Professor Andrew Hathaway Credit: Andrew Hathaway
Today, I’m joined by Andrew Hathaway, professor in the Department of Sociology and Anthropology at the University of Guelph, to discuss why decriminalizing possession of controlled drugs has once again fallen out of favour and why various levels of government are sticking to that consistently tried and true failure known as the war on drugs.
In August 2022, Hamilton city councillors voted to ask for an exemption in law to decriminalize small amounts of illicit drugs for personal use. Fred Eisenberger was mayor at the time – although, Andrea Horwath took over the office of the mayor in November of that year.
While possession of illegal drugs remains a criminal offense in Canada, cities can apply for individual exemptions from Health Canada.
Instead of being arrested, charged or having their drugs seized, adults are given information and assisted with referrals for health and social supports.
Ontario Big City Mayors, Ontario Association of Police Chiefs, Registered Nurses of Ontario and the Canadian Centre on Substance Use and Addiction have also advocated for decriminalization.
Hamilton’s request was never forwarded to Health Canada because the city had to conduct extensive analysis and consultation before making this application. That included looking at the potential benefits and risks, local addiction support services and different options for a specific decriminalization approach, including evidence and a robust evaluation plan.
Now, councillor Paul Danko no longer supports the exemption citing the fact that British Columbia ended its decriminalization plan a mere 16 months into a three-year pilot.
Recently, Health Canada rejected a request from the City of Toronto to decriminalize possession of controlled drugs for youth as well as adults.
And, always hovering in the background is the Ford government’s fierce opposition to decriminalization.
In a recent article printed in The Conversation, and reprinted in the Hamilton Spectator, titled, Decriminalization failures show half measures are not enough, Hathaway cited the myriad of factors that contribute to the drug crisis.
The list included health disparities and a lack of resources in underserved communities, social isolation, economic burden, stress, a lack of access to treatment and barriers to care as contributing factors to the health effects of drug dependence.
Hathaway is calling for implementation of a public health approach to effectively address substance use. That’s because, while decriminalization is an important first step, it does absolutely nothing to address the root causes of addiction which can be traced back to the social determinants of health – income, education, food security, housing security, job security, social inclusion and access to universal healthcare.
Altering the current trajectory would require provincial governments, like Ford’s, to invest in a basic income guarantee (BIG) – or, as I call it, a guaranteed standard of living; truly affordable housing; increased unionization to ensure living wages and workers rights; livable, walkable communities; and a robust universal healthcare system that includes dental, prescriptions and alternatives to the long-term care industrial complex of death.
Research proves that investing in the social determinants of health not only saves tax dollars, but lives. That’s because folks with addictions to either drugs or alcohol tend to consume less when they have hope.
Hathaway and I discuss why governments, like the Ford government, are so reticent to invest in what’s needed to create healthy communities and societies, yet so ready to cut essential social services and privatize the public commons so they can lower taxes for the wealthy and corporations.
Over 20 years ago Portugal decriminalized the use and possession of heroin, cocaine, LSD, marijuana and other illicit street drugs. However, the Portuguese government also invested in the social determinants of health as well as social safety nets and wrap around services.
Results proved that investing in the redistribution of resources to support the integration of services, housing and employment of folks with addictions is an immensely preferable choice to simply spending more on policing and imprisoning addicts.
Drug treatment court is an alternative that is available in Ontario that diverts folks from the criminal justice system into the public health sphere.
Drug treatment courts provide court-monitored treatment, trauma-informed support, and an alternative to incarceration for some of the most vulnerable and difficult to engage participants in the criminal justice system. The multi-sector team approach aims to reduce recidivism, reduce crime severity, address detrimental social health, increase public safety and reduce higher risk interactions with law enforcement.
Hathaway and I also discuss the Geni coefficient which is a means of measuring social inequality. The higher the score the more inequitable the distribution of wealth or life expectancy within a given country. A high score coincides with increased rates of addiction and incarceration.
We also discuss rates of happiness across countries and not surprisingly, Scandinavian countries with their high rates of unionization and excellent social services are the happiest nations of the world.
Canada ranks 13th while the United States is 16th (2022).
Small Change listeners and readers know that I’ve spoken with Dr. Kerry Beal about the changes the Ford government made to the rules governing which agencies can access large quantities of Naloxone kits.
Naloxone reverses the effects of opioid overdose by restoring normal breathing within minutes. And, that can mean the difference between life and death while waiting for paramedics.
Shelter Health Network in Hamilton is not incorporated and that means the organization can no longer get bulk Naloxone kits from pharmacies or Public Health under Ford’s Ontario Naloxone Programs for Pharmacies (ONPP).
That is a huge problem because Shelter Health Network distributes Naloxone kits throughout the community at all hours of the day and night. These days it’s not unusual to have to administer several nasal or injectable doses in order to revive someone who has taken opioids laced with other substances.
Ford also declared that Naloxone training can no longer be done in groups like at universities, long term care homes, summer festivals or First Nations communities. Instead, training must be conducted inside a pharmacy one person at a time.
Ford and the Ontario Ministry of Health claimed that this was a way to cut red tape. Truth be told, this is a government that views folks as disposable and a problem solved when they are dead. This policy is designed to accelerate that process.
The Centre for Addiction and Mental Health (CAMH) suggests opioid agonist therapy as a viable treat for opioid use disorder (OUD) – a chronic, relapsing condition where folks are addicted to either prescription or illegal opioids, or both.
Sustained long-term remission from opioid use disorder not only involves effective treatment and follow-up, but also integrates social supports to optimize the determinants of health and address the psychosocial factors that influence both substance use and quality of life.
The Canadian Medical Association Journal recommends opioid agonist treatment using buprenorphine–naloxone, because of buprenorphine’s superior safety profile when it comes to overdose risk
Unfortunately, most community opioid agonist clinics are private, for-profit ventures and that has changed the focus from patient-centred to profit-driven care. Some believe privatization and profiteering has stigmatized this health intervention including those within the justice systems as well as harm-reduction advocates.
Yet, the Ford government refuses to listen to experts from healthcare, the social sciences and those with lived experience or to invest in preventions like opioid agonist therapy and wrap-around services to address the opioid crisis.
Fifty years ago, the Canadian government came out strongly in favour of a public health approach to substance use. Unfortunately, we remain a society in denial.
The decriminalization of drugs really hinges on addressing social inequalities including the redistribution of wealth and resources as well as how we, as a society, assign social worth.
Unfortunately, Canadians are increasingly bankrupt when it comes to social empathy.
The only real course of meaningful action is socialism where the means of production, distribution and exchange are owned and regulated by the community as a whole. A real redistribution of wealth and re-investment in community and people while protecting the environment for future generations.
Now is the time to act, because time, and hope for a livable future, is literally running out.
Editor’s Note: BC physicians and allied healthcare professionals working on the frontlines of the toxic drug crisis are calling on all levels of government to come together to solves the crisis rather than using it as electoral fodder.
They clearly state, re-criminalization is not a solution.
June 10th: Vancouver Island physicians, healthcare staff sign open letter on political weaponization of workplace safety https://drugdatadecoded.ca/vanisle/
May 31st: BC NDP are weaponizing drug law to cover their healthcare and housing failures: Nurses & healthcare staff https://drugdatadecoded.ca/decrim-davideby
Thanks to everyone who read today’s article and listened to my podcast. With your continued support, a little Nicoll can make a lot of change.
Music: Real Estate by UNIVERSFIELD is licensed under a Attribution 4.0 International License. freemusicarchive.org.
*Be sure to download the Substack app to get the most from your podcast experience.
Share this post