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Vancouver, British Columbia, has notably become the epicentre of the opioid epidemic in Canada. The opioid crisis, which has notoriously overwhelmed Vancouver’s Downtown Eastside, took over 2000 lives in 2021 alone. On the other side of the world, what has been called a ‘war on drugs’ has swept across the Philippines since President Rodrigo Duterte took office in 2016. So what can these two different contexts tell us about drug crises? 

To gain some more insight into the issue of drug abuse and different approaches to tackling it, Spheres of Influence spoke with two individuals, one with personal experience of substance use and ties to the opioid crisis, and the other with personal ties to the Philippines. Here is what they had to say – but first some background. 

Vancouver & the Downtown Eastside 

In April 2016, British Columbia declared the overdose crisis a public health emergency. Since then, over 21,000 people across BC have died due to overdose. The Vancouver Coastal region has experienced the highest rate of overdose, which was estimated to be 36.8 per 100,000 people in 2018. 

In response to the drug crisis and in an attempt to reduce overdose deaths, the Vancouver Police Department has stated that it “supports a move to decriminalize possession of small amounts of drugs and supports a harm reduction and public health approach to dealing with substance use.” Between 2007 and 2018, over 244,000 people were arrested under the Controlled Drugs and Substances Act (CDSA); 81% of the offences were for non-violent possession, and 76% were eventually cleared. 

Consequently, the BC government has plans to decriminalize the possession of illicit drugs, including up to 2.5 grams of heroin, cocaine, and methamphetamine. The law is scheduled to come into effect in January 2023. 

The Philippines: The War on Drugs

Drug use in the Philippines stems from several interdependent factors, such as poverty, inequality, healthcare, organized crime, drug trafficking, and systemic violence. The prevalence of drug users in the Philippines is estimated to be 2.05% of the population. As a result, President Duterte, who was newly replaced by Ferdinand Marcos Jr. in the recent May 2022 elections, ran a strong anti-drug campaign coming into the presidency in 2016. According to government data, there have been 6,241 deaths related to ‘drug operations’ since July 2016. However, human rights organizations estimate triple that amount of deaths.

In an interview with Spheres, a Filipino activist, who will remain anonymous, gave his thoughts on Duterte’s call to action against the drug crisis. He explains that the former President and proponent of this so-called anti-drug sentiment asserted that he would eliminate drug lords and big cartel players while wiping out the problem of drug addiction in the ‘slums’. This was generally well received by the public, with Duterte being elected in 2016. 

“It’s a deeply Catholic and conservative country, so those values carry into their perception of people who suffer from addiction. They definitely view it as a crime, a societal ill, rather than what it really is – a health issue and a symptom of a bigger class problem.” 

As the campaign played out, however, it proved to be “essentially a war on the poor because I’ve never heard of any big time drug lords or cartel leaders being put away,” he explained. 

However, police accountability and corruption have long been a problem known to the Filipino people. “Growing up, we pretty much viewed the police as…well, useless,” he explains. “[Now], because Duterte gave all cops the green light to go kill drug dealers or drug users, some cops would use that, if they had to execute a rival dealer, to claim a double cash reward. Your cartel boss pays you for executing a rival and the police chief pays you for killing a drug dealer… so it increases the prevalence of this [corruption].” 

Patterns of Over-Policing & Targeted Drug Policies 

To gain some more insight into Vancouver’s struggle with opioid addiction, Spheres spoke to Eric, a student at the University of British Columbia who has previously struggled with substance abuse and addiction. Eric began working in safe injection facilities in Vancouver’s Downtown Eastside in 2019 and is now a strong advocate for decriminalization and the provision of a safe supply. 

Eric believes there is significant targeting and irony in certain drug policies and stigmas. “We penalize opium because of our sentiments toward the Asian population; we penalize marijuana because of our sentiments of Latin Americans; we penalize crack more than we do cocaine (even though it’s the same compound) because of our sentiments against Black people.” In particular, Indigenous populations have been disproportionately affected by the opioid crisis. Intergenerational trauma, which has carried the enduring legacy of colonialism, residential schools, and systemic violence, has made Indigenous peoples far more vulnerable to falling victim to the opioid crisis. Although Indigenous peoples make up 2.5% of the population, they ultimately account for 10% of overdose deaths in BC. 

