Category: Harm Reduction

  • Canadian Drug Policy Coalition/Canadian HIV / AIDS Legal Network Policy Briefs

    Canadian Drug Policy Coalition/Canadian HIV / AIDS Legal Network Policy Briefs

    Harm Reduction Brief

    Canada is known around the world as a leader in harm reduction. It is host to the first, and only supervised consumption site in North America, Insite, which has saved lives and helped to build a healthier community in one of the most at-risk neighbourhoods in the county. Unfortunately, the federal government has moved away from harm reduction and more towards a criminal approach to drugs. Of course, there is a way forward. In our policy brief, we make the case that not only should the federal government restore the harm reduction model, but expand upon what is already in place. Please click and read below.

    CDPC-HarmReduction-Brief English

    CDPC-HarmReduction-Brief Français

    Overdose Brief

    The tragedy of drug overdose has increased dramatically in recent years. The rise of fentanyl, an extremely potent opioid, has dramatically increased overdose deaths in recent months. Policy change at the federal level is urgently needed. Fortunately, overdoses are preventable. From allowing for easier access to lifesaving medication such as naloxone, to testing the purity level of street drugs, there are several actions the government can take right now to put an end to these avoidable deaths. Our policy brief contains many commonsense policy solutions that the government can enact immediately. Please click and read.

    CDPC-Overdose-Brief English

    CDPC-Overdose-Brief Français

    Cannabis Brief

    Cannabis law is changing around the world. From the United States to Latin America, a wider consensus is growing that cannabis prohibition has failed to prevent both the sale and consumption of the plant for non-medicinal purposes. Public opinion in Canada and worldwide is experiencing a paradigm shift, and the mindset of policymakers needs to change with it. Clearly, an alternative strategy to this broken system needs to be taken seriously. In the following brief, we outline our strategic recommendations on how the federal government can end prohibition, and use its power to begin the process to create a regulatory system that works.

    CDPC-Cannabis-Brief English

    CDPC-Cannabis-Brief Français

  • Le temps est venu de repenser notre approche en ce qui concerne la consommation de drogues en milieu carcĂ©ral

    Le temps est venu de repenser notre approche en ce qui concerne la consommation de drogues en milieu carcéral

    Il s’agit du troisiĂšme d’une sĂ©rie de trois articles consacrĂ©s Ă  l’importance d’envisager une rĂ©forme des politiques et programmes en vigueur dans les prisons canadiennes. Vous pouvez consulter le premier article ici et le deuxiĂšme article ici.

    Dans cette sĂ©rie d’articles, j’ai remis en cause l’efficacitĂ© des mesures de contrĂŽle des stupĂ©fiants en milieu carcĂ©ral et soulevĂ© un certain nombre de questions en ce qui concernel’accĂšs aux mĂ©dicaments dans les Ă©tablissements du Service correctionnel du Canada (SCC). Sous le gouvernement actuel, qui se veut dĂ©terminĂ© Ă  s’attaquer Ă  la criminalitĂ©,la population carcĂ©rale augmente et la majoritĂ© des dĂ©tenus dĂ©clare ĂȘtre aux prises avec des problĂšmes de toxicomanie. Face Ă  cette rĂ©alitĂ©, il importe de se demander si les dĂ©tenus font l’objet d’interventions, en matiĂšre de consommation de drogues, qui amĂ©liorent leur Ă©tat de santĂ© et leur bien-ĂȘtre, et facilitent leur rĂ©intĂ©gration dans la sociĂ©tĂ© ?

    Pour les personnes dĂ©sireuses de rĂ©duire ou d’éliminer leur consommation d’alcool ou de drogues, les traitements de la toxicomanie peuvent avoir un impact positif. Au fil des annĂ©es, le SCC a Ă©laborĂ© plusieurs programmes ciblant la consommation de drogues en milieu carcĂ©ral (p. ex. les programmes d’intensitĂ© moyenne et Ă©levĂ©e) et dĂ©clare avoir enregistrĂ© des succĂšs aussi bien en milieu institutionnel que suite Ă  la libĂ©ration. Les Lignes directrices nationales du SCC relatives Ă  l’aiguillage vers les programmes correctionnels stipulent que les plans correctionnels doivent permettre aux prisonniers de participer ‘le plus tĂŽt possible’ aux programmes de lutte contre la consommation abusive de drogues. Cependant, plusieurs dĂ©tenus, y compris ceux aux prises avec de graves problĂšmes de toxicomanie, se retrouvent sur de longues listes d’attente.
    De nombreux obstacles s’opposent Ă  la prestation efficace et en temps opportun de traitements contre la toxicomanie en milieu carcĂ©ral. Les prisons constituent, de par leur conception, un milieu difficile pour les programmes de rĂ©adaptation. Les gens ne s’y trouvent pas volontairement. Les impĂ©ratifs de sĂ©curitĂ© dictent les procĂ©dures opĂ©rationnelles (p. ex. l’isolement cellulaire), ainsi que l’attitude adoptĂ©e par le personnel correctionnel et les employĂ©s des programmes. Il y a considĂ©rablement plus d’argent allouĂ© Ă  l’infrastructure de sĂ©curitĂ© qu’aux programmes, et le financement des programmes est davantage susceptible de subir des coupures budgĂ©taires. Par exemple, l’ombudsman des Services correctionnels du Canada a notĂ©que l’investissement dans le programme du SCC dans le traitement d’entretien de la mĂ©thadone, un traitement efficace de substitution aux opiacĂ©s, devait ĂȘtre rĂ©duit en 2014/15. Comme les populations carcĂ©rales continuent de croĂźtre et le financement public se rarĂ©fie, le surpeuplement qui en dĂ©coule (p. ex. la double occupation des cellules, le manque d’espace pour les programmes) et les problĂšmes de ressources (p. ex. le manque de personnel qualifiĂ© pour satisfaire Ă  la demande du programme) auront une incidence sur l’accessibilitĂ© et la qualitĂ© des programmes.

