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Why decriminalizing drug possession won’t fix Canada’s toxic supply

This is an excerpt from Second Opinion, CBC Health’s weekly health and medical science newsletter. If you haven’t subscribed yet, you can do that by clicking here.

Canada’s toxic drug supply problem can’t be fixed by decriminalizing the possession of small quantities of drugs alone — a move that advocates say is a step in the right direction but a far cry from addressing the worsening overdose crisis.

In response to the crisis, the federal government announced a plan this week to allow adults in British Columbia to possess small amounts of some illicit drugs — up to 2.5 grams of opioids, cocaine, methamphetamine and MDMA within British Columbia.

But in the past decade, the illicit drug supply has gone from unthinkably bad to unimaginably worse as fentanyl has completely overtaken heroin and even more dangerous drugs have entered the supply. 

Since 2016, 26,690 Canadians have died from suspected opioid overdoses, and in B.C. alone there were 2,224 suspected overdose deaths in 2021 and more than 9,400 since 2016 — the leading cause of unnatural deaths in the province.

“No one knows, no one can know, what they’re selling or what they’re putting in their bodies,” Karen Ward, a drug user and advocate in Vancouver’s Downtown Eastside, told CBC News in a recent interview.

“I don’t even want to think about how much worse it could get.” 

7,000% rise in fentanyl in last decade

The dramatic rise of fentanyl in Canada has been stark. In 2012, only 217 of the street drug samples seized by law enforcement agencies across Canada tested positive for fentanyl. In 2021 that number grew to over 16,000 samples — an increase of more than 7,000 per cent.

Of the more than 24,000 opioid drugs seized by law enforcement agencies across Canada last year, 72 per cent contained fentanyl or fentanyl analogues, as well as 45 per cent of the heroin samples confiscated.

But at the same time, the actual amount of heroin in Canada fell by more than 60 per cent over five years as fentanyl took over — leading to an unpredictable and dangerous supply. 

“A lot of people talk about the heroin supply being contaminated with fentanyl, but we haven’t had heroin supply for a long time — the supply is fentanyl,” Nick Boyce, director of the Ontario Harm Reduction Network, said in a recent interview. 

Nick Boyce, director of the Ontario Harm Reduction Network, says the heroin supply has been completely overtaken by fentanyl in Canada. (Evan Mitsui/CBC)

“You don’t know what dosing you’ll get and there’s many different fentanyl analogues out there, some which are more potent than others.”

Carfentanil in particular is one of the most dangerous opioids in the drug supply: 100 times more toxic than fentanyl, 10,000 times more toxic than morphine and undetectable by sight, smell or taste. And after declining in 2019, it’s now on the rise in Canada again. 

The statistics are compiled by Health Canada’s Drug Analysis Service (DAS), which tests approximately 125,000 samples of drugs apprehended by the Canada Border Services Agency, the Correctional Service of Canada and police forces across the country each year.

And while it merely provides a snapshot of the crisis, it also paints a tragic picture, one that simultaneously shows the disappearance of heroin as fentanyl and other dangerous opioids contaminated the supply while the number of overdose deaths skyrocketed. 

“It’s a scary situation — it’s like the well was poisoned,” said Ward. “This whole community is just falling apart because so many people have died.” 

WATCH | Fighting an opioid overdose epidemic during a pandemic:

Fighting an opioid overdose epidemic during a pandemic

The opioid crisis was a problem in British Columbia before the COVID-19 pandemic, but combined with an unsafe drug supply and fewer safe injection sites, the crisis has become an overdose epidemic.

In the first year of the pandemic alone, there was a 95 per cent increase in suspected opioid-related deaths, with 7,224 lives lost in Canada, compared to 3,711 in 2019. 

“This is the worst public health crisis we’ve ever seen with regard to toxic drugs in the history of our country,” said Donald MacPherson, executive director of the Canadian Drug Policy Coalition, a policy advocacy group made up of about 50 organizations.

“We have never seen anything like this before.” 

Decriminalization won’t have ‘huge impact’

But the federal government’s decriminalization plan doesn’t come into effect for another seven months and falls short of the 4.5 gram threshold that the province and harm reduction advocates called for — an amount that many critics already believed was too low

“If this is intended to make enough of a difference to save lives, why does it not take effect for another seven months?” Ward said in reaction to the announcement, adding that it does little to address the toxic supply of drugs in Canada.

WATCH | Small-scale illicit drug possession decriminalized in B.C.:

B.C. receives exemption to decriminalize small-scale illicit drug possession

The federal government has granted an exemption that will see the decriminalization of small-scale possession of certain illicit drugs in B.C. The exemption comes into effect in 2023.

MacPherson said that while the announcement “signals the direction that we need to go” as a country, it should have been rolled out at a national level in order to make a real impact in Canada given that the overdose crisis isn’t just a B.C. problem. 

“This is discriminatory, if you live in another province, you’re not really going to have the benefits of this model. It’s for B.C. residents only, so that’s disappointing,” he said. 

“And it’s really not going to have a huge impact on the toxic drug supply — that is the number one problem.” 

The federal government has signalled it is open to discussing expanding the scope of decriminalization beyond just B.C. to other provinces and cities across the country, but Saskatchewan, Manitoba and Nova Scotia already said they won’t be next in line. 

Kayla DeMong, executive director of Prairie Harm Reduction in Saskatoon, said that while decriminalization overcomes a century of “highly discriminatory” drug policy, it falls short of addressing the overdose crisis in a meaningful way. 

“Do I think it’s going to have a huge impact on our toxic drug supply? No,” she told CBC News. “What I do hope is that it will provide better support and resources and less criminal enforcement for people that use substances.” 

A drug user injects heroin at the Moss Park Overdose Prevention Site in downtown Toronto in December 2018. (Evan Mitsui/CBC)

Focus needs to be on toxic supply: advocates

MacPherson said that while some drug users in B.C. who are stopped by police with small amounts of drugs will benefit from the decriminalization move, police already don’t arrest many people for possession in Vancouver and it likely won’t lead to major changes there. 

“It also means we’re going to be spending the next seven months putting together a model of a policy change that really isn’t about the toxic drug supply,” he said. “So the focus of the response is in the wrong place.” 

Advocates have been calling for a safe and regulated drug supply for decades in order to enable people who use drugs to access regulated substances, such as medical-grade heroin, from a legal source, rather than potentially toxic versions from the illicit market. 

“There’s so much so much more to do in the area of giving people alternatives to the toxic drug market that is not happening — that’s where the real crisis is,” MacPherson said. 

“That kind of action needs to start happening, and in combination with decriminalization that would make sense. But decriminalization on its own? When over 90 per cent of people who die are dying from drug toxicity? That needs to be dealt with.” 

Karen Ward says the federal government’s decriminalization announcement does little to address the toxic supply of drugs in Canada. (Rafferty Baker/CBC)

Ward said until the toxic drug supply issue is addressed head on in Canada, people who use drugs will continue to die at an unfathomable rate.

“The problem is they’re not illegal because they’re dangerous, they’re dangerous because they’re illegal,” Ward said. 

“People are dying. I’m surprised I’m still alive. People are falling apart. We’ve been through so much. They’ve suffered so much, and they’ve been poisoned to death by the policy that we’ve decided not to change.” 

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