Fact or Fiction: Will decriminalizing and regulating illegal drugs save lives in Ontario?

Fact or Fiction: Will decriminalizing and regulating illegal drugs save lives in Ontario?

As COVID-19 continues to devastate the country, a silent epidemic armed with an unregulated poison has killed Ontarians at an appalling rate.

Several health officials have raised the alarm about the impact of border closures on the illicit drug supply in Ontario, particularly opioids.

Closed borders mean drug manufacturers no longer have access to smuggled substances. Therefore, they reduce their supply with what they have available – substances like carfentanil, a sedative for elephants that is far more deadly.

Lockdown and physical distancing also mean drug users have had to find new, nearby suppliers who sell substances they have not used before.

Cue the perfect storm for an accidental overdose.

“The toxicity of drug supplies has changed dramatically due to border closings,” said Adrienne Spafford, CEO of Addictions and Mental Health Ontario. “Since COVID-19 in Ontario, we’ve seen deaths from overdose increase by 35 to 40 percent weekly.”

A harrowing number? According to Spafford, three quarters of these people used it alone.

Paramedics are trying to keep up with the growing toxicity of opioids.

“If you turn the calendar back five years, we used to give 0.4 mg, or 2 mg would be the absolute maximum for naloxone,” said Darryl Wilton, president of the Ontario Paramedic Association.

Up to 20 mg of naloxone was given to reverse the effects of a strong opioid – 50 times higher than the starting dose, Wilton said.

“Most Ontario paramedics – where we used to only carry 4 mg in every ambulance – now carry an average of 12 mg of naloxone in Ontario, which is readily available in every ambulance, especially because things like purple heroin are so much more powerful. “

The dire situation is causing more and more people to look carefully at how things would change if the government intervened.

“When you have an unregulated product, there is always a chance it could be adulterated or contaminated,” said Andy Hathaway, professor of sociology at the University of Guelph.

“Decriminalizing illicit drugs has potential benefits as it recognizes that harm reduction saves lives.”

Decriminalization means removing criminal penalties for personal drug use and possession.

This would mean that mass incarceration for property – which affects black, indigenous and colored people in particular – would be reduced.

According to Spafford, Wilton, and Hathaway, it would also mean public perception is shifting to viewing addiction as a public health crisis rather than a criminal.

“As part of legalization … there are increasing opportunities to understand the user’s motivations and reasons for using them, aside from being a so-called ‘criminal’ or a ‘drug addict’,” Hathaway said.

Rather than focus on monitoring and punishing drug users, Hathaway and Spafford say the government is instead allocating resources to treating addiction and the circumstances that cause it, such as social inequality, access to education, and precarious jobs and housing would.

A popular example of the positive effect of decriminalization is the “Portugal model”.

Portugal decriminalized its drugs in 2001, according to DrugPolicy.org. Ten years later, the number of fatal opioid overdoses fell five-fold.

Within 12 years – two of them before decriminalization – the number of people seeking addiction treatment rose by 60 percent.

In addition, the number of drug users has not increased, although many believe that decriminalization would trigger an increase in drug use.

Proponents of decriminalization also often push for legalization and regulation, which means that the government produces the substances, strictly regulates them, and carries out strict quality control of their ingredients, effectiveness and packaging.

This means that consumers know exactly what they are injecting.

“As long as the drug market remains illegal, people are at risk,” Spafford said.

Regulation would also mean that the government could collect more data on drugs and publish factual information about their adverse effects.

“We call it ‘black market’ for a reason. It is black…. It’s hard to keep track of, hard to monitor, ”said David Hammond, professor of public health at the University of Waterloo.

“I think a concerted effort needs to be made to better understand illicit drugs so that we are careful not to de-normalize and stigmatize consumers as they are often our best source of information about what is out there.”

According to Hammond, the regulation also hosts honest conversations with consumers. Canadians have seen this firsthand with a substance that was once illegal – cannabis.

“We’ve been following this for many years and we see Canadians reporting more information and health literacy immediately before and immediately after legalization … and you know what? When we talk to consumers of different substances, that’s exactly what they want Most of them want more information or are curious about what they are ingesting and what impact it might have. “

Hathaway, Spafford and Wilton all agree that regulating illegal drugs would mean fewer toxic substances and fewer deaths from overdose.

But if many key players in harm reduction want the same thing, what’s the downside?

According to experts: stigma.

“If you think about the reasons why people overestimated the risks of cannabis, it’s because it was illegal,” said Hammond.

“In fact, it’s our legal drugs that in many cases do the most harm, and tobacco use is a good example … so it has to do with our social norms.”

While Hathaway and Spafford say decriminalization and regulation are “a big piece of the puzzle”, ending the drug epidemic is no silver bullet.

Instead, a multi-faceted approach needs to be pursued that enables improved and equal access to mental health services, consumption and treatment centers (CTS), clean equipment such as needles, tubes, spoons, case management for addiction problems, and drop-in programs for peer support.

But none of these things can happen without adequate government funding, which Spafford said did not come about.

“I believe I can say with confidence that funding to address the opioid overdose crisis has nowhere near met the needs of the crisis. We must take immediate action to implement the government’s mental health and addiction strategy . “

Until then, said Spafford, the war on drugs will continue to be a losing battle.

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