    Un autre aspect problĂ©matique est la hiĂ©rarchisation des candidats Ă©ligibles aux programmes de traitement de la toxicomanie. Les anciens membres du personnel correctionnel expliquent que la durĂ©e des peines et les dates d’admissibilitĂ© Ă  la mise en libertĂ© sont souvent utilisĂ©es pour dĂ©terminer qui aura d’abord accĂšs aux programmes. Les individus purgeant des peines plus courtes (p. ex. quatre ans ou moins) voient s’accĂ©lĂ©rer le plan d’exĂ©cution de leur peine. Inversement, ceux qui purgent des peines plus longues, peu importe leurs antĂ©cĂ©dents personnels, sont parfois dĂ©priorisĂ©s, ou ne sont retenus pour les programmes que plusieurs annĂ©es plus tard. Cela aboutit Ă  une situation incohĂ©rente. En outre, tout prisonnier prĂ©sentant une demande de libertĂ© conditionnelle sans avoir complĂ©tĂ© sa programmation dĂ©signĂ©e, est susceptible d’ĂȘtre jugĂ© inadmissible ou sans fondement.

    L’absence d’accĂšs en temps opportun aux traitements de la toxicomanie pourrait expliquer pourquoi certains dĂ©tenus continuent Ă  consommer de la drogue pendant leur incarcĂ©ration. Les politiques de tolĂ©rance zĂ©ro dans les prisons fĂ©dĂ©rales rendent difficile l’institution de programmes de sensibilisation et de services de rĂ©duction des mĂ©faits. J’ai dĂ©jĂ  traitĂ© en dĂ©tail des obstacles politiques et opĂ©rationnels, y compris la suppression d’élĂ©ments de preuve, qui empĂȘchent la mise en oeuvre de certains programmes de rĂ©duction des mĂ©faits, tels que les projets de tatouage sĂ©curitaire et de distribution de seringues au Canada. De tels programmes ont vu le jour dans d’autres pays. Ici au Canada, des efforts plurilatĂ©raux sont en cours pour renforcer l’appui apportĂ© Ă  la mise en oeuvre de programmes de distribution d’aiguilles et de seringues, en vue d’amĂ©liorer les services de santĂ© offerts aux dĂ©tenus.

    Il est essentiel de se rappeler que la plupart des dĂ©tenus fĂ©dĂ©raux sont Ă©ventuellement rĂ©intĂ©grĂ©s Ă  la collectivitĂ©. Pour les consommateurs de drogues, la pĂ©riode initiale suivant leur remise en libertĂ© est reconnue comme un moment critique. Il est possible qu’ils rĂ©intĂšgrent un rĂ©seau social qui encourage la consommation de drogues ou qu’ils recommencent Ă  consommer des drogues qui augmentent leur risque de surdose. Au cours de cette pĂ©riode de transition, la continuitĂ© des soins (p. ex. l’établissement de liens entre les anciens dĂ©tenus et les traitements communautaires de la toxicomanie et les services de rĂ©duction des mĂ©faits) est un autre domaine auquel il faudrait apporter d’importantes amĂ©liorations. Aussi est-il d’autant plus important que les toxicomanes puissent bĂ©nĂ©ficier de programmes et de services de traitement de qualitĂ© qui les aident Ă  accroĂźtre leur sĂ©curitĂ© pendant leur incarcĂ©ration. Si nous ne parvenons pas Ă  relever ces dĂ©fis, les mesures que nous prenons sont insuffisantes et arrivent trop tard.

  • Why Canada is no longer a leader in global drug policy

    Why Canada is no longer a leader in global drug policy

    Co-authored with Jenna Valleriani, director of Canadian Students for Sensible Drug Policy.

    This op-ed first appeared in the Globe and Mail, Feb. 27, 2015

    Prime Minister Stephen Harper’s statement about the failures of our existing drug policy is mostly on point. It’s just the last bit he gets wrong: “I think what everyone believes and agrees with, and to be frank myself, is that the current approach is not working, but it is not clear what we should do.”

    He’s wrong, because we know what we should do: Supervised injection sites; prescription heroin; medical cannabis dispensaries; crack pipe distribution; drug testing kits; Naloxone for reversing opioid overdose.

    We know these innovative health services reduce the harms of drugs and save lives, and we all agree “the current approach is not working.” And yet, access to these important innovations is unequal across Canada because of a lack of leadership at the federal level, and a failure to collaborate across all jurisdictions – local, provincial, national and international.

    We don’t need to look far to start. Vancouver is known internationally for its innovation in drug policy reform – it houses North America’s first supervised injection site and prescription heroin program, and has recently seen a proliferation of medical cannabis dispensaries. The city’s drug policy is based on an evidence-based four pillar approach: harm reduction, prevention, treatment and enforcement. This approach has been adopted around the world, but also here in Canada, officially forming the basis for the Toronto’s drug strategy.

