On Aug. 19, 2022, Kamilah Sword took a single hydromorphone pill, believing it to be safe. She overdosed and was found dead by her grandmother the next day. She was 14.

Kamilah believed the drug was safe — despite having bought it illicitly — because she was told it came from a government-run “safer supply” program, according to Kamillah’s best friend Grace Miller and her father.

“I’ll never get to see her get married, never have grandkids, never get to see her graduate,” said Kamilah’s father, Gregory Sword, lowering his chin to keep his voice steady.

“It’s a black hole in the heart that never heals.”

Sword faced significant challenges trying to get his daughter help during the year he was aware she was struggling with addiction. He blames British Columbia’s safer supply program and the province’s legal youth treatment framework for exacerbating his daughter’s challenges and ultimately contributing to her death.

“It’s a B.C. law — you cannot force a minor into rehab without their permission,” said Sword. “You cannot parent your kid between the ages of 12 and 18 without their consent.”

Sword is now pursuing legal action against the B.C. and federal governments and several health agencies, seeking accountability for what he views as systemic failures.

B.C.’s “Safe” supply program

B.C.’s prescribed safer supply program, which was first launched in 2020, is designed to reduce substance users’ reliance on dangerous street drugs. Users are prescribed hydromorphone — an opioid as potent as heroin — as an alternative to using potentially lethal street drugs.

However, participants in the program often sell their hydromorphone, in some cases to teenagers, to get money to buy stronger drugs like fentanyl.

According to Grace Miller, she and Kamilah would obtain hydromorphone — which is commonly referred to as Dilaudid or “dillies” — from a teenage friend who bought them in Vancouver’s Downtown Eastside. The neighbourhood, which is the epicentre of Vancouver’s drug crisis, is a 30-minute SkyTrain ride from the teenagers’ home in Port Coquitlam.

Sword says he initially thought “dillies” referred to Dairy Queen’s Dilly Bars. “My daughter would ask me for $5, [and say], ‘Yeah, we’re going to Dairy Queen for a Dilly Bar.’ I had no idea.”

He says he only learned about hydromorphone after the coroner informed him that Kamilah had three substances in her system: cocaine, MDMA and hydromorphone.

“I had to start talking to people to figure out what [hydromorphone] was and where it was coming from.”

Sword is critical of B.C.’s safer supply program for being presented as safe and for lacking monitoring safeguards. “[Kamilah] knew where [the drugs] were coming from so she felt safe because her dealer would keep on telling her, ‘This is safe supply,’” Sword said.

In February, B.C. changed how it refers to the program from “prescribed safer supply” to “prescribed alternatives.”

Grace says another problem with the program is the quantities of drugs being distributed.

“It would be a big difference if the prescriptions that they were giving out were dosed properly,” she said, noting addicts would typically sell bottles containing 14 pills, with pricing starting at $1 a pill.

‘Safer supply’

Sword estimates his daughter struggled with addiction for about 18 to 24 months before her final, fatal overdose.

After Kamilah overdosed for the first time on Aug. 21, 2021, he tried to get her into treatment. A drug counsellor told him that, because she was over 12, she would need to verbally consent. Kamilah refused treatment.

B.C.’s Infants Act allows individuals aged 12 or older to consent to their own medical treatment if they understand the treatment and its implications. The province’s Mental Health Act requires minors aged 12 to 16 to consent to addiction or mental health treatment.

While parents can request involuntary admission for children under 16, a physician or nurse practitioner must first confirm the presence of a mental disorder that requires treatment. No law specifically addresses substance-use disorders in minors.

When Kamilah was admitted to the hospital on one occasion, she underwent a standard psychiatric evaluation and was quickly discharged — despite Sword’s protests.

Ontario also has a mental health law governing involuntary care. Similar to B.C., they permit involuntary care only where a minor has been diagnosed with a mental disorder.

By contrast, Alberta’s Protection of Children Abusing Drugs Act enables a parent or guardian to obtain a court order to place a child under 18 who is struggling with addiction into a secure facility for up to 15 days for detoxification, stabilization and assessment. Alberta is unique among the provinces and territories in permitting involuntary care of minors for substance-use issues.

