Punitive Drug Policies Are Costing Lives

Provincial governments should prioritize harm reduction policies to prevent further drug overdoses.

Photo Credit: REUTERS / Jesse Winter

By Tomo Wakiyama Newton

THE OPIOID EPIDEMIC HAS SWEPT across Canada in the past decade. Almost every Canadian knows someone who has been affected by this epidemic, leaving many wondering how we got here.

More than 30,000 Canadians who use drugs have died from opioid overdose in the last eight years, with the majority of them being young adults. Eighty-five percent involved fentanyl contamination. People are being denied life-saving services, we are now amid a national crisis, and our communities cannot withstand more loss. Inadequate drug policies have led us here and - now is the time to collectively reassess and reimagine a societal solution. 

Current drug policies in Canada are rooted in prohibition and punishment. Under the Controlled Drugs and Substances Act, adopted in 1996, anyone found seeking to obtain or in possession of illegal substances is subject to fines and imprisonment. However, the system is skewed, and the costs are tremendous. People of colour, people living in poverty, and people with mental health illnesses are over policed and more likely to be incarcerated than their counterparts, with Black and Indigenous people drastically overrepresented in the prison system. In addition, the financial costs of incarceration are astronomical; in 2017, the overall cost of the criminal justice system (policing, courts and correctional services) amounted to 944.9 million dollars. Policies of prohibition and punishment perpetuate cycles of oppression and economic loss. Rising rates of overdoses are ringing alarm bells that our society cannot endure these regressive policies any longer. 

Furthermore, prohibition and punishment of drug-related activities creates a thriving black market of unregulated, tainted drugs that hurt and kill unsuspecting users. Fentanyl, a synthetic opioid pain reliever, is cheap to manufacture and undetectable, incentivizing dealers to lace milder products with the potent drug. Fentanyl is 20-40 times stronger than heroin, and carfentanil, its close relative, is 100 times stronger than fentanyl. A few grains of either can be fatal, but without product regulation users are forced to consume unreliable supplies of drugs. People who use drugs are faced with the inescapable and exacerbated risk of overdose. 

Marginalized communities are hit the hardest by the consequences of poor drug policies. Indigenous people in BC and Alberta are five times more likely to overdose on opioids and three more times likely to die from them. Houselessness and housing instability was reported by 30 percent of patients in a study of 1,261 emergency department cases in BC. Drug possession, a low-level offence, accounted for 73 percent of drug arrests in 2016, indicating that users (and not dealers) are bearing the brunt of legal repercussions, increasing their risk of relapse and reinforcing their underprivileged circumstances. Policies of prohibition and punishment pretend to protect vulnerable populations, but ultimately prey on them instead. 

It’s clear that our current drug policies are harming the very people they should be helping, and a serious commitment to harm reduction is urgently needed to counteract the risks involved with using drugs. 

Harm reduction as a philosophy, practice, and policy provides a solution to the overdose crisis by putting people first and punishment last. We employ harm reduction practices in our everyday lives when we protect ourselves from potential injury with helmets, seatbelts, and oven mitts, and the same precautionary approach can apply in the realm of illicit drugs. Harm reduction as an approach to illicit drugs encompasses anything that will minimize the risk of harm to the user: clean syringes, naloxone kits, sterile injection equipment, a legal and reliable supply of drugs and holistic support services. Harm reduction policies prevent overdose deaths, minimize the spread of infectious diseases and improve the quality of life for people who use drugs. It is essentially where evidence and reality meet. 

Specific harm reduction policies and practices vary according to the differing needs of communities that use drugs, but the objectives are universal: to humanize, support and empower people who use drugs with dignity, health and autonomy. To insist on the eradication of drugs is futile; humans have consumed mood and mind-altering substances for as long as we have existed. It is the damage and death caused by consumption that we can curtail with harm reduction policies.

A large-scale enactment of harm reduction policy is decriminalization and legal regulation of illicit drugs. Decriminalization nullifies legal repercussions of consumption. Legal regulation facilitates the acquisition of drugs. Legal regulation would guarantee reliable and quality-controlled products to meet the needs of drug users, just as antidepressants and insulin are prescribed to address the needs of a client with depression or diabetes. This facet of harm reduction calls for a complete transformation of drug laws and policies, requiring the coordinated action of various policy makers, strategies, systems of implementation and communities. 

Paving the road for these changes can start with smaller-scale and equally significant acts of harm reduction. Safe injection sites, also known as safe consumption sites, mitigate the risks of drug use by providing people the resources and space to use drugs in a clean, calm, and judgement-free manner. The fear and shame created by current policies cause many people to use alone, in the shadows of urban spaces or behind closed doors with unsanitary equipment. This reduces their chances of receiving aid in the case of overdose and increases risk of infection. Safe injection sites prevent overdose deaths and reduce the spread of infections through safe drug practices. 

Montreal currently has four safe injection sites in operation, Vancouver has two and several more are scattered across the country. Vancouver’s Insite was the first safe injection site to open in North America and has been in service since 2003. Insite service providers have intervened in more than 6,440 overdoses. In other words, they have saved 6,440 lives. With the increasing strength and unpredictability of street drugs, there is a clear need for more safe injection sites.

Harm reduction can further be utilized through universalized training and access to naloxone, a drug that immediately reverses the effects of an overdose. While naloxone is used frequently by first-responders, we need to normalize the possession and administration of it so everyday civilians are equipped to respond to overdose emergencies. Naloxone should be a household essential. 

Harm reduction also encompasses the provision of holistic care and services. Drug use is often compounded by hardships such as houselessness and discrimination. Ensuring dignity and quality of life means addressing these disadvantages with subsidized housing, food and clothing services, judgement-free counselling and mental health support, employment programs and culturally sensitive approaches to harm reduction. 

Lastly, to reduce harm we need to demystify, destigmatize and neutralize the conversation around drug use.  The punitive system legally strips people who use drugs of their humanity and dignity, but stigma does this socially. We need to recognize and respect people who use drugs as people with a breadth of stories, complexities, skills and dreams. Their lived experiences qualify their expertise in identifying drug policies that will best serve them and it is the duty of policymakers to include the intended beneficiaries in the conversation. 

Outdated practices of punishment are costing thousands of lives and millions of dollars. They are alienating cherished members of society and endangering their lives. It’s time to admit the failings of our short-sighted strategies and develop policies that save lives and serve society. We can do this by employing practices of harm reduction.

Tomo Wakiyama Newton (she/they) is a Master’s of Public Policy candidate at the Max Bell School and founder of a solidarity organization that cooks for shelters in Tiohtià:ke/Montreal called Community Cooks Collective. Their interests include harm reduction, restorative justice, food security and community organizing.