    Unfortunately, the federal government is out of step with international dialogue and doesn’t believe in the four pillars – it dropped harm reduction in 2007 when it changed the National Drug Strategy to the National Anti-Drug Strategy. While countries like Portugal have moved towards decriminalization and a more health-focussed approach, Canada has instead pursued a more punitive, conventional “war on drugs” approach – epitomized by the introduction of mandatory minimum sentencing for low level drug offenses. Recently Health Canada spent $7-million of our precious tax dollars on a fear-based anti-cannabis ad blitz that the country’s top physician groups suggested was politically motivated.

    The lack of vision at the top means that in a country known internationally for its innovation in harm reduction, many of our best public health interventions only exist in isolated local cases. This is not entirely unexpected. The story of drug policy reform is often one of grassroots change lead by users, local authorities, politicians, drug policy experts, service workers, and organizations. In Europe, for example, cannabis social clubs are driving much of the pressure for cannabis reform. Harm reduction services in countries like Germany, Switzerland, and the Netherlands started as trials in innovative cities before being scaled up nationally.

    In Canada, this bottom-up drive for change is exemplified by the current explosion of medical cannabis dispensaries in Vancouver. Dispensaries have always operated outside the federal access program, in a type of quasi-legal status, or as an act of ‘civil disobedience.’ But the city’s recent explosion of these storefronts has underscored the disconnect between local and national. Although the federal government projects a $1-billion free market medical cannabis industry in the future, currently it’s a notoriously slow, selective, bureaucratic process with little approvals and many rejections.

    The result is a void that “unofficial” dispensaries have been happy to fill. One Vancouver city councillor recently pegged the number of dispensaries at 61. Because of shifting of cultural norms around the acceptance of cannabis – polling shows that Canadian attitudes on cannabis are well ahead of the laws – the city and the police aren’t entirely sure what to do. But they are on record saying they will not bother dispensaries that follow best practice dispensing.

    This is fine for Vancouver, but we need a comprehensive national drug policy, so that essential healthcare innovations like medical cannabis – and prescription heroin, harm reduction kits, and product testing – are available consistently, throughout the country.

    Instead, Canada heads backwards, no longer an international drug policy leader, and our reputation on the international stage suffers for it. Innovation at the municipal level is essential, but it needs to be backed by federal support. Canada needs to stop criminalizing people and instead address the health needs of Canadians. The current approach is not working.

  • Le contexte entourant l’application des lois antidrogues dans les prisons fĂ©dĂ©rales canadiennes

    Le contexte entourant l’application des lois antidrogues dans les prisons fĂ©dĂ©rales canadiennes

    Voici le premier d’une sĂ©rie de trois articles consacrĂ©s Ă  l’importance d’envisager une rĂ©forme des politiques et programmes en vigueur dans les prisons canadiennes.

    Au cours des derniĂšres annĂ©es, le Service Correctionnel du Canada (SCC) a intensifiĂ© ses efforts visant Ă  empĂȘcher l’introduction de drogues dans les prisons. NĂ©anmoins, la prioritĂ© accordĂ©e Ă  la dĂ©tection des drogues et Ă  l’application des lois antidrogues en milieu carcĂ©ral semble ĂȘtre Ă  l’origine de plusieurs problĂšmes.

    Pour certains, une peine d’emprisonnement constitue en effet une chance de se « dĂ©sintoxiquer ».  Cependant, l’idĂ©e qu’une prison offre un endroit sĂ»r et libre de drogues pour tous est fondĂ©e sur des hypothĂšses erronĂ©es au sujet de la rĂ©duction de la demande et de l’offre de stupĂ©fiants en milieu carcĂ©ral. Dans le cadre de mes recherches, j’ai dĂ©couvert qu’en dĂ©pit d’un financement considĂ©rable et de l’application accrue de lois antidrogues dans les prisons, l’objectif de non-circulation de la drogue dans les prisons est encore loin de pouvoir se rĂ©aliser au Canada.

    En 2007, le SCC a mis en oeuvre son Programme de transformation qui inclut, dans le cadre de ses cinq domaines d’action prioritaire, « l’élimination des drogues en milieu carcĂ©ral ». L’annĂ©e suivante, le systĂšme carcĂ©ral fĂ©dĂ©ral a bĂ©nĂ©ficiĂ© d’un investissement de120 millions de dollars Ă©chelonnĂ© sur cinq anspour intensifier sa stratĂ©gie antidrogues . Ce financement visait Ă  amĂ©liorer les outils permettant de dĂ©tecter, perturber et dissuader la consommation de drogues dans les prisons, tels que les tests de dĂ©pistage alĂ©atoires de drogues dans l’urine, les agents de renseignement de sĂ©curitĂ©, les chiens dĂ©tecteurs de drogues et les scanneurs ioniques. Il s’agit lĂ  d’une trousse d’outils Ă©norme et coĂ»teuse, et nous ne disposons toujours pas de preuves certaines de son efficacitĂ©.

    Les avis demeurent partagĂ©s sur l’application des lois antidrogues et leur incidence en milieu carcĂ©ral. Certains observateurs bien renseignĂ©s, tels que les anciens agents correctionnels et les employĂ©s d’organismes communautaires offrant un soutien aux prisonniers, dĂ©clarent que le renforcement des mesures d’application des lois antidrogues a non seulement Ă©chouĂ© Ă  empĂȘcher l’introduction de drogues dans les prisons, mais contribue au contraire Ă  aggraver la situation. Les problĂšmes liĂ©s aux mesures d’application incluent les individus qui changent le type de drogue qu’ils consomment (qui passent p. ex. du cannabis aux opiacĂ©s) pour Ă©viter d’ĂȘtre repĂ©rĂ©s, une recrudescence des comportements Ă  risque, des tensions accrues, la violence liĂ©e au commerce de la drogue et une baisse du nombre de visiteurs.

