TORONTO (Reuters) – A Canadian experiment to decriminalize small amounts of hard drugs could reduce stigma and police confrontations against addicts, but it does little to address a larger problem of overdose deaths from drugs laced with deadly ingredients.
The province of British Columbia, at the epicenter of a drug poisoning crisis that has already killed more than 32,000 Canadians since 2016, began a three-year pilot program last week in which people carrying less than 2.5 grams of drugs like methamphetamine and heroin not be processed.
But doctors and advocates for drug users argue that preventing overdose deaths also requires expanding a “safe supply” of drugs that allows people at risk of overdose to legally obtain prohibited substances through prescriptions.
Partly due to supply disruptions stemming from the COVID-19 pandemic, street drugs are increasingly laced with toxic or unknown ingredients, causing drug users to overdose and die.
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“There (are) no measures involved in decriminalization that address the fact that supply is very, very variable, volatile and dangerous,” said Gillian Kolla, a drug policy researcher at the Canadian Institute for Substance Use Research in Victorian University.
“If you want to have an impact on the overdose crisis, you’re going to have to target supply.”
The thinking behind safe supply programs and other “harm reduction” initiatives is that people who use drugs will continue to do so and offering them a safer option will keep them alive. Advocates say they are not meant to be an alternative to addiction treatment, but rather in addition to it.
In part, it reflects a broader move away from criminal charges as a deterrent to drug use and a shift toward treating addiction as a health problem.
‘RECOVERY ORIENTED APPROACH’
Still, expanding safe supply on a large scale would mean a major shift in the government’s approach to illicit substances, involving it in the supply and regulation of now-illegal drugs.
Critics worry it could backfire by encouraging drug use and causing drugs to be diverted for sale on the street, something prescribing doctors say is rare.
Studies show that programs can be successful. A 2021 study by the British Columbia Center on Substance Use of 42 participants in a Vancouver program that distributed tablets of hydromorphone, an opioid, found that it reduced street drug use and the risk of overdose and improved health. , well-being and pain control.
A 2016 study from the Canadian Institutes for Health Research found a 67% reduction in illicit drug use in a group treated with prescription heroin or diacetylmorphine, and a 47.7% reduction in a group treated with the opioid methadone. .
But not everyone in Canada favors that approach: Alberta, a province with a Conservative government that borders British Columbia, has emphasized a “recovery-oriented” approach to addiction that favors more abstinence-based treatment.
Under that approach, people with addictions are encouraged to enter residential treatment centers and quit substances.
Pierre Poilievre, leader of the opposition Conservative Party, said last week he would kill BC’s plan if he were prime minister, arguing that de facto decriminalization has been in place in BC for years and has been “a complete disaster” and “hell on earth”. .”
British Columbia police file thousands of drug possession charges annually.
About 32,632 Canadians have died from opioid-related deaths since 2016, with a rate of 20.9 opioid-related deaths per 100,000 people in 2021, compared to a rate of 24.7 in the United States that year.
Canada faced the challenge of a tainted illicit drug supply earlier than the United States and has been quicker to adopt harm reduction tools to address drug overdose cases, said Lindsey Richardson, a research scientist at the BC Center on Substance Use. .
British Columbia has been at the forefront of trying new methods to address the crisis, including opening North America’s first official sanctioned supervised drug use site in 2003. Its latest program is being closely watched elsewhere.
Toronto also filed to decriminalize personal possession of illegal drugs last year, and the city says it is working with authorities to decide how that will be defined.
Decriminalization could improve the lives of patients of Scott MacDonald, the lead physician at Vancouver’s Providence Crosstown Clinic.
Many of them receive pharmaceutical-grade injectable heroin because they have severe addictions and cannot tolerate or respond to more conventional treatments, said MacDonald, who has 115 diacetylmorphine and hydromorphone patients there.
Some of them still buy street drugs. But he says they can now feel that “it’s safer to leave the house; it’s safer to go to the supermarket; it’s safer to go to a clinic.”
But Ryan Maddeaux, who started using drugs as a teenager and continues to use them at age 44, says BC’s latest plan isn’t helping him because he risks taking something deadly every time he buys street drugs.
“I don’t know what they are, I don’t know the exact potency,” he said.
(Reporting by Anna Mehler Paperny; Editing by Denny Thomas and Deepa Babington)
Copyright 2023 Thomson Reuters.