Poilievre’s anti-drug pitch a failure of imagination

In a video posted online over the weekend, Conservative Leader Pierre Poilievre gave us his take on this country’s ever-growing epidemic of opioid overdose. It’s an incredibly disappointing and potentially dangerous take, but let’s focus on common ground to start: The numbers are horrifying.

From April 2020 to March 2022, nationwide, 15,134 Canadians perished from opioid toxicity. That’s up an astonishing 91 per cent from a pre-pandemic baseline; it’s about 40 per cent of COVID-19’S death toll over the same period. As ever, British Columbia leads this sorry pack: In 2021 B.C.’S opioid overdose rate was 43.9 per 100,000 population — ahead of Alberta (36.4), Saskatchewan (27.2) and Ontario (19.4). In September of this year, B.C. reported an average rate of 5.7 opioid overdose deaths per day — roughly 50-percent more than there were deaths from COVID.

Poilievre claims to know why this is happening, and he chose a Vancouver tableau — mountains, skyline and a homeless encampment — as the site for his video pitch.

“The addictions that we see that are terrorized (sic) these (homeless) people and our communities, they are the result of a failed experiment,” Poilievre ventured, linking the opioid and homelessness crises to rising urban crime. “This is a deliberate policy by woke Liberal and NDP governments to provide taxpayer-funded drugs, (to) flood our streets with easy access to these poisons.”

He was referring to B.C.’S recent and relatively bold offer of pharmaceutical-grade opioids to addicts by prescription. “From March 2020 to July 2022, more than 14,000 people were dispensed prescribed safer supply through Risk Mitigation Guidance (RMG),” B.C.’S health ministry reported earlier this month.

Poilievre’s position: “There is no safe supply of these drugs. They are deadly, they are lethal and they are relentlessly addictive.”

I implore him to reconsider. There is no denying the addictive nature of opioids, no matter what their source. But there absolutely is a vastly safer supply of “these drugs” than there is on the street. It’s called a pharmacy.

It is by now common knowledge that the surge in opioid deaths in recent years is down in large part to street heroin being laced or replaced with unpredictable doses of fentanyl, a synthetic opioid often cited as being up to 50 times more powerful than heroin and 100 times more powerful than morphine. Fentanyl analogs such as carfentanil are often described as 100 times more powerful still.

The data from B.C. are unambiguous. From 2019-2022, the B.C. Coroners Service deemed fentanyl and fentanyl analogs relevant in 86 per cent of drug-overdose deaths in the province. It deemed “other opioids” — everything from prescription oxycodone to street-corner heroin — relevant in 23 per cent of deaths. Cocaine was implicated in more deaths than fentanyl-free opioids (45 per cent) as were amphetamines and methamphetamines (42 per cent) and even good old-fashioned alcohol (26 per cent).

From March 2020 to December 2021, the B.C. Centre for Disease Control reported, “there were no illicit drug toxicity deaths where hydromorphone was the only substance detected in post-mortem toxicology” — hydromorphone essentially being pharmaceutical-grade heroin, now available by prescription in B.C.

If that “safer supply” somehow replaced the current supply entirely overnight, the number of accidental overdose deaths would plummet, simply because everyone would know what they were taking and how much of it. And if that supply were cheap or free, there would be no reason for addicts to pursue desperate criminal acts to pay for it.

This really ought to be intuitive. Anyone would hope that a loved one struggling with addiction took a known dose of something likely to render him sleepy, unproductive and constipated rather than something that might very well render him dead. Treatment is Poilievre’s preferred approach. Treatment is pretty much everyone’s preferred approach. But it has proven entirely ineffective with cadavers.

Clearly that’s not intuitive to a lot of people. Minds remain to be changed, including Poilievre’s. But the facts Poilievre is marshalling to bolster his case are more bizarre than normal.

If distributing clean opioids to addicts is behind Vancouver’s alleged descent into lawlessness, responsible for “terrorizing” the community (as Poilievre put it), then why do we hear the same city-gone-to-pot narratives out of other West Coast cities — Seattle, San Francisco, Los Angeles and Portland, Ore., for example?

Astonishingly, Poilievre claims those cities are also suffering from the “safer supply” problem. “This has been tried not just in Vancouver, but in places like Los Angeles, Portland, Seattle, San Francisco,” Poilievre averred, “and always with the same results: major increases in overdoses and a massive increase in crime.”

That’s just empirically incorrect. “As such programs grow in Canada, nothing of the sort exists in the United States, where 108,000 people died from overdoses in 2021, largely driven by fentanyl,” Stat News reported recently. Many American jurisdictions make opioids like methadone and buprenorphine available, but those are designed to help addicts quit; they don’t help people who aren’t ready to quit to get high.

At this point in our evolving understanding of addiction, it’s simply a failure of curiosity not to understand how difficult it is to get addicts into therapy, and to make it stick — and thus unforgivably simplistic to say “let’s focus on treatment over safe supply.” You do both, for God’s sake. Both. Hundreds of lives are waiting to be saved. There are more than enough barriers in the way of that without Poilievre erecting more, especially on false pretences.

TREATMENT ... HAS PROVEN ENTIRELY INEFFECTIVE WITH CADAVERS.