A recent visit to Boston highlighted stark differences in how the two cities handle addiction and homelessness. While walking through Boston, I reflected on my experiences in Vancouver, where the visible effects of addiction have become increasingly alarming.

In Vancouver, open drug use, discarded needles, and homeless encampments have become common sights. The Downtown Eastside, known for its struggles with addiction, is just one area affected by this crisis. Many residents feel that the city has failed to protect its citizens from the consequences of addiction and mental health issues.

The situation in Vancouver has drawn criticism, particularly towards harm reduction strategies that some believe have exacerbated the problem. Advocates argue that these approaches have dominated discussions in healthcare and academia, leading to a lack of effective solutions.

In contrast, Boston, which has a similar population of around 700,000, has taken a different approach. The city declared a public health emergency in 2021 due to addiction and homelessness, following a similar declaration in 2014 regarding the opioid crisis. At one point, Massachusetts had higher opioid overdose death rates than British Columbia, but the situation has since shifted.

In 2014, Massachusetts recorded 1,356 overdose deaths, while British Columbia had 370. By 2023, Massachusetts reported 2,104 confirmed overdose deaths, while British Columbia's numbers reached 2,588, despite its smaller population.

During my time in Boston, I noticed a cleaner environment and a sense of safety that was absent in Vancouver. I encountered only one homeless tent and did not see any individuals struggling with addiction on the streets. The absence of discarded needles and the lack of public intoxication stood in stark contrast to my experiences in Vancouver, where the streets often reek of urine and chaos is prevalent.

Both cities face challenges related to the opioid epidemic, but Boston's approach includes a strong emphasis on recovery alongside harm reduction. This focus may contribute to the differences in public perception and the overall environment in each city. As Vancouver continues to grapple with its addiction crisis, many are left wondering what lessons can be learned from Boston's strategies.