In response to overdose deaths, B.C.'s top health officials discuss an end to the war on drugs

At a June 9 conference in Vancouver, B.C.'s health minister called the war on drugs a "failure" and suggested others in government feel the same

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      If B.C.’s top health-care professionals had their way, the province would decriminalize drugs “in a heartbeat”.

      That was one message that Dr. Mark Tyndall, executive director of the B.C. Centre for Disease Control, told the Straight that he took away from a June 9 meeting in Vancouver convened in response to an increasing number of illicit drug-overdose deaths.

      In a telephone interview, Tyndall explained that one of the day’s sessions focused on drug-policy reform. He said the consensus was in support for an end to prohibition.

      “I think a year ago, that was just pie in the sky,” he said. “But I think we are at a point now when the tide is shifting. These things are highly complicated. But I think most people in the room would go to a Portuguese model in a heartbeat. So I think there was widespread support for that.”

       In 2001, Portugal decriminalized hard drugs, including cocaine and heroin, and abolished criminal penalties for the possession of those substances. At the same time, the country increased funding for treatment and addictions support. The sale and distribution of narcotics, meanwhile, remained illegal. (A good overview of the so-called Portuguese model can be read here.)

      A number of the province’s top health officials, doctors, and researchers were in attendance at the June 9 meeting, plus drug users and family members of addicts.

      They included Health Minister Terry Lake, for example, and provincial health officer Perry Kendall, among many others.

      Speaking to reporters outside the conference, the province’s chief coroner revealed that so many people have died of overdoses in B.C. this year that drugs are now killing more people than automobile accidents.

      “Last year, there were 300 deaths in motor-vehicle incidents, and this year, as the minister said, we’ve had 308 deaths already from illicit-drug overdoses,” Lisa LaPointe said. “If this trend were to continue, we’d be looking at about 750 deaths this year. So it’s hugely significant. The number of people dying from illicit-drug overdoses is higher than any other unnatural category.”

      More than half of those deaths are attributed to fentanyl, a synthetic opioid that can produce effects similar to heroin but which is roughly 10 times more toxic.

      In 2015, there were 484 drug-overdose deaths in B.C. That was up from 364 in 2014, 331 in 2013, and 273 in 2012, according to the B.C. Coroners Service.

      Speaking at a news conference alongside LaPointe, Lake called the war on drugs a “failure”.

      “My view is that, as a society, we are taking a different sort of approach to drug use than we used to,” he said. “I think that any politician that I have talked to understands that the so-called war on drugs has been a failure and that we need to have different approaches. That will take some time.”

      Lake however noted drug regulations are largely a federal issue.

      B.C. health minister Terry Lake has suggested opinions about the war on drugs may finally be turning to support a new approach.
      Travis Lupick

      On April 14, the province declared a public-health emergency. The June 9 conference saw more than 80 stakeholders meet to decide on next steps that will, hopefully, begin to bring the number of overdose deaths back under control.

      Tyndall acknowledged that nothing concrete was decided at the meeting—there was no funding for new programs, for example, which a number of nonprofit groups have repeatedly called for. But he said there were specific ideas that the province is now working with partners to implement.

      The first is more supervised-injections sites, Tyndall said. “We had some very good discussions about how to accelerate our work on supervised injection,” he added.

      At the news conference held the previous day, Lake said the government was working to establish five new sites in Vancouver and that health authorities in Victoria, Kamloops, and Kelowna are planning to establish facilities of their own.

      Tyndall said a second area where work is already in progress is in making the so-called overdose antidote, naloxone, more easily available.

      A third was opioid-substitution therapy, Tyndall continued. In that regard, he explained that health officials are especially focused on transitioning opioid addicts to a drug called suboxone, which is similar to methadone but, for many people, has been found to involve fewer side effects.

      Tyndall said a fourth intervention that received a substantial amount of discussion at the conference was heroin-assisted treatment and hydromorphone, two therapies that involves supplying long-term addicts with prescription opioids as a means of reducing harms associated with street drugs and other harms caused by prohibition.

      “We talked about ways to identify people who would really benefit from this, which, clearly, isn’t for everybody who is using opioids,” he noted. “But there is a segment of the population for which we could scale that up.”

      Tyndall described the meeting as encouraging.

      “There still remains a lot of work to be done,” he said. “But it was an excellent first step.”

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