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We Could Change BC’s Drug Policies and Save Six Lives Today

The well is poisoned, and the only way to solve the problem is to sell safer, better, over-the-counter drugs.

Karen Ward 10 Jun 2021TheTyee.ca

Karen Ward consults for the City of Vancouver on drug policy, the overdose emergency and the Downtown Eastside, and would prefer that everyone stop dying so that she can focus on making GIFs and other art. Or anything, really.

The provincial government has developed a habit of claiming its hands are tied when asked about action on the poisoning massacre. Of course they aren’t: they have decided to let thousands die. Look at their budget. It’s a choice.

But the government, through the solicitor general, has the authority to regulate the retail sale of drugs — just as B.C. lifted alcohol prohibition at the end of the pandemic that took place from 1918 to 1921. Regulated, retail sale of drugs would enable access to a safe supply, which would disrupt criminal economies and violence and reduce money laundering, petty crime, poverty and death. The last year has shown us that doctors will not and cannot prescribe as is needed. Further, the province’s current risk mitigation guidelines take a clinical approach based in addiction medicine — but this is a public health emergency. Not everyone who uses drugs is addicted.

Drug supply in B.C. has lost all predictability, all consistency. Throughout Vancouver, throughout the province, the well is poisoned.

Drug-checking analysis in Vancouver finds everything from carfentanil to talc and xylitol in “down,” meaning heroin, fentanyl and opioids. One week, the heroin supply might contain no benzodiazepines — and the next it could contain up to 30 per cent benzodiazepines.

582px version of FentanylWeb.jpg
An illustration of what drug checking analysis found in the 'down' in Vancouver in one week.

This is not going to change by magic. We are in a new context of synthetic drugs, one that was accelerated by the COVID-19 pandemic.

We must stabilize this. We must flood the system. The well is poisoned.

851px version of BenzoFentanylGraph.jpg
The percentage of benzodiazepines in 'down' in Vancouver varies widely from week to week.

The supply is poison not because of what’s in it, but because the consumer does not know what’s in it, and they don’t know its potency. People do not know what they’re putting in their body because it is a prohibited, criminalized substance. This is a problem regulation will solve.

When the product is accessible, consistent and better, the illicit supply will become unprofitable. This is not a clinical approach, but a public health approach to an economic problem.

Shift the frame: safe supply is a market intervention that will return billions of dollars to the province. We can deter youth from working in criminal economies by creating legal opportunities, not by putting cops in schools and gang units on the streets. The best harm reduction is harm prevention.

At least 2,000 people will die through consumption of unknown, unregulated substances in British Columbia this year.

At least two thousand.

IllicitDrugDeathsGraph.jpg
Illicit drug toxicity rates are on track to be the worst yet in BC in 2021. Graph by the BC Coroners Service.

This can only get worse.

The excuse that the Controlled Drugs and Substances Act is federal does not hold water. Public health is provincial, and so are the regulation of pharmacists and the retail sale of certain regulated substances. We need to take action now.

We need to regulate over-the-counter access to safe supply via pharmacies, including co-ops.

We need to sell all currently illicit drugs — all of them — and make sure that what’s for sale over the counter is better than what’s for sale on the street. Illicit substances won’t be profitable anymore.

A public health approach — as we’ve taken with COVID-19 vaccination — means that a medication is universally prescribed. Accessible safe supply will prevent harm to everyone, as everyone takes drugs. But only some are legal. When it comes to safe supply, we must move away from the addiction model.

Are you against crime and violence and money laundering? End prohibition. Are you against the racist criminalization of Black and Indigenous people? Really? Then end prohibition. The war on drugs is one key way the state uses its laws to enforce racism.

“But the children! What if kids start using these drugs? What about youth?”

What do you think they’re using now?

Look. We are in trouble here. No. You are in trouble here.

B.C. is consistently the first or second sub-national jurisdiction with the highest overdose death rate in the world. We’re world-class murderers.

The other is West Virginia, where harm reduction, overdose prevention and needle exchanges are illegal. Think about that, and about what has happened here and what you are allowing to continue.

We have drug stores and pharmacists. We could do this right now and save six lives today. And every day. We can end this emergency now.  [Tyee]

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