Critics say the overdose crisis has been politicized in British Columbia’s election

When NDP Leader David Eby announced this month that the province would open “secure facilities” for the involuntary care of people with serious drug addictions or mental health problems, it was a moment of political unity with British Columbia’s rival Conservatives ahead of the fall election.

But for drug policy advocate DJ Larkin, the consensus was full of irony – given that the province is currently unable to provide enough beds even for those who want treatment, let alone those who don’t.

“This shift toward involuntary treatment is a knee-jerk reaction,” Larkin, executive director of the Canadian Drug Policy Coalition, said in an interview. “It is clearly a political move to create a simple solution to a problem that requires multiple interventions.”

With more than 15,000 deaths from toxic drugs since British Columbia declared a public health emergency in 2016, the province is at the forefront of debate, science and policy to address the crisis.

Critics, including Larkin, say the issue itself is tainted by politicization.

British Columbia Green Party leader Sonia Furstenau has accused major parties of using “dehumanizing rhetoric” against drug users, while former chief coroner Lisa Lapointe described plans for involuntary treatment as unrealistic and without scientific justification.

Advocacy group Moms Stop the Harm has branded the NDP government’s withdrawal of a drug decriminalization project “ridiculous,” while others claim drug users are being scapegoated.

“The politicization is devastating,” said Larkin, executive director of the Canadian Drug Policy Coalition, a group of more than 50 organizations. “This rhetoric has actually made people who use drugs a problem.”

Larkin said British Columbia’s three-year decriminalization project and implementation of safer supply alternatives to toxic street drugs were not designed to succeed.

“Right now we are at a crossroads where harm reduction and policy changes are being blamed for our situation and there is no evidence to support this. That’s not correct,” Larkin said.

“However, we have not taken the necessary steps to be able to support such programs and actually deliver the benefits we need.”

Dark background for political advances

British Columbia’s election campaign comes after the province suffered a record 2,551 drug deaths in 2023 linked to the unregulated market.

The crisis provided the grim backdrop for a number of policy initiatives, including the decriminalization pilot, which allows adults to carry up to 2.5 grams of opioids, cocaine, methamphetamine or ecstasy for personal use without facing charges . It relied on an exemption granted by Health Canada under the Controlled Drugs and Substances Act that allowed open drug use in some public spaces.

There are also safer care programs that offer prescription alternatives to toxic illegal drugs.

In July, provincial health officer Dr. Bonnie Henry to explore the idea of ​​expanding this to provide alternatives to opioids and other street drugs without a prescription. Former coroner Lapointe has also advocated for over-the-counter access to controlled medications.

But B.C.’s safer care programs came under fire after police said some of the prescribed drugs, such as the opioid hydromorphone, ended up in the hands of illegal drug dealers.

Eby has repeatedly rejected proposals for a safer supply of over-the-counter medicines and announced in April that drug use would be recriminalized in public spaces such as parks, public transport and hospitals.

Leslie McBain, co-founder of the policy advocacy group Moms Stop the Harm, was part of the working group for the decriminalization pilot. She called the NDP’s withdrawal disappointing, saying it was “just political” and that the group was not consulted.

“It’s also ridiculous because the people who do this in public places have no other place to do it because there isn’t enough housing, because there aren’t enough safe consumption services or overdose prevention sites,” she said.

Lapointe said that while it is difficult to measure the effectiveness of decriminalization, it is “not a failure.” She said coroner statistics now show fewer people are dying after decriminalization.

“The death toll is trending down and as of this writing the latest data they have released is from the end of July. They show the lowest death rate in this province since 2020. This is the period after decriminalization and the number of young people.” Death has also decreased.

She said there was “little evidence” of the effectiveness of involuntary care and therefore warned against relying on it as a “response to this very complex public health emergency.”

The leaders of the NDP and BC Conservatives argue their plans are compassionate toward those struggling with addiction and address public safety issues.

