Commons Sense Health: Who is responsible for illegal fentanyl use?

By Dr. Gifford-Jones and Diana Gifford-Jones on April 11, 2025.

This column is written with deep regret about what’s happening to Canada and the U.S. These two nations have been great friends for many years. Both of us, being Canadians, love the United States for many reasons. The elder of us was the only Canadian in the class of 1950 at the Harvard Medical School. That final year, afflicted by polio, the family of an American classmate extended weeks of care in their home during recuperation from paralysis. The younger of us also received an education in the U.S., at Wellesley and Harvard, worked in Washington for a decade, and has a strong network of American friends.

The ideals of the United States helped shape who we are. How could we not love and respect this country? But one man has caused a massive fissure between old friends. The accusation that Canada is responsible for illegal drugs crossing the border stands in contradiction with one of those ideals, the due process of law.

Canada is accused of having a lax and porous border. Canada allows, President Trump argues, the easy entry of fentanyl into the U.S. killing thousands of people. The U.S. – Canada border is expansive and it’s hard to catch all those who smuggle drugs across it. But so is it challenging at the U.S. – Mexico border, where far greater quantities of fentanyl enter the U.S.

Trump is right that Canada should do more to decrease the amounts of illegal drugs crossing the border, but he should acknowledge that this must be accomplished in concert with the U.S., Mexico, and others. And a focus on border issues misses the mark in any event.

Where is the better lever to addressing fentanyl deaths? It’s the legal system. Laws need to be respected, and there needs to be sharper punishment for drug pushers, plain and simple. Canada and the U.S. must admit that part of the drug crisis rests with their own citizens. Treating drug users as victims is like accepting a cancerous growth as a minor inconvenience. Sooner or later, the cancer grows, leading to widespread illness. This is what’s affecting the health of both Canada and the U.S.

Then there’s the cost. Taxpayers in Canada have been spending millions of dollars on methadone treatment in clinics that were supposed to ease the withdrawal symptoms of illegal drugs. Large numbers of Canadians have been hooked on bad drugs, and tens of thousands of addicts have been treated – over 40,000 in Ontario alone!

A suggestion was sent to readers years ago. Why not send all these addicts to northern Ontario during the cold winter months where they could learn to chop wood. This experience would teach them a lesson. Tons of angry emails from Canadians and Americans were received firmly agreeing with the proposal.

Politicians and governments have been too soft in dealing with the drug crisis. In the past, there were no methadone clinics. There were no tent encampments where addicts would in plain daylight be using and selling drugs. To the contrary, there were societal expectations of adherence to a moral code of law and order, and everyone regardless of colour, creed, or socioeconomic status abided or faced consequences.

Now, times have changed. While we need to address inequities, bad luck, or systemic discrimination, we have enabled too much finger pointing about all the things that can be labeled as someone else’s fault. Deaths from drug misuse will continue because humans are foolish. In the absence of tough laws and enforcement, people will purchase fentanyl and other illegal drugs, and we all pay the price.

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