As the world continues to reckon with the realities of life during the COVID-19 pandemic, the city of Vancouver is making strides to turn the corner on a different type of public health emergency: the opioid crisis. On November 25, 2020, the entirety of Vancouver’s City Council voted to submit a proposal to the federal government regarding the decriminalization of small amounts of illicit drugs. Such a decision is undoubtedly an important progression in shifting public resources away from the hyper-criminalization of drug use, which according to the Vancouver Area Network of Drug Users (VANDU), “[drug prohibition] fuels a toxic drug supply, and impedes access to health and harm reduction services.”
City Hall’s proposal also comes at a time when many of B.C’s residents are facing the realities of COVID-19 and the compounding effect it has had on the opioid crisis. The B.C. Coroners Service has confirmed record-setting statistics of drug-toxicity fatalities throughout 2020, with a 74% increase in annual deaths compared to 2019. Beyond setting a startling precedent, these statistics represent the loss of a friend, a partner, a sibling, a member of the community. And as the pain of such unimaginable loss echoes through our collective consciousness, so do questions like: Where are our government representatives? What are they doing about this? Will they do anything at all? Though long overdue, the government may finally be giving a straight answer.
The Opioid Crisis
The province of British Columbia officially declared the opioid crisis a public health emergency in 2016, recognizing the devastating statistics surrounding rising overdose fatalities. Spheres of Influence guest writer and local advocate Bruno Gagnon has taken on various roles on the frontlines of the opioid epidemic across Canada. While talking with Bruno about the opioid crisis and how Vancouver’s decriminalization proposal might affect it, he provided some valuable insight into the crisis’s personal and community implications.
Bruno worked as a paramedic on Montreal’s outskirts from 2012-2016 and says that even before the opioid crisis was formally recognized, overdose cases were leading to an increasingly calamitous public health situation. In 2017, Bruno also participated in a government pilot project cooperating with the Provincial Health Service Authority (PHSA) to provide psycho-social support to workers on the frontlines of the opioid crisis across the entire province of B.C.
When asked what factors of the opioid crisis have taken the biggest toll on both frontline workers and himself, Bruno expressed that a significant part of the burden comes from knowing that the crisis does not exist in a vacuum. “It’s a supply chain problem” he explains, referring to the insufficient amount of government funds being allocated to address the socio-economic issues that have fueled this public health emergency. The intersection of poverty, a lack of access to healthcare, barriers to employment, and unstable housing situations have been proven to increase the risk of addiction vulnerability. Yet, Canada’s inadequate social assistance programs reveal the tendency of the government to treat the symptoms of the problem by penalizing drug use, rather than recognizing the consequences of systemic marginalization.
The Significance of Decriminalization
Although public funding and agency are key aspects of the government response to the opioid crisis, the prospect of decriminalization has also played a vital role. For decades, drug-user advocate networks have operated on the fringes of Canadian society, contending with the hyper-criminalization of drugs implemented by government administrations and law enforcement.
The Vancouver Area Network of Drug Users (VANDU) is a locally and internationally renowned organization fighting at the forefront of drug-user activism since its conception in 1997. Its stance on decriminalization and its role in the ongoing opioid crisis is simple: “Decriminalizing drug possession in Vancouver is a bare minimum response to save lives amid ongoing housing and overdose crises and COVID-19.”
The burning question of how decriminalization could potentially save lives cannot be fully addressed without exploring the ways in which decades of criminalization have contributed to rising rates of opioid-related deaths. The threat of criminal penalization is known to generate riskier and more isolated methods of using drugs. Illegality creates accessibility barriers for harm reduction and support services such as safe injection sites. Moreover, police officers tend to disproportionately target low-income and minority communities under the pretense of drug-enforcement. Given the increasing toxicity of Vancouver’s local drug supply and an estimated 500 annual fatalities attributed to the opioid crisis, it is now more important than ever to mitigate the risks of marginalization and isolated drug-use.
Thus, creating a space in which drug users are no longer criminalized and condemned is a long overdue but certainly necessary step in combating the opioid crisis and saving lives.
The Push For Change in Vancouver
With the end of the COVID-19 pandemic still a ways off and overdose cases continuing to rise, Vancouver city officials have started to recognize the urgency of moving forward with decriminalization efforts. Mayor Kennedy Stewart, council officials, and Health Canada representatives are predicted to initiate formal conversations surrounding the decriminalization proposal in the coming months.
In terms of what decriminalization means for the policing of drug-users in Vancouver, Bruno explains that the project will essentially cement what is already being done in the field. He says, “it was already common practice for police officers to dismiss small drug possession charges, however, the issue is that it has been completely at the discretion of the officer.”
This caveat of discretionary policing has led advocates to argue that decriminalization efforts will only work if these new policies are fully implemented. VANDU representatives claim that partial decriminalization programs, such as those utilized by Portugal, “preserves the same fear and distrust that drives drug use underground, negatively impacting our lives in much the same ways as criminalization itself.”
Despite the progress in public policy that these plans represent, they are certainly not a one-stop solution. After experiencing various government initiatives on the frontlines of the opioid crisis, Bruno expresses cautious optimism about the practical realities of the decriminalization proposal. He says, “although we are moving forward as a society, decriminalization in Vancouver runs the risk of being a political project, a token, rather than a recognition of grassroots push for change”.
This being said, Vancouver has a wealth of groundbreaking local initiatives that could potentially help inform government policy. Members of the Overdose Prevention Society (OPS) have provided critical care, including naloxone administration, to Vancouver’s Downtown Eastside for nearly five years. The experience and knowledge of frontline workers in the OPS harm-reduction collective, along with similar networks, would be an invaluable asset to city officials and health representatives as they move forward with their decriminalization proposal.
Policy in Words Saves Politicians, Policy in Action Saves Lives
As Vancouver forges its own path towards decriminalization, the initiative’s ultimate fate will depend on the trust of those it affects. Communities who have spent decades being criminalized and marginalized by government officials and law enforcement are unlikely to have blind faith in bureaucratic reforms that in the past have turned out to be nothing more than hollow promises. Therefore, Vancouver’s decriminalization plan needs to have a genuine will for change, represented by full decriminalization measures and must include local voices.
Building bridges with organizations like VANDU and OPS may give Vancouver city officials the insight needed to finally create a viable plan if they are serious in their intentions to do so. For the sake of the thousands of lives that depend on it, many certainly hope that they are.