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Drug treatment debate heats up

 

Across Canada, how best to approach drug abuse and its societal effects varies from person to person and province to province. But with increased addiction driving an increase in random acts of violence around the country, Canadians on both sides of the violence deserve an approach that works. Photo credit: Sandy Hill Community Health Centre

 

It is a sad fact that once any issue becomes highly politicized, facts go out the window. That has certainly been true for the current debate in Canada over how to treat drug addicts who are increasingly committing violent and seemingly random crimes against ordinary citizens. 

There have always been drug addicts committing crimes and likely always will be, but the sheer volume of these events and the fact they are imperiling average people just trying to go about their daily business has understandably raised the profile of this issue in political circles. The reality that new, more addictive and more deadly drugs have entered the scene further complicates an already difficult situation. 

To date, more left-leaning governments have favoured a harm reduction approach. This used to mean having safe injection facilities, sites where drug addicts could obtain clean needles and take the drugs they brought with them in an environment where, if they overdosed, medical personnel were on-site to save their lives. 

These sites were controversial enough, with opponents claiming that such facilities encouraged drug use and brought crime to surrounding communities. Supporters say they save lives and can help addicts get exposed to social programs that can assist with their addictions. The evidence is mixed as to whether such sites have an overall positive impact or not. 

More recently, the concept of “safe supply” has been introduced – notably in British Columbia – in which the government provides “safe” drugs to addicts to reduce deaths from street drugs that often contain deadly ingredients such as fentanyl. BC also appealed to the federal government last year to decriminalize possession of some hard drugs for personal use such as heroin, fentanyl, morphine and cocaine in an attempt to reduce the shame and fear associated with substance abuse, and the federal government agreed. Debate over how effective these drug strategies have been has blown up recently in the House of Commons and in the run-up to the Alberta election. 

The federal Liberal government continues to vehemently support their approach of harm reduction and the provision of safe supply, despite the data that indicate deaths from drugs have increased every year in BC, which continues to be a test case for these types of policies. Currently, it is estimated that seven deaths occur daily in BC from drug-related causes. Federal Liberal Minister Carolyn Bennett continues to claim that without these policies there would be even more deaths, but that is difficult to support considering that deaths continue to climb year after year compared to periods prior to the enactment of harm reduction and safe supply policies.  

It has also been shown that the free “safe” drugs provided by the government, usually opioids, are frequently sold on the street in order for addicts to obtain stronger, illegal fentanyl, which is a major cause of drug overdoses and deaths. The increase in safe supply-provided opioids has led to a 90 per cent reduction in the drug’s cost on the street, such that the government is effectively responsible for a massive reduction in drug costs and increased availability. Needless to say, this is not exactly the outcome any government drug reduction policy should be trying to accomplish. 

Alberta has taken a very different approach, with a focus on recovery from drug addiction, not facilitating further drug use. In the last couple of years, drug deaths have been declining in Alberta while increasing in BC, seemingly lending support to Alberta’s focus on recovery approach. But the evidence is still slim to date as to which method has the best results as there has not been enough experience with either approach to be conclusive. 

International experience shows that Portugal is often cited as having a relatively successful approach to drug addiction, after being cited as Europe’s worst country for drug addiction and deaths. Portugal has pursued a combined policy of decriminalization coupled with an intense focus on treatment and rehabilitation. 

In other words, while Liberals and Conservatives in Canada fight over the two different visions for helping drug users and reducing the resulting crime from drug addiction, the solution appears to be a balanced combination of the two approaches in which addicts are not viewed as criminals but are directed quickly into treatment. Portugal has also had success with a country-wide approach where people were treated the same throughout the country, whereas Canada has a patchwork of different policies in various cities and provinces. 

The fact that so many Canadians have been alarmed by the growing number of incidents of random violence, much of which is driven by substance abuse and resulting mental illness, ensures that this issue will be front and centre in the next federal election, as well as upcoming provincial elections. Looking at local and international experience to date, it seems the best solution would be for all political parties to abandon their partisan biases and pursue solutions that have been proven to work. We can only hope.  

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