A conversation on drug policy is overdue

Many years ago George Carlin, famous for his sardonic humour, rhetorically asked the question, “Why is it only my drugs are illegal?”

He was making the point that mind-altering, addictive drugs like alcohol and tobacco, and dozens of prescription medications, were easily acquired and abused.

We need to have an adult conversation about drugs, beginning with the observation that mind-altering substances, like opium, peyote and alcohol have been used for thousands of years and will continue to be used by some no matter how hard we wish it were otherwise.

We can do better than lurching from the “war on drugs” to creating safe consumption sites.

More than half a century ago, in 1969, Pierre Trudeau established the Commission of Inquiry into the Non-Medical Use of Drugs, commonly called the Le Dain Commission. The commission was tasked with reviewing current research and experience around the world on the non-medical use of drugs, like marijuana. The commission was also tasked with making recommendations to the government on how to reduce the private and public cost of the use of non-medical drugs.

The principle recommendation on the use of marijuana stated simply, “The costs, particularly the potential for criminal records for young people, of a policy of prohibition of simple possession were not justified by the potential for harm of marijuana.” With respect to “hard” drugs, the commission also recommended “a gradual withdrawal of criminal sanctions against non-medical users of all illicit drugs, including substances like cocaine and opioids.”

In 2018, more than four decades later, the federal government finally acted. In the face of continuing opposition about the likely disastrous effects of legalizing marijuana, the younger Trudeau passed legislation allowing for the legal, controlled sale of the drug in Canada. Legalizing marijuana was met with shrug by most Canadians.

At the same time governments, both federal and provincial, have been attempting to develop a coherent approach to the use of opioids and synthetic prescription opioids, like fentanyl and oxycontin. These drugs are far more destructive and addictive than marijuana and easily tainted, making them particularly lethal.

To date, no government has been able to develop a thoughtful and practical approach that would solve two problems; reduce harm to individual mental and physical health, and manage the social and judicial costs of the crimes being committed by gangs and drug-users determined to feed their habit.

The establishment of safe consumption sites seemed like a reasonable approach to reducing the harm individuals face when using street drugs. The second problem, the cost of law enforcement and the judicial process, were not adequately addressed by decriminalizing personal drug possession or implementing harm reduction strategies.

This was the approach pioneered by the Portuguese government in 2001. A report on the success of the Portuguese approach noted the following improvements: a dramatic drop in drug-related deaths and HIV infections, a reduction in problematic drug use, and a decrease in criminal justice burdens related to individual users.

The B.C. government chose to follow the model used in Portugal. They established safe injection sites and convinced the federal government to decriminalize the simple possession of drugs in B.C. The catch being that the drugs users were injecting could only be purchased on the street — drugs that could only be purchased if the drug user had money.

What this approach effectively did was make the sale of illicit drugs by drug-dealers to drug-users less risky for both users and drug dealers. No one asked where the drugs came from at the consumption site. No one asked the question, “Where did the drug users get the money to buy the drugs?”

The answer to the second question was of course, in many cases, from theft and the selling of favours, sexual and otherwise. The problem was that the government didn’t have the courage to supply the drugs that people craved.

While most of the drugs sold on the street are part of the illicit drug trade, medical-grade drugs are easily obtained and would be relatively cheap and safe if they were provided as part of a government-run health and harm reduction effort. Providing drugs of choice to people addicted is not as expensive, individually or collectively, as continuing to criminalize the use of such drugs.

A decision to supply users with the drugs they need would offer them immediate support. A significant side benefit would be the elimination of street drug dealers as suppliers. If safe drugs were provided on site, there would be no need for a local drug dealer and no need for users to find ways to pay for the drugs they need.

Providing free clean drugs and supervising their consumption will accomplish several things.

It would significantly reduce the number of drug overdose deaths; reduce deaths from tainted drugs; reduce the need of those addicted to sell their bodies or steal to fund their drug habit; and reduce the demand for non-prescription drugs on the street. It would also significantly reduce the cost of policing and protecting users from overdoses and abuse on the streets, and help build trust with caregivers and increase the likelihood of addicts seeking help on a personal level.

Fifty years of ever-greater expenditure on police efforts to deal with drug dealers has failed miserably. Our current approach ignores the simple fact that offering a safe injection site for own-sourced drugs, or decriminalizing simple possession, doesn’t reduce criminal behaviour or self-destructive behaviour. It means addicts are always left to deal with the drug dealers and possibly tainted drugs on their own. Addicts still have to find the money to buy the drugs in a back alley from a local drug dealer.

Perhaps the biggest irony to this conundrum is that governments around the world have successfully used supply management to thwart drug dealers peddling another dangerous drug — alcohol. Instead of trying to capture bootleggers and rum runners, the government simply decided to control the supply. Managing the supply and its distribution ended the illicit trade in alcohol and protects users from taint alcohol.

The B.C. government’s attempt to solve its drug problem by decriminalizing drug possession while offering safe injection sites was misguided. Neither initiative altered the drug supply chain, and that is what needs to be changed. The government controlling the supply of drugs to those hopelessly addicted eliminates the criminal element from that part of the non-medicinal drug use market. It is a precondition to providing a safe supply of drugs. It also offers safety and the opportunity for meaningful intervention for those addicted.

Our current reluctance to change our practice ignores research and the failed policies of the last 50 years. We need safe injection sites. But only controlling the supply, as has happened with alcohol — and more recently marijuana — will actually reduce the tremendous cost of policing the drug-addicted population. It may also end the revolving door of medical treatment, incarceration, and death for drug users.

We need a national drug policy. Managing the supply of drugs will save lives and improve the safety and security of our communities. It is time for that conversation.

Jerry Storie was an MLA and teacher and writes from Winnipeg