New drug policy needed to fight overdose crisis

Addiction is a serious issue, but it shouldn’t be a criminal one, says Derek Chang.

“I just learned that my cousin overdosed at a friend’s party. His friends were afraid of calling 911 and left him alone. He was eventually brought to the hospital but remained in a coma and died the following day.”

Biting her lips, my patient told me this painful news in the clinic. I thought I wouldn’t be hearing these kinds of tragedies again after the Good Samaritan Drug Overdose Act came into legislation last year.

Her story not only broke my heart, but also made me furious. How could it be that those people, who were supposed to be his “friends,” wouldn’t call 911 because they were afraid of being caught for using drugs? I guess my outrage wasn’t directed at them, but at the larger system that had driven their behaviour. Why is it that in 2018 we still call drug-users criminals?

Just over a year ago, I struck up a conversation with a woman while waiting at a bus stop. We chatted about the record-breaking amount of rain we had that month in Vancouver and our work. She had a college degree and was working for the government. When I told her I worked in addiction medicine, she said, “Oh, those addicts should all be put into jails.”

My jaw dropped for a few seconds. Meanwhile, what she said also reminded me of my own beliefs many years ago before I started working with street youth. Like her I used to think “addicts” were solely responsible for their addiction and should, indeed, be treated as criminals.

Over the years, I’ve educated myself on the issue of addiction and different spheres of social determinants of health. Addiction is complex. It’s a health issue, a social issue, an economic issue — but it shouldn’t be a criminal issue. Many studies around the world have shown drug criminalization perpetuates the drug problem and it’s not effective.

I was fortunate to have twice listened and talked to Dr. Joao Goulao, the pivotal figure behind Portugal’s drug decriminalization. The first time was in a conference in Lisbon in 2015 and the second was at the B.C. Recovery Day in New Westminster last fall. Since Portugal’s drug policy was implemented in 2001, continuation rates of drug use decreased by 15 per cent within a decade and Portugal’s levels of drug use have dropped below the European average.

The policy not only reduced many harms associated with drug use, including overdoses and HIV infections, but also freed up resources, which the government could reinvest in addiction treatment, mental health and social services. In addition, it allowed the criminal justice system to focus on eliminating drug supplies.

Most importantly, it helped reduce the stigma of addiction and now more people are willing to speak up or seek help.

While this remains a delicate subject that often provokes emotionally charged debates, it nevertheless can’t be avoided as we’re in the midst of a serious public health emergency: thousands of Canadians have died of overdoses. According to the Coroners Service of B.C., overdose-related deaths have surpassed 1,100 in the first nine months of 2017 and the number is still rising.

What we’ve been doing isn’t working and the contributions of front-line clinicians like myself aren’t sufficient.

We need to have a systemic change to respond to this crisis and to help prevent tragedies. I applaud the federal government’s passing of the Good Samaritan Drug Overdose Act, but it’s not enough.

As a physician, it nevertheless took me several years to educate myself on this matter and I understand it takes time to change the opinions of some.

However, many of our families, friends and patients are dying from overdoses every day, so we don’t have the luxury of waiting until the majority of the country is on-board before we decriminalize substance use.

The government needs to show greater leadership to end our outdated and non-evidencebased drug policy.

My hope is I no longer have to hear such heartbreaking stories like that of my patient’s cousin, and drug-users will no longer be treated as criminals, but as any other human being living with chronic illness, such as diabetes and high blood pressure. What they need is dignity and care, not more shame and punishment. Derek Chang is a family doctor with addiction medicine specialty training and a clinical instructor in the department of family practice at the University of British Columbia

I just learned that my cousin overdosed at a friend’s party. His friends were afraid of calling 911 and left him alone. He was eventually brought to the hospital but remained in a coma and died the following day.