How to heal the scars of our war on drugs
Success in policy should focus on health, not arrests, say five experts.
The legalization of cannabis and rapid scale-up of supervised-injection sites — as well as community-led initiatives, such as the site set up by Overdose Prevention Ottawa in Lowertown this month — have thrust Canada back into the limelight of global drug policy. Against the backdrop of a national overdose crisis and a fracturing of global consensus on drug prohibition, these are welcome changes. Yet they only begin to chip away at the drug policy challenges facing Canada.
Canada’s policy community remains divided about how best to tackle the overdose crisis. As the death toll mounts, should we invest more in law and order approaches, treatment, harm reduction or some combination?
A report published in July offers recommendations to begin addressing these challenges. The report is the result of two days of deliberations by more than 200 experts who met in Ottawa in April as part of Canada’s Drug Futures Forum. The forum deliberately convened groups with diverse views, including police, frontline harmreduction workers, doctors and nurses, corrections staff, judges and lawyers, public servants, researchers and people who use drugs.
The consensus was clear: We all need to think of problematic substance use as a health, rather than a criminal justice, issue. The new Canadian Drugs and Substances Strategy, launched in 2016, which replaced the Harperera National Anti-Drug Strategy, takes a more publichealth-oriented approach and enables supervisedconsumption sites. But the continuing criminalization of people who use drugs does little to reduce drug use or crime and puts funding into the justice system at the expense of treatment and prevention. The forum proposed major shifts in resources out of the courtroom and into the health and social sectors.
The toughest question is how, especially as the United States under Donald Trump is doubling down on punitive tactics. Even inside Canada, dismantling the institutional machinery of prohibition is like turning a giant ship. But other countries have done it: After decriminalizing drugs and scaling up treatment 15 years ago, Portugal has seen a dramatic drop in overdose deaths and unneeded arrests.
First, the report calls for meaningful consultation with people who use drugs on all drug policy proposals. Though many argue for rapid decriminalization of all drugs, the report notes that this is not a panacea and unintended consequences are inevitable; thus a commission should map out a thoughtful pathway toward regulation.
Even under current laws, the government can reduce the harms of criminalization, which have disproportionately affected Indigenous and black Canadians. Key steps include: a process for pardoning past cannabis convictions, expanding diversion program eligibility criteria, repealing mandatory minimum sentences and using alternative sentencing options.
Canada is a global leader in harm reduction. Yet other measures, like distribution of safer crack kits to prevent the spread of infectious disease, medication-assisted therapy (the “gold standard” treatment for opioid dependence) and drug-testing for recreational users, need urgent scale-up.
Some Canadians remain skeptical about these measures, in part because they challenge the traditional metrics of drug policy “success.” The report suggests the establishment of a national Drug Policy Observatory to analyze data on drug use and law enforcement patterns. Success in drug policy should be measured in health and equity outcomes, not kilos of cocaine interdicted or number of arrests.
Canada has a real opportunity to lead internationally on a more humane and evidence-based approach to drug policy. As the first G20 nation to tackle the task of regulating cannabis at the federal level, Canada can lead in finding constructive solutions to tensions between federal policy and international treaties that currently criminalize drugs. Canada should make progressive drug policy a real element of its foreign aid and international security strategies.
The overdose crisis in Canada is urgent and tragic — but not inevitable. This report demonstrates that even so-called adversaries in drug policy debates agree on major next steps. With bold policy-making, we can heal the scars of the war on drugs in Canada and beyond.