We Count Overdose Deaths. Why Don't We Count Recoveries?

By Dr. Larry Smith

Parksville, British Columbia
June 2026

There were 1,826 toxic drug deaths recorded in British Columbia in 2025. That's about five deaths every day.

We know this because the province tracks overdose deaths with urgency and transparency. Public dashboards report fatalities, geographic patterns, and emerging contaminants in the drug supply.

Yet there is no routinely published public reporting system tracking how many British Columbians are in long-term recovery.

As someone in long-term recovery, I have spent years sharing my own story and listening to hundreds of others describe how they rebuilt their lives. Yet those stories rarely appear in the metrics used to evaluate addiction policy.

These are not ideological questions.

They are outcome questions.

Yet they receive far less attention than overdose statistics.

People cannot recover if they are dead. Harm reduction, emergency interventions, and medication-assisted treatments can all play important roles in keeping people alive long enough for change to become possible.

But stabilization is not the same thing as recovery.

Recovery is not simply the absence of craving or the absence of overdose. It is the presence of health, purpose, connection, and the ability to participate fully in life.

That distinction matters because public systems tend to value what they measure.

When governments publish detailed reports on deaths but provide little information about recovery outcomes, the public conversation naturally gravitates toward crisis management rather than long-term transformation.

The result is that we know a great deal about how people die and comparatively little about how people rebuild their lives.

This is not because recovery is rare.

Research suggests otherwise.

A landmark 2017 study led by Harvard addiction researcher John Kelly found that tens of millions of Americans have resolved a significant alcohol or drug problem. People recovered through a wide variety of pathways, including treatment programs, mutual-aid groups, faith communities, family support, and personal change outside formal systems.

The pathways differed.

The outcome did not.

People rebuilt their lives.

Yet those rebuilt lives are rarely reflected in the metrics used to evaluate addiction policy.

If recovery occurs at this scale, why is it so difficult to find public reporting on recovery outcomes?

Recovery researchers have long argued that recovery involves far more than the reduction of symptoms. Historian and recovery scholar William White has described recovery as a process of rebuilding a meaningful life, restoring health, relationships, purpose, and community participation.

More recently, researchers have developed the concept of "recovery capital" to describe the personal, social, and community resources that support long-term recovery. Housing, employment, family support, education, social connection, and a sense of purpose are all factors associated with sustained recovery.

Over the years, I have watched people return to work, reconnect with their children, repair their marriages, and rebuild lives they once believed were lost.

Importantly, these are not abstract ideals. They can be measured. If we are willing to count overdose deaths, we should also be willing to measure the factors that help people rebuild their lives.

Part of the challenge is that recovery is harder to measure than mortality.

A death is a clear event. Recovery is a process.

That reality is often cited as a reason recovery receives less attention in research and public reporting. But difficulty is not the same thing as impossibility.

Healthcare systems routinely measure complex outcomes in fields such as cancer care, cardiac rehabilitation, chronic pain, and mental health. They use patient-reported outcome measures, quality-of-life assessments, and functional questionnaires to track progress over time. Addiction treatment could do the same.

The more important question is not whether recovery can be measured. It is what we choose to measure.

Simple questionnaires administered at intake and at regular follow-up intervals could track changes in housing stability, employment, family relationships, physical and mental health, community involvement, and overall quality of life. Validated tools already exist, including recovery capital assessments, quality-of-life scales, and recovery outcome measures. The challenge is not the absence of measurement tools. It is the absence of a consistent commitment to using them.

A recovery dashboard would not need to endorse abstinence, medication-assisted treatment, harm reduction, or any other specific pathway. It would simply ask whether people's lives are improving. How many people achieve stable housing? How many return to work or school? How many reconnect with family? How many reduce their involvement with the criminal justice system? How many report improvements in physical and mental health? How many remain engaged in recovery after one year, three years, or five years?

These measures would not capture everything. Some of the most important aspects of recovery, purpose, belonging, self-respect, and hope, are difficult to quantify. Yet they matter profoundly.

I continue to see dramatic, life-changing transformations on a regular basis. These people are real, even though they rarely show up in the data.

At present, much of what people describe as recovery rarely appears on public dashboards. Family restoration. Employment. Community participation. Long-term stability. Meaningful lives rebuilt. These outcomes are often discussed anecdotally, but seldom measured systematically.

If public systems focus primarily on overdose deaths, overdoses reversed, retention rates, or reductions in craving, those outcomes naturally become the centre of public discussion. Important as they are, they represent only part of the story.

The question is not whether survival matters.

It does.

The question is whether survival is the destination, or the beginning of something larger.

This is not an argument against harm reduction.

Nor is it an argument for any single recovery model.

It is an argument for accountability.

If public funds support addiction programs, the public deserves to know not only how many lives are being preserved, but how many lives are being rebuilt.

If safer-supply programs function as bridges, we should know how many people cross them.

If treatment programs are effective, we should be able to describe what success looks like and how often it occurs.

And if recovery remains possible for millions of people, as both research and lived experience suggest, then recovery deserves to be measured with the same seriousness that we apply to overdose deaths.

Because what we measure reflects what we value.

Right now, we count the dead with remarkable precision.

Perhaps it is time we started counting the recovered.

If these conversations resonate with you, I invite you to join my Reader’s Circle at drlarrysmithauthor.com/readers-circle, where I explore recovery, resilience, human connection, and the deeper questions surrounding healing in an increasingly complex world.