The rain drops against the window of Anita Rempel’s small Winnipeg apartment sound like tiny knocks – persistent reminders of the greater loss she carries. On her coffee table sits a framed photo of her brother David, his smile wide beneath kind eyes that couldn’t hide his struggle.
“The last time I saw him, he begged me to find him help,” Anita says, her voice steady but weighted. “We called everywhere. The detox centers were full. The treatment programs had waiting lists of months. His doctor prescribed medication but couldn’t get him into counseling for seven weeks.”
Three days before that appointment, David died from an overdose in his apartment. He was 42.
Anita’s story echoes through Winnipeg’s neighborhoods, where families navigate a fractured system of addiction support that many describe as impossible to access when need is most urgent. Her experience has transformed her grief into advocacy, joining a growing chorus of voices calling for fundamental reforms to the city’s approach to substance use disorders.
“The system isn’t just broken,” she explains, “it’s designed to help only after someone has completely fallen apart. My brother was still working, still had housing. They told us he wasn’t ‘bad enough’ for emergency intervention.”
Winnipeg’s addiction services operate through a patchwork of government, non-profit, and private programs that rarely communicate effectively with each other. According to the Manitoba Centre for Health Policy, only about 20 percent of those struggling with substance use disorders successfully connect with appropriate treatment in any given year.
Marion Willis, founder of St. Boniface Street Links, has witnessed this gap firsthand. “We have people coming to us who’ve been turned away from five different services,” Willis explains from her office, where the phone rings constantly. “The barriers are tremendous – waiting periods, strict sobriety requirements, complex intake processes. Most people simply give up.”
The disconnect between crisis response and treatment means many only receive help after interacting with police or emergency departments. Dr. James Bolton, who studies addiction and mental health systems at the University of Manitoba, points to research showing earlier intervention drastically improves outcomes.
“We know that addressing substance use disorders during the contemplation phase – when someone is considering change but hasn’t hit rock bottom – leads to much better results,” Bolton says. “Yet our system is almost entirely built around crisis response, which is both more expensive and less effective.”
Walking along Higgins Avenue on a brisk morning, outreach worker Keisha Thomas points out the gaps. “See that clinic? They’ll give you harm reduction supplies but can’t connect you to detox. The detox center is across town and doesn’t coordinate with residential treatment. Each place has different paperwork, different requirements.”
The result is what Thomas calls “treatment ping-pong” – individuals bouncing between services without continuity of care. For families like Anita’s, this fragmentation creates an impossible maze during life-or-death moments.
Provincial data shows substance-related deaths in Winnipeg have increased by 43 percent since 2019. Meanwhile, average wait times for residential treatment programs have stretched to 9-12 weeks, with some specialized programs reporting six-month waits.
“The night David called me,” Anita recalls, “he said he was ready. He was terrified and wanted help immediately. I thought that’s how the system worked – that when someone reaches that moment of clarity, help would be available.”
Instead, she encountered what many families describe: a system that places administrative barriers above immediate need.
Rachel Usher lost her daughter Emma to fentanyl last year after struggling to navigate treatment options. “They told us to call back every morning to see if a bed had opened up,” she says. “Emma couldn’t even hold the phone some mornings. After three weeks of calling, she gave up.”
Some healthcare providers acknowledge the system’s limitations. Dr. Lindy Lee, who has worked in addiction medicine for over two decades, describes a