    Les consĂ©quences peuvent ĂȘtre immĂ©diates ou se prolonger bien au delĂ  de la peine d’emprisonnement. Par exemple, lorsque les prisonniers qui s’injectent des drogues partagent leurs aiguilles, ils risquent de contracter le VIH et l’hĂ©patite C . Lorsque les familles, les amis, et les bĂ©nĂ©voles se sentent marginalisĂ©s et accablĂ©s par des mesures de sĂ©curitĂ© envahissantes, oulorsqu’on leur refuse l’accĂšs en raison de renseignement potentiellement inexacts, ils visitent moins souvent, ou cessent tout simplement de visiter. Ceci affaiblit les rapports essentiels Ă  la rĂ©insertion fructueuse des dĂ©tenus au moment de leur libĂ©ration.

    Ces problĂšmes sont souvent rĂ©interprĂ©tĂ©s ou rejetĂ©s par le SCC. Le SCC souligne plutĂŽt l’augmentation du nombre de saisies de drogue et le nombre rĂ©duit de tests d’urine positifs et de refus, pour indiquer que les mesures d’application de la loi fonctionnent. Les visiteurs qui tournent le dos aux portes des prisons sont prĂ©sentĂ©s comme Ă©lĂ©ments probants de l’efficacitĂ© des mesures visant Ă  dissuader les dĂ©tenteurs de stupĂ©fiants. Bref, ces questions demeurent controversĂ©es. Mais il importe de souligner que le SCC, ainsi que les autres autoritĂ©s pĂ©nitentiaires, ont tendance Ă  blĂąmer les dĂ©tenus et les visiteurs pour tous les problĂšmes liĂ©s Ă  la drogue, sans Ă©gard Ă  l’incidence de leur politique Ă  tolĂ©rance zĂ©ro et Ă  son application.

    Cette approche focalisĂ©e qui exclut les informations et les perspective divergentes rend difficile la tĂąche de rĂ©former les approches et les pratiques courantes. Il y a quelques annĂ©es, le ComitĂ© parlementaire permanent de la sĂ©curitĂ© publique et nationale  a rassemblĂ© un groupe variĂ© d’intervenants et d’experts bien informĂ©s, dont des reprĂ©sentants du SCC, pour Ă©tudier le« problĂšme accablant » des drogues et de l’alcool en milieu carcĂ©ral. Les tĂ©moins ont exprimĂ© des « points de vue trĂšs divergents au sujet des politiques et des mesures prises par le SCC ». Certains ont mĂȘme tĂ©moignĂ© que l’application des lois antidrogues n’a pas rĂ©ussi Ă  Ă©liminer les stupĂ©fiants du milieu carcĂ©ral et contribue Ă  compromettre la santĂ© et la sĂ»retĂ© des dĂ©tenus, du personnel pĂ©nitentiaire et des collectivitĂ©s. En dĂ©pit de tout cela, le rapport final recommandait un investissement continu dans le renforcement des mesures d’application des lois antidrogues et s’obstinait Ă  dĂ©fendre son engagement envers « l’établissement de prisons sans drogues ». Autrement dit, il ne s’écartait pas du Programme de transformation. Les Canadiens devraient porter un regard critique sur de tels rapports et demander quels changements ont rĂ©ellement Ă©tĂ© apportĂ©s.

    Le SCC administre un grand nombre de dĂ©tenus dans des prisons implantĂ©es d’un bout Ă  l’autre du Canada. Bien que nous prĂ©conisions une rĂ©forme des politiques sur les drogues hors du milieu carcĂ©ral, nous ne devons pas oublier les politiques et les programmes qui affectent les consommateurs de drogues purgeant une peine de ressort fĂ©dĂ©ral (y compris le nombre disproportionnĂ© de personnes autochtones). Une Ă©valuation complĂšte et bien conçue des mesures d’application des lois antidrogues en milieu carcĂ©ral se fait attendre depuis beaucoup trop longtemps. Et compte tenu de la consommation continue de drogues dans les prisons canadiennes, une Ă©valuation rĂ©aliste des programmes appropriĂ©s de rĂ©duction des mĂ©faits, tels que l’éducation Ă  la consommation de drogues plus sĂ©curitaire et les programmes de distribution de seringues, devraient Ă©galement ĂȘtre une prioritĂ©.

  • Les politiciens d’un bout Ă  l’autre du Canada souffrent d’un Abus de politique en matiĂšre de drogues

    Les politiciens d’un bout à l’autre du Canada souffrent d’un Abus de politique en matiùre de drogues

    Une nouvelle affection psychiatrique invalidante a Ă©tĂ© reconnue aujourd’hui par la Coalition canadienne des politiques sur les drogues. Malheureusement, plusieurs politiciens sont atteints de ce mal, que l’on a baptisĂ© l’« Abus de politique en matiĂšre de drogues ».

    Vous avez sans aucun doute observĂ© les symptĂŽmes. Ces politiciens qui rĂ©sistent au changement et Ă©cartent les donnĂ©es probantes. Qui persistent Ă  se montrer « sĂ©vĂšres » et Ă  envoyer un message rĂ©pressif. Qui refusent d’examiner les diffĂ©rentes approches envisageables en ce qui concerne les politiques sur les drogues, malgrĂ© l’abondance de preuves dĂ©montrant les retombĂ©es physiques, psychologiques et sociales dĂ©favorables de notre approche actuelle envers les drogues, qui perdure depuis des dĂ©cennies.

