The overdose crisis. It’s nothing new for those in British Columbia. A crisis was first declared by British Columbia in 2016 and since then, the number of deaths due to overdose have only risen. So, what is the solution? The BC government recently announced the decriminalization of up to 2.5 grams of certain drugs for personal possession (Government of Canada, 2022). This policy, while a step in the right direction, is not without limitations. A model of decriminalization is certainly necessary to establish for the goal of reducing stigma and characterizing drug use as a health and social issue instead of a criminal one (Greer & Shane, 2021). However, by failing to address the root cause of overdose deaths, this proposal will do little to address the overdose crisis. In some ways, it can even exacerbate the crisis.
In my view, to truly address the opioid overdose crisis in BC, it is important to get to the root of the problem. Overdose deaths are occurring due to a toxic drug supply that is contaminated with fentanyl (British Columbia Coroners Service, 2022) and distributed by an illegal market. The illegality of the drug market results in inconsistencies in the quality and potency of drugs. Dr. Mark Tyndall, then, suggests that there is not an opioid overdose crisis but rather a mass poisoning of drugs due to the presence of deadly fentanyl (Moraff et al., 2020). Within this context, it is necessary to provide a safe supply of drugs that is uncontaminated and consistent in its quality, alongside decriminalization policies. Others may argue that to prevent overdose deaths, we must stop people from using drugs altogether. However, such a position denies that drug use exists on a spectrum and that not all drug use is problematic. The reality is that drug use has existed for years and the demand for drugs persists whether under a system of prohibition, decriminalization, or legalization. Within such a reality, it is unproductive to suggest that all people should simply stop using drugs or that people should want to stop using drugs. Rather, it is more effective to meet people where they are at.
To address the toxic supply of drugs then, there needs to be a safe supply of drugs provided. Providing a safe supply moves beyond decriminalization by removing the control of production and distribution from organized crime groups and instead placing it under the control of the government which would create drugs that are uncontaminated (Canadian Association of People Who Use Drugs, 2019). Regulating drugs in this manner allows for control on the quality of drugs, restrictions on age, and location-specific rules. Notably, legalization also reduces organized crime and provides greater access to social supports such as housing, addiction management services, and employment opportunities. There are multiple models of safe supply, and each should be implemented simultaneously in consideration of the differences amongst drugs themselves. The key five models of safe supply are doctoral prescriptions, pharmacist prescriptions, licensed retailers, licensed premises, and unlicensed premises (Canadian Association of People Who Use Drugs, 2019). Each model has a varying level of control inherent within it alongside its own pros and cons which are not within the scope of this piece. Instead, my intention is to draw attention to the fact that alternatives to the discriminatory and failed war on drugs do exist.
If such an alternative exists that seems to show promise in ending – or at least, greatly reducing – deaths from overdose, why are we not implementing such policies? One reason for that is stigma. There is a ton of misinformation among society around drug use and people who use drugs (Pierre, 2020), which has caused much of the public to be against alternatives to prohibition. Politicians, whose main goal is that of (re)election, are reluctant to initiate innovative change unless the public is in support of them. Thus, we as a society need to reimagine how we view drugs and people who use them, through mindful education and openness. When it comes to the overdose crisis, political ideologies should not take priority over saving people’s lives (Canadian Drug Policy Coalition, 2020). We must also acknowledge that the experts in this situation are people with living or lived experience in using drugs. They must be at the table during policy deliberations and their knowledge needs to be valued equally to other ‘professionals’ when creating and implementing drug policies.
It is important I state that this piece has simply touched the surface of drug policy discourse. I highly recommend taking the course Drug Policy (CRIM 417) with Dr. Alissa Greer to delve deeper into these topics and critically think about drug strategies. I am also open to having a meaningful discussion about this subject through Instagram (@sharondeep.kaur). In the meantime, here are two thought-provoking videos to consider:
https://youtu.be/PY9DcIMGxMs
https://www.ted.com/talks/ethan_nadelmann_why_we_need_to_end_the_war_on_drugs?utm_campaign=tedspread&utm_medium=referral&utm_source=tedcomshare
References
British Columbia Coroners Service. (2022, July 14). Illicit drug toxicity deaths in BC: January 1, 2012 – May 31, 2022. https://www2.gov.bc.ca/assets/gov/birth-adoption-death-marriage-and-divorce/deaths/coroners-service/statistical/illicit-drug.pdf
Canadian Association of People Who Use Drugs. (2019). Safe supply concept document. Zenodo. https://doi.org/10.5281/zenodo.5637607
Canadian Drug Policy Coalition. (2020, October 5). Getting to tomorrow: Ending the overdose crisis [Video]. YouTube. https://www.youtube.com/watch?v=1IEk1iYtJGw
Government of Canada. (2022, May 31). Exemption from Controlled Drugs and Substances Act: Personal possession of small amounts of certain illegal drugs in British Columbia (January 31, 2023 to January 31, 2026). https://www.canada.ca/en/health-canada/services/health-concerns/controlled-substances-precursor-chemicals/policy-regulations/policy-documents/exemption-personal-possession-small-amounts-certain-illegal-drugs-british-columbia.html
Greer, A., & Shane, C. (2021, June 28). Decriminalizing drug use is a necessary step, but it won’t end the opioid overdose crisis. The Conversation. https://theconversation.com/decriminalizing-drug-use-is-a-necessary-step-but-it-wont-end-the-opioid-overdose-crisis-162497
Moraff, C., Farah, T., & Siegel Z. (2020, February 28). Dead people don’t recover – The importance of safe supply with Mark Tyndall (No. 38) [Audio podcast episode]. In Narcotica. https://podcasts.google.com/feed/aHR0cHM6Ly9uYXJjb2Nhc3QuY29tL2ZlZWQvcG9kY2FzdC8/episode/aHR0cHM6Ly9uYXJjb2Nhc3QuY29tLz9wPTE1MjI?sa=X&ved=2ahUKEwirssvs2eTsAhXkczABHfOYDVQQkfYCegQIARAF
Pierre, L. (2019, November). Decolonizing substance use & addiction [Video]. TED. https://www.ted.com/talks/len_pierre_decolonizing_substance_use_addiction