The Canadian Mental Health Association (CMHA) will hold a three-day conference in Victoria next week. Ahead of one of its biggest meetings of the year, the organizations CEO, Patrick Smith, made a provocative admission to the Straight.

“We’re going to be distributing drugs,” he said in a telephone interview. “We’re going to have breaks for you to take your drugs.”

Smith was referring to a stimulant that many Canadian adults consume in a liquid form every morning: caffeine. He said there are lessons there that should be applied to a much larger context.

“We are a drug-using society,” Smith explained. “Most societies are. So we need to have less of a moralistic approach, less like the war on drugs, and truly look at a policy that talks about legalization and regulation.”

Those conversations should include hard drugs like heroin and cocaine, Smith continued. He explained that the country is struggling with rising rates of opioid abuse and an epidemic of overdose deaths complicated by the prevalence of fentanyl, a dangerous synthetic opioid. Smith said that means policymakers must rethink how Canada thinks about addiction.

 “We need to break down the stigma associated with drug use and have a much more public-health approach to it,” he said.

During the first 10 months of this year, 622 people died of an illicit-drug overdose in B.C. That’s an all-time high, up from 510 the previous year and 370 in 2014.

On Monday (November 28), Smith will participate in a panel at the CMHA conference that will delve into those numbers and what needs to be done about them. He’ll sit alongside the B.C. government’s top doctor, Perry Kendall, and Michael Pond, an addictions counsellor and author who wrote a book about his own struggle with alcohol.

Smith noted B.C. policymakers such as Kendell have long led the way with calls for an end to the war on drugs. Another name he mentioned was Donald MacPherson, who drafted the Vancouver's "four pillars" response to another overdose crisis the city dealt with the late-1990s.

"The arguments around legalization and regulation—because they go hand in hand—have huge impacts on the public-health perspective," he said. Smith noted legalizing drugs would also take the supply of narcotics and the profits of that industry away from organized crime.

Another area he plans to touch on at the conference is how we can prevent people from ever having to think about fentanyl in the first place.

“The panel itself is on the opioid crisis,” Smith said. “But I’m going to try and take it back to the theme of the conference and look at how we got here.”

That theme is “B4stage4”, encouraging a focus on prevention and early intervention, improved access to addictions care, strengthening recovery systems, and improving crisis care.

Smith argued that what Canada needs to do to meet the fentanyl problem is nothing less than a restructuring of mental-health care.

“When it comes to mental health—including addictions, as the second most common mental-health diagnosis in Canada—most of the primary-care mental-health services and addictions services that other countries rely on and take for granted—things like addiction counselling, cognitive behavioural therapy—are mostly not available in Canada,” he said.

“Most mental-health practitioners are sitting on the sidelines and not involved in the publicly funded system—psychologists, addictions therapists,” Smith continued. “We don’t tolerate that in any other area of health. So we need to redefine primary care when it comes to mental health.”