British Columbia·Opinion

And the band played on: Overdoses, death and a resistance to change

The head of B.C.'s drug policy coalition says legally regulating drugs like fentanyl is the only way to stop deaths.

Head of drug policy coalition shares his views in series, The Fentanyl Fix, solutions to B.C's overdose crisis

Donald MacPherson is the executive director of the Canadian Drug Policy Coalition. (Canadian Drug Policy Coalition)

In 1987, Randy Shilts published a book called And the Band Played On: Politics, People and the AIDS Epidemic.

His reference to the musicians who continued playing on the deck of the Titanic as the ship went down referenced a business as usual approach to an extraordinary problem that he saw during the early stages of the AIDS crisis in the 1980's.

In 2017, another band plays on while a deadly epidemic of overdose deaths is being allowed to continue in Canada.

This one is killing and maiming thousands of Canadian citizens, accidentally poisoned by drugs purchased from the illegal drug market.

And it results from governments refusing to find the courage to change the way we respond to illegal drugs. Last year, more than 2,000 people died in Canada from these drugs.

Not a new problem

And this is not the first time we've seen this. In 1994, Vince Cain, British Columbia's chief coroner, called for the reallocation of government funds from the criminal justice system to the health system to address the overdose epidemic.

A man pulls a small wagon down a Downtown Eastside alley in Vancouver. (Rafferty Baker/CBC)

He also called for decriminalization of all drugs and, if necessary, the consideration of legal regulation of currently illegal drugs in order to build a public health response to stop the deaths that were devastating so many families in B.C. in the 90's.  

What happened? Cain's report was shelved. Other approaches were not considered.

And the band played on.

Radical and risky to stay the course

Now, as British Columbia, Alberta and Ontario experience far worse death rates than in the 1990s, we echo his words — it's time to consider a legal and regulated system for controlling currently illegal drugs.

Many will see this as far too radical and risky, thinking a better version of drug prohibition will actually take drugs off the streets and protect youth. We think the evidence is in — prohibition is a bust.

Prohibition has created a complex and diversified system of production and distribution of drugs to consumers 24/7 in communities across the country.

Drug dealers don't ask for ID; prohibition does not protect our youth. It exposes them to a wide range of harmful substances and unregulated dealers from an early age.

The radical and risky action in this case is to stay the course.

Prohibition creates toxic choices

Here's the thing: the presence of illegally produced or imported fentanyl, which is implicated in over 60 per cent of the overdose deaths in British Columbia, is a logical outcome of drug prohibition — the policy framework that underlies Canada's approach to drug control.

Prohibition favours highly concentrated substances that are difficult to detect — the more powerful the better.

During alcohol prohibition, it was hard alcohol that prevailed — wine and beer disappeared. When opium was prohibited, powdered heroin became the product of choice.

Fentanyl is the most toxic product on today's illegal drug market and it's here to stay.

In some ways, we have a simple choice — after 100 years of having the likes of the Hells Angels and outlaw gangs organize and control the availability of drugs to our communities, shouldn't we try another approach?

Our thinking must evolve

We, as a society, make dramatic changes as our thinking evolves on social issues.  

In 2005, Canada enacted the Civil Marriage Act, which allowed same sex marriage, becoming only the fourth country in the world at the time to forge this path. We now also support certain individuals in deciding when to end their lives with the support of physicians.

These are big shifts in social policy. Now, it's time for a new paradigm when it comes to drugs.

For people who use drugs, a safe supply is life or death.

Some governments are working hard to respond to the current crisis.

Yet, no government is thinking outside of the box. No government has called for an end to the policy that has created this mess. No government has considered a safer supply of drugs for people who need them in order to eliminate the deadly illegal market.

As with AIDS, governments are allowing this health crisis to continue by refusing to consider alternative approaches. As Einstein said, doing the same thing over and over again expecting a different result is the definition of insanity.

And the band played on.

This story is part of CBC.'s Opinion content. For more information, please read this editor's blog and our FAQ.

Donald MacPherson is the executive director of the Canadian Drug Policy Coalition at Simon Fraser University.