The problem with the provincial health officer’s special report recommending decriminalization of all illicit drug users is that Dr. Bonnie Henry chose to make that her only recommendation.
Three years after a public health emergency was declared because of an epidemic of deaths from illicit opioids, B.C. still has no comprehensive addictions strategy.
It has a stunning lack of treatment services, no universal access to services, no simple pathway to what few services there are, no provincial standards or regulation of privately operated treatment and recovery homes services.
Government ministries such as health, mental health and addictions services, social development and housing remain siloed and the root causes of addiction remain largely unaddressed.
While there has been substantial investment in harm-reduction measures including overdose prevention sites, free naloxone kits (to reverse an opioid overdose), low-barrier shelters and poverty reduction, the needs are greater.
Overdose deaths have only hit a plateau – not dropped. Every day, four people British Columbians die.
Yet, Henry is adamant that decriminalization is the most important next step.
“It’s about a focus and an intent,” she said. “Instead of police focusing on requirement of the Criminal Code, it builds off-ramps to connect with services. And, that in itself, ensures those systems are built.”
The majority of those who have died of overdoses were young men using alone at home. Without fear of being arrested and with the stigma of addiction being reduced, the expectation is that addicts or recreational users would be more likely to go to a supervised injection site, use with a friend (with a naloxone kit at the ready) or call for help if they overdose.
Henry calls decriminalization “a necessary next step to stop the death toll from rising and to make harm-reduction services more readily available.”
But it’s a question whether those recreational users would do that, because many addicts say that they use alone for a variety of reasons — not least of which is that they don’t want to share their drugs or they don’t want anyone to know what they do when they’re high.
The report recommended two options for British Columbia to work around the Criminal Code provisions.
Solicitor General Mike Farnworth firmly and quickly said no to both. But he noted there are pilot projects in Vancouver, Abbotsford and Vernon where rather than charging for possession, police are linking users with services. An evaluation of those will be completed in the fall and, depending on the results, they may be expended to other communities.
Henry makes no secret of the fact that her ultimate goals for Canada are full legalization and regulation of all drugs to ensure that there is a safe supply. If that were to happen, Canada would be the first in the world to do that.
Portugal is mentioned frequently in the report and by Henry. Possession for personal use was decriminalized more than 20 years ago. But it was done only as part of a comprehensive, drug strategy.
Police still arrest anyone found with illicit drugs. They are taken to a police station where the drugs are weighed. If the amount is above the maximum limit set for personal use, they are charged and go through the criminal justice system.
If the amount is below the limit, tickets are issued and users told to appear at the Commission for the Dissuasion of Drug Use within 24 hours. There, they meet with a social worker or counsellor before going before a three-person tribunal, which recommends a plan for treatment.
People don’t have to comply. But if they are arrested again, the commission can impose community service, require that they seek treatment, impose fines and even confiscate people’s property to pay those fines.
That’s not the kind of decriminalization Henry is recommending. Instead, the onus here would be on police officers – not trained addictions specialists, psychologists or social workers — to connect users with services.
Part of the reason for the difference is that Portugal’s goal wasn’t legalization or keeping addicts alive until they chose to go treatment. Its focus was and is on getting addicts into treatment and recovery so they could resume their place in society.
Harm reduction is only a small part of the Portuguese plan. Its first supervised injection site has only recently opened. But there is free and easy access to methadone (which dampens heroin addicts’ craving for the drug) and free needles to stop the spread of infection.
These harm reduction measures are deemed to temporary bridges to abstinence for all but older, hardcore, long-term heroin users rather than long-term solutions. Of course, fentanyl and carfentanil have yet to be found in its illicit drug supply.
Its treatment services as extensive and include everything from outpatient treatment to three years’ residency in a therapeutic community during which time the users’ families are provided with income supplements.
Nothing in this decriminalization report moves British Columbia anywhere close to that kind of comprehensive system. And until we get there, it’s hard to imagine that this overdose crisis ending anytime soon.