Cannabis is done. Opioids now, please
Congratulations to the Liberal government for the successful launch of its cannabis project this month. It was a high-risk and potentially disastrous policy commitment, if it had not been executed in a carefully phased effort, with sufficient time to build consensus and allow everyone involved to prepare. But it raises this question. Even when illegal, its fiercest critics could not credibly claim that cannabis kills. Opioids kill a dozen Canadians daily, more than 4,000 last year. If the reasons for cannabis legalization were, in part, harm reduction, to take it out of the hands of organized crime, to make it tougher for children to become users, what are we going to do about heroin and illegal opioids?
For nearly 17 years, Portugal has used harm-reduction-based policies, grounded in the decriminalization of heroin and contraband synthetic opioids, and their distribution through medical clinics. Death and HIV rates have plunged. It is incredibly difficult to limit the distribution and access to “super synthetic” opioids, such as the “horse-strength” fentanyl, fatal after consuming a few grains, available on the internet.
However, addiction experts have argued for years for the benefits of offering users a walk-in medical setting, where, unlike the safe-injection sites now spreading across Canada, technicians could dispense as well as assist with injection. Such a system would not kill the illegal trade, but it might make it less attractive to users frightened by so many overdoses all around them.
Such clinics could offer reduction strategies, health and lifestyle counsel, as well as a safe environment. Pilot projects in Europe have demonstrated their ability to extend, even transform, the lives of users. To critics who will angrily denounce taxpayers’ money being used to fund drug dealing, one might ask this:
Do you have a better plan to save the young Canadians who will die this year, to spare parents the agony of watching helplessly as their child slides into oblivion?
The venerable conservative British journal The Economist has for decades argued for full legalization of all drugs, given that attempts to effectively prohibit them have cost taxpayers hundreds of billions of dollars, cost many tens of thousands of lives and destabilized countries from Afghanistan to Pakistan and Jamaica to Mexico.
Their argument is less political or ethical than merely pragmatic. The decades-long wars on drugs have all ended in defeat, whether or not their sponsors are willing to so admit.
It is harder to defend the use of certain killer drugs such as methedrine and its cousins, but the opioid crisis is real, growing and out of control. Its principal victims are the young, the poor and Indigenous Canadians.
However, what sets it apart from previous drug death explosions, like crack 20 years ago, is that the opioid crisis is also killing many more politically sensitive victims: urban, white and affluent.
There is a strong imperative for all politicians to be seen to be more effective in wrestling with it.
A good starting place would be Canadian pilot projects as called for by various expert panels, to offer counsel, safety and, yes, supervised injectable opioids. The experience of front-line communities such as those in New Mexico — where the drug supply lines on interstate highways literally flow through the state on their way north — has been bitter.
After several years of education, training, counselling and vigorous interdiction, they have wrestled the death rate from a stunning 17.5 per hundred thousand in 2016 to less than 14; that is still more than twice the Canadian death rate. The battle will not be easy, and it will be long, with or without decriminalization.
As Canada has now shown global leadership on cannabis, perhaps it is time for us to tackle a far more deadly and difficult drug dilemma, with equal courage. Robin V. Sears
is a principal at Earnscliffe Strategy Group and was an NDP strategist for 20 years. He is a freelance contributor for the Star. Follow him on Twitter: @robinvsears