Understanding Vancouver’s Overdose Crisis Through the Lens of Trauma and Healing

Every day in Vancouver, another life is lost to the toxic drug crisis. Since British Columbia declared a public health emergency in 2016, over 14,000 people have died from toxic drug poisoning. And these are not just numbers. They are parents, siblings, friends, coworkers, and neighbours. They are people who matter and who are deeply missed. Each loss sends quiet ripples of grief through families, workplaces, and communities across the province.

As a psychiatric nurse working on an outreach team, I have witnessed this first-hand. I have seen the deep stigma and mistreatment that people who use substances face. I have also witnessed the heartbreak of losing many to toxic drug poisoning, people who were kind, creative, resilient, and deserving of care.

It is easy to feel helpless in the face of something this big. But if we look closer, this crisis is not only about drugs.It is about pain, disconnection, and trauma, both personal and collective. To understand what is really happening, we need to ask a different question: why does this pain exist in the first place?

Addiction as a Response to Pain

Dr. Gabor Maté, a Vancouver-based physician and trauma expert, has spent decades working with people who use substances. He reminds us that addiction is not a choice or a moral failing. It is a response to suffering. In In the Realm of Hungry Ghosts, Maté writes that the real question is not “Why the addiction?” but “Why the pain?”

For many people, substance use begins as a way to cope with trauma, loneliness, or loss, a way to quiet the nervous system when life feels unbearable. When we begin to see addiction through this lens, we stop asking what is wrong with someone and start asking what happened to them. That shift, from judgment to understanding, changes everything.

The overdose crisis is also a mental health crisis, one closely tied to trauma, stigma, and inequity. If we want lasting change, we have to treat the cause, not just the symptom.

The Weight of History: Indigenous Communities and Intergenerational Trauma

No group has been impacted more deeply than Indigenous Peoples in British Columbia. The First Nations Health Authority reports that First Nations people die from toxic drug poisoning at nearly six times the rate of non-Indigenous people.

That reality cannot be separated from our province’s history. Residential schools, land theft, family separation, and systemic racism have left deep scars that span generations. When people lose connection to culture, language, and belonging, that pain does not disappear. It gets carried forward.

Substance use often becomes a way to manage that pain and fill the void left by disconnection. Healing, then, has to include reconnection to land, to identity, and to community.

What Trauma-Informed Care Looks Like

If trauma is at the root, our systems of care have to respond differently. Trauma-informed care means recognizing that many people who use substances carry a history of pain and that traditional “tough-love” approaches often make things worse.

Trauma-informed care involves:

• Creating spaces where people feel safe and respected

• Building trust through consistency and empathy

• Recognizing the signs of trauma

• Supporting choice and autonomy in every step of care

When services take this approach, people engage more fully, and recovery becomes possible. It is not about fixing people; it is about helping them feel safe enough to heal.

The Power of Connection

Isolation and disconnection fuel this crisis, and connection is what helps people survive it. Across British Columbia, we have initiatives that strive to build connection and healing:

• Peer support programs where people with lived experience walk beside others

• Cultural gatherings that bring Indigenous communities together through song, ceremony, and language

• Safe consumption sites that keep people alive and link them to care

• Outreach teams who meet people where they are, without judgment

Every one of these efforts builds belonging, and belonging is medicine.

Moving Forward

Healing this crisis will not come from one program or policy alone. It will come from small, collective shifts in how we see and support one another.

That means...

• Addressing inequities and insecurities in housing, poverty, and access to healthcare

• Investing in mental health and trauma services that are culturally safe

• Training more frontline staff in trauma-informed approaches

• Listening to communities, especially Indigenous and peer voices, in designing solutions

• Replacing stigma with understanding and compassion

When we focus on healing the pain beneath the surface, we create room for recovery, connection, and hope.

Closing Thoughts

The overdose crisis is not just a tragedy; it is a mirror reflecting the wounds we have ignored for too long. When we understand addiction as a human response to pain, we can meet it with empathy instead of blame. Healing begins when we see people for who they are: resilient, resourceful, and worthy of care.

At Salal Mental Health Training, we believe that mental health education should build exactly that: compassion, awareness, and trauma-informed understanding. Because when we learn how to respond to pain with care, we strengthen the roots of our communities.