An exploration of Canada’s municipal attempts at harm reduction, and lessons we can learn from other nations
Ariana Zumaran Castillo (she/her) // Contributor
Scarlett Side // Contributing Illustrator
Around seven people in British Columbia lose their lives every day to drug overdoses, indicates BC Gov News.
It is undeniable that this has been a long-standing issue in B.C. over the years, and of course, the question that arises is why is it not stopping if the province is making huge efforts. According to the webpage of The City of Vancouver, Vancouver is the only city in North America to offer safe injection sites supervised by health professionals, where clean needles prevent needle-sharing and blood contamination which can lead to HIV outbreaks. On the other hand, there is the issue of fentanyl (the strongest opioid on the market, 100 times stronger than opioids like heroin) having started a crisis of accidental overdoses by contaminating other drug supplies. In B.C., people who have attempted and failed at recovery multiple times have access to safe prescriptions from health professionals to access opioids that are confirmed to not be laced with fentanyl. It is also important to note drug users are not persecuted by the law anymore, allowing them to seek professional and governmental help. These measures sound good in theory, but some gaps occur in practice.
Safe opioid prescriptions often end up in users selling the substance on the streets and using the money to buy the fentanyl they were aiming to get from the start, states the Vancouver Police Department. They call this strategy “diversion” and they calculate that half of overdoses caused by morphine (and drugs of the same family) have been caused by a “safe batch” initially provided by the government. Decriminalization also struggles to address issues as the police’s only authorized intervention is to recommend detox resources by request.
On top of it all, detox centers are only available after weeks of waitlist which requires users to start detoxing on their own and calling the center daily to secure their spot. This leads to the question of what is the demographic of people who have the resources to seek help, because it seems only open to people who can access a support system, a cell phone and shelter to stay away from drug-present spaces. The socio-economic class also determines who is affected by how the law transforms around this topic. “Decriminalisation will always exist for the upper class. When someone has enough money to snort cocaine in the privacy of their own home, the police are never going to get them,” saysBrittany Graham of the Vancouver Area Network of Drug Users. Lack of economic resources may even be among the reasons why drug usage is prevalent in the first place: “[…]Fundamentally, Vancouver or the Lower Mainland is generally a really hard place to live in. Costs of living are so high. […] Ultimately until there is a solution to give individuals a solid foundation, I don’t believe we will see a solution in the near future” says Brandon Chow, a psychology student at Capilano University.
Maybe the answer can be in imitating what has given results already.
Portugal was once at the same place B.C. is right now. Lisbon in the 1980s and 1990s used to be known as the “drug capital” of Europe with one in 100 people being addicted to heroin, according to The Guardian. After they implemented their own harm reduction measures, this number decreased by 75 per cent and Portugal one of the countries with the least incidences of drug-related deaths and HIV infections.
The American Addiction Centers webpage indicates that what the government did to achieve this, is understanding three concepts. “Soft” or “hard” labels for drugs did not matter as much as the relationship an individual has with the drugs, consumers recur to drugs as an escape from an already existing struggle and that drug use is impossible to be fully eliminated. People who are found to be in possession of drugs in Portugal are investigated by public health workers and psychologists to reach an imperative and personalized treatment. If the person is not found in possession of drugs in the next six months, they can be released with no charge. Volunteer therapists also go to the streets to offer resources like clean syringes and psychological support. A key element is that detox is not a requirement to receive treatment. The main focus is the root of why drug users started consuming in the first place.
Changes in law were inherently linked with changes in the culture and how society itself views drugs. The approach of Portugal is founded on not seeing drug usage as the problem, but rather seeing it as the byproduct of human suffering, which is what has moved the government to help no matter the stage that a person is in their healing process.
While others may claim getting rid of criminalization is the way to go, there are a few consequences to be considered. Seeking psychological help would mean risking going to jail. HIV statistics would likely rise again as access to clean syringes would no longer be available. Accidental overdoses from unexpected mixed-in substances would be impossible to prevent with no drug-checking facilities. Most importantly, countries ranked by the Pan American Health Association as highly burdened by drug use do not necessarily follow a trend of criminalizing drugs or not. The law might just be a piece of a bigger puzzle that requires a collaboration between the realms of society, culture, economy and public health.