    Tels sont les symptĂŽmes de l’Abus de politique en matiĂšre de drogues. Et la CCPD a lancĂ© une campagne pour sensibiliser les citoyens Ă  cette maladie invalidante.

    Consultez le site Web de la campagne ici.

    La bonne nouvelle, c’est qu’il existe un traitement efficace pour ceux qui reconnaissent avoir un problĂšme en ce sens. Il suffit de garder l’esprit ouvert et de reconnaitre que l’élaboration de politiques bien orientĂ©es, peu importe l’enjeu, nĂ©cessite un dialogue franc et ouvert, Ă©clairĂ© par des donnĂ©es probantes. Comme le fait que les services de rĂ©duction des risques et les interventions rĂ©glementaires amĂ©liorent l’espĂ©rance de vie et augmentent la probabilitĂ© que les consommateurs problĂ©matiques de drogues suivront un traitement. Et que le taux de consommation de drogue n’augmente pas dans les juridictions oĂč les drogues ont Ă©tĂ© dĂ©criminalisĂ©es ou lĂ©galisĂ©es.

    Heureusement, certains individus de diverses allĂ©geances politiques sont prĂȘts Ă  entamer le dialogue. Les parlementaires fĂ©dĂ©raux en faveur de la lĂ©galisation du cannabis incluent non seulement le chef libĂ©ral Justin Trudeau, mais Ă©galement le dĂ©putĂ© conservateur Scott Reid et la leader adjointe du NPD, Libby Davies. Le NDP soutient la dĂ©criminalisation du cannabis depuis 40 ans, une politique officielle qui a Ă©tĂ© rĂ©affirmĂ©e par le leader actuel du parti, Thomas Mulcair. Le Parti Vert d’Elizabeth May appuie la lĂ©galisation de la marijuana et dĂ©sire engager une consultation publique au sujet de la dĂ©criminalisation de toutes les drogues illicites. De mĂȘme, le dĂ©putĂ© libĂ©ral de l’Ile du Prince Edouard, Wayne Easter, soutient que les sites d’injection supervisĂ©s sont nĂ©cessaires et appuie la mise en place d’un cadre rĂ©glementaire en ce qui concerne les drogues illicites, puisque « les lois actuelles en matiĂšre de drogues ne fonctionnent pas. »

    Au niveau provincial, la chef du parti Wildrose Alliance de l’Alberta, Danielle Smith, est en faveur de la dĂ©criminalisation du cannabis. En Colombie-Britannique, le succĂšs d’Insite, le site d’injection supervisĂ© de Vancouver, dans la prĂ©vention de la transmission du VIH et autres infections Ă  diffusion hĂ©matogĂšne, la rĂ©duction des risques de surdose et la mise en rapport des consommateurs de drogues avec les services appropriĂ©s.  Et les anciens procureurs gĂ©nĂ©raux Kash Heed et Geoff Plant parlent ouvertement du besoin de rĂ©glementation en ce qui concerne le cannabis en Colombie-Britannique et au Canada.

    Au plan municipal, l’ancien maire de Vancouver Larry Campbell a fait campagne en prĂ©conisant la mise en place de sites d’injection supervisĂ©s et certains conseillers municipaux de Toronto ont exercĂ© des pressions pour que de tels sites soient implantĂ©s dans leur ville. Huit maires de Colombie-Britannique, y compris celui de Vancouver, Gregor Robertson, ont rĂ©clamĂ© l’élaboration de nouveaux rĂšglements portant sur le cannabis au Canada. Le maire de Thunder Bay (et ancien officier de police), Keith Hobbs, en a fait de mĂȘme.  Les conseillers et les maires ayant assistĂ© Ă  la convention de 2012 de l’Union des municipalitĂ©s de la Colombie-Britannique ont adoptĂ© une rĂ©solution exigeant que les niveaux appropriĂ©s de gouvernement « dĂ©criminalisent la marijuana et Ă©tablissent une politique de recherche, de fiscalitĂ© et de rĂ©glementation de la marijuana.

    À l’internationale, les politiciens europĂ©ens appuient activement les efforts de rĂ©duction des risques et les dirigeants latino-amĂ©ricains exigent des alternatives Ă  la criminalisation et aux actions strictement punitives ayant Ă©tĂ© mises en oeuvre au cours des 40 derniĂšres annĂ©es. L’Uruguay projette de lĂ©galiser la consommation adulte du cannabis. Plus prĂšs de chez nous, deux Ă©tats amĂ©ricains (le Colorado et l’état de Washington) ont fait de mĂȘme, par l’entremise de votes au scrutin adoptĂ©s grĂące en partie Ă  l’appui de certains hauts fonctionnaires. Il est certain que d’autres Ă©tats en feront de mĂȘme.

    L’idĂ©e est que les politiciens n’ont pas Ă  souffrir d’Abus de politique en matiĂšre de drogues. Certaines juridictions explorent des solutions de rechange Ă  la lutte contre la drogue. Le dialogue a Ă©tĂ© entamĂ©.  Malheureusement, plusieurs politiciens canadiens craignent ce dialogue et ont du mal Ă  envisager des approches diffĂ©rentes.

