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Getting to Tomorrow: a Report on Canadian Drug Policy

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Getting to Tomorrow: a Report on Canadian Drug Policy GETTING TO TOMORROW: A REPORT ON CANADIAN DRUG POLICY getting to tomorrow: a report on canadian drug policy 2 getting to tomorrow: a report on canadian drug policy authorship: connie i. carter & donald macpherson ©2013 The authors are grateful to the Policy Working Photo Credits Group and the Steering Committee of the Joe Mabel Canadian Drug Policy Coalition for assistance Mack Male with this document. The following persons pro- Victor Vizu vided detailed review of this document: Wikimedia Commons Raffi Ballian Design Lynne Belle-Isle Briana Garelli Susan Boyd Walter Cavalieri Project Manager Irene Goldstone Caroline Mousseau Philippe Lucas Michaela Montaner Copyediting Bernie Pauly Douglas Haddow Susan Shepherd Ron Shore Printing Kenneth Tupper Special Screencraft Printers Dan Werb Ltd., Vancouver, bc The Canadian Drug Policy Coalition wishes This work was made possible to extend its gratitude to the key informants with the support of the mac representing organizations from across Canada aids Fund, the Open Society who wish to remain anonymous. Global Drug Policy Fund, private donors and Steve This document was published by the Canadian Chapman. The Canadian Drug Drug Policy Coalition: www.drugpolicy.ca Policy Coalition also wishes to thank the Faculty This document can also be downloaded as of Health Sciences at Simon a pdf from: www.drugpolicy.ca/progress/ Fraser University and the getting-to-tomorrow Centre for Applied Research in Mental Health and Addiction Canadian Drug Policy (carmha) for their assistance Coalition / CDPC with this project. Simon Fraser University 2400-515 West Hastings St Vancouver, bc v6b 5k3 Email: [email protected] canadian drug policy coalition · cdpc 3 1 2 3 Introduction Substance Services Use: A & Supports Canadian for People Summary who use Drugs Page 11 Page 17 Page 25 4 5 Harm A Case for Reduction Urgent Action: in Canada Overdose Prevention & Response Page 39 Page 59 getting to tomorrow: a report on canadian drug policy 4 6 Drug Policy on a Federal Level Page 65 7 8 The Canada Criminalization on an of Drugs International in Canada Stage Page 73 Page 91 List of Acronyms Notes Page 97 canadian drug policy coalition · cdpc 5 EXECUTIVE SUMMARY The Canadian Drug Policy Coalition is a broad of the overall use of the criminal coalition of non-governmental organizations and law in responding to the use of individuals committed to working with Canadians illegal substances and drug to create an approach to drug problems that will related problems. take a radical new direction—a course that will put the protection of public health and safety, social The findings of this report, based justice and equity at the forefront of Canada’s on interviews with change- response to drugs. The primary goal of this report makers and service providers, is to provide an overview of the state of Canadian and scans of important docu- drug policy by focusing the lens on key issues of ments and research, reveals concern to Canadians: public safety, access to ser- that Canada is at a crossroads vices and supports for people with drug problems, when it comes to drug laws national-level drug policy, and Canada’s escalat- and policies. A new direction ing role in the international war on drugs. in drug policy is required. We can continue to work within the This report highlights the failing role that current paradigm of drug prohibition or federal drug policies play in supporting safety we can begin to explore alterna- and health and draws attention to the acute need tive approaches and chart a new for an improved system of supports for people course that can help save lives, who use drugs including harm reduction. This respect human rights and be report also highlights the patchwork of provincial more cost effective. policies and services that support people with drug problems. These policies, while valiant at- The use of illegal substances is tempts to integrate and streamline services, do a complex issue and people use not always translate into meaningful changes on drugs for many reasons. Most the front lines. This report also calls for a review people do not experience sig- getting to tomorrow: a report on canadian drug policy 6 nificant problems because of their drug use, some First Nations, Métis and Inuit do develop drug problems, and others may ex- citizens. perience clear benefits from illegal drug use. But despite deep public purse investments in enforce- Canada still relies on the ment-based approaches, lifetime use of cannabis criminal law to curb illegal stands at 39.4% and the non-medical use of pre- drug use and stem the growth scription opioids is the fourth most prevalent form of illegal drug markets. These of substance use in Canada behind only alcohol, laws and policies dispropor- tobacco and cannabis. Rates of hiv and hcv asso- tionally target already mar- ciated with drug use are unacceptably high partic- ginalized groups. Canada also ularly among some groups. In 2010, 30.4% of