UPDATE: Given the recent legal change where adults in B.C. are no longer subject to criminal charges for the personal possession of small amounts of certain illegal drugs I have re-visited my blog from a year ago, thankful that some progress has been made on assessing the effectiveness of our drug rehabilitation programmes.
I was once asked to run politically in a South Okanagan federal riding. The idea was appealing but we moved away soon after and the opportunity disappeared. I sometimes wonder how such a bid might have gone. After recent local and national leaders’ debates, and having facilitated such local riding debates in the past, I am not sure how I might have fared. I am rather imaginative in speaking though not so good at following party lines. More relevant is that I get nervous which things get contentious.
I wonder how might I have dealt with volatile issues such as the management of the Opioid Crisis and related homelessness issues in Kamloops and in most cities and towns throughout British Columbia. Addiction response here features only minimally in our present federal election campaign. “Most of Canada’s main federal parties have voiced support during the election campaign for removing criminal penalties for simple drug possession and offering safer alternatives to street-level drugs as overdose deaths reach record-high levels across the country. While no party has made the overdose crisis a focus, the NDP and Greens have included decriminalization and safe supply in their platforms. The Liberals have not, with leader Justin Trudeau only saying that his government would work with community partners interested in those actions.” (1)
The matter of decriminalization is significant as but one piece of a multi-stage process of rehabilitation. Amidst some abstinence-based programmes here in BC we tend to focus on harm reduction as a health engagement and physical support strategy. Such a strategy seeks to engage victims of drug dependency where they presently are. Such engagement initiates a process which moves participants through multiple experiences — a healthier user environment; increased connection with medical and social services; progression towards more secure and stable housing; progression into a sometimes-lengthy and expensive process of rehabilitation; movement into entry-level employment and more independent living; and finally, towards secure employment, deeper social participation and in some cases, public leadership roles. It is a long and difficult road for sure.
For some, such a process is simply too long, too unpredictable, too complicated and endlessly resource consuming. Such folks say, “lock them up, keep them off the property, give us back our streets.” To be clear, I hear the real frustrations of business owners and residents who no longer think parts of our cities are safe to visit, safe to walk through and work day after day. I share some of these fears myself. The truth however is that the so-called war on drugs has not worked, here or elsewhere (2). Filling our jails with folks charged with simple possession will create more hardened and repeat offenders. Sure we could adopt the violent policies of Singapore or China, though I would certainly not be willing to live under such controlling regimes. We need to do something different and now.
The chief obstacle to success here is not as some suggest the attitude and motivation of the person, but the invasion of an increasingly influential criminal element which exploits vulnerable persons for their own enrichment and sometimes to feed their own abusing habits. What we now experience on the streets of Kamloops, Victoria and Prince George is a mix of vulnerable persons who genuinely wish to get better and to do better with what they are offered, and a more volatile and dangerous criminal element which is simply out to create chemical dependencies through provision of an increasingly dangerous supply of illegal drugs all with malicious intent. Safer supply, reduction of stigma, and decriminalization of drug possession will reduce the influence of drug traffickers. So why are we not doing this here? Is it just our prejudice and the stigma associated with drug abuse, a stigma which could and has been directed towards alcohol abuse in the past. Possibly we simply lack the courage and political will to do something different. Possibly we need a model, and that we have, in Portugal. (3)
Portugal is widely considered to be the best-in-class national drug treatment and response system worldwide. In Portugal drug addiction rarely kills anyone; fewer than thirty people die annually. “There is still drug abuse in Portugal but not the misery and not the death. Progressive public policy has turned around a disaster. In 2001, Portugal decriminalized the personal possession of all drugs as part of a wider re-orientation of policy towards a health-led approach. As a result drug-related deaths have remained below the EU average since 2001; The proportion of prisoners sentenced for drugs has fallen from 40% to 15%; rates of drug use have remained consistently below the EU average.” (4)
Concerning harm-reduction itself Toronto-based Emma Woolley explains what she does and why she believes it’s effective: “Frequently, I’m asked if I think what I’m doing “enables” people to use drugs – insinuating that harm reduction increases drug use or makes it “worse” – and just perpetuates the issue. I find these kinds of questions come from a perspective in which all drug use is labelled “bad” and in which it is my job to ensure someone stops using – and this simply isn’t what harm reduction is about . . . Harm reduction approaches are used on a daily basis by the general population: hand washing, seat belts in cars, crosswalks and bike helmets. So you can think of it as an approach that acknowledges that people do and will use drugs, and so instead focuses on limiting potential consequences.” (5)
A few weeks ago someone thrust a petition into my hand demanding that “government do something about people on the streets.” My unwelcome response was that something is indeed being done; we differ however on the strategy. Our response as government, health care professionals, enforcement officers, spiritual care providers, the business community, media and residents must continue wrestle, now, to find a solution. Ideas and practices must be researched, tested, reality-checked and evidentially supported. There are no simple fixes here. There is simply a lingering problem which has grown in size rapidly and in complexity. It is no longer confined to larger urban centres; it is right her and right now. Time to roll up our sleeves (!) and do things differently.
1 How the political parties are addressing Canada’s overdose crisis https://www.cbc.ca/news/canada/calgary/federal-election-opioid-drugs-crisis-1.6171434
2 After 50 years of the war on drugs https://www.npr.org/2021/06/17/1006495476/after-50-years-of-the-war-on-drugs-what-good-is-it-doing-for-us
3 How Portugal Successfully Tackled Its Drug Crisis: Does the answer to B.C.’s overdose crisis lie in Portugal? – Chris Brown, CBC The National, special feature https://www.youtube.com/watch?v=uQJ7n-JpcCk
4 Transform Drug Policy Foundation: What you need to know https://transformdrugs.org/blog/drug-decriminalisation-in-portugal-setting-the-record-straight
5 Is harm reduction an appropriate response to addictions? Emma Woolley, Research Assistant Canadian Observatory on Homelessness/Homeless Hub: York University https://www.homelesshub.ca/blog/harm-reduction-appropriate-response-addictions
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