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Decriminalization a good step, but safe supply key: chief coroner

“We have lost far more people to drug toxicity over the COVID pandemic than we have to COVID."
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B.C. chief coroner Lisa Lapointe says she hopes that with decriminalization, people who use drugs are more apt to seek services, that society takes a kinder view of people who use drugs, and that governments will find a way to regulate a safe supply. CP

To stop toxic-drug deaths, governments must provide a safe supply of drugs with the same urgency that they provided people with COVID vaccines, says B.C.’s chief coroner.

“We have lost far more people to drug toxicity over the COVID pandemic than we have to COVID,” Lisa Lapointe said Wednesday.

Including the death toll for May, there have been more than 10,000 drug poisoning deaths in B.C. since 2016, when opioid overdoses were declared a public health emergency, she said.

On Tuesday, the federal government announced its approval of B.C.’s request for an exemption to the Controlled Drugs and Substances Act to allow people 18 and older to possess a cumulative 2.5 grams of opioids, cocaine, crack cocaine, methamphetamine and MDMA (ecstasy) for personal use.

Lapointe called the three-year trial, which starts in January, encouraging if it leads to less stigma for drug users. “I’m really hopeful that this signifies a dramatic shift in how we view and recognize that people who use drugs are not criminals and are only criminals now because there is a law that says they’re criminals.”

While decriminalization alone won’t save lives, said Lapointe, it could when paired with a regulated safe supply of drugs for people dependent on their use.

Up until about 2013, people buying street drugs largely got the drug they expected, but then illicit and highly concentrated fentanyl — much stronger than heroin — started being cut into other drugs, killing unsuspecting users.

The coroner’s office soon began seeing an increase in overdose deaths. A couple of years into the public health emergency, it began calling the accidental overdoses toxic drug poisonings.

Naloxone can reverse an overdose if used immediately, but of late, drugs such as benzodiazepines — also sedatives — are being used more widely, and are not responsive to naloxone.

“It’s just a toxic mess,” said Lapointe. “And we never see a death that is solely one substance.”

Lapointe hopes that with decriminalization, people who use drugs are more apt to seek services, that society takes a kinder view of people who use drugs, and that governments will find a way to regulate and deliver a safe supply.

“Do we want to give them a handout, which is what decriminalization and safe supply is, or do we want to just say: ‘Go away, you’re on your own and we don’t care what happens to you’ — which is what’s happened in the past,” said Lapointe.

As for the threshold of 2.5 grams for personal use set by Health Canada, Lapointe is disappointed the federal government didn’t adopt the 4.5 grams suggested by several research groups.

Lapointe hopes that as the three-year decriminalization trial unfolds, the threshold could be reconsidered.

Bernie Pauly, a professor in the UVic School of Nursing who is involved in the research and evaluation group that’s developing the monitoring framework for the decriminalization trial and reviewing it, says decriminalization will hopefully make people more likely to access street-drug-testing services like the Vancouver Island Drug Checking Project.

Pauly, who has led the development of policy papers on illicit drug use and harm reduction for the Canadian Nurses Association, said she’s heard through decades of research that criminalization of drugs creates a barrier for people accessing supportive services.

Decriminalization, she said, means “you’re not destroying people’s lives by criminalizing them — you’re not putting them in prison, you’re not creating prison records that then act as a barrier to housing, to employment.”

The next step is providing a regulated safe supply, said Pauly.

She noted that it’s important to remember that it’s the fatal overdoses — occurring at a rate of about five a day in the province — that are the public health crisis, not addiction.

Addiction is a factor, but “anyone who accesses the illicit drug market is at risk of overdose,” she said.

ceharnett@timescolonist.com

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