More work needed on B.C.'s decriminalization plan, experts say

A stock photo of illicit drugs. (Getty Images)

In an attempt to combat stigmas and barriers associated with substance-use, the province has set out on a three-year project to decriminalize the personal use of drugs, allowing the small possession of certain illicit substances.

But with a death toll that has now amassed over 11,000 in the last seven years - with one thousand of those deaths reported as First Nations - some experts say decriminalization alone is not enough.

Jade Boyd is an assistant professor in the department of medicine at the University of British Columbia and a research scientist with the BC Center on Substance Use. He said it's a common agreement among drug policy experts across the globe that criminalization paired with “harsh drug laws and policing under drug prohibition” causes a negative impact on health outcomes, disproportionately affecting poor and marginalized people.

“Punitive and prohibitive drug laws and policies; they create a lethal environment where an illegal drug market can exist,” said Boyd. “It also creates stigma, violence, and human rights violations, including extreme barriers to health and social services.”

When considering stigma and criminalization associated with drug-use, Boyd said it keeps drug-users from seeking support while also decreasing their access to jobs, housing, and education.

“What it does produce is social inequality,” said Boyd.

She explains that the deaths related to the opioid crisis and toxic drug supply are preventable and are a “direct consequence of prohibition and punitive drug laws, and our very poisoned drug supply.”

“We want to reduce rather than exacerbate health and social outcomes,” she continued.

Boyd explained that the reform in drug policy is an important step forward, though criminalization may continue for its lack of consideration of the realities of drug-users.

“I think we need to do so much more, because as it is, it's not going to stop overdose deaths, unfortunately,” she said. “That's because a big portion of people who use drugs in British Columbia will remain criminalized with our current model of decriminalization.”

The original amount the province requested for decriminalization was 4.5 grams, though many advocates and some committee's believed this to be too low for those that use drugs at a higher tolerance, shared Boyd. Currently the limit is 2.5 grams, but Boyd expects that many users could still carry more.

“It doesn't necessarily reflect the actual realities of some people's drug use and purchase practices,” she said of the new legal limit.

Additionally, she notes that under decriminalization the province includes particular drugs, but because of the unpredictable nature of the street market, people often don't know the combination of substances that they're using.

Included in the current decriminalization policy is 2.5 grams of opioids (heroin, morphine, and fentanyl), crack and powder cocaine, methamphetamine (meth), as well as MDMA (ecstasy).

For example, benzodiazepine is not included as a drug in decriminalization, though a number of adulterated drugs include benzodiazepine, said Boyd.

DECRIMINALIZATION ENCOURAGES DRUG CHECKING

The Vancouver Island Drug Checking Project is a confidential service across the region where people can get drug samples checked to identify “main active ingredients, fillers or cutting agents, any unexpected drugs, and the presence of fentanyl.”

“It's more than data, it's trying to basically provide people with more drug information to be able to navigate some of the current risk associated with overdose and in drug supplies,” shared Bruce Wallace, co-lead, alongside Dennis Hore, with the Vancouver Island Drug Checking Project and a professor in the school of social work at the University of Victoria.

“Decriminalization doesn't change the illicit drug supply that currently is linked to overdose,” said Wallace. “What that means is that there's a real value to having drug checking.”

“With decriminalization in place, it really removes barriers for people to be able to access drug checking,” said Wallace.

The Vancouver Island Drug Checking project currently operates from Victoria on Cook Street. Their distributed model sites are located in Port Alberni, Campbell River, the Comox Valley, and Duncan.

Boyd said that to reduce deaths due to the opioid crisis and toxic drug supply, decriminalization should be paired with access to “legal non-adulterated pharmaceutical-grade drugs, further expansion of harm reduction services and treatment services, as well as education rolled out across the province.”

“ Additionally housing and a living wage, and mental health support; all of those things are really important to have alongside decriminalization if we want to reduce deaths,” added Boyd.

“It's helping create a safer situation for people that are using,” said Les Doiron, vice-president of the Nuu-chah-nulth Tribal Council, when reflecting on decriminalization.

“It's devastating our young people at a very nasty rate,” he said.

Doiron noted that within Nuu-chah-nulth territory, there is a gap in access to detox and treatment services, a shortcoming that was identified at a forum held by Tseshaht in late March to address the opioid crisis.

“There seems to be a big void for the number of people that are out there that are struggling with it,” said Doiron. “This is everywhere, this isn't just in Port Alberni. This is in every community.”

“We need to come up with some type of land-based healing,” he added. “Where we can keep our young people tied more to our land and culture.”

DEVELOPING RELATIONSHIPS WITH DRUG USERS

Similar to Nuu-chah-nulth, for the Penticton Indian Band the opioid crisis has been devastating for their young people. Recently they created a Mental Health and Substance-use team that members can go to for treatment options.

“Whatever people are needing to get out of drugs,” said Jackie McPherson, the Penticton Indian Band's health manager. “The people who need the services, they always feel safer and more comfortable in our community, in our offices.”

The Integrated Community Outreach Team consists of the Mental Health and Substance-use team, an Interior Health paramedic and RCMP. They frequent the community, weekly, where there is known drug-use, with aims to provide resources, information, and build relationships.

“It's opening up that relationship so that they do feel safe,” continued McPherson. “It's made a huge impact.”

The Mental Health and Substance-use team offers referrals and sets up counseling, detox, and treatment for community members.

McPherson notes that amid a lack of capacity to deliver the services needed throughout communities, it's important to collaborate with Interior Health and the RCMP to deliver the services and resources that are available.

“Supporting community groups that support people who use drugs is really important, because they know best what is needed for their communities, and they're not getting the resources,” said Boyd. “I think there's a lot more that needs to be done.”