Eby promised “secure involuntary care facilities under the Mental Health Act” for people with serious addictions, mental illness and brain injury. That marked a shift in the party’s platform, which had previously focused on harm reduction.

The NDP announced plans to add more than 400 psychiatric beds for involuntary care in new and expanded hospitals.

“These are the people we see on our streets, lying face down on the pavement or involved in incidents with people where they are threatening or sometimes setting fires or engaging in other disruptive behavior in communities lay,” he said at a press conference. “They are not currently being cared for in our system (and) the system is not responding appropriately to this patient population,” he said, adding that involuntary care is only part of the NDP plan.

British Columbia Conservative leader John Rustad has also promised involuntary treatment and secure facilities. However, he criticized Eby’s actions, saying it would take hospital beds away from other people.

“In my opinion we need to expand our capacity,” he said in an interview.

“It will be a big process. It won’t happen overnight, but it is the only way to solve this problem. “Obviously the path that (BC) has taken with decriminalization and safe supply — which is not safe, but very dangerous drugs — is not working.”

Rustad also said the Conservatives would close injection sites in Richmond, B.C., calling them “drug dens,” echoing federal Conservative leader Pierre Poilievre’s terminology.

The Greens, meanwhile, have said they want to expand prescription and safer supplies of opioids and other drugs and explore an over-the-counter model – strategies supported by Lapointe, who stood by Furstenau when the party unveiled its policies on Tuesday.

Lapointe said the province would be “setting itself up for disaster” if the focus shifted to involuntary care.

“There are waiting lists for detox, there are waiting lists for recovery. If people don’t have access to the voluntary care they want to receive, how can we involuntarily incarcerate them when there is no evidence that would be successful? “she said during the press conference.

Mixed results for drug trials

Research into the effectiveness of the strategies used in BC has produced mixed results.

A study published in January in JAMA Internal Medicine found a “relative increase” of nearly 63 percent in hospitalization rates for opioid overdoses across British Columbia following the introduction of safer care.

In an interview with The Canadian Press in April, study co-author Shawn Bugden said there was no attempt to imply “causation” and that the result could be due to a variety of reasons, such as the unregulated market.

Another study published the same month in the British Medical Journal found that a day or more of dispensing prescription opioids was associated with “significantly reduced all-cause mortality” and overdose deaths in the next week.

In response to calls for involuntary care, Larkin cited a Swedish study published in the journal Drug and Alcohol Dependence in 2022. A “very high” risk of dying immediately after discharge from compulsory care was found.

But some community leaders say they are juggling mental health and addiction issues as well as concerns about public safety and crime.

Kelowna, B.C., Mayor Tom Dyas said introducing mandatory care is “necessary.” He told a panel at the recent Union of BC Municipalities convention that there were 2,274 overdose calls in his city in 2023, a 25 per cent increase from 2022.

“The reality is that allowing these people with mental health and addiction issues to suffer on our streets is just unmerciful,” he said.

He said any politicization was unintentional.

“It is a reality that all of our communities, our residents and our businesses face,” he said.

Larkin said a key reason for the public’s concern about the crisis is that there are “simply more people in public spaces.”

“The issue of homelessness has been confused with public drug use,” Larkin said, adding that the drug supply is also more unpredictable and tainted with benzodiazepines, sedatives and sedatives.

“This results in people being extremely sedated, potentially for hours,” Larkin said. “So that doesn’t necessarily mean that people are using more or that there are more people who need to use drugs in public places, it just means that people are more visible because they’re outside and they look very sedated,” for one a long time.”

The pandemic is largely to blame, Larkin said, explaining that it has sparked a “dramatic shift toward more volatile and effective drugs.”

Lapointe said regulation is “common sense” but one of the biggest problems is that there are “not enough doctors who can prescribe.”

“Regulating drugs is not a radical idea. It is irresponsible to allow thousands of people to die in our country without taking action,” she said. “Regulation is common sense.”

This report by The Canadian Press was first published Sept. 28, 2024.