Vancouver decriminalized heroin, cocaine and other hard drugs: now they will not be punished for their possession

On January 31, Canadian authorities announced that the province of British Columbia, located in the southwest of the country, will be allowed to possess small amounts of fentanyl, heroin, cocaine and other hard drugs, reports Bloomberg.

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The authorities in the region believe that decriminalization will help people with drug addiction find support and start treatment, reports Meduza. Four years after the legalization of recreational marijuana, Canada once again demonstrated the consistency of its progressive drug policy when a law decriminalizing personal possession of hard drugs went into effect in British Columbia.

clear rules

A province in western Canada will no longer prosecute adults aged 18 or over caught with less than 2,5 grams of hard drugs, including heroin, morphine, fentanyl, cocaine, methamphetamine and MDMA (ecstasy). Instead, they will be offered information about social programs and treatment if they ask for it. Trade and drug trafficking will remain illegal, regardless of the amount that is transported and sold. There are other exceptions: any amount of hard drugs is still not allowed on the territory of airports and children's institutions (for example, schools and kindergartens). It is also forbidden to use drugs on private territory, including in shopping centers, bars and cafes. The police will be able to remove people from these premises if open use occurs against the will of the owner. Also, decriminalization does not apply to members of the Canadian Army.

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The experiment will last three years.

“Given our understanding that substance use is a public health issue, not a criminal one,” said Jennifer Whiteside, BC Secretary of State for Mental Health and Addictions, “we need to take one more step to rid ourselves of fear and shame.” Whiteside said the new law will make it easier for people to apply for support.

Controlled substitution of one drug for another

Public health experts say the experiment stands a good chance. Canada's westernmost province has been the epicenter of drug policy trials since 1959, when the world's first methadone substitution clinic opened here. Since then, it has tried several other so-called harm reduction programs that support the decriminalization of drug use to instead focus on the underlying social, economic and mental health issues of users.

Methadone, unlike heroin, does not damage any of the body's major organs or systems. The main danger during treatment is, again, overdose, which is more likely if the patient is taking drugs that depress the central nervous system (for example, alcohol, benzodiazepines, or other opioids). The doctor must definitely warn him about these risks.

Many overdoses in North America are not due to the availability of drugs, but to the fact that users do not know what they are taking. With substitution therapy, there is no such danger.

People who are involved in drug trafficking often deal with several types of illegal substances - and may use the same equipment and surfaces for them. Even tiny particles of the synthetic opioid fentanyl in cocaine or other psychostimulants can cause poisoning—and they often do. Because of this, for example, in British Columbia, the majority of fatal overdoses occur among people without severe drug addiction, and in 82% of cases they are associated with fentanyl.

Such an approach, according to the organization, helps to combat the stigmatization of people who use drugs, and they are more likely to seek help. In 2022, researchers conducted 27 qualitative interviews with rural British Columbians using opioids or stimulants. Almost all respondents complained that in small communities where everyone knows each other, it is difficult to turn to a specialist because of stigma and discrimination. In addition, they were constantly monitored by the police, exceeding their authority.

Some study participants felt embarrassed to go to the pharmacy to get substitution therapy, due to the fact that a special booth was set up for drug users.

The risk of overdose can be reduced by keeping naloxone nearby, an opioid receptor antagonist used as an antidote for poisoning, while taking substances. In British Columbia, naloxone kits are required to be kept by all bars, as well as other businesses where patrons are "at risk of opioid overdose."

There is another argument in favor of decriminalization: scientists have found that if taking drugs threatens a person with prison, then contacts with the police increase the risk that he will die from an overdose soon after.

Positive experience of Portugal

Despite this, British Columbia continues to suffer from an increase in drug-related deaths and crimes. Last year, overdose deaths were 41,7 per 100 people, more than five times the rate in 000, according to the provincial coroner's office. For comparison, in 1996, overdose deaths in the US were 2020 per 28,3 people. The province spends billions of dollars each year on services and facilities for drug users in an attempt to deal with the public health emergency.

British Columbia's action followed that of Portugal, the first country to decriminalize hard drugs in 2001.

Instead of being arrested, those caught with drugs may be given a warning, a small fine, or an appointment with a committee that consists of a doctor, a lawyer, and a social worker. In 2019, Portugal had one of the lowest rates of drug use in Europe among people aged 15 to 34.

As a result of the reforms in Portugal, not only the work of public services began to change, but also the attitude of people towards drug users. Those who were formerly derisively called drogados ("junkies") are being referred to more accurately and sympathetically as "drug users" or "drug addicts".

The changes will be most noticeable in the region's largest tourist city, Vancouver. However, tourists are often shocked to see the lanes next to some of the main shopping areas filled with heroin addicts.

