Drugs: Which (policies) are good, which (policies) are bad?

Any week in which the people closest to Rob Ford are imploring him to seek treatment for his unverified crack predilection is a good week to talk about Drug Policy. You see, Rob Ford is the ultra-conservative mayor of Toronto and his idea of fighting drug use focuses largely on law enforcement and can be fairly criticized for downplaying more holistic, evidence-based harm reduction strategies. The same, unfortunately, can be said about our federal drug policies.

A new report commissioned by the Canadian Drug Policy Coalition and released last week, “Getting to Tomorrow: A Report on Canadian Drug Policy”, examines the failings of current federal drug policy under the Harper Government™—an approach which relies on force, stigma, and an atavistic urge to punish—and has determined that alternative approaches which account for everyone’s right to physical and mental health must be implemented.

Nixon’s war on drugs – not just failed US policy anymore!

On its surface, the most startling proposal made in the report is the outright decriminalization of drugs. All of them. Crack, heroin, weed, meth. The “holy crap!” factor of this, however, should be mitigated by the fact that when it comes down to it, criminalization/prohibition simply does not work. The people who wind up in custody are mainly low-level dealers and, worse, those who are addicted. Indeed, prohibition of drugs does little more than create a very lucrative, very shady black market where there are no checks on the sale of the product—they can sell anything (eg. dangerously impure MDMA) to anyone (eg. 15 year olds).

Naturally, decriminalization won’t completely eliminate problems associated with drug use. Every single person reading this has drunk illegally obtained butterscotch schnapps from a beer bong, and you’re a goddamn liar if you say you haven’t. The point is, whether drugs are legal or illegal, they will be plentiful and they will be misused. If, however drugs are decriminalized and subject to regulation much like liquor or Prozac (depending on the drug) we will be making a positive step towards cleaning up and mitigating the spread of drugs which are currently readily available.

This is the minor omission, the quick sleight-of-hand that lurks behind the implementation and acceptance of the Conservatives’ National Anti-Drug Strategy: the implication that we can abolish drugs if they are criminalized. With criminalization of drug use, though, comes de facto depersonalization of the user, and the average Canadian is able to put them out of mind. It also becomes easier to attribute drug use (A CRIMINAL ACTIVITY!) to a personal and moral failing, and we as a public become less inclined to want to help and more willing to agree to a tough-on-crime approach.

The problem, however, is that we’re often talking about non-violent individuals with substance use problems—that is, we’re talking about health issues. That minor omission then becomes a glaring ideological failure, since incarceration does not decrease drug use, contains few safeguards to prevent further health deterioration of the incarcerated and is financially costly. HIV and Hepatitis C (HCV) rates in prisons are 10% to 30% higher than the general public and, as per the report:

“The annual average cost of keeping a federal inmate behind bars has increased from $88,000 in 2005-06 to over $113,000 in 2009-10. In contrast the daily average cost to keep an offender in the community is $80.82 or $29,499 a year.”

Yet the Harper Government™ prefers to view drug use through a punitive lens and, as the authors point out, have devoted significant sums of money to fight the scourge of drugs. From 2007 to 2012, 70% of the National Anti-Drug Strategy’s $578.6 million budget was directed to law enforcement initiatives. Conversely, areas such as prevention (4%), treatment (17%) and harm reduction (2%) were all but cut off from federal funds.

The audacity of health

This prioritization on law enforcement undermines the ability to rehabilitate those with problematic drug issues within the confines of their community. In order to keep such an individual in the community, that community must contain supportive elements. One common theme “Getting to Tomorrow” repeatedly touches upon is that every individual, drug user or not, has the inalienable human right to physical and mental health.

Within the context of drug users, this right is best manifested in drug treatment systems run by knowledgeable medical practitioners and social workers. While the authors note that Canada is brimming with the right minds to achieve such systems, problems persist. Amongst the worst problems are discrimination against drug users (stigma, racism, sexism), chronic underfunding as money is diverted to punitive measures, and the lack of services available in rural and remote regions.

Which leads us to the premise of harm reduction. As the authors describe it:

“Harm reduction involves a pragmatic, non-judgmental approach to the provision of health services that respects the dignity of people who use drugs and values their human rights. Harm reduction provides skills in self-care (and care for others), lowers personal risk, encourages access to treatment, supports reintegration, limits the spread of disease, improves environments and reduces public expenses. It also saves lives.”

There is no one definition of harm reduction, and strategies need to be honed and adjusted to fit the needs of specific communities/individuals, but harm reduction typically includes services such as “education about safer drug use and safer sex, distribution of new supplies for injection and inhalation, condoms, safer consumption services and/or facilities, programs to prevent and treat overdose and methadone and other opioid substitution therapies.”

One high profile example of such a strategy is Vancouver’s Insite facility, in operation since 2003, which provides a safe place for heroin users to inject, complete with fresh needles, nurses, and a chance for social workers to connect with the clientele in an attempt to get them into treatment programs. Since 2007, harm reduction has been eliminated from the federal government’s National Anti-Drug Strategy. Insite has survived in spite of this, including a Supreme Court victory after the Harper Government™ attempted to bar its operation.

The crux of a service such as Insite is not to promote drug use, but to mitigate the negative public health effects of drug use. As a society, we are better off if people who use needle drugs do not contract HIV, something Insite protects against through clean needles and education. Further, such facilities markedly decrease the prevalence of dirty needles in city parks or on city streets. The counterargument would claim that locking people up would have the same effect, but this misses the point. People who are incarcerated still have access to drugs, and the chances of contracting a disease are high in prison. Further, these people will eventually be released back into society and everyone will be worse off than if a facility such as Insite was available to them in the first place.

Getting to tomorrow

In the end, it boils down to how society views drug misuse: as a savage criminal act deserving of harsh retribution, or as a public health crisis requiring nuanced treatment programs. The Harper Government™, after examining how tough-on-crime policies poll with the electorate and accepting an ahistorical view of the War on Drugs, have aligned federal policy with the former. The authors of “Getting to Tomorrow”, after examining peer-reviewed studies and speaking with individuals on the ground, align themselves with the latter. We as a society need to take note and encourage our politicians to craft a more conscientious drug policy.


Written and Researched by Todd Fanter, contributor to Vancity Buzz. Connect with Todd on Twitter at @toddfanter.

Image: garyowen