Partial truths from politicians won’t fix the toxic drug crisis
by Ian Culbert and Natalie Brender
The Hill Times, Opinion
June 19, 2024
Recent efforts by political leaders to reverse progressive policies intended to address the toxic drug crisis are misguided. People who use drugs are not the only ones being harmed by several actions: British Columbia’s request that Ottawa re-criminalize the public use of illicit drugs in that province; Ontario’s refusal to support the City of Toronto’s decriminalization application; and Premier Doug Ford’s promise to review and limit supervised consumption facilities. In fact, political leaders’ misleading justifications for these policy reversals are doing harm to all Canadians’ understanding of the nature of the toxic drug crisis, what’s needed to address it, and our collective stake in this crisis.
Political leaders are not serving Canadians through their frequent use of the claim ‘we tried it and it didn’t work; the crisis got worse.’ Such framing is nearly always misleading because the toxic drug crisis isn’t one problem, but an interwoven tangle of different problems. These include individual-level issues (trauma, mental illness, and mismanaged pain), as well as structural factors (an increasingly toxic drug supply, impacts of the pandemic, ongoing legacies of colonialism), and failures in governmental policy (homelessness, impacts of criminalization, and inadequate measures for prevention, treatment, and harm reduction).
Each of these problems requires specific policy efforts, and the effect of any single response can be assessed only in relation to specific outcomes. Until a comprehensive, evidence-based approach is fully resourced and implemented, we cannot expect to see improvement in the crisis as a whole.
For example, decriminalization is an evidence-based policy measure intended to reduce the stigma, social barriers, and costs associated with criminalizing people who use drugs. The primary direct indicator of its impact would be a changing rate of involvement of people who use drugs with the criminal justice system. Supervised consumption facilities are a policy measure intended to reduce the rate of toxic drug poisoning deaths in the surrounding population, and research confirms their effectiveness.
On their own, however, these measures will not change large-scale trends. Any politician who says they ‘don’t work’ in light of rising toxic drug poisoning deaths in a given jurisdiction is actively ignoring all of the other factors in play, and should be called out for misleading the public.
Recent experience shows that interventions to save the lives and improve the well-being of people who use drugs may—when under-resourced or inadequately managed—be perceived as contributing to negative impacts on neighborhood safety, business activity, or property values. Of course policy interventions can and should be designed and resourced to lessen potential negative side effects. Nonetheless, politicians’ claim that such side effects show the interventions ‘don’t work’ in achieving their purpose is simply deceptive.
Another way in which politicians critical of progressive interventions in the toxic drug crisis are misleading Canadians is in their invocations of ‘community.’ When leaders imply that measures to help people who use drugs impose intolerable burdens on the well-being of the community—meaning non-drug users—they encourage us to see people who use drugs as being separate from the rest of us.
The families of the over 43,000 Canadians who have died from toxic drug poisonings since 2016 know otherwise. People using toxic illicit drugs are our neighbours, our friends, and our family members—and anyone in denial about this truth may be one tragic event away from learning otherwise. According to a 2024 study, an estimated one-third to one-half of fatalities from opioid poisoning in Canada were among recreational users who were never diagnosed with an opioid use disorder. These were students, parents, and working tradespeople in the midst of ordinary community life.
Although some politicians tout more treatment beds as an all-purpose solution, available treatment beds wouldn’t have prevented those deaths, and won’t prevent many more to come. What’s needed to save these community members is a decriminalized context for drug use with access to a regulated safer supply, and more robust harm reduction measures supported by properly-resourced health and social services.
The overriding cause of drug poisoning deaths today is the toxic drug supply, and each of us is at risk of having our families and communities upended by its impacts. Political leaders owe Canadians better than over-simplifying causes and effects behind this crisis, or cherry-picking interventions that suit their ideologies or interests.
Ian Culbert is the executive director of the Canadian Public Health Association, and Natalie Brender is its director of policy.