As a cold September rain poured down in Kenora, a van stopped to pick up a young man who residents in this northwestern Ontario town typically shun.

"People cross the street when they see me," Jory Smith said. "It feels horrible."

This was no ordinary van. It was a mobile health unit, run by a small team of street nurses, and it was designed to give some dignity back to drug users like Smith.

The 31-year-old has been addicted to opioids for years, but said they've become "harder to find" in this region since authorities started cracking down on opioid prescriptions. So he's turned to crystal meth, a dramatically different kind of drug that has become readily available here.

Despite its reputation as a tourist haven — with its cottages on Lake of the Woods and renowned fishing and boating — Kenora is a town gripped by addiction.

Like many others in this community of 15,000, Jory Smith is addicted to opioids and crystal meth, and every day is a quest to find a way to alleviate the debilitating withdrawal symptoms and cravings that make him "dopesick."

"I become this irritable, rude, like, just paranoid, delusional person."

And like many other addicts, Smith is prepared to do whatever it takes to find and pay for the drug that makes life bearable. That includes "fencing" (acting as a go-between for stolen goods) or finding drugs for other addicts (for a price, of course).

Using and dealing have made Smith a pariah in this small community, even though he grew up here. But the Northwestern Health Unit van is a safe space, free of judgment.

Nurses Becky Shorrock and Jen Carlson, along with family doctor Jonny Grek, recognize addiction as a health issue. The team believes that in addition to dispensing clean needles, wound care and HIV testing, their mobile unit is meant to build trust with addicts who don't feel welcome in doctors' offices, hospitals or social service agencies.

Shorrock said a big part of the team's job is fostering "an environment where [people with addictions] can come and feel like normal people."

Climbing into the van, Smith cheerfully accepted a sandwich and shelter from the rain. He and Shorrock began to joke with one another.



It's a respite from an often tough existence. In the last year, Smith was hit in the head with an axe during a fight (it took 17 stitches to sew up the wound). He has also been mourning the death of his girlfriend, who suffered from health problems indirectly related to drug use. He almost died himself recently from an overdose.



Jory Smith speaks with Becky Shorrock, one of the nurses who works in the mobile van unit in Kenora. (Nicole Ireland/CBC)

Jory Smith speaks with Becky Shorrock, one of the nurses who works in the mobile van unit in Kenora. (Nicole Ireland/CBC)

Opioids such as heroin, oxycodone and fentanyl depress the nervous system and have a sedative effect. Methamphetamines, on the other hand, are stimulants and have the opposite effect, making people euphoric and feeling like they have endless energy.



As a result, meth can keep users awake for days at a time as well as suppress their appetite, putting them at risk of malnourishment or dehydration. Crystal meth can also raise blood pressure, induce an irregular heartbeat and cause agitation, involuntary body movements (sometimes known as "flailing" or "tweaking"), hallucinations and paranoia. It can also create the sensation of "meth bugs," where users feel things crawling under their skin and claw at themselves, creating a risk of infection. Many users get meth psychosis.

Smith has experienced both hallucinations and psychosis, which is why he tries to get enough rest. "If I don't sleep every night, then it's like Dr. Jekyll and Mr. Hyde. I become this irritable, rude, like, just paranoid, delusional person."

People take crystal meth by either smoking or injecting it. Smith does the latter, which he notes is "ironic." While growing up in Kenora and the nearby Rat Portage First Nation, Smith remembers being "scared of needles."

"I never planned this [life] for myself. It's not something I wanted to do."

That said, he was exposed to drugs at a young age. "The first person to shoot me up was … someone who I looked up to as a younger person," Smith said. "If he was to tell me not to use, then I probably wouldn't have used."

In addition, Smith's father sold weed out of an apartment in Kenora known as "the Office," which he later turned over to his son. Smith sold other drugs, including meth and opioids, out of that unit before the building was shut down.

"Crystal meth is everywhere. It’s affecting all walks of life in our community."

Smith would much rather have a legitimate job, but when he tries to apply for one, his reputation comes back to haunt him. "Either I won't get called back [or] if I do, and then they … realize I am who I am, then they'll cancel [the interview] or they'll say they overbooked or whatever."

So Smith's life has become a seemingly unbreakable cycle, in which he commits crimes to feed his addiction, goes to jail, comes out sober and then relapses, starting all over again. Without a trace of resentment or self-pity, he acknowledged that jail has been the only place where he's been drug-free for long stretches.

"As much as, like, nobody wants to go to jail, [it's] really the only place where I can grow as a person," Smith said.

Fellow Kenora resident Will Lacy knows the devastation of crystal meth intimately. The 47-year-old said he ran a million-dollar business before addiction tore his life apart. "It took me down harder and faster than any other drug I've used," Lacy said. "Within months, I was unable to keep a place to live in."

Lacy has been in and out of recovery for 25 years. While he continues to struggle with opioids, he's now an outreach liaison between the Northwestern Health Unit and other drug users in Kenora. "Crystal meth is everywhere," Lacy said. "It's affecting all walks of life in our community."



Picturesque Kenora is better known for its cottages, fishing and quaint downtown. (Nicole Ireland/CBC)

Picturesque Kenora is better known for its cottages, fishing and quaint downtown. (Nicole Ireland/CBC)

Kenora is a microcosm of a larger problem. A few years ago, it took shocking death tolls for most Canadians to realize that opioids like fentanyl (and the more potent carfentanil) had created a public health emergency. While federal, provincial and territorial governments have been preoccupied with stemming opioid addiction, crystal meth use has been rising, particularly in western and central Canada.

Health care workers and law enforcement officials warn that meth's powerful hold on users, in tandem with its disruptive, hard-to-treat symptoms, may be leading Canada into a devastating drug emergency on top of the existing opioid crisis.