When Madeline finally got sober seven years ago, she did not just have to quit heroin — she had to learn how to be a person again.
“I felt like a child in a 27-year-old’s body,” she told Canadian Affairs in a private message on the social media forum Reddit. “Even remembering to take a bath or brush my teeth was hard.”
Canadian Affairs agreed to not use Madeline’s last name to avoid affecting her job prospects.
Arthur, from Edmonton, once took more than 100 milligrams of oxycodone a day — double the maximum dosage advised for lower back pain — at the height of an addiction that spanned more than a decade.
His real name is also being withheld due to potential legal risks tied to his past drug use.
Last October, Arthur successfully weaned himself off Suboxone — a medication used to treat opioid dependence — after years of use left him with severe dental damage.
“I have been opiate-free ever since, short of maybe two or three days of oxycodone, if I’ve needed it,” the 53-year-old told Canadian Affairs on a video call.
“I never stopped trying to get out of that spiral.”
While there is no single path to overcoming opioid use disorder, interviews with people in long-term recovery point to common threads: medical treatment alone is not enough; and psychological support, a stable environment and a personal commitment to healing are essential.
“Methadone is only one piece of the puzzle,” said Madeline, referring to another opioid dependence medication.
“You have to take the first steps in your journey, but there will be people there to help you along the way.”
Over-prescribing
Canada’s opioid crisis began in the 1990s, when pharmaceutical companies heavily marketed prescription painkillers such as OxyContin as safe and non-addictive. Doctors prescribed them liberally in both Canada and the U.S., leading to widespread dependence.
Provinces and states eventually cracked down on prescribing practices, suddenly cutting people off from their supply. Many turned to the streets, where heroin and increasingly potent synthetic opioids such as fentanyl filled the gap.
Today, Canada’s drug crisis is driven not by prescription pills, but by an unregulated drug supply contaminated with fentanyl and other toxic substances such as xylazine.
In a 2024 ruling, the Supreme Court of Canada cleared the way for governments to sue opioid companies together for health-care costs. But the damage has been done. More than 52,000 people have died in Canada from opioid toxicity in the last nine years.
While overdose deaths continue to dominate headlines, there is less attention paid to those who survive.
Rock bottom
The descent into addiction is often gradual, but recovery begins the moment someone decides to reach out for help.
For Arthur, of Edmonton, the journey through addiction was both physical and emotional. After years of being prescribed oxycodone for chronic back pain, he was prescribed 200 pills at once — an amount he now recognizes as dangerously excessive.
“I left with 200 oxycodone,” he said. “I didn’t know that that was too many, I didn’t know that it should be doled out monthly. I didn’t know what was about to happen.”
Over the next five years, his use escalated as he ran out early and sought more prescriptions. “I was figuring out how to smoke it and shoot it,” he said. “I was getting more and more and more.”
Perhaps because he never turned to street drugs, Arthur thought he was functioning — until he and his wife realized the extent of his dependence.
“I spent every waking minute thinking about oxycodone, and taking it,” he said. “One day I woke up and my wife and I were like, oh, you actually have a problem.”
When he first sought help, he was often dismissed, given more medication or dropped by physicians altogether. This left him cycling through doctors and pharmacies, enabling his addiction to continue unchecked.
Madeline, now 33 and living in Regina, traces her addiction back to a knee injury at 19. After taking prescribed oxycodone for five months, her prescription suddenly ended — and she turned to street drugs. What began with Dilaudid and illicit oxycodone quickly escalated to smoking and injecting heroin.
“Within about 16 months of breaking my leg I was a full fledged heroin addict,” she said. “[But] every time I hit rock bottom, I had only found the basement.”
Trapped in an abusive relationship with a drug dealer, she grew increasingly ill. “I was getting assaulted regularly,” she said. “I eventually realized that I was going to overdose or get murdered if I didn’t make huge life changes.”
Though methadone treatment helped, she relapsed multiple times. “I did this probably seven or eight times,” she said.
Across the border in Syracuse, N.Y., 38-year-old Kevin Harmon’s addiction began more subtly — using opioids recreationally with his now-wife.
“We would get some once a month or something like that,” he said in an interview with Canadian Affairs, comparing it to couples sharing a bottle of wine. But their use escalated, and over time, heroin took hold.
The couple spent years trying to quit, but were locked in a cycle of relentless relapse.
‘Extra steps’
For people recovering from opioid addiction, personal motivation is vital — especially when navigating broken, profit-driven addiction treatment systems that require relentless self-advocacy.
