International Overdose Day: End the war on drug users

Monday, August 31st is International Overdose Awareness Day.

As another rash of fentanyl overdoses flares up in cities across the country, it is time Canadians—and our government—come to think of drug use as the health issue it is. The current war-on-drugs approach entrenched by Conservatives in public policy and heralded during their election campaign is simply not working, and it’s costing lives.

Changing our understanding—and widely held misconceptions—of drug use and people who use drugs is central to addressing the health emergency that drug overdoses present. While there are a range of established medical responses to drug use that have been proven to save lives, the government has rejected these rights- and science-based approaches. Criminalization in the form of mandatory jail terms and tougher sentencing have instead characterized their response, abandoning members of our communities to risks of infection, overdose, and death.

Many of the responses in the medical panoply to deal with opiate overdose are well known and well supported by scientific evidence. Insite, Canada’s only supervised injection facility, provides space for people who struggle with drug addiction are to inject with clean needles in a sterile facility, with medical staff on standby in case of an overdose. Insite also refers hundred of people a year into treatment, and serves as a front-line medical clinic for people for whom traditional medical care is difficult to access.

More than a decade of peer-reviewed published research proves that Insite saves lives, saves money, and reduces crime. Yet earlier this year the federal government passed Bill C2, which amended the Controlled Drug and Substances Act to make the Health Minister’s approval for Insite to continue operating much more difficult to grant and sets up barriers to opening similar facilities in other Canadian cities.

One of the main arguments the Minister of Health marshalled in her opposition to Insite is that the drugs users are bringing into the facility are purchased on the black market. This is ironic given the federal government’s opposition to Vancouver’s pilot prescription heroin maintenance program, which provides diacetylmorphine—the chemical name for heroin—as an alternative to more conventional maintenance therapies like methadone and suboxone that have failed long-term heroin users. This treatment ensures that those who are severely addicted receive their regulated treatment from a prescribing doctor, rather than seeking and injecting the dangerous drug on the streets.

A final item in the war on overdose is a drug called Naloxone. Marketed under the trade name Narcan, naloxone clears opiate receptors in the brain of the drug and reverses the overdose. Naloxone is administered by nurses at Insite when someone overdoses, and it is also distributed to people who are at risk of overdose under a pilot program of the BC Centre for Disease Control. Despite the increasing reports of fentanyl-related overdose, however, naloxone is available only by prescription and only to people who admit to a healthcare provider that they need it.

The inaccessibility of health care and the stigma of admitting opiate drug use in combination with other barriers imposed on the program by federal regulations keep naloxone out of the hands of people whose lives could be saved by it, in the midst of a trans-national fentanyl epidemic.

These federal barriers are injurious enough, but the insult is the federal framework that puts bystanders at risk of criminal prosecution if they call 9-1-1 when they witness an overdose. The recent case of two Elmira teenagers facing a number of possession charges is exemplary.

Until our policy makers begin to see drug use as a health issue instead of a crime problem, the most vulnerable Canadians will continue to be abandoned to overdose and death when proven tools are available to help them.

People struggling with drug addiction are sick; they are not bad. Public policy that punishes sick people stands starkly at odds with Canadian values of compassion that used to be the hallmark of our nation on the world stage.

This article was originally published in The Georgia Straight.