British Columbia declared the coronavirus a public-health emergency two weeks ago, on March 17. It’s a rare measure that authorities have only deployed a few times in the province’s history. Even more extraordinary, B.C. was already in a state of emergency when it decided that COVID-19 warranted this classification.
That crisis remains ongoing and, according to UBC professor of law Benjamin Perrin, is now compounded not only by the coronavirus, but also by the measures we’re taking to slow its spread.
In a telephone interview, Perrin explained that many long-time drug users have compromised immune systems, which can make them more susceptible to the virus. In addition, it’s difficult to practice social distancing if a dependence on opioids requires trips to a dealer multiple times each day. Finally, people are being told to self-isolate, which is a very dangerous order for those using drugs that involve the risk of an overdose.
“The coming together of the opioid crisis and the COVID-19 crisis is very concerning,” he told the Straight.
Perrin has made himself something of an expert on the first of these two health emergencies. It’s the subject of his latest book, Overdose: Heartbreak and Hope in Canada’s Opioid Crisis, which was released today (March 31).
Overdose is an accessible investigation of Canada’s drug crisis. It’s also one written from an unexpected vantage point. For one year beginning in April 2012, Perrin was the top criminal-justice adviser and legal counsel to the office of Conservative prime minister Stephen Harper. That government fervently fought against virtually every single program and policy for which Perrin advocates in Overdose. And so the book also takes readers through Perrin’s change of mind and the evidence that led him there.
“While fentanyl is what we all see as the direct and most immediate cause of the overdose crisis in Canada and United States, it could just as well be any drug,” Perrin said.
He explained that the rise of synthetic drugs—narcotics that are cooked by chemists in laboratories, as opposed to harvested by farmers—have changed the game forever, and that it is the drug war that is to blame for this development.
“Today it’s fentanyl, tomorrow it will be something else,” he continued. “Unless we change our approach to how we deal with substances in society, we are going to continue to put people's safety at risk and have lives be lost.”
The problem is prohibition
Rooting his analysis in Vancouver’s overdose crisis, Perrin argues in the book that prohibition has a “devastating impact on the people who use illicit drugs, most notably on regular users who have opioid use disorder but also on those who use drugs occasionally or recreationally.”
Perrin details seven fatal flaws in our current approach to drug use and addiction. They include “punishing people for having substance use disorder”, “isolating people who use drugs from support”, and “fostering other criminal and risky behavior”, among others.
“The combined effect of these seven massive failings is staggering,” the book continues. “Not only has the criminalization of those who use illicit drugs been a colossal failure, it’s making the opioid crisis even worse. It’s costing lives. If we were starting from scratch and looking at various options for dealing with illicit drugs, the status quo—which has no evidence to support it—would be at the bottom of the list.”
On the phone, Perrin dismissed the suggestion this analysis is controversial, and said this is simply where his research took him.
“When I first heard of the idea of things like prescription heroin, I thought the idea was absolutely nuts,” he explained. “But once I once I understood why people use drugs, once I understood substance-use disorders, and once I understood that people will continue to use a contaminated, toxic drug supply, the jump from that to safe supply was very quick.”
He noted that since Canada’s federal government began tracking fatal drug overdoses in 2016, opioids alone have been associated with an estimated 14,700 deaths (up to the end of September 2019). For comparison’s sake, the novel coronavirus was responsible for 29 deaths across Canada as of March 26, although that number is expected to rise.
Perrin emphasized that it’s understandable that every level of government is prioritizing its response to COVID-19. But he added that the coronavirus has not slowed the country’s overdose crisis. “I really think that this also needs to be part of the discussion right now,” he said.
A conservative voice for progressive policies
If you’ve spent the last five years following every twist and turn of B.C.’s overdose crisis, there’s not a lot for you to learn from Perrin’s book. The names and opinions that appear in its pages are the same ones that fuel Vancouver journalists’ daily coverage of the crisis. But Overdose serves as a good introduction to the issues and one in which people less familiar with the crisis will find progressive arguments presented in a straightforward and compelling manner.
Today, Perrin says he regrets his uncritical support for the Conservative’s law-and-order approach to drugs. Given his former role in that government—the administration that spent six years (from 2006 to 2011) in the courts fighting to shut down Canada’s first supervised-injection facility, Insite—he hopes the arguments in Overdose resonate with former colleagues.
“I deeply regret that I accepted the party's dogma and ideology around drug policy,” Perrin said. “Long-standing opposition to things like supervised-consumption sites absolutely rests squarely with the Harper government, as well as with the provincial Conservative governments who, to this day—even to this week, in Saskatchewan, for example—deny them funding.
“Those policies have cost lives and they will continue to cost lives,” he added.
Overdose also includes similar criticism for Prime Minister Justin Trudeau’s current Liberal government. It describes a pair of meetings that Trudeau held in Vancouver—one of them very likely a January 2017 meeting reported on by the Straight—in which advocates for drug-policy reform tried to convince the prime minister that decriminalizing drugs would minimize stigma, encourage people to seek help for an addiction, and therefore save lives. But Trudeau said he could not do it, the book recounts. Perrin says the most troubling aspect of this refusal was Trudeau’s reason for it.
“He said they would not decriminalize drugs…because of what he described as the political problems [Conservative criticism] he was having trying to legalize cannabis,” Perrin said. “The prime minister's true reason for not decriminalizing substances is political.”
Perrin highlighted the absurdity of the prime minister’s position—one that he argued amounts to support for illegal drug markets that exist outside any government structure and therefore lack any semblance of oversight or regulation.
“I would have a harder time going out right now and buying unpasteurized milk in Vancouver than I would going out and getting street drugs laced with fentanyl,” he said.
“We allow an unregulated criminal underworld to dictate what is in the drugs that people are taking, forcing those people to play Russian roulette,” Perrin added. “The radical option here is the one we have now.”
Benjamin Perrin was previously scheduled to host a Vancouver book launch in April. Precautions related to COVID-19 led organizers to move the event online. A digital launch and discussion with Perrin is scheduled for April 16 beginning at 5pm PST.