Alexander Dolly, 30, from Massachusetts, is a moderator of r/OpiatesRecovery, a Reddit community with more than 56,000 members dedicated to supporting those in recovery.
As a moderator, Dolly regularly responds to messages from people seeking guidance. “You feel you want to help everybody,” he said. “But [in] a lot of these situations … it’s a lot of the same thing — they want to get well and they want to get better, but they’re not willing to take the extra steps.
“So you have to put the energy in, and you give them the resources, but they have to want to do it — we can’t force them.”
Most members of the subreddit he moderates are based in the U.S., where Dolly says addiction treatment programs often fall short. Even when people are ready to seek help, he says, many rehab and recovery programs are more focused on profit than actual healing.
“Even though they had a good facility, and I got well there, we had revolving door patients,” he told Canadian Affairs, describing how some centres cycle clients through ineffective care — and even dole out kickbacks for referrals from recovery coaches.
Arthur had a similar experience in Canada. “Rehab was bullshit,” he said. “They felt more like businesses than therapeutic centres.”
After attending three rehab programs in Alberta and B.C., he found them filled with unproductive “drug talk” and underqualified — or actively addicted — staff.
Before rehab, Arthur sought medical detox in the U.S., where the opioid treatment medication Suboxone was then administered via implant, before Suboxone’s approval in Canada.
Though medications like Suboxone and gabapentin helped, he says they introduced new forms of dependency. Missing a dose could trigger withdrawal symptoms, making it nearly impossible to taper off it or travel without access to the medication.
“You can’t go into withdrawal, and you can’t go on holiday, so there’s these obsessive components [to addiction medications,” he said. “With Gabapentine, if I decrease it too quickly, then I get psychosis.”
“So it’s a real anchor [or] a chain … it doesn’t just stop.”
Dolly echoed this concern, calling methadone clinics in the U.S. “liquid handcuffs” — stabilizing, but also binding patients to daily routines that serve a profit model.
Despite these hurdles, Arthur credits his strong personal resolve and his desire to be present for his family as central to his recovery.
“My pure desire to be present as a parent, as a husband, as a son, as a father — that’s really what has driven me,” he said. “You have to fight for yourself.”
Into the void
In recovery, getting sober is just the beginning. After physical detox, the real work begins.
Dolly, now a case worker and recovery advocate, says untreated psychological pain can intensify the mental anguish of withdrawal. “When psychological issues go untreated, withdrawal becomes unbearable,” he said.
Dolly believes this is why many treatment programs fail: they neglect the root causes that fuel addiction in the first place.
Madeline credits her recovery not just to methadone, but to leaving the environment that sustained her addiction.
After moving from Vancouver to Calgary with a family member and starting treatment at a methadone clinic, she was able to stay in the program. But the true turning point came when she was finally diagnosed with ADHD and depression.
“I was … properly medicated for the first time ever,” she said. “It relieved a lot of the impulsiveness and dopamine-seeking behaviour I had been engaging in … I always felt like there was something missing, like I had a void to fill and didn’t understand why.”
For Harmon, community was the game-changer. After a friend intervened in his and his wife’s addiction — which they initially experienced as a betrayal and later recognized as tough love — they entered an outpatient program: Refuge Recovery — a Buddhist-oriented, yet non-theistic, online recovery group.
“I was always really resistant to [community recovery groups],” he said. “[But] it is really making all the difference.”
Harmon says group therapy, mindfulness and Buddhist philosophy helped him reframe his relationship with suffering and cultivate inner strength.
Arthur’s progress came only after he enrolled in Calgary’s opioid deprescribing program, which is part of Alberta Health Services’ Opioid Dependency Program. The program helped him taper his opioid use gradually.
Arthur says it was the first time he had encountered a team that did not force a solution on him.
“They worked with me where I was,” he said. That opened the door to deeper trauma work — including ketamine-assisted psychotherapy — which allowed him to reconnect with buried pain and develop tools such as self-compassion and emotional regulation.
“Ketamine took me so deeply inward to address my trauma,” he said. “It changed my relationship with my bullshit, my pain, my mental health — it changed my relationship with everything that was chaining me down.
“It’s not like those things don’t exist anymore. They still exist, but I have a different relationship with them.”
Well written article Ms. Keeler.
You wrote……When Madeline finally got sober seven years ago, she did not just have to quit heroin — she had to learn how to be a person again.
Alcoholics with drug problems can get sober and clean. Drug addicts often become clean….but not clean and sober.
There is a difference.
Retired, Senior, Socialist, Sober & Clean and Canadian
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