British Columbia’s Drug Decriminalization: A Drastic Measure or a Drop in the Bucket?
It was August of 2022, and after a long day of exploring downtown Toronto with my cousin, we were about to pull into the parking lot of her apartment building. There on the sidewalk, a man was lying completely motionless. I don’t remember very much of what happened after that, except that my aunt and I ran to the nearest women’s shelter, about two blocks away, where a woman gave us Narcan and hurried instructions. The woman may have come back with us, or maybe we went back a second time to ask for help. Someone must have called 911 and maybe there was an ambulance, or maybe there wasn’t. At one point, we found a woman lying behind a shed. About a minute after a dose of Narcan, she was on her feet. I don’t think she said anything, but I do remember her face, pallid and gray.
As a 16 year old girl who had always lived in small towns, I was extremely shaken up. I had heard about the opioid crisis and the fentanyl crisis and Nixon’s War on Drugs, but all of this faded out of my awareness in the time it takes to change the radio station. I never thought I would see it for myself, laid out on the pavement. Six months later, in British Columbia, drug possession was decriminalized.
In 2016, British Columbia declared a public health crisis in response to growing drug use and drug related deaths. Since that declaration, more than 13,000 British Columbians have died as a direct result of the tainted drug supply, and are currently dying at twice the rate as in 2016 according to a report by British Columbia Chief Coroner, Lisa Lapointe. As a method of harm reduction, British Columbia began piloting new legislation in January of this year, allowing adults 18 and older to carry no more than 2.5 grams of any hard drug, including opioids, crack cocaine, heroin, and MDMA. Producing or trafficking drugs remains illegal. The goal is that drug users will feel more confident in seeking help without the fear of going to prison. The B.C. government website explains that “it will help reduce the barriers and stigma that prevent people from accessing life-saving support and services. Substance use is a public health matter, not a criminal justice issue.”
While this approach may be a step in the right direction, a critical element in the plan is missing; a safe drug supply. While possession of drugs is legal, selling or producing them is not. This means that drug dealers still make dangerous and unregulated drugs, and the safety of the drug supply has dramatically worsened as fentanyl becomes more common and dangerous. Jerry Martin, a recovered drug addict of 15 years who lost his brother to an overdose in 2022, planned to open a store selling drugs such as heroin and cocaine safely and in the legal amount, to combat the contaminated drug supply. Josh Grant of CBC News writes, “by having the drugs tested, Martin not only hopes to prevent overdoses and deaths, but also offer a safe place for people struggling with addiction. Martin says he'll warn customers about the dangers of using drugs, and direct them toward neighborhood resources that can help them get clean, give them a place to spend the night, or offer something to eat.” Because selling drugs remains illegal in British Columbia, Martin expected to be shut down as soon as he opened the store - and he was. Just a day after opening, he was arrested. “But he was ready to be arrested,” writes Yasmine Ghania of CBC News, “because he wanted to launch a constitutional challenge arguing for a legal safe supply of drugs.” He was later arrested for driving without insurance, and his mental health began to worsen. On June 30, 2023, Martin passed away from a fentanyl overdose, three days after being found unresponsive in a vehicle. It is unclear whether or not he knew the drugs were contaminated.
Another concern over the changes is public drug use, and two months ago, an adjustment was made in response to these concerns. Drug use in public spaces, such as parks, bus stops, beaches, and sports fields would no longer be legal. However, on December 28th, a pause was put on this adjustment, as some believe that pushing drug users to use alone is dangerous and rooted in stigma. In fact, many addicts have chosen to use in public places in the hopes that if they were to overdose, a bystander would call for help. While the majority of those in affected communities are open to the new policy, many are pushing for tighter restrictions. Business owners, for example, don’t want open drug use and overdoses in front of their stores, and parents are strongly opposed to exposing their children to drug use in public parks.
One proposed method of harm reduction is the use of a medical model. Addiction medicine specialist Dr. Christy Sutherland is working to lead a harm reduction clinic in Vancouver where she doses pharmaceutical grade fentanyl to drug users. By prescribing safe fentanyl in a safe environment, users are able to get away from the dangerous drug supply and recover under the supervision of doctors. “Often for people who are using opioids, it's the criminalisation of their lives that is causing the harm,” says Sutherland. “They have to engage in sex work or a crime to get their drugs. And then when they do buy the drugs, they don't know what is in it, it could be any percentage of fentanyl. So if you eliminate the violence, the need to do crime, they can exit from sex work. And when they have a caring nurse and a primary care doctor who will wrap them in services, you see people get better.”
But not everyone agrees that this is an effective method. A November 2023 news release by chief coroner, Lisa Lapointe, reports that one of the most important solutions is the establishment of a safe drug supply, and that a medical model is not feasible at any time in the near future. “There are limits on the types of medications that can be prescribed,” says the report, “and any expansion of the programs would place additional burden on an already strained health-care system in which more than 20% of British Columbians do not have a primary-care provider.” The report strongly advocates for the implementation of a safe drug supply as a top priority.
“If people know what’s in their drug and can regulate their dosage in conjunction with some of the other supports, especially at home,” says Dwayne Strohm, a harm reduction worker at an overdose prevention site for the Canadian Mental Health Association. “Then they can stabilize their lives and begin to work towards a solution. But if you’re in the street and you are just taking random doses of random drugs you are probably not going to survive and you’ll never get a leg up.” Interestingly, he compares the current situation to early 19th century prohibition. “Safe supply has to be done like alcohol was,” he says, “where they said, ‘this is poisoning people, it’s causing societal ills, it’s a huge problem.’ They legalized it, they decriminalized it, they regulated the supply, and they made safe places to do it. And that didn’t prevent people from abusing alcohol or dying from it but the numbers are now so much less than, say, in prohibition era, where people were dying like they are now, comparatively.” While this sounds like a radical solution to most, it might be British Columbia’s best chance at beating the drug crisis.