From the Canadian HIV/AIDS Legal Network
Health Canada has launched a consultation on strengthening Canada’s approach to substance use issues. The purpose of this consultation is to ask Canadians for new and innovative ideas on how to further strengthen the federal government’s health-focused approach to substance use issues through the Canadian Drugs and Substances Strategy (CDSS).
In Canada, drug use and dependence are treated largely as criminal law concerns, rather than as health issues. But the overreliance on prohibition and punishment (a.k.a. “the war on drugs”) is ineffective and is taking a terrible human toll on people who use drugs and their families and loved ones. Canada’s drug policy must instead be grounded in sound public health evidence, and in the principle of the universality of human rights — rights to which all people are equally entitled, including people who use drugs. The Legal Network is committed to reducing the harms caused by harsh, misguided drug laws—which involves scaling up access to health, harm reduction and social support services for people who use drugs, decriminalizing all drugs for personal use, and developing models for the legalization and regulation of currently criminalized substances.
Here’s your chance to tell Canada to stop punishing people who use drugs and support health and human rights by filling out this survey.
The consultation contains 20 optional questions and some additional demographic questions. Take five minutes to copy and paste the three responses below in the suggested question boxes.
Question 10: In addition to current harm reduction initiatives — such as supervised consumption sites or needle exchange programs — what other harm reduction services should governments consider implementing in Canada?
Canada is in the midst of a historic overdose crisis with no end sight. The government must scale up access to health, harm reduction and social support services for people who use drugs in need of such supports.
While there have been improvements in scaling up access to supervised consumption services (SCS), greater flexibility is still needed to facilitate a wide range of SCS across the country. An array of service models are necessary to most appropriately address community needs, including mobile sites, housing facilities, drop-in centres, shelters, stand-alone sites, trailers in parking lots, nurse-led, or peer-led services. At the same time, greater flexibility is necessary to accommodate a variety of services including supervised inhalation, assisted injection, drug testing and drug sharing, as well as medical options such as opioid prescription.
To facilitate the operation of life-saving SCS, Canada must end the blanket criminal prohibition on the possession of drugs, which criminalizes those seeking or providing SCS and requires sites to undergo costly and time-consuming exemption processes. In the interim, Canada should grant a class exemption protecting clients and staff (including volunteers) from prosecution for drug possession or trafficking when accessing or providing SCS responding to minimum standards. Such measures are entirely consistent with the federal government’s recognition that SCS are life-saving services that improve health, are cost effective, do not increase drug use and crime in the surrounding area and are an entry point to treatment and social services for people who are ready to stop or reduce their use of substances, as has been shown by both Canadian and international research.
It is also critical that Canada provide people in prison with equivalent access to health services, including key harm reduction measures. Significant numbers of prisoners use drugs, and studies have also revealed high rates of syringe-sharing in Canada’s prisons, due to the lack of sterile injection equipment behind bars. Research also shows that the incarceration of people who inject drugs is a factor driving Canada’s HIV and HCV epidemic. There is overwhelming evidence of the health benefits of prison-based needle and syringe programs and opioid substitution therapy (OST), yet there remain serious barriers to access to both these harm reduction measures in federal prisons. The Correctional Service of Canada’s current “prison needle exchange,” for example, violates prisoners’ confidentiality at many points and prioritizes unfounded security concerns, thus severely restricting the number of prisoners who can participate and forcing prisoners to continue to use non-sterile drug injection equipment. Prisoners are also reportedly subject to lengthy waiting lists to access OST or involuntarily removed from OST as punishment, leaving them vulnerable to overdose. To uphold prisoners’ right to health, the federal government should ensure prisoners have reasonable and effective access to sterile injection equipment and OST, consistent with public health principles and professionally accepted standards.
Question 13: What further steps can the federal government take to better address current regulation and enforcement priorities, such as addressing organized drug crime and the dangerous illegal drugs like fentanyl being brought into Canada?
Increasingly, members of the public, health professionals, law enforcement and politicians are recognizing the need to address the contaminated supply of drugs and the participation of organized crime in the drug market. It is thus imperative that Canada examines models for the legalization and regulation of currently criminalized substances, as it does with other risky products and behaviours, as part of an evidence-based, public-health approach to drug policy.
Instead of costly, ineffective and harmful prohibition that fosters the existence of unregulated criminal markets, Canada must move toward a forward-thinking regulatory approach that brings illegal drug markets under its control through responsible, legal regulation. This would enable a greater focus on protecting public health than the blunt tool of criminal prohibition that leaves the market unregulated and in the hands of organized crime. The process of legal regulation must be evidence-based and guided by the principles of protecting and promoting human rights and public health. The development and implementation of regulation should engage key civil society stakeholders and the communities most affected by punitive approaches, including people who use drugs, young people and small-scale actors in the illegal market.
Question 16. How can governments and the health, social, and law enforcement sectors design more effective substance use policies and programs for at-risk populations?
Canada must decriminalize the possession of small quantities of all drugs, and repeal mandatory minimum prison sentences for minor, non-violent drug-related offences. The government’s current, punitive approach to drug policy reinforces stigma against people who use drugs, legitimizes the violation of their human rights, represents a major obstacle to reaching public-health objectives and exacerbates violence and criminality. For example, criminalization makes it harder to connect people with health services and contributes to new HIV and hepatitis C infections, among other harms. In 2014, 11 percent of new HIV infections in Canada resulted from injection drug use. Incarcerating people for minor drug offences leads to even greater risk of infection, given the inadequacy of harm reduction measures behind bars. Racialized communities are also disproportionately charged, prosecuted and incarcerated in Canada under these laws, depriving them of their rights to equal treatment in the justice system, to security of the person, and to health and social services. Imposing a criminal record on people who use drugs merely exacerbates their vulnerability. The mounting evidence shows that the continued emphasis on drug prohibition over the years has failed to decrease the use and availability of drugs, while worsening the risks and harms of using drugs and the violence associated with illegal markets.
Continuing to criminalize people who use drugs, including through the use of mandatory minimum sentences, ignores Canada’s previous commitments to combat racial discrimination, to address the overincarceration of Indigenous Peoples, and to fulfill the right to health, including for people who may be dependent on drugs. Prohibition is not meeting its stated public health and safety goals, but is wasting public resources while contributing to lasting damage to people’s lives. Decriminalizing the simple possession of all drugs has been done in law or in practice to varying degrees in other countries with great success. The decriminalization of all minor drug offences, and the responsible regulation of supply, would reduce overdose deaths, reduce new HIV and hepatitis C infections, and address problematic drug use as a health — rather than criminal — issue.