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Drug decriminalization is about to roll out in B.C. How will we know if it works?

Decriminalization of simple possession is the first step in treating drug addiction as a health problem instead of a criminal one
Vince Tao of the Vancouver Area Network of Drug Users says drugs won't be truly decriminalized until possession thresholds go away. ARLEN REDEKOP, PNG

The rest of the country will be watching on Tuesday as B.C. begins a three-year experiment with drug decriminalization.

The problem is no one can agree on what success looks like.

While the goal is to treat drug addiction as a health problem instead of a criminal one, experts say decriminalization is unlikely to stop an average of six people a day from dying of drug poisoning.

Critics say a key piece of the puzzle is missing: B.C. lacks the addiction treatment system crucial to providing wraparound health care and stopping the cycle of addiction.

Starting Jan. 31, B.C. will be the first place in Canada where people 18 and older found with a total of 2.5 grams or less of opioids, cocaine and amphetamines will not face criminal charges or mandatory treatment, nor will their drugs be seized.

B.C.’s chief coroner, Lisa Lapointe, said she has hope on the eve of decriminalization, a policy change she’s advocated for years.

“I feel like this is such an important step toward shifting the way we as a public think about people who use drugs, the way we talk about people who use drugs and, and the way we marginalize people who use drugs,” Lapointe said. “This is a small step and it’s just the beginning.”

Almost 11,000 people have died in the province since April 2016, when the government declared a public health emergency, according to the B.C. Coroners Service.

Most of the deaths occur in homes. That’s evidence, Lapointe said, that people continue to use drugs while alone. This is where the stigma around drug use can turn deadly, advocates say.

Lapointe appeals for patience and stressed we won’t see changes overnight. It’s important to gather good statistics, such as the number of people accessing health supports, Lapointe said.

“It can’t all be focused on the number of deaths. Because I don’t believe we’re going to see a significant change [in deaths] in the short term.

“There will be naysayers who say that after six months or even after a year … ‘the deaths haven’t decreased, it didn’t work,’ ” she said. “Well, we’re shifting something that’s been in place for decades.”

Oregon was the first state in the U.S. to decriminalize some drugs for personal use, in 2021. Oregon lawmakers, however, have decried the low uptake of treatment services and the higher number of drug-related deaths.

According to figures from Oregon’s health authority, less than one per cent of the 16,000 people who accessed services entered treatment in the first year of decriminalization, despite the state dedicating hundreds of millions of dollars for addiction treatment and harm-reduction services.

Those figures don’t bode well for B.C., said Elenore Sturko, the B.C. Liberal’s mental health and addictions critic and a former Surrey RCMP officer, considering the woefully inadequate number of publicly funded treatment beds across the province. B.C. also lacks a central database that could tell us how many people are waiting for treatment and where.

Sturko, who represents Surrey South, said the province has focused only on harm reduction, abandoning the three other pillars of drug strategy: prevention, treatment and enforcement.

“We’ve gone really quickly toward this decriminalization, but the other pillars have not come at the same rigour that one would expect when we are dealing with such a deadly crisis,” she said.

B.C.’s addictions minister, Jennifer Whiteside, acknowledged the province must add more treatment beds but said the work is underway.

Federal NDP Leader Jagmeet Singh called on Prime Minister Justin Trudeau to fulfil his 2021 election promise to create a new mental health and addiction transfer payment to the provinces and territories.

“While [decriminalization] and the approach of compassion is absolutely the right approach, there also needs to be supports around treatment, rehabilitation, mental health services, addiction services so we can actually provide people with the care they need,” Singh said Friday during a news conference in Victoria. Singh said his father struggled with addiction and the only way he got help was through a publicly funded addiction treatment centre.

Federal Addictions Minister Carolyn Bennett said in a statement that decriminalization is one tool to reduce stigma and prevent overdose deaths. The other tools, she said, are prevention, harm reduction and treatment, which have received $800 million in federal funding since 2017.

However, harm reduction advocates say the federal government has shown a tepid approach to decriminalization, approving a possession threshold of 2.5 grams, which they say is too low.

The B.C. government’s submission to the federal government asked for a 4.5-gram threshold, while the Canadian Association of Chiefs of Police called for decriminalization of one gram or less. Health Canada approved a limit somewhere in the middle.

“We want decriminalization as full decriminalization, meaning no thresholds,” said Vince Tao of the Vancouver Area Network of Drug Users. “That means hands off users, hands out of our pockets.”

Tao is disappointed that drug users with lived experience were not invited to weigh in on shaping the policy or how police officers are trained, which is a key factor in reducing stigmatization and criminalization.

Whiteside said she’s heard concerns around the 2.5-gram limit and said it’s a number officials will watch carefully to see if it’s the right amount.

Danya Fast, a research scientist at the B.C. Centre on Substance Use, worries about the unintended consequences of excluding youth under 18 from decriminalization. The abstinence-based drug approach for youth has not worked, she said.

“Whenever we’re excluding youth under 18 from an important policy change, we’re risking deepening the harm for that population and deepening inequities in terms of health and social outcomes,” she said. “We know that very young people use drugs, we know that very young people deal drugs.”

Oregon does not have an age limit on decriminalization.

Abbotsford Police Chief Mike Serr, who co-chairs the Canadian Association of Chiefs and helped draft the decriminalization training B.C. officers will receive in the coming months, said when police interact with an adult who is found to have less than 2.5 grams of drugs on them, they will give them a resource card with localized contact information for available health supports.

If a person under 18 is found with drugs, police have the authority to seize the drugs.

“I understand the [concerns around] stigma, but I also know it scares me to think of a 16-year-old, a 15-year-old, a 17-year-old using these very toxic dangerous drugs and us having absolutely no mechanism to try to get them in to see somebody that can give them support,” Serr said.