    Alors pour ceux qui s’en remettent Ă  des thĂ©ories dĂ©passĂ©es, le temps est venu de discuter! Consultez le site Web de la campagne et signez l’engagement Ă  communiquer avec vos reprĂ©sentants Ă©lus, s’ils souffrent d’un problĂšme d’Abus de politique en matiĂšre de drogues. Le site de la campagne met Ă  votre disposition des outils vous permettant de diffuser des messages Twitter aux chefs des partis politiques nationaux, dans le cadre d’un plus vaste dialogue visant Ă  guĂ©rir ce mal dont souffre notre pays.

    Nous vous invitons donc à consulter les détails de la campagne, à visionner les vidéos et à passer le mot à vos amis.

  • Canada is ignoring easy, ways to prevent overdose deaths


    Canada is ignoring easy, ways to prevent overdose deaths


    This article first appeared as an op-ed in the National Post, October 22, 2014

    A particularly potent batch of heroin recently resulted in 31 overdoses at Vancouver’s Insite safe injection clinic. The facility proved its value yet again, as staff applied immediate treatment and ensured none of the victims died. But what about those who can’t access Insite? In 2013, 308 people died in British Columbia due to illicit drug overdoses, the majority of which were opioid-related.

    Canada-wide, we can only speculate about the total numbers because there is no national database tracking overdose deaths. But the numbers we do have, from a patchwork of provincial data and news reports, tell us that far too many Canadians are dying from an entirely preventable phenomenon. And not preventable in the sense of “well, if people didn’t use drugs, there wouldn’t be overdoses.” While that’s essentially true, we know people will use drugs. One hundred years of prohibition hasn’t stopped that.

    No, these deaths are preventable thanks to easy-to-implement, non-controversial policy changes at our disposal.

    The most pragmatic and immediately effective remedy would be to improve access to naloxone, a 40-year old medication that, when administered during an opioid overdose, reverses the effects of the drug. It has no narcotic effect and people cannot become dependent on it.

    Currently, naloxone is used predominantly by ambulance and medical staff — like those at Insite — but we could save countless more lives if it were available to those most likely to be with someone experiencing an overdose. Eighty-five percent overdoses occur in the presence of others, often in the home. For this reason, naloxone should be included in provincial drug plans and made available over the counter.

    In addition, we should scale up existing “take-away naloxone programs” to increase the distribution of overdose response kits among people trained to prevent, recognize and respond to overdoses. Streetworks in Edmonton pioneered this programming in Canada, and similar initiatives have spread throughout the country. The most robust program — Take-Home Naloxone (THN) — was established at the B.C. Centre for Disease Control in 2012. THN operates in 51 sites, from large urban hubs like Vancouver and Surrey, to smaller rural centres such as Cranbrook, Campbell River and Fort St. John. More than 2,200 people have been trained, including staff and volunteers at health and social service agencies, as well as friends and family members of people who use drugs. THN has dispensed more than 1,200 kits, and 125 overdoses have been reversed.

    Clearly naloxone is a life-saver, but reducing barriers to its access and providing training are just part of a comprehensive overdose response. We also need to immediately implement appropriate guidelines for opioid prescriptions, improve national data collection on overdose events, and reduce barriers to calling 911 during a drug overdose. Again, most overdoses occur in the presence of other people. Though witnesses to heart attacks rarely hesitate to call 911, witnesses to an overdose often lose precious minutes wavering over whether to call for help — if they make the call at all. They may fear arrest, the loss of custody of children, or judgment from friends and family.

    This would be resolved by the passage of Canadian 911 Good Samaritan legislation — so called because it provides protection from arrest and prosecution for drug possession if the evidence is obtained as a result of the person calling 911. In the last four years, 11 U.S. states have passed some form of this legislation, often with bipartisan and near-unanimous support.

    Such legislation recognizes that accidental drug overdose is a health issue that doesn’t merit attention from the criminal justice system. Indeed, public health imperatives should drive all policy relating to overdose response.

    While much of the responsibility for this issue rests at the local and provincial level, ultimately the federal government plays an important leadership role in setting the overall tone and guiding any national strategy. At the 2012 annual meetings of the United Nations Commission on Narcotic Drugs, delegates passed a resolution recommending that member states include effective elements for the prevention and treatment of overdose in national drug policies, including the use of naloxone. Although the Canadian delegation supported this resolution, and despite the simplicity of implementing such programs and policies, to date the government has not acted on this matter. It’s time for that to change.

  • Prendre le contrĂŽle : sur la voie de politiques efficaces en matiĂšre de drogues

    Prendre le contrĂŽle : sur la voie de politiques efficaces en matiĂšre de drogues

    Aujourd’hui, la Commission globale de politique en matiĂšre de drogues a publiĂ© le rapport Prendre le contrĂŽle : sur la voie de politiques efficaces en matiĂšre de drogues. Le rapport demande aux gouvernements de rĂ©orienter les politiques mondiales sur les drogues, de prendre certaines mesures immĂ©diates pour rĂ©soudre les problĂšmes liĂ©s aux drogues, et de ne pas reculer devant le potentiel de transformation d’une rĂ©glementation responsable comme solution Ă  plus long terme. Les recommandations surviennent au moment oĂč de plus en plus de gouvernements reconnaissent que l’approche traditionnelle de la « guerre aux drogues » a Ă©chouĂ©, et que de nouvelles approches sont nĂ©cessaires. Reconnaissant ces faits, l’AssemblĂ©e gĂ©nĂ©rale des Nations Unies a convoquĂ© une session extraordinaire (SEAGNU) sur les drogues en 2016 afin de discuter de solutions au problĂšme mondial des drogues. Lors de la SEAGNU et Ă  d’autres assemblĂ©es diplomatiques, le rapport invite les dĂ©lĂ©guĂ©s de l’ONU Ă  garder Ă  l’esprit le mandat des Nations Unies, assurer la sĂ©curitĂ©, les droits de l’homme et le dĂ©veloppement.

