A gateway policy — not a ‘gateway drug’

The legalization approach for cannabis should be extended to all drugs
The opioid overdose crisis points to the need for reform in drug policy. 
The opioid overdose crisis points to the need for reform in drug policy. SHANNA HUNTER/THE VARSITY

As the theme of this week’s issue may make you aware, recreational cannabis use will be legalized on October 17. While this is grounds for celebration, cannabis legalization should also open up serious consideration for the legalization and regulation of all presently illicit drugs.

Drug use should not be viewed through a criminal justice lens, which results in unnecessary arrests and imprisonments and forces drug users to live with the lifelong consequences of a criminal record. Instead, drug use should be dealt with as a matter of public health. This is especially true given the opioid crisis that is currently afflicting the country.

Understanding addiction

By criminalizing the possession of drugs, addiction — recognized by both the American Psychiatric Association and the World Health Organization as an illness — is also being criminalized. This means that people addicted to drugs face legal penalties, including imprisonment, as opposed to medical intervention and support in order to overcome their addiction.

According to a 2012 Statistics Canada report, approximately 21.6 per cent of Canadians 15 and older met the diagnostic criteria for a substance use disorder at some point in their lifetimes. At the time, four per cent of Canadians had symptoms of dependency on a substance other than alcohol or cannabis at some point in their life. Substance use disorders were most common among young people between 15 and 24.

When a person addicted to drugs stops using the substance, they are faced with painful or otherwise unpleasant withdrawal symptoms. These occur as the person’s brain chemistry slowly returns to normal.

These symptoms can prevent people from maintaining normal lives. As a result, people may feel forced to continue using drugs simply to get through the day. For users of harder drugs, such as heroin, withdrawal symptoms can manifest as soon as six hours after their last hit.

Although treatment for addiction is available, access to it is not equal nationwide. Some people have more difficulty accessing care due to their location or socioeconomic status.

Considering the opioid crisis

With the ongoing opioid crisis, considering drug policy reform has become even more critical. In 2017, Toronto saw 303 opioid overdose-related deaths — a 63 per cent increase over the previous year. The chance of accidental overdose is increased when a drug user’s hit contains a dangerous amount of even more potent opioids, such as fentanyl or carfentanil — two extremely powerful painkillers that have, in recent years, begun to show up in supplies of street drugs, such as heroin.   

In an attempt to self-manage the situation, some drug users have begun carrying naloxone, which can temporarily reverse an opioid overdose. Concerns about accidental overdoses have also spread to university campuses, where student leaders at some schools have been trained to administer naloxone in the event of an overdose on campus. Four colleges at U of T confirmed to The Varsity last year that their dons do not carry naloxone.

Since people who use drugs can never be sure if their drug supply will be lethal, criminalization furthers a lack of quality control, which endangers drug users’ lives. As well, criminalization forces drug users to buy and use substances in secret, and often in unsafe spaces, where the risk of overdosing or contracting a bloodborne infection is more likely.

Furthermore, criminalization stigmatizes drug users, making them less likely to seek help for their addiction if they desire it. It also contributes to the number of overdose deaths, since drug users and those around them are more hesitant about getting medical attention for an overdose for fear of police intervention.

Legalization as the best course of action

In June, Toronto’s Medical Officer of Health, Dr. Eileen de Villa, presented a report to the Toronto Board of Health about the importance of taking a public health approach to drug policy.

The report noted that Canada’s decision to criminalize some substances, such as cannabis, but not others was not based on scientific assessments of the risks posed by different substances. Instead, these decisions were made according to “moral judgements and racist ideas about people and the drugs they were using.” De Villa’s report goes on to point out that the War on Drugs, which began in the 1970s, has not been effective at reducing drug use. Thus, it is time to consider the alternatives.

Among the recommendations, de Villa highlights the need to decriminalize personal drug use and possession. The possibility of full legalization and regulation is also discussed, though, as the report points out, establishing an effective system through which to regulate substances would be extremely complicated. Thus far, no country has opted for full legalization.

Despite this, total legalization, if managed correctly, seems to be the best course of action for Canada. Unlike decriminalization, legalization would allow the government to regulate drugs and control their distribution. This means that money would be funnelled away from organized crime, and regulated producers would ensure that drug supplies are not laced with even more potent, more addictive, and, potentially, more dangerous substances.

The need for safe injection sites

Until harder drugs are legally regulated in Canada, the introduction of more safe injection sites is necessary. These sites allow for more regulated drug consumption and ensure that people are using clean needles. Furthermore, staff members are able to intervene if an overdose occurs.

Unfortunately, Ontario’s current Progressive Conservative (PC) government has decided to put a hold on the opening of three new sites, one of which was to be located in Toronto. The government is also considering whether or not to continue funding existing sites.

During the 2018 election, PC leader Doug Ford voiced his opposition to safe injection sites. “I believe in supporting people, getting them help,” he said. “I ask anyone out there, if your son, daughter, or loved one ever had an addiction, would you want them to go in a little area and do more drugs? I’m dead against that.”

This stance shows a fundamental lack of understanding of addiction on Ford’s part. As Co-Director of the Ontario HIV and Substance Use Training Program Francisco Sapp pointed out to The Canadian Press, abstinence-based treatment programs have low success rates, with forced rehabilitation likely to be lower still.

Ford’s position ignores evidence that these safe injection sites facilitate access to rehabilitation programs and other social supports when a drug user is ready for them.

Most importantly, these sites save lives. According to The Canadian Press, the overdose prevention site at Toronto’s Moss Park had reversed about 200 overdoses as of April. The closure of this and other sites would be a huge step backward in the management of the opioid crisis.   

Public health, not criminal justice

Canadian drug policy in general can and should be reimagined. Cannabis legalization provides us with a unique opportunity to learn important lessons about establishing new systems through which to regulate substances — lessons that can and should be applied to other substances in the future.

At the very least, cannabis legalization will hopefully start a critical conversation about how drugs, users of drugs, and drug policy should be understood as concerns of public health, not criminal justice.

The Varsity’s editorial board is elected by the masthead at the beginning of each semester. For more information about the editorial policy, email editorial@thevarsity.ca.

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