Introduction

The toxic drug overdose crisis has reached a point in British Columbia where bold action is necessary to prevent more deaths. To combat the overdose crisis we need legal regulation of an accessible safe supply with minimal barriers, to decriminalize drugs, and to actively address intersecting challenges such as poverty and homelessness, racism and prejudice, physical health, mental health, and trauma. People with lived and living experience need to be heard and consulted, and their voices need to be prioritized, as they are the ones who are most impacted by this crisis.

For the past decade, the circulation of toxic drugs has been increasing and has had a grave impact on the community. Since BC declared the overdose crisis on April 14, 2016, over 10,000 people have died of overdose in the province. Death from overdose is now the number one cause of unnatural death in the BC.

Our community in the Downtown Eastside is wrought with intersecting challenges, including poverty and homelessness, mental and physical illness, addiction, racism, trauma and oppression. The stigma faced by people who use substances in the Downtown Eastside is mounted and the hardships are compounded. Although people who use drugs come from all different walks of life, those who use substances in our community are often further marginalized and often face harsher stigma and criminalization.

Each of these individuals who have passed leave behind loved ones and each death greatly affects the community. These deaths could have been prevented with better access to safe supply, and the decriminalization of illicit substances.

The steps that the BC government has taken to fight the overdose crisis are insufficient. In 2022, the provincial government received exemption from Health Canada under the Controlled Drugs and Substances Act to decriminalize the “possession of some illegal drugs for personal use.” But the action taken will not be enough to curb the alarming amount of toxic drug overdoses, and will continue to criminalize the majority of marginalized people who use substances.

The three-year exemption, starting in January 2023, only decriminalizes those who carry a cumulative threshold of 2.5 grams. Research done by local drug advocates (VANDU) indicated that 4.5 grams is closer to the amount carried by people who use drugs. With the majority of substance users carrying over 2.5 grams per individual substance, the small threshold will only ensure that the majority in the community will continue to be stigmatized and criminalized. This limit further puts those who are unhoused at a disadvantage, as they lack a place to store their drugs for future use and are limited to carrying their substances on them at all times.

FIRST UNITED believes in a multi-pronged approach to sensible, compassionate, and evidence-based drug policy that includes safe supply and legal regulation, decriminalization, and a proactive approach of addressing intersecting challenges.

Safe Supply

Access to safe supply with minimal barriers is necessary to prevent overdose from toxic drugs. It was reported by the Canadian Centre on Substance Use and Addiction (CCSA) in 2020 that 91% of opioid-containing samples in BC contained fentanyl, analogue, and other substances. While these substances were commonly found in the unregulated drug supply, survey respondents reported not expecting or unintentionally consuming these substances (confirmed by urine samples). The reports also showed that many other unexpected substances were found in the unregulated drug supply, including novel synthetic opioids, benzodiazepines, and synthetic cannabinoids. This is particularly concerning, because benzodiazepines do not respond to naloxone, which makes it harder to reverse overdoses.

With a regulated safer supply, people who use drugs can know exactly what they are getting in their supply and how much.

Decriminalization

The seizure of drugs and mistreatment of marginalized substance users by police continues to create stigma, shame, fear around substance use, and cycles of poverty and criminalization. The fear of repercussions from law enforcement can cause hesitation in marginalized substance users to seek or obtain the help of services that could potentially their lives.

While the BC government states that police will not arrest, fine, or seize drugs from people carrying under 2.5 grams, they still tasked the police with referring people to health and social services. The role of police in this context is unnecessary, considering that the government stated this is a health issue and not a criminal one. Qualified social and health service professionals are much better suited to provide referrals.

Intersecting Issues

While safe supply and decriminalization are necessary, it is crucial to address the intersecting challenges often faced by people who use drugs in the community. Members of the community can face poverty and homelessness, a lack of access to resources, mental health, trauma and addiction, physical health challenges and disability, racism, and prejudice. Proper resources need to be allocated to addressing these issues, as they all play a significant role in this crisis. It is also critical to work in partnership with, and take strategic direction from, people with lived and living experience of these issues and to take actions supporting their expertise and autonomy.

Conclusion

All levels of government need to take quick, decisive, and bold action to stem the tide of deaths by overdose. But the existing approach to drug policy fails to address the issues and experiences of those who are being impacted by this crisis the most. A fully accessible safe supply is needed to combat the toxic drugs in circulation. Along with decriminalization, legal regulation and safe supply, the government also needs to listen to people with lived and living experience. They need to adequately address intersecting challenges faced by marginalized people who use substances, which include racism, mental and physical health challenges, poverty, and homelessness.