International Overdose Awareness Day - End the War on People Who Use Drugs

International Overdose Awareness Day, August 31st 2023

This day matters. The lives that have been lost to overdose matter. Our leaders’ decisions about policies surrounding opioids and other currently illicit substances matter.

New Brunswickers cannot ignore the opioid epidemic. It is not remote, just happening on the other side of the country to “those people” who make “bad choices.” Illicit substance use has been in our province for a long time, but until recently, the drug supply was largely predictable and mostly hidden behind closed doors. It looks different now that more people no longer have doors. But don’t assume it is only where you can see it. The crisis is more visible, and it is far, far more deadly than it was even three years ago, but it still hides in families and neighbourhoods where you might not expect it.

Roughly every hour, someone’s loved one in Canada dies of opioid toxicity, also known as overdose. The term overdose sounds like the person took too much, but often what looks exactly like their usual dose contains unexpected, toxic ingredients or ingredients at a much higher concentration than expected. Fentanyl, a very cheap, synthetic opioid, is present in 80% of these deaths, and we’re beginning to see even scarier additives that do not respond to naloxone (Narcan), which can usually help save lives from an opioid overdose.

With such dangers, people might think it seems reasonable our society long ago declared a War on Drugs! But this war on drugs is really a war on people who use drugs. It has made organized crime incredibly profitable locally and internationally by forcing deadly innovation. For example, when it becomes harder for organized criminals to smuggle large volumes of the illegal ingredients needed to make fake Dilaudid pills, the solution is to bring in more concentrated ingredients to make the same number of pills – or more – while taking up dramatically less space. The bonus for the drug lords is that synthetic opioids are not only smaller and much stronger than natural opiates but are extremely cheap and addictive (when they don’t kill). 

Killing customers might seem like a bad business model. But as long as we focus on criminalizing people who use drugs over helping people recover from or avoid developing substance use disorders and fail to adequately address the mental health and housing crises, there will be a steady supply of customers for the substances they use to fight physical or psychic pain. Anyone from any walk of life can develop a substance use disorder and/or experience toxic drug poisoning. But those hardest hit tend to live with chronic pain, individual or intergenerational trauma, neurodivergence, physical or mental illness, stigma, isolation, racism, misogyny or poverty.

The failure of the war on drugs shouldn’t surprise anyone familiar with the unintended consequences of Prohibition in Canada and the United States over a century ago when a moralistic crusade against the societal dangers of rampant alcohol use (particularly by immigrants) drove drinking underground, gave rise to organized crime, and made high proof liquor easier to find than beer and wine - the more concentrated, the easier to smuggle. The folly of Prohibition was realized, and since then, alcohol use has become not only legal and regulated but socially accepted and even a celebrated part of our culture (wine o’clock, anyone?) even though many lives have been destroyed or damaged by excessive alcohol use. Cigarettes, which we know have horrible impacts on health, remain legal and regulated. Cannabis is now legal and regulated throughout Canada. Addiction is possible for each of these mood-altering substances, and excessive use of any of them will damage our health or kill us in the long term. But Canadians who enjoy them do not have to fear there are toxic ingredients that might randomly kill them within minutes of consumption. The criminalization of people who use narcotics is counterproductive and allows organized crime to thrive and poison some of the most vulnerable Canadians.

End the war on people who use drugs.

Defund organized crime by decriminalizing (and regulating) currently illicit substances while directing resources toward treatment and address the medical, psychological, social and economic reasons people develop substance use disorders. This means flexible forms of treatment, available in various health care and social settings, are needed. How to use a naloxone kit should accompany workplace safety training, with kits available. Naloxone should be accessible at every pharmacy, as it is in other provinces, instead of being $30. We need safe consumption sites across the province to help provide safety for people who use drugs, drug testing, responding to overdoses, and linking people to resources. Above all, we need housing first. People need to live inside, with supports suitable to their needs, before any stability is possible. Private developers cannot provide all the housing needed; we have to invest in a not-for-profit housing sector that meets people where they are and helps them get to where they want to be.

Demand safety for all!

[You can read a brief history of drug policy in Canada and its racist/xenophobic underpinnings at https://drugpolicy.ca/about/history.] 

This blog post was co-written by Dr. Sara Davidson and Christine Cook Cross