It is also well worth touching on some of the harmful effects that policing has had on the issue of substance abuse in Vancouver’s Downtown Eastside. Organizations that work in the area claim that over-policing has actually worked to “undermine public health and safety,” as an overwhelming police presence inhibits and discourages individuals from accessing harm reduction services. Opponents of over-policing advocate that individuals who are already “particularly vulnerable in terms of their health, safety and economic condition” should not be targeted by police as criminals for drug use. 

In the Philippines, police seem to have exacerbated the issue into what it has become – a war on drugs. In many cases, witnesses and the families of victims have chosen to not take part in investigations for fear of their own safety. Police are not required to have search or arrest warrants to conduct house raids, and have routinely swept neighbourhoods based on hearsay leads. “It’s up to the discretion of the officer to determine whether it’s a serious case or non-serious case,” our anonymous source tells us. “It’s a culture of impunity, the police and security forces can pretty much do whatever they want because they’re ‘acting in the [so-called] interests of public safety.’” 

A Harm Reduction Approach to Drug Crises

So what is a possible solution to substance use and addiction crises? 

Many advocates have advanced the idea of a harm reduction approach, which seeks to “meet people where they are at” by focusing on reducing the negative health and social consequences associated with substance use, rather than requiring complete abstinence. Harm reduction is where the movement to decriminalize substances stems from. While Eric explains that BC’s move to decriminalize the possession of 2.5 grams of illicit drugs is “a good step in the right direction, it’s nothing close to enough…there’s a lot of work to be done.” 

Eric, who began volunteering at safe injection sites after he reached 6 months of sobriety, says that the benefits of approaches oriented around harm reduction are substantial. A safe injection site (or supervised consumption site) is a facility meant to decrease the harmful risks of drug use by regulating its use, providing safe drugs and clean needles, and facilitating access to health services. “It’s like drug users looking after drug users – that’s the way it should be. You’re employing the almost ‘unemployable’… It’s putting money in their pocket, it’s giving them a sense of dignity, purpose, and community.” 

Safe injection sites have considerable benefits to the communities they are in. These sites can result in the reduction of crime, as studies have shown data of “an abrupt, persistent decrease in crime after the opening of a supervised injection site.” Additionally, individuals are 30% more likely to use detoxification services after using the sites. The facilities also significantly reduce the risk of spreading HIV, hepatitis C, and infections through shared needles. Moreover, the provision of safe drugs and/or testing kits is essential in decreasing overdose rates. According to Vancouver Coastal Health, fentanyl was detected in 87% of overdose deaths in 2018, and 90% of illegal opioid drugs that have been tested in the area also contain fentanyl. 

Safe injection sites are an effective approach to harm reduction and preventing overdose deaths when compared to other measures, such as needle exchange programs. They are also economically beneficial to communities that are affected by high rates of overdose deaths “by preventing stress on downstream services like emergency rooms and paramedics.” 

Lastly, Eric emphasizes the importance of breaking the stigma around substance abuse. “It’s important to vocalize and encourage people to ‘come out of the drug-closet’,” he explains. “People can be a lot of different things – I’m a student and I’ve also messed around with meth and weed and everything in between.” In breaking the stigma and allowing people who use substances access to safe spaces, compassion is one of the best steps to take for those who need help. 

With a change in presidency in the Philippines, the future of the war on drugs is in question. While Marcos Jr. has asserted that he will not recognize any external investigations done on the drug war, including that of the International Criminal Court, he has also acknowledged the need for a shift in the state’s approach to the drug crisis. Marcos explained that the approach has been too focused on enforcement, and an increased emphasis on prevention and education, along with improvements in the country’s treatment facilities, is needed in the Philippines. 

While a harm reduction approach ultimately seems like the best attempt at controlling and dealing with the outbreak of drug crises, the climate created in the Philippines by complete police impunity and mass extrajudicial killings is one to be de-escalated before such an approach can even be considered. Only when approached through a public health perspective and human rights standard can the harms of substance use be minimized. 

If you or someone you know is struggling with substance use or addiction, check out this list of resources to see what is available closest to you.

Edited by Chelsea Bean

Lara Yacoub

Lara is originally half-Syrian and half-Egyptian, but grew up in Mexico City and Calgary, AB. She moved to Vancouver in 2019 to complete a B.A. in International Relations at the University of British Columbia....