Grace, who also became addicted to opioids, says her recovery journey involved several failed attempts.

“I never thought I would have almost died so many times,” said Grace, who is now 16. “I never thought I would even touch drugs in my life.”

Grace’s mother Amanda (a pseudonym) faced similar struggles as Sword in trying to get help for her daughter. Amanda says she was repeatedly told nothing more could be done for Grace, because Grace would not consent to treatment.

“One time, [Grace] overdosed at home, and I had to Narcan her because she was dead in her bed,” Amanda said. “I told the paramedic, ‘Our system is broken.’ And she just said, ‘Yes, I know.’”

Yet Grace, who today has been sober for 10 months, would question whether she even had the capacity to consent to treatment when she was addicted to drugs.

Under B.C.’s Health Care (Consent) and Care Facility (Admission) Act, an adult is only considered to have consented to health care if their consent is voluntary, informed, legitimately obtained and the individual is capable of making a decision about their care.

“Mentally able to give consent?” said Grace. “No, I was never really mentally there.”

System failure

Today, Sword is one of two plaintiffs leading a class-action lawsuit against several provincial and federal health authorities and organizations, including the B.C. Ministry of Health, Health Canada, Vancouver Coastal Health and Vancouver Island Health.

All four of these agencies declined to comment for this story, citing the ongoing court proceedings.

The lawsuit was filed Aug. 15 and is currently awaiting certification to proceed. It alleges the coroner initially identified safer supply drugs as a cause of Kamilah’s death, but later changed the report to omit this reference due to pressure from the province or for other unknown reasons.

It further alleges B.C. and Ottawa were aware that drugs prescribed under safer supply programs were being diverted as early as March 2021, but failed to monitor or control the drugs’ distribution. It points to a Health Canada report and data showing increased opioid-related problems from safer supply programs.

According to Amanda, Kamilah had wanted to overcome her addiction but B.C.’s system failed her.

“I had multiple conversations with Kamilah, and I know Kamilah wanted to get clean,” she says. “But she felt so stuck, like she couldn’t do it, and she felt guilty and ashamed.”

Grace, who battled addiction for four years, is relieved to be sober.

“I’ve never, ever been happier. I’ve never been healthier. It’s the best thing I’ve done for myself,” she said. “It’s just hard when you don’t have your best friend to do it with.”

This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.

Public disorder and open drug use raise concerns in picturesque mountain-rimmed town.

“Just the other night, we had an intruder in our yard,” Kirsten Stolee recounted, her voice unsteady. Her two daughters often watch television with their windows open. “He easily could have gotten inside,” she said.

Stolee lives in Nelson, a picturesque, mountain-rimmed town in BC’s Southern Interior that is struggling with rising public disorder. Some residents, herself included, say that local harm reduction initiatives – which appear to be operating without adequate accountability and safety measures – are responsible for the decay.

Near Stolee’s house, one can find the Stepping Stones emergency shelter alongside the former Nelson Friendship Outreach Clubhouse, which used to provide support services for individuals struggling with mental health issues before being abandoned late last year.

When the clubhouse still operated, supporters claimed that it provided clients with a space to socialize and partake in “art, gardening, cooking and summer camp” – but critics countered that it was a drop-in centre for drug users. After the provincial government announced plans to open a supervised inhalation site at the clubhouse early last year, local residents protested and had the project, and eventually the clubhouse itself, shut down.

Although Stolee supports harm reduction in principle, she opposed the opening of the inhalation site on safety grounds. The incidents near her home were concerning: an assault just outside her window, a drug-addled individual stabbing a pole with scissors, people carrying weapons on the street in front of the site. When her daughter’s phone was stolen, it was eventually recovered from a man at the clubhouse.

Although the clubhouse is closed, Stepping Stones continues to operate and has been similarly chaotic. Stolee watched a suspected drug dealer attack one of the residents there, and learned that another resident had made an inappropriate comment to her daughter.

She has also observed fire hazards near local homeless encampments, including a burning electrical panel and abandoned fires, and says that local drug users “play with fires” on sidewalks and streets. She finds these incidents concerning, as BC and Alberta have recently been ravaged by large wildfires and Nelson’s downtown is filled with historic wooden architecture.

