More than 40,000 people have died from opioid poisoning in Canada since 2016. That’s 22 deaths a day. The drugs are more toxic and more accessible than ever. And it’s not getting better, especially in the West. At the epicentre of the crisis are Alberta and British Columbia. Since 2020, more deaths have been attributed to overdoses than to COVID-19. While the Rocky Mountains separate the two provinces, they are also divided by an ideological divide over how to fight this epidemic.
When Lorna Bird arrives at the office, she asks her colleagues if anyone in the community has died during the night. “Almost every day, I hear that someone close to me has died,” the 67-year-old says, as if in a normal way.
The president of the Vancouver Area Network of Drug Users (VANDU) has lost her daughter, two sisters, two nephews, her best friend and literally hundreds of other acquaintances in recent years.
Lorna Bird, an Ojibwe from Manitoba, doesn’t live in a war zone, but in Vancouver’s notorious Downtown Eastside. All died of opioid overdoses. “There was a time when I couldn’t even talk without bursting into tears,” she says, her body hunched. “But now it’s like I’m numb. It doesn’t do anything to me anymore.”
VANDU is a community organization run by drug users to improve their lives. Lorna Bird is a crack user herself. She welcomes us into her office, which is littered with cigarette butts and empty cans. Dozens of posters in memory of former VANDU members who died of overdoses hang on the walls.
Decriminalization
East Hastings Street in the Downtown Eastside has been called “the worst street in Canada.” It has an end-of-the-world feel: For nearly two kilometres, hundreds of sick people smoke or inject drugs without even hiding. People wander around like ghosts, their backs bent. The buildings here that aren’t boarded up or dilapidated are usually community organizations.
British Columbia is the epicentre of the country’s overdose crisis. The year 2023 saw another record-breaking 2,511 deaths from illicit drugs. Since 2019, it has been the leading cause of unnatural death among people under 18 in the province.
In an attempt to curb the carnage, possession of 2.5 grams or less of drugs has been decriminalized since January 31, 2023, as part of a three-year pilot project. The measure has not reduced the mortality rate. Last May, the British Columbia government partially backed down by recriminalizing drug use in public spaces.
In interview with The dutyB.C.’s Minister of Mental Health and Addictions Jennifer Whiteside, nevertheless points out that drug possession charges are down 76 per cent in the province. “We didn’t anticipate immediate, significant changes in overdoses,” she said. “It may take time.”
Benjamin Perrin, a law professor at the University of British Columbia and former legal advisor to the Prime Minister’s Office under Stephen Harper, explains that the goal of decriminalization is rather to reduce the stigma and judicialization of drug users. “Without a safe drug supply, we will not see a decrease in mortality,” says the author of the book Overdose: Heartbreak and Hope in Canada’s Opioid Crisiswho now campaigns against the prohibitionist policies he once supported. “It’s black market drugs that are killing people.”
“Public health disaster”
In British Columbia, over 4,200 people currently have access to a safer drug supply through the BC health system. It is estimated that over 225,000 people are using substances at risk of being contaminated with fentanyl or similar drugs.
The Dr Scott Macdonald of Providence Crosstown Clinic in the heart of the Downtown Eastside is one of the doctors who prescribes opioids to patients struggling with addiction. He is a pioneer in reducing the harms associated with drug use. He was involved in the NAOMI study of prescription heroin in Montreal and Vancouver from 2005 to 2008. His findings, published in the New England Journal of Medicinehave demonstrated that medical heroin therapy is a safe and effective treatment for chronic heroin addicts.
“What we’re seeing right now is a public health disaster and an ethical misstep. Prescription heroin reduces mortality, crime and public disorder. It allows us to treat users for whom opioid antagonist treatments like methadone and suboxone don’t work. It should be more widely available.”
In November 2023, a BC Coroners Service Overdose Death Review Committee also noted that the safe medical supply is far from adequate. It therefore recommends a non-prescription approach.
But Whiteside rejects that avenue. “We need health professionals involved in the distribution and administration of these drugs,” she says. “We think our safe supply program needs to be expanded, but cautiously. It’s a real challenge to practice this kind of medicine these days.”
Civil disobedience
The Drug Users Liberation Front (DULF), a compassionate club that offers illicit drugs, didn’t wait for government approval to take action. In August 2022, the organization, which operates in the Downtown Eastside, purchased cocaine, methamphetamine and heroin on the underground Internet, tested them for purity and sold them at cost to a group of 47 VANDU users. This allowed them to obtain up to 14 grams of the prohibited substance, in full view of the authorities.
“The government is leading us to our graves,” said DULF co-founder Garth Mullins, himself an opioid user. “We had to act quickly.”
An experiment in completely illegal civil disobedience to prove the merits of compassion clubs. The DULF nevertheless tried, in vain, to obtain an exemption from Health Canada. “The ideal would have been to obtain pharmaceutical-grade drugs from licensed manufacturers instead of having to buy them on the dark web,” adds Garth Mullins.
A study published in theInternational Journal of Drug Policies shows that during the months of DULF’s existence, non-fatal overdoses among subjects were reduced by half. There were no opioid-related deaths among the 47 participants.
But in October 2023, the Vancouver Police Department raided the organization’s offices. Two of the group’s founders, Jeremy Kalicum and Eris Nyx, now face three counts of drug trafficking.
Questioning the law
This fight against drug prohibition is now in the