new spends enormous amounts of infections in women versus 13.5 % of new cases in money annually to prevent men were attributed to injection drug use. Cases the purchase, use and distribu- of hiv attributed to injecting drug use among First tion of illegal drugs both inside Nations, Métis and Inuit persons have gone up to Canada and beyond its borders. more than 50 per cent in the period spanning 2001 The federal government has to 2008. allocated $527.8 million for the National Anti-Drug strat- Deaths related to overdose of prescription opiates egy for 2012-2017, much of it on whether used medically or non-medically have enforcement related activities. risen sharply and are estimated to be about 50% This strategy only accounts for of annual drug deaths. But like hiv and Hepatitis a portion of government spend- C infections, overdose deaths are highly prevent- ing on drug control. “Activities able. This report addresses some of the urgent such as rcmp drug enforcement, changes needed to support a comprehensive drug interdiction, and the use harm reduction and public health approach to the of the military in international prevention and treatment of overdose. drug control efforts, drive up po- licing, military and border secu- Despite often heroic efforts at the provincial and rity budgets. Cannabis remains local levels to improve the system of supports, a key target of these policing many people still wait unacceptably long for ser- activities—cannabis posses- vices. Where sound and relatively safe treatments sion charges numbered 61,406 exist, provincial governments and health authori- in 2011, a rate of 178 per 100,000 ties drag their feet because of outmoded ideas people in Canada. Police re- about some drugs or shortsighted concerns about ported incidents of cannabis finances. The Federal government remains openly possession are far higher than hostile to evidence-based measures like key harm any other illegal drug (21 for reduction services and has clearly taken a puni- cocaine possession and a rate tive approach to addressing drug use problems. of 30 for all other illegal drugs Failure by all levels of government to fully meet combined.) And incidents the needs of people with drug problems, means of cannabis possession have that some groups are still outright denied these increased 16% between 2001 lifesaving services and many community-based and 2011. Cannabis remains a organizations struggle to meet the basic needs lucrative market—annual retail of their clients. These difficulties are particu- expenditures on this substance larly acute for residents in rural areas, women and are estimated to be about $357 canadian drug policy coalition · cdpc 7 million per year in bc alone. for the replacement of the National Anti-Drug Cannabis is a popular drug, and Strategy with one focused on health and human its harmful effects are certainly rights, the decriminalization of all drugs for per- less than alcohol and tobacco, sonal use and the creation of a regulatory system but the potential financial ben- for adult cannabis use. efits of regulated and taxable product like cannabis are com- 2. Support and expand efforts to implement ev- pletely unavailable to federal idence-based approaches to eliminate stigma and provincial treasuries. and discrimination, and social and health ineq- uities that affect people who use drugs. Rather than curbing drug markets, drug enforcement 3. Support the scaling-up of comprehensive has actually been shown to health and social services, including housing escalate drug trade violence. and treatment services that engage people with Canada’s prisons are already drug problems. Increase support for efforts overcrowded and the effects of to reduce the harms of substance use which recently introduced mandatory includes robust educational programs about minimum sentences for some safer drug use, programs for distributing new drug crimes are yet to be fully supplies for injection and crack cocaine use, felt. And because of poor data safer consumption services, opioid substitu- collection we still do not have a tion therapies and heroin assisted treatment. full picture of the effects of the Ensure these services are part of larger public millions of dollars spent every health approach to substance use that respects year on enforcing Canada’s the human rights of people who use drugs. drug laws. Canada has good people working at every level One of the most urgent issues from front line services and organizations to affecting Canadians is discrimi- provincial and federal ministries, whose efforts nation against people who use are severely hampered by fear, lack of leader- illegal drugs. This discrimina- ship, and poorly informed policies based on tion and the accompanying outdated ideas and beliefs about drugs and hostility towards people who the people who use them. At the same time, a use drugs can be felt in the de- global movement of sitting and former politi- rogatory statements that appear cal leaders is emerging that acknowledges the routinely in media reports of over-reliance on the criminal law in address- public debates about services.
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