Maybe it would all have been different if Emily* hadn’t fallen that day.

She slipped on ice when she was 15, falling down the stairs on her way to her car. It was her first day off crutches following a skiing accident.

Everywhere the granite stairs hit her neck and vertebrae, she was injured. She didn’t receive proper treatment, like physiotherapy, and her spine never fully recovered. 

“It was awful to be in some level of pain every single day,” Emily said.

Arriving at Queen’s as a first year in 2007, Emily went to see Queen’s Health, Counselling and Disability Services (HCDS), now known as Student Wellness Services (SWS). 

After her first doctor’s Tylenol prescription didn’t work, Emily was referred to another doctor within HCDS. The doctor prescribed Emily Percocet and Oxycontin instead.

“By the time I was in fourth year, I had running prescriptions for Percocet and at least two Oxy’s a day,” Emily said. 

While Emily’s experience was legal, a 2016 National College Health Assessment Survey reported 5.5 per cent of Canadian post-secondary students had used prescription pain relievers not prescribed to them in the past 12 months. 

Their use, even when  prescribed, can sometimes lead to abuse. 

As opioids, the drugs manage pain and “produce a state of relaxation or euphoria,” according to educational material from Kingston, Frontenac and Lennox & Addington Public Health (KFL&A). The effects can be achieved through legal prescriptions or illegal street opioids.

Narcotics, including opioids, are still prescribed at Queen’s by SWS, according to its Director, Jennifer Dods. However, they’re prescribed rarely, and students who do receive prescriptions are monitored closely. They’re are also required to sign a treatment agreement regarding the drugs’ use, in addition to complying with regulations. 

The drugs’ illegal use is often minimal on campus. 

However, in the past year and a half, Staff Sergeant Keith Hill of the Kingston Police Drug Unit said he’s seen a steady increase in illegal opioid busts around the city. None so far have occurred within the University District.

“Fentanyl and other opiate drugs are so prevalent that it can’t help but go into all areas of the city of Kingston,” Hill said. The University District may be no exception. 

So far, Kingston’s fentanyl supply has not shown up on campus and no overdoses have been reported, according to Todd Zimmerman, Director of Campus Security & Emergency Services at Queen’s. 

If there were students using illegal opioids—not selling—Zimmerman said security would take the approach of helping the student. 

“If an individual is in distress due to personal use or an unexpected exposure, then getting assistance for the victim is the most important step and there is no intent to punish the student,” Zimmerman said.

Even with no fentanyl incidents to date, campus security has begun carrying Naloxone kits. 

The kits work like an epi-pen for opioid overdoses, temporarily halting the drug’s effects.

Additionally, SWS Health Promotion Coordinator Beth Blackett said they also “delivered substance training to all Orientation leaders and Residence Life student staff which included how to recognize and respond to an opioid overdose.”

***

As she dealt with her spinal injury, Emily was taking a heavy dose of OxyContin. She found it difficult to concentrate while on the drugs. Her trouble focusing in school, as well as the tolerance she eventually developed, led her to begin abusing the medication.

Emily would hoard the pills and take several days’ worth at once.

“When I was having a really bad day, I’d crush them up and take it like a line of coke,” she said.

She loved the numb, fuzzy feeling they brought.

Emily never bought opioids illegally. All of her uses—and abuses—were prescribed and lawful.

Every month, she would go see her doctor to renew the prescription. She was tested for drugs in her system, but the test didn’t detect the amount—meaning the times she would overuse couldn’t be recognized.

She believes more access to counselling could have helped mitigate her addiction. During her time at Queen’s, students could only attend a certain amount of sessions per year through HCDS.

Currently, counselling sessions have no cap. However, wait times can still be a concern for some students. 

Emily still wishes there was more effort to fix the root of her pain, rather than mask it. 

More than a decade later, Emily cites her recent trip to the chiropractor as the most effective solution to her constant discomfort.

“I was in pain every day for 12 years,” she said.

***

Shannon* made the same trip to HCDS following the development of horrible muscle pain in her stomach.

She walked with a cast due to a torn ligament in her foot. Her injured foot was an inch or two higher—an imbalance that  caused the significant stomach pain. 

Shannon went to her local ER during Christmas break of her first year in 2006 for the pain. After several tests that couldn’t find the cause, she was sent home with Percocet.

Still in pain back at Queen’s, Shannon went to the HCDS walk-in clinic to refill her prescription. The clinic doctor filled her script again and sent her on her way. 

The pills weren’t helping, so finally she went to her chiropractor, who diagnosed the cause of her pain and gave her stretches to fix it.

With her pain now gone, Shannon was still dependent on the pills. She went back one more time to the walk-in clinic.

“[The clinic doctor] just took me on my word that my doctor had prescribed it, [and] my doctor had given no refills,” Shannon said. 

She doesn’t even recall being asked if she had the pain any more.

The doctor gave her 30 pills—but Shannon needed more. Back in her dorm room, she scratched the “3” into an “8.”

The pharmacist didn’t buy it. He called her doctor and confirmed it was fake. Shannon pleaded ignorance and blamed it on her roommate.

While Shannon and Emily never took the drugs illegally, the prescription-to-abuse pattern has become common. 

***

Recently, attention has been focused on the high number of overdoses from illegal, non-prescribed street opioids, which can be cut with more potent fentanyl. According to the Government of Canada, there were 3,996 opioid-related deaths in Canada in 2017, an increase of 32.9 per cent from 2016.

Illegal fentanyl is connected to legal prescriptions, according to Dr. Samantha Buttemer, a Senior Public Health and Preventive Medicine Resident Physician with KFL&A Public Health. 

She explained users can get hooked on prescriptions and turn to illegal drugs once they run out. 

Prescription opioids are one of the few publicly funded tools doctors can use to treat pain. The drugs—particularly OxyContin—were heavily marketed beginning in the 1990s. 

Alternatives like massage and physiotherapy usually aren’t publicly covered. These factors all make opioids a more available tool for some doctors. 

Dr. Buttemer added the rise in overdoses in the past few years is due to a shift from predictable opioid prescriptions to street opioids cut with fentanyl. Its potency can mean overdoses occur much more easily.

“It’s kind of a web of many problems that have all [created] this terrible situation that we’re really having a hard time getting a handle over,” she said.

OxyContin was delisted, meaning it wouldn’t be covered by the government, in 2012. This caused many users to turn to illegal opioids, according to Justine McIsaac, a harm reduction counsellor at the KFL&A Public Health Overdose Prevention Site, operated just blocks away from Queen’s. 

“We left a whole bunch of vulnerable people [with] no choice but to then turn to the black market,” McIsaac said. 

***

After her attempted forgery, Shannon’s pharmacist told her she was lucky not to spend a night in jail. Shannon took her encounter as a wake-up call.

She flushed her pills down the toilet, never using them again.

As she reflects on her experience, Shannon echoes Emily’s sentiment—the doctors she saw tried to conceal the symptoms rather than fix them.

“The pain went away when I was taught a way to stretch and move in a specific way that fixed the [problem], as opposed to just masking the side effect or the symptoms,” Shannon said.

“I didn’t know that [Percocet] was [so] addictive.” 

*Names have been changed to protect the anonymity of students.