Calling the police seemed unhelpful. In one case, officers dismissed her concerns about a man who was carrying large rocks, considering him non-threatening. However, the man was later arrested for assault and for using these types of rocks to break into a gas station.

Gavin Halford, a representative of Interior Health, the provincial agency which oversees most of the region’s harm reduction programs, stated that his organization “does not tolerate or condone any form of criminal activity, including trespassing.” He claimed that Interior Health has taken “a number of steps to increase security at the Clubhouse,” including increased signage, lighting, video surveillance and on-site security services.

However, the acquisition of 24/7 security services was facilitated by Stolee’s partner, after Interior Health told him that no such options were available. The partner also alleges that he was told by local police officers that Interior Health asked them not to enforce the “No Trespassing” signs around the clubhouse.

Stolee’s family has since invested $1,000 into security upgrades such as video surveillance and fencing. “We have baseball bats and pepper spray by our front door and a bat under the bed,” she said, noting that she wrote a letter to BC Premier David Eby detailing their experiences, which received no reply.

Kari Kroker, another neighbour of Stepping Stones, said that downtown Nelson has experienced a noticeable decline as open drug use and trafficking have proliferated, including sales to youth. “The alley behind my house has become a place of screaming and chaos,” she said, expressing frustration at how some drug users have told local children that using drugs is a form of “play.”

“I’m all in favour of putting more money into this situation, but I think we’re going the cheap way,” said Kroker. “I don’t see the province doing much to solve this. I don’t see rehab and supports for people. We need rehab. Where are the facilities to support people?” She believes that the town’s social fabric is fraying and that “harmony has been completely undermined.”

Tanya Finley, owner of Finley’s Bar and Grill and Sage Wine Bar, is an outspoken critic of provincial harm reduction policies and a leading figure in N2, the local residents’ association. She says that human feces, drug dealing, broken windows and home invasions are daily issues in her community: “Our eighty-year-old neighbour, who had just had surgery, had a brick thrown through her window.”

Finley says that her activism has had personal and professional costs and that, after she wrote a newspaper article advocating that homeless individuals be relocated to more suitable locations, a harm reduction advocate urged for a boycott of her business on social media. This led to a decline in sales and caused some of her employees to worry about their job security.

N2 was formed earlier this year after the province attempted to open the aforementioned supervised inhalation site. Local residents believed that the location of the site was unsuitably close to several youth facilities and that health authorities had, in contravention to Health Canada guidelines, failed to adequately consult the community.

“We were lied to deliberately and continuously,” said Kroker. “We found out later that this had been in the works for almost a year.”

Early efforts to address public safety concerns were undermined by accusations of NIMBYism and inadequate responses from government authorities. After N2 was formed and took collective action – such as letters to officials and media engagement – officials began to take these concerns more seriously and temporarily halted the opening of the inhalation site.

Polly Sutherland from ANKORS, a local harm reduction organization, acknowledged friction with the community but said that deteriorating public safety is largely due to limited resources. “We need more staff hours… We have the expertise and compassion for these individuals. Just give us the resources to do our jobs, and we will get it done,” she said.

She said that high rents have worsened homelessness and dereliction, and that mobile services could mitigate the concentration of public disorder in certain areas.

Nelson’s Mayor, Janice Morrison, who has had 35 years of experience working in healthcare, emphasized that municipal authority over healthcare is limited and argued for improved communication with provincial and federal agencies, which she believed needed to provide more funding.

“I think ANKORS is totally correct in that they need more staff hours and more resources,” she said, while stressing the importance of funding existing roles, such as community safety officers and outreach workers. “Drug addiction is a health issue, not a crime,” she said.

Morrison also criticized Interior Health for its inadequate community consultation regarding the placement of harm reduction sites. “They’ve had a hard go of it in their area,” the mayor said, referring to these sites’ neighbours.

Despite public safety challenges, Morrison noted that Nelson has made progress with operating several safe injection sites and would soon be adding 28 supportive housing beds. She remained committed to finding solutions despite persistent funding difficulties. “I’m ready to hear the solutions, and to support anyone with viable ideas,” she said.