    Les membres de la Commission sont notamment l’ancien prĂ©sident du BrĂ©sil, Fernando Henrique Cardoso, l’ancien prĂ©sident du Mexique, Ernesto Zedillo, l’ancien prĂ©sident de la Colombie, CĂ©sar Gaviria, l’ancienne prĂ©sidente de la Suisse, Ruth Dreifuss, Richard Branson et d’autres. Dans le cadre du lancement, les commissaires vont rencontrer le secrĂ©taire gĂ©nĂ©ral des Nations Unies, Ban Ki-Moon, et le secrĂ©taire gĂ©nĂ©ral adjoint des Nations Unies, Jan Eliasson, pour prĂ©senter les recommandations du rapport.

    Leurs recommandations sont les suivantes :

    – Assurer avant tout la santĂ© et la sĂ©curitĂ© des collectivitĂ©s requiert une rĂ©orientation fondamentale des prioritĂ©s et des ressources en matiĂšre de politiques, qui permettrait d’abandonner les mesures punitives inefficaces au profit d’interventions sanitaires et sociales Ă©prouvĂ©es.

    – Assurer un accĂšs Ă©quitable aux mĂ©dicaments essentiels, en particulier les analgĂ©siques Ă  base d’opiacĂ©s.

    – Cesser de criminaliser l’usage et la possession de drogues – et cesser de « traiter » de force des personnes dont la seule infraction est l’usage ou la possession de drogues

    – Appliquer d’autres options que l’incarcĂ©ration pour les acteurs non violents du bas de l’échelle du trafic de drogue, tels les fermiers et les passeurs, entre autres personnes engagĂ©es dans la production, le transport et la vente de substances illĂ©gales.

    – Viser en prioritĂ© une rĂ©duction du pouvoir des organisations criminelles et de la violence et l’insĂ©curitĂ© engendrĂ©es par la concurrence entre elles ainsi qu’avec l’État.

    – Permettre et appuyer les essais dans des marchĂ©s lĂ©galement rĂ©glementĂ©s de drogues actuellement interdites, en commençant, sans s’y limiter, par le cannabis, la feuille de coca et certaines nouvelles substances psychoactives.

    – Profiter de l’occasion offerte par la SEAGNU de 2016, qui approche Ă  grands pas, pour rĂ©former le rĂ©gime mondial des politiques en matiĂšre de drogues.

    Vous pouvez consulter le rapport intégral ici.

  • Preventing music-festival drug deaths must go beyond saying ‘just say no’

    Preventing music-festival drug deaths must go beyond saying ‘just say no’

    This article first appeared as an op-ed in the National Post, August 20, 2014

    It’s summertime, so we can count on this unfortunate fact: Young Canadians will die or become seriously ill because of drug use at music festivals. Earlier this month, three deaths and dozens of cases of illness were attributed to drugs at the VELD festival in Ontario and Boonstock in BC. And the resurgence of large-scale, camp-out music events — especially EDM (electronic dance music) festivals — means these incidents will only become more common.

    The conventional response to these tragedies is predictable and ineffective. We tend to blame the individuals for making bad choices and trumpet the “just say no to drugs” mantra.

    But there’s a better way. For starters, we need to acknowledge that drug use is not going away. Which isn’t to say we should condone it or encourage it. However, it’s naïve to think that we can eliminate drug use at music festivals, or anywhere, for that matter.

    So let’s make it safer. The world is full of instructive solutions to the problems we face: Canadian youth are not unique in supplementing their partying with psychoactive substances. In the Netherlands, Switzerland, Portugal, Colombia, Spain and Austria, authorities have developed “safer parties” strategies to help concert-goers determine if the pills they are about to ingest are as advertised.

    In Austria, for example, ChEckiT project workers attend large music events and offer professional drug testing for purity and accurate labelling, which provides results within 30 minutes. It’s part of an integrated drug-checking service that includes information, individual counselling, crisis intervention, group discussions, telephone hotlines, and educational videos on drug-related themes. Colombian NGO Accion Tecnica Social has initiated a similar program in that country.

    Other countries provide continuously available street-level testing facilities. One example is the Dutch Ministry of Health’s Drug Information Monitoring System (DIMS), which began in 1988 with testing ecstasy at raves. Today, people can drop off their substances for analysis at a DIMS office, and then check on the internet a couple of days later for results. This system also gives authorities a real-time assessment of drug market trends, enabling general warnings to the community at large when warranted. Here in Canada, only police seizures and hospital visits give us that data, at which point it’s usually too late.

    None of these programs serve to endorse drug use. But they do send clear messages to young people that society actually cares about their wellbeing. Their fate doesn’t need to be conceded to the vagaries of an unregulated, potentially unsafe black market.

    Unfortunately, we don’t send these messages in Canada. Beyond broad platitudes about education and awareness, the concrete measures taken are primarily reactive rather than preventative. Public officials and police will wring their hands, warn people not to take drugs and perhaps step up attempts to go after the dealers. Event promoters will increase screening at the gate, bring in more emergency responders, and establish “chill-out tents” for those who need a break.

