We need evidence based solutions for opioid crisis

A bottle with a hydrocodone (the generic name for drug sold under other names by various pharmaceutical companies) label and hydrocodone tablets spilling out isolated on white background. Hydrocodone is a popular prescription semi-synthetic opioid that is used to treat moderate to severe pain. Hydrocodone is said to be one of the most common recreational prescription drugs in America.

Our political parties have become increasingly polarized.  We are a point in history where the opposition will reject legislation and policies that are clearly in the best interests of the country simply because it is a different party putting the idea forward.

It is uplifting and opens the door to hope when a bill like the Good Samaritan Drug Overdose Act is embraced by all sides of the House.  Bill C-224 provides immunity from prosecution for anyone calling 911 to save the life of someone who has overdosed.  Sponsored by Bill McKinnon, Liberal MP for Coquitlam-Port Coquitlam BC, members of all three parties spoke to endorse the Bill and its underlying purpose, that being the reduction of overdose deaths.

It is notable how far the Conservatives have shifted in the wake of the opioid crisis now afflicting Canada.  Bill C-2, oddly named the “Respect for Communities Act”, introduced in 2014 by Rona Ambrose, then Minister of Health in the Harper cabinet, became law in 2015.  This act ostensibly sought to get community agreement before any safe injection site could be opened or could continue to function. It was touted as a victory for the not-in-my-back-yard contingent.  In reality, this thinly veiled attack on Vancouver’s Insite and other safe-injection facilities, was an attempt at an end-run around the 2011 Supreme Court ruling “in which the court found that supervised injection sites have been proven to save lives and that the health minister’s failure to provide an exemption was in violation of drug users’ constitutional rights to life and security of the person.”

The Harper government was not known for being supportive of harm reduction.  Health Minister Ambrose said, “I’m not interested in having a debate about harm reduction … the larger debate that I’m trying to have is to put some focus — not just on Insite, which is controversial and one small part of the overall harm reduction — but let’s also talk about harm elimination.”  In this context, harm elimination appeared to mean jailing addicts and shutting down facilities where addicts could be safe and would have points of contact with health care and social services personnel.

Indeed, Harper’s personal war on drugs was, from the outset, a war on drug users.  Although it may be deeply satisfying to punish those who won’t do as they are told and just stop using drugs, addiction is far more complicated than that.  While it may seem counter-intuitive, relaxing drug laws and treating addiction as a health issue rather than a legal issue, has shown very positive results in Portugal.  Canada is not there yet, although Bill C-224 and the work currently being done to legalise marijuana for recreational use in Canada are both steps in the right direction.  C-224, the Good Samaritan Drug Overdose Act, became law in Canada earlier this May.  A women-only safe injection site, SisterSpace, just opened in Vancouver’s Lower East Side to give female drug users a safer space to inject and seek medical care and support.  These are small steps, but they are backed by empirical evidence and best practices that show such programs reduce deaths in this vulnerable population.  Calls to decriminalise and eventually legalise all drugs in Canada are becoming more common.  And there is a sound argument for this.  Donald MacPherson, executive director of the Canadian Drug Policy Coalition, points out that the market for drugs is not going to go away.  In the absence of regulation and control (which can only be put in place through legalisation) people will continue to buy drugs from criminal organisations and they will continue to die from consuming tainted or unknown substances.

As the death toll in Canada from overdoses on fentanyl, carfentenil, and other opioids rises, MPs from all parties are no doubt experiencing pressure from constituents to DO SOMETHING.  Statistics on overdose deaths across Canada are unavailable, but 922 people died in BC alone in 2016, and another 227 British Columbians died in January and February of 2017.  In Alberta, 343 people died from Fentanyl overdose.  Provinces are rolling out programs to make the Naloxone antidote to overdose available to police and community service organisations, and to also make it available to vulnerable people without a prescription.  It is not enough, but it is a start.

Canadians tend to be cautious, particularly about big, sweeping changes.  The glacial pace of the legalisation of marijuana reflects the political need to address the many challenges raised by those who do not want this legal change to happen.  We know prohibition is not working, not with marijuana, and not with opioids.  We know that a criminal justice “solution” disproportionately harms marginal and vulnerable communities.  We know that the criminality of drug use is a barrier to people seeking help with their addictions.  We can see evidence in other jurisdictions that a health care based approach has been successful.  This is an issue that is taking Canadian lives every day across the country, and not just in economically disadvantaged inner city areas.  Overdose deaths are occurring in the suburbs, in rural Canada, and across all ages and socio-economic groups.  It is time Canadians began to think and talk about why we resist trying a different approach, when the current one is so clearly failing.  We need, as a society, to work through which concerns are valid and which are based on ideology and bias.  We need to let our MPs know that this is a pressing issue, that Canadians want to see real debate and discussion of evidence-driven solutions.  Political will is influenced by the will of the public.  The success of Bill C-224 shows that our government and opposition can work together, if pushed sufficiently hard.

More from Norlaine Thomas.

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