When British Columbia decriminalizes small quantities of some illicit drugs next year, Canada will join a growing number of countries that have taken steps toward removing penalties for drug use.
But as many Canadian public health experts call on lawmakers to go one step further – and replace black market street drugs with a regulated safe supply – their international counterparts say they are looking to see if their What can countries learn from each other?
Ottawa announced last week That from January 31, adults in BC will be allowed to have 2.5 grams of opioids, cocaine, methamphetamine and MDMA — a sign that it will treat addiction as a mental health problem rather than a judicial one.
The federal government has not yet made a commitment to a regulated safe supply; In fact, a private member’s bill from the NDP that would include a strategy was defeated in the House of Commons on Thursday.
But advocates have proposed Safe supply model number For Canada, with options ranging from prescribing pharmaceutical-grade drugs – as is already the case to a very limited degree Allowing the sale of drugs in licensed recreational places or dispensaries.
If adopted, those more liberal models would put Canada into internationally unknown territory, says Jonathan Colkins, a professor and drug policy researcher at Carnegie Mellon University in Pittsburgh.
“No country in the world has been moving faster in that direction than Canada, and no country in the world has even seriously thought of doing so for heroin or fentanyl or cocaine.”
So as Ottawa navigates de-criminalisation, jurisdictions around the world say they will be looking to see what, if any, safe drug supply models are adopted.
And Nation World News spoke with some of those international drug policy experts to see what Canada can learn from their countries’ experience.
Estonia’s fentanyl crisis
When Estonia decriminalized all drugs in 2005, the black market for illegally manufactured fentanyl was on the rise.
With almost no harm reduction measures or treatment options, the country quickly became Europe’s Drug Overdose Capital,
Estonia’s fatal overdose rate began to fall in 2017 following a major fentanyl bust – but it is still holding onto damage reduction.
“We don’t have safe supplies, and we don’t have safe consumption rooms, and we don’t have state-supported drug testing,” says Aljona Kurbatova, head of the Drug Abuse and Infectious Disease Prevention Center at Estonia’s National. Health Development Institute.
“Having harm-reduction responses as basic as needle and syringe exchange programs has been a challenge for us because of a very strong public protest over the past two decades.”
She said it’s encouraging that Canada already has a robust harm-reduction model in place before decriminalization, and Kurbatova said she hopes it will have “the courage to try new things” — including a regulated supply of drugs. also includes.
“If Canada would introduce secure supplies, it would certainly be an argument for even our politicians to really listen and say that maybe we too, in order to avoid the repetition of past mistakes, should be something like this.”
Back in 2001, facing a crisis of heroin overdose deaths, Portugal became the first country in the world to decriminalize the possession and use of all illicit drugs. Instead of sending people to court for drug possession, its model focuses on education, treatment, and harm reduction.
Portugal’s drug-related mortality rate is four times less than the European Average, according to the continent’s drug-monitoring agency in 2017.
And these figures are despite all the medicines of the country coming from the black market.
To date, fentanyl has not emerged as an issue there, although it is only a matter of time, according to Dr. Joao Gaulao says. ,
As a result, a secure supply model is no longer part of the plan.
“We are comfortable with what we have,” Gaulao said. Of course, we are ready to innovate, but this core discussion about the legal framework for drugs is not the primary concern.”
Instead, Gaulao is focusing on expanding harm reduction services, such as drug screening and safe consumption sites, which are in their infancy in Portugal.
“I saw more resources in the city of Vancouver than in the whole country,” Gaulao told Nation World News in an interview from Lisbon, before heading to Canada for a conference this week.
Portugal does not want to export its decriminalization model, he said, but it hopes to inspire other countries to develop.
“You in Canada, and in the Americans, you are living a moment that is similar to our epidemic of heroin in the ’90s … It is, in my view, a window of opportunity to change things.”
safe supply of heroin
Although Switzerland has not yet decriminalized the drugs, it took an important step toward a safer supply in 1994 by prescribing pharmaceutical-grade heroin for long-term users.
the result was Fewer overdose deathsAs well as falling rates of HIV and hepatitis C infection and a decline in crime.
“The result is this: you don’t have people on the street [using drugs]You don’t have people dying of overdoses in the street or in private places… and people have great relationships. [using drugs] and the health sector,” said Jean-Félix Savory, general secretary of the Romand Group of Addiction Studies (GREA) in Geneva.
During the pandemic, the country allowed people to use prescription heroin at home instead of restricting its use to supervised sites.
“It was a huge success,” Savari said.
Although fewer people use prescription heroin than other treatments such as methadone, there is now debate about the expansion of prescription heroin in Switzerland.
“There’s still this ethical thinking that if you give someone a drug, it’s going to be bad… better than methadone from a medical point of view,” said Savari.
“It’s just a drug.”
Demonetization south of the border
If Canada wants to know what de-criminalisation looks like without a safe supply of drugs, it only needs to look some 600 kilometers south of the border. Faced with rising opioid-related deaths, Oregon became the first US state to decriminalize drugs in 2020, following a referendum.
since, The death toll continues – as they have in Canada – as the drug supply has become more toxic in both countries.
“Mere de-criminalisation will not prevent people from dying of drug overdoses,” said Tera Hurst, executive director of the Oregon Health Justice Recovery Alliance.
He and other drug reform advocates in Oregon are still working to implement safer consumption sites and other harm reduction measures that they hope will keep people safe over time.
“We’re trying to solve these big problems with these incremental steps, and incremental steps are sometimes the only thing you can get people to do.”
As street drugs become increasingly dangerous on both sides of the border, Hearst is watching closely to see if Canada – where she grew up – listens to the call for any regulated safe supplies.
“Safe Supplies feels like such an important conversation when we’re seeing so many people dying right now,” she said. “And that seems to be where most people are from when it comes to drugs.”