City's model of decriminalization leaves out those who need it most
Thresholds set too low to protect vulnerable, Thomas Kerr and Garth Mullins say.
In response to the ongoing and escalating overdose crisis, the City of Vancouver recently announced its intention to apply to the federal government to decriminalize personal possession of small amounts of drugs.
The decriminalization of drug possession has been recommended by a range of international organizations, and models of decriminalization have been implemented in a range of settings, most notably 20 years ago in Portugal. The approach has potential to reduce the harms of drug prohibition, including those associated with arrest and incarceration.
The City of Vancouver is taking a bold step, but success largely depends on the details, and there has been much controversy surrounding this initiative. People who use drugs and the organizations that represent them were only consulted after the most critical elements of the submission to Health Canada were drafted. The result? A proposed model that doesn't reflect the realities of people who use drugs in Vancouver and has potential to perpetuate their ongoing criminalization and its associated harms.
The lack of consultation has led to the city setting the amount of different substances a person can have in their personal possession — referred to as “thresholds” — too low. To inform discussions about thresholds, the City of Vancouver drew upon data provided by researchers working at the B.C. Centre on Substance Use, including the long-standing Vancouver Injection Drug Users Study. While these data were limited by the fact that they were collected prior to the COVID era and revealed only daily drug use patterns (not possession patterns) among people who inject
People who use drugs, and their organizations, need to be co-creators of this policy.
drugs, they provided a range of potential thresholds, and the limitations of the data were clearly spelled out.
The range included a comprehensive inclusion approach, which would set thresholds at approximately 13 grams for opioids, 14 grams for cocaine, 22.5 grams for crack cocaine, and 19 grams for amphetamines. The city's own document states that this level of inclusion would provide coverage for those with “severe substance use disorders” for a multi-day supply. Despite these data, the city instead decided to cut down those amounts substantially, and set the following thresholds: two grams of opioids, three grams of cocaine, one gram of crack cocaine, and 1.5 grams of amphetamines.
It's not entirely clear how the city arrived at these thresholds. What is clear is that the thresholds were established in collaboration with the Vancouver Police Department and are not based on the data provided by local researchers nor the lived experiences of people who use drugs. The city's thresholds would likely leave a majority of those at highest risk for overdose vulnerable to arrest, being charged with possession, or having their drugs confiscated — the latter of which only serves to exacerbate risk and harm to people who use drugs and the local community at large.
While the city and Mayor Kennedy Stewart should be commended for launching this bold initiative, this important policy must be done right, and therefore it's time to press pause and refresh. People who use drugs, and their organizations, need to be co-creators of this policy. After all, drug users are the experts. They have lived experience and wisdom that is critical when shaping effective drug policy. Up-to-date data that reflects the current situation in the COVID era should also be collected before any threshold amounts are established.
The mayor has stated that time is of the essence and has warned that the window of opportunity could be lost if more time is spent developing this exemption application. The real opportunity is this — to get this policy right and to get it right now, not later. Lives depend on it, and the rest of Canada is watching.