcement. In Canadian news stories that had a solutions focus surveyed by Webster, Rice and Sud, 25 per cent after 2016 cited policing – the highest of all proposed solutions by a significant margin, followed by government intervention (20 per cent) and naloxone (18 per cent). Legalization was only mentioned in seven per cent of solutions-focused news stories.

Including law enforcement in stories relating to substance use continues to muddy coverage with tropes that justify continued criminalization, explained Crackdown podcast host and drug policy reform activist, Garth Mullins. “When the police are commenting on something that a journalist says is a health issue, you have to ask yourself why,” Mullins says. “If you’re talking about a new cancer clinic opening, you don’t go get a comment from the deputy chief of police – they have nothing to do with it.”

“‘If you’re talking about a new cancer clinic opening, you don’t go get a comment from the deputy chief of police.'”

“It’s time for the coverage to mature, it’s time for everyone to become an adult about covering this … it can’t stay in the same emotional tone that it was five years ago of this sort of hand wringing and shock and a picture of a needle in a gutter. We have to move on from that,” Mullins says.

He suggests newsrooms could develop strategies akin to covering the climate crisis to keep audiences engaged, and perhaps more importantly – feel empowered to do something.

“We really need journalism to think about (the overdose) crisis in the same way as thought about other crises,” Mullins says. “Reporting in a way that is not just making everyone nihilistic … but is actually engaging and informing and maybe even giving (news audiences) some agency in the whole thing.”

When it comes to how drug use and people who use drugs are discussed in coverage, he has seen some improvements over time.

“When we at (the Vancouver Area Network of Drug Users) started organizing in the late ‘90s – in the last overdose crisis really – the media was a lot meaner to drug users, and drug users were a lot more of a mystery in the coverage,” Mullins says. “We’ve actually punched our way into the mainstream discussion about this.”

Mullins says there is still a lot of room to evolve the way in which substance use is covered in Canadian journalism, particularly when it comes to coverage on the toxic drug supply crisis.

Making space for people to bring their identities into their reporting without being tokenistic, or considering it a threat to our coverage is, for Mullins and other movement-driven journalists, an important next step. “I think there is room for all kinds of experiences in journalism,” Mullins says. “I think all you have to do is reject the claim that there is one little bandwidth of truth and everything else is not this objective view of the powerful — the view from nowhere. Once in your newsroom you decide maybe that’s bullshit, you can have the view from lots and lots of somewheres.”

If journalists with lived experience with substance use were able to work in environments where they could feel comfortable engaging with their experience as an asset to their reporting rather than a detriment, it could strengthen news coverage on the whole.

“If there were a way for them to share their experiences in a way that was safe, in a way that didn’t get them fired. That could make things safer for them too — a lot of people have to keep it a secret,” Mullins says.

Undoing double standards in drug coverage

There have been pockets of evolution. Crackdown has been recognized with awards including the 2020 Canadian Hillman Prize. Globe and Mail reporters like Andrea Woo, Marcus Gee and Ian Brown have won awards for their coverage of the opioid crisis, including for their 2021 portrait of 100 overdose victims.

But across the media ecosystem, coverage of drug use still ranges from subtly harmful to openly hostile. A March analysis outlines recent and continuing demonization of policy options surrounding legalization and safe supply programs. A May 9 National Post article claiming safer supply drugs are being redistributed on the black market was criticized for amplifying mischaracterizations of the realities of safer supply programs. It also claimed that critics of the safe supply program are self-censoring due to fear of recrimination. Another National Post article by the same author published Jan. 2 claiming a B.C. professor critical of safe supply was being silenced by the provincial government was challenged in a Press Progress analysis.

“‘We have to tell the truth about what using drugs is really like, not what people who hate people who use drugs think it’s like.'”

Bonn said a big part of reporting on the toxic drug supply crisis and on drug use in general is about pushing past some of the narratives created by some mainstream and conservative publications. “We have to tell the truth about what using drugs is really like, not what people who hate people who use drugs think it’s like.”

And journalists who are open about using drugs often have a number of barriers to face when reporting. They risk their job security and often have to work extra hard to ensure that their work is presented as evidence-based in order to be taken seriously. A story written by someone with lived experience doesn’t mean it will lack credibility. “We still represent different sides, fact-check everything and go through peer-reviewed literature,” Bonn says.

Following the legalization of cannabis in 2018, companies – including the Canada Post and the CBC – pushed for the ability to regularly drug test within their offices. Measures like these have raised questions about discrimination and the ethics of drug testing in newsrooms.

With so many other marginalized groups still largely unrepresented in legacy newsrooms, Vice’s Krishnan says it’s unlikely that we’re going to see reporters who are open about drug use prioritized as hires in these spaces for the sake of improving coverage. But she does see some improvements in awareness around issues like mental health within some organizations.

“Certain newsrooms are providing funding for therapy now. But I would say overall there’s definitely a lot more that can be done in terms of addressing mental health.”

Megaphone Magazine, a monthly non-profit publication sold on the streets of Vancouver and Victoria by homeless and low-income vendors, recognizes the value that lived experience can bring to newsrooms. Managing editor Paula Carlson says they launched a pilot program in partnership with Langara College in the spring of 2021 to train two people with varying forms of lived experience with substance use, homelessness and other marginalized experiences to give them the tools to report on stories within their communities. The program, officially the Megaphone and Read Mercer Entrance Award, is just about to start its third year. “This isn’t a new idea. Back in the glory days of print and beat journalism it was common for reporters working in a specific sector – say health, education, or finance – to have a background or special training in that area,” says Carlson. “In short – it makes for better reporting.” In April of this year Megaphone also created its official peer newsroom, The Shift, made up of a diverse group of community members with lived experience to meet for monthly assignments, help guide the direction of the magazine and develop best practices for reporting on marginalized communities.

When it comes to covering all of the complexities and the nuance in stories about illicit and prescribed drug use, addiction, drug policy, and everything in between, Zwarenstein says journalists need to break the tendency to try to equally balance all sides of a story. “I’m not looking for equality in who I interview … I look for who lacks power and highlight their voices.”