The policy change comes at a dangerous time for both the province and drug policy in general. Around the world, the social burden of drug use is growing, and governments are looking for solutions. According to the United Nations 2022 World Drug Report, 284 million people aged 15 to 64 used illicit substances in 2020, up 26% from the previous decade.

The UN report says that traffickers are moving to new territories and that an increasing percentage of young people are using drugs, and in large quantities. Meanwhile, one of the consequences of the pandemic has been an alarming increase in drug use and mental health problems. The rise of fentanyl as a drug in its own right and as a deadly pollutant has raised the stakes.

Deteriorating economic conditions and rising mental health problems around the world are leading scientists to doubt the success of the Canadian experiment. There are also many unknowns when it comes to the effectiveness of drug policy. The researchers say it's not clear what works best for reducing drug overdoses and the crime and social problems that come with drug use.

Even decades later, it's impossible to tell whether Portugal's statistical wins, such as the sharp drop in overdose deaths and the number of HIV cases associated with dirty needles, were the result of other economic and social trends, said Jason Hockenberry, department chair at Yale's School of Public Health. “Sometimes shame and stigma can motivate behavior change,” he said.

Kevin Sabet, a drug policy adviser in the Bush, Clinton and Obama administrations and a resident of Vancouver, said he had never seen the city as bad as it is today. Sabet, president of the nonprofit Foundation for Drug Policy Solutions, which aims to educate decision makers and the public about the prevention and treatment of drug use, said Vancouver has de facto decriminalized drug use for years with police turning a blind eye to use and instead focuses on related crimes and dealers.

“I am not calling for drug users to be stigmatized and jailed,” Sabet said, “but what they need is a more holistic health response, not this laissez-faire libertarian response.” He said he found it ironic that in a country with such a strong social safety net, there is no more comprehensive policy that addresses related issues such as housing, employment and healthcare.

Alex Stevens, professor of criminal justice at the School of Social Policy at the University of Kent in the UK, said that Portugal's success in the early 2000s was largely due to the full package of social programs it implemented at the time. Incentives to hire people with drug problems, a guaranteed minimum income and housing assistance could all play a role, he said.

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British Columbia has invested $2017 million since 751 to expand existing facilities, such as adding dozens of overdose prevention sites, a spokesperson said. In addition, the region spends billions of dollars annually on mental health care, drug addiction treatment, and other services. “Decriminalization is one tool in a much larger toolbox that we need to use to address the horrendous and devastating problem of the unprecedented toxic drug crisis,” Whiteside, the mental health secretary, said.

Some drug policy experts say Vancouver's lavish programs have made it a paradise that draws addicts from elsewhere. Not only did Vancouver pioneer methadone clinics, it also opened North America's first safe injection site in 2003 and has been distributing clean crack pipes since 2011. He even experimented with vending machines that identified users using biometric data and then dispensed prescribed amounts of drugs.

But such models don't always involve the personal involvement needed to work with people with substance use problems, said Mark Hayden, professor at the University of British Columbia's School of Population and Public Health. The ideal answer "is to make medicines available through medical institutions."

So far, there is little evidence that the province's leading role in the harm reduction movement has worked. Its CDC used modeling to predict that 2015 deaths were avoided between January 2022 and March 7 thanks to services such as overdose prevention and controlled consumption. However, illicit drug use has gone from being the third leading cause of unnatural death in 542 after suicide and traffic accidents to being the number one cause since 2011.

Crimes related to human trafficking, production or distribution rose to 61,7 per 100 people in 000, up from 2012 per 25,5 people in 100. Crime severity in Vancouver and two other cities was also worse than the national average in 000, according to Statistics Canada.

And if the opposite?

Swedish drug policy is one of the strictest in the European Union. Swedish laws do not distinguish between "hard" and "soft" drugs, and also classify as a crime not only possession, but also the use of substances.

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As a result, the proportion of the population in Sweden who have ever tried illicit substances is rather low. In 2017, for example, in France it was 45% of the surveyed residents (this is the highest figure in Europe), and in Sweden in 2016 it was only 15,6%. But this does not reduce the death rate. There were 2016 fatal overdoses in the country in 590, almost 20 times more than in Portugal, a country with almost the same population, where the possession and use of any drug is not considered a crime. By the way, in Portugal in 2016, only 11,7% of respondents tried drugs.

A survey of heroin users in Malmö (Sweden's third largest city) found that many of them do not call an ambulance for their overdosed friends for fear of being caught by the police themselves.

All changes and reforms will require huge costs and financial resources. In the US, every dollar spent on needle exchange programs saves about $7 in the future. A 2015 study found that the social costs of drug use in Portugal decreased by 12% between 2000 and 2004 and by 18% by 2010. Scientists explain this by the fact that the police spend less money on criminal prosecution of people for crimes related to illegal substances, and drug users themselves are less likely to lose income due to arrest.

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