    All of which is perfectly worthwhile and laudable, but in the meantime, young people will die because no one in authority is willing to consider product safety as a potential solution to music festival deaths.

    Product testing isn’t complicated. It wouldn’t require any major legislation overhaul, and public-health workers could partner with existing grassroots organizations active in the space to carry it out. For example, the Toronto Raver Information Project (TRIP) already provides info and supplies around safer drug use for the perpetual cohort of partyers for whom simply “saying no” is not a realistic goal. ANKORS does similar work — including some rudimentary product testing — at B.C.’s Shambhala festival. Outside of the events themselves, police could more regularly disclose Health Canada results of the contents of substances seized at raves. Currently, they only do so in exceptional circumstances when it suits their purposes.

    Whatever the test results, however, we know from constant warnings of police and others that no drug is made safer when left in the hands of organized criminals and unregulated dealers. So as part of a product-safety regimen, we should also open a discussion about alternatives to across-the-board prohibition, like experimenting with a legal regulated market for party drugs — as New Zealand has done.

    Product testing and drug policy experimentation isn’t the same as creating a free-for-all where all drugs are available in any corner store for whoever wants them. Nor would it minimize the importance of health information and drug education and awareness programs — similar to how we approach tobacco and our favourite party drug, alcohol.

    It is simply the recognition that we have the power and knowledge to prevent unnecessary deaths at music festivals and anywhere else drugs are taken. What is holding us back?

  • Harm Reduction Comes of Age in Canada, or Does It?

    Harm Reduction Comes of Age in Canada, or Does It?

    This post first appeared in the Centre for Addictions Research of BC’s blog Matters of Substance.

    The Supreme Court of Canada’s September 2011 decision allowing Vancouver’s supervised injection site, Insite, to keep operating was a critical milestone for harm reduction in Canada.

    One only has to look at the list of interveners in the case in support of this innovative service to see that it has become a valued and mainstream service in Canada. Canadian health organizations including the Canadian Medical Association, Canadian Nurses Association, Canadian Public Health Association and 11 others saw fit to come before the court to support Insite. But even with this high level of support, scaling up harm-reduction services in Canada remains a challenge.

    Harm reduction gained traction as a result of the HIV/AIDS crisis in the early 1980s and played a critical role as a strategy to engage injection-drug users in HIV prevention. Harm reduction’s more recent challenges have elevated the critique of policy-related harms – harm caused by policies that criminalize people who use illegal drugs.

    Harm reduction acknowledges that there are significant risks associated with illegal drugs and also attempts to work towards mitigating harms within the criminalized environment where drug use occurs. This often puts the public-health goals of engaging people who use drugs in conflict with traditional public-safety strategies that rely on disruption of illegal drug markets, and in turn disruption of the lives of people who use illegal substances.  Harm-reduction approaches balance these realities and focus on creating safer environments as much as possible within a context of criminalization. Some examples include promoting supervision of consumption or discouraging using drugs while alone, promoting rapid response strategies in the form of peer-delivered naloxone programs and strategies that work towards achieving a kind of détente between health efforts and enforcement practices. Given the context of criminalization, a key goal of harm reduction is to maximize the benefits of public-health interventions and minimize the harm of drug use and the enforcement of drug policy.

    So what should Canada be doing to facilitate the development of a more robust harm reduction approach as a part of a comprehensive response to drug use? We urge governments to begin with a review of current drug policies to determine the benefits and harms to individuals and communities that accrue from the criminalization of drugs and the people who use them.

    Other countries have done such an analysis and have decided to eliminate criminalization as a response to possession of drugs for personal use in an effort to maximize the benefit of a public-health approach to drug problems. Portugal (2001) and the Czech Republic (2009), are two examples of jurisdictions that have taken this step. Both have decriminalized all drugs that are deemed to be for personal use. Portugal decriminalized drugs as part of a response to an HIV epidemic and high rates of drug overdose. The Czech Republic did the same as a result of an extensive evaluation of the previous policy of criminalization. Evaluation of the experience in Portugal has shown that results have been positive overall – HIV incidence and overdose deaths have been reduced, police are supportive of the new law as it has given them more meaningful and helpful involvement in steering individuals towards health services, more people are accessing treatment and other health services which were improved as a part of the decriminalization policy. Additionally no negative trends have been seen in terms of increased harms attributed to this policy change.

    Achieving a policy shift as significant as decriminalization will take some time. In the meantime, the Canadian Drug Policy Report, Getting to Tomorrow, outlines some possibilities for improving the development of harm reduction in Canada in the short term:

    • Acknowledge that harm reduction is much more than supply distribution and is an essential component of a comprehensive public health response to problematic substance use that offers client-centred strategies with health engagement at their core.
    • Acknowledge that harm reduction values the human rights of people who use drugs and affirms that they are the primary agents of change for reducing the harms of their drug use.
    • Provincial governments can commit to articulating harm reduction strategies across mental health, addictions and infectious disease policy frameworks.
    • Where harm reduction language is present within policy frameworks ensure implementation at the community level.
    • Support innovation at all levels. An ethic of experimentation will help create an environment where new ideas and novel approaches can be developed and explored.
    • Provide leadership to bring health and policing agencies together to get “on the same page” with regard to harm reduction. Opposition by some in the policing community is unfortunate and an unnecessary barrier to scaling up harm reduction programs.

    Developing a robust and equitable harm-reduction approach for Canadians will necessitate new thinking about old strategies — thinking that exposes the harms that flow directly from our current policy frameworks and will open the door to new ideas and approaches that are emerging around the world.