Decriminalization begins in British Columbia as coroner releases overdose death data

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The decriminalization of people with small amounts of illicit drugs for personal use has become a reality in British Columbia, but drug users and researchers say the change is unlikely to make an immediate difference because of a supply of ‘ toxic drugs.

VANCOUVER — Decriminalizing people with small amounts of illicit drugs for personal use has become a reality in British Columbia, but drug users and researchers say the change is unlikely to make an immediate difference because supply of toxic drugs.

The policy change began Tuesday when the BC Coroners Service announced suspected drug toxicity in 2022 claimed 2,272 lives, the second highest in the province in a calendar year, after 2021. when 2,306 deaths were recorded. On average, six people died every day last year.

Health Canada has approved BC’s request for decriminalization with an exemption from federal drug laws, which allows people 18 and older to carry up to 2.5 grams of opioids, such as heroin and fentanyl, as well as crack and powder cocaine, methamphetamine and MDMA. Users will not be arrested or have their drugs confiscated by police in a three-year pilot.

Dean Wilson, who started working as a peer facilitator at the BC Center on Substance Use as a heroin user in 2017, said decriminalization is a welcome change to prevent drug user interactions. drugs with the police.

But he said this must be accompanied by a bold plan to provide more people with a wide range of safe alternatives to toxic street drugs that profiteers often cut or contaminate with the powerful opioid fentanyl.

“They will cut their cocaine for five minutes, then they will cut their fentanyl by the same amount and suddenly there is fentanyl on top of the cocaine. And if someone who has never taken an opioid takes that[hit]who had a little bit of fentanyl, they’re dead,” Wilson said.

A regulated supply of pharmaceutical alternatives should be available through multiple avenues, including compassion clubs, to save the lives of people facing fatal overdoses, he said.

“Nothing is for sure unless you test your dope every time. And you can’t do that if you’re an active addict.”

Insite, a supervised consumption facility that opened in Vancouver in 2003 as the first facility of its kind in North America, is among the few places that have a specialized machine that drug users can access to have their substances analyzed for toxins, including fentanyl.

Take-home Fentanyl test strips are also available there and at select locations so people can test their medication in seconds.

Despite these services, over 11,000 people in BC have suffered fatal drug overdoses since 2016, when the province declared a public health emergency.

These deaths led to a policy of decriminalization of people who use drugs to reduce the stigma and therefore they were more likely to get help for an addiction.

“If people believe there’s a link between decriminalizing drugs and reducing overdose deaths, it’s not going to happen,” said Wilson, 64, who has been in a methadone treatment program. since last May Reducing cravings for opioids, which he said he started taking in a while. the age of 13 years.

Chief Medical Examiner Lisa Lapointe said Tuesday that a safer supply of drugs, along with many other harm reduction measures, is urgently needed, as she recognizes that this is a “crisis centered on the people”.

“So, it’s everything, it’s safer care, it’s decriminalization, it reduces stigma, it’s harm reduction (and) it’s a continuum of care,” she said.

“And finally there’s an assessment of what’s going on in terms of treatment and recovery. We know that many beds have been added in the province in recent years. We have yet to see a formal regulatory and classification system for this.”

Researchers and drug users say the 2.5 gram limit is too low for those who may be forced to have more contact with black market sellers as they try to avoid interactions with the police. The province had requested a limit of 4.5 grams, while the police required a total of one gram for all drugs allowed under the exemption.

They say that decriminalization needs adequate support so that people can get the help they need when they ask for it.

For example, in Portugal, decriminalization includes various harm reduction services and social treatments.

Jennifer Whiteside, BC’s Minister of Mental Health and Addiction, said the province has expanded its harm reduction programs and more than 360 new treatment and recovery beds have opened since 2017. A safer prescription supply program strengthened in July 2020, making BC “the first province in Canada to do so,” she added.

More than two-thirds of officers from the city’s RCMP and BC departments have so far completed training on aspects of decriminalization, in which so-called resource cards are distributed to drug users, Whiteside said in news conference Monday.

They include information on how to contact new “substance use navigators,” who have been hired specifically by health officials to connect with local service providers and connect people referred by police, Whiteside said.

“Decriminalization is a historic change, but we know that it will not solve the toxic drug crisis alone.”

Mike Serr, co-president of the Canadian Association of Chiefs of Police, said that although the group has been in favor of decriminalization, he was concerned that it would be a “challenge” to provide more services to people in areas like the north. of BC to provide.

“These are things that I will be watching and this is something that the government needs to address. That’s a very important, critical part of it,” said Serr, who is also deputy police chief in Abbotsford, BC.

Federal Mental Health and Addictions Minister Carolyn Bennett said the plan is to steer people away from the criminal justice system and into health and social services, so programs like this need to increase.

As for safer alternatives, some doctors are still uncomfortable prescribing them despite guidelines from the College of Physicians and Surgeons of BC and its Ontario counterpart, Bennett told The Canadian Press.

“We were very concerned that some of the prescribers were being reported to the college by some of their peers,” she said.

“I worry about the number of deaths caused by people in the construction, crafts or natural resources (sectors). Or even at parties, the fact that someone can die from being used once. We will have to really explore the options and I think we are convinced that the prescription model alone cannot stop this tragedy.”

Bennett noted that a project in Vancouver that prescribes fentanyl powder to a small number of drug users could show promise as part of an increased, regulated supply to more people.

Decriminalization will be monitored and evaluated, and some changes may be made based on evidence that emerges during the pilot, Bennett said.

“The evidence we had was that most of the catches were well below 2.5 (grams) so we will continue to monitor this, but we are ready to adapt in any way to be able to fulfill our promise, that this project remains in the public interest.”

Kora DeBeck, a research scientist at the BC Center on Substance Use, said that although the cumulative 2.5 grams is low, the fact that substances up to that level are no longer confiscated is a positive step for those otherwise he is using drugs or drugs. They borrow money and put themselves at risk of violence or even experience painful withdrawal symptoms.

“I would describe the decriminalization of drug possession as an incredibly progressive, important step and a recognition that criminalization is harmful,” she said. “It responds to what I see as decades of research showing that Prohibition was a failure and a disaster.”

However, the supply of poisoned drugs is the main problem that leads to overdose deaths, said DeBeck, who is also an associate professor at Simon Fraser University’s School of Public Policy.

“I think it’s actually incredibly dangerous to think that (decriminalization) is going to have an impact on overdoses in the short term.”

This report by The Canadian Press was first published on January 31, 2023.

The Canadian Press’ health reporting is supported by a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Camille Bains, The Canadian Press


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