Decriminalization yet another 'half measure' as B.C. confronts full-sized drug crisis, advocates say
Chief coroner says ideological shift needed away from believing we have to 'harm' drug users to help
More than six years and 10,000 deaths since the declaration of a public health emergency over the tainted illicit drug supply, B.C. remains a land of pilot projects and what many describe as "half measures."
Safer supply is still only available to a small fraction of people who use drugs. Most supervised consumption sites still don't allow smoking, even though inhalation is responsible for the majority of deaths.
Meanwhile, wait times for treatment and recovery beds are long, and there's still no provincial regulation ensuring facilities are using evidence-based methods and employing qualified staff.
On Tuesday, British Columbia adds decriminalization to that list, with the launch of a three-year pilot project allowing personal possession of very small amounts of certain drugs — much less than what the province and advocates had recommended.
Chief coroner Lisa Lapointe, one of B.C.'s most uncompromising voices for bold measures to end the crisis, describes the decriminalization pilot as "a really important first step."
But she said if we really want to save lives, what's needed is a complete ideological shift away from seeing police, the courts and punitive treatments as the solution.
"For decades, the goal has been to deter people from using drugs by harming them — let's harm them as much as we can, and that will stop them from using," Lapointe told CBC News.
That approach, she said, has clearly failed.
"What we have now are thousands of hurt people and thousands of people who have died."
The goal needs to shift to helping people who use drugs, she said.
That's a point of view shared by drug users and advocates, who say they're sick of watching as governments in Victoria and Ottawa take baby steps to fight a monster of a problem.
"Drug policy … is politicized and used as a way to score political points across political parties, and the people who are struggling and suffering and dying from this drug supply are really being abandoned," B.C. Green Party Leader Sonia Furstenau said.
In her mind, decriminalization is emblematic of this problem — "not even a half measure."
That language was echoed by the HIV Legal Network, which issued a press release Monday warning "half measures and stop-gap fixes will not end the crisis that drug prohibition has created."
During a press conference on Monday, B.C. Minister of Mental Health and Addictions Jennifer Whiteside acknowledged the decriminalization pilot alone won't fix the problem.
"We know there's more to do and we won't stop working until we turn the tide on this crisis," she said.
'There is not wide access to safer supply'
Katt Cadieux of Prince George's United Northern Drug Users described the 2.5-gram threshold as "ridiculous." B.C. had asked for a limit of 4.5 grams, which many advocates already believed was too low.
Cadieux said 2.5 grams doesn't meet the daily needs of many people who use drugs, and it also creates additional costs, since it's usually cheaper to buy in bulk.
The limit also doesn't take into account people who live in rural areas, often far from the cities where they buy their drugs.
"People who are rural and remote … they need to pick up a larger quantity so that they can go back home and spread it out," Cadieux said.
But the really big issue in the north, she said, is the fact that the vast majority of drug users don't have access to a regulated, safe supply of drugs. Just a small number of doctors in Prince George will prescribe alternatives to street drugs, according to Cadieux.
"I know 30 people off the top of my head that would love to start safer supply, but can't," she said.
Exact numbers are hard to come by, but according to Lapointe, safer supply is only available to "a small portion" of the estimated 74,000 people with diagnosed opioid-use disorders in B.C. and the countless others who use drugs.
And yet the perception across Canada is that safe supply is widely available in B.C. Some have even suggested it's so easy to access that it's contributing to the relentless death toll.
Lapointe says those impressions are completely false.
"There is not wide access to safer supply and it is absolutely not driving this crisis. We watch that very, very carefully," she said.
She says the results from a pair of small federally funded pilot projects in Vancouver and Victoria, providing pharmaceutical-grade options like fentanyl patches to around 300 people, suggest safer supply can make a huge difference in people's lives.
"They are stabilized, they don't have to seek their drugs and they don't have to use their minimal money that they have to try to subsist day by day to buy drugs," Lapointe said.
She wants the public to understand that safe supply isn't being recommended in opposition to addiction treatment. It's meant to protect people from a poisoned, unregulated drug supply, and ensure that if they want to seek treatment, they will still be alive to do so.
Dying for treatment
But accessing evidence-based treatment is also an issue in B.C.
"There are people who are waiting weeks or months for treatment and recovery. There are people who are dying while they're waiting for treatment recovery services," Lapointe said.
The B.C. Ministry of Mental Health and Addictions' doesn't collect data on average wait times to access treatment, but figuring out how to do so is one of the goals for this year, according to its current service plan.
Vancouver advocate Karen Ward pointed out this information gap on Twitter, writing, "How is it okay for the government that funds these services not to know this?"
Meanwhile, the province still hasn't followed through on an urgent recommendation from a 2018 B.C. Coroners Service death review panel to regulate the treatment industry.
Lapointe said the failure to regulate sometimes leads to treatment that can be so expensive families have to take out second mortgages to help their loved ones. It also means the industry is still dominated by treatment programs that require complete abstinence, in part because many still follow the principles of the 12 steps of Alcoholics Anonymous.
"Abstinence-based treatment has been proven to be very, very challenging because we know many, many people die following a period of abstinence," she said.
Watch | Chief coroner disappointed that crisis 'almost doesn't matter' to many in B.C.
To get through this crisis, Lapointe says B.C. needs to follow through on a recommendation from the most recent death review panel, which called for a collaborative response and plan of attack developed in cooperation between the health authorities and various ministries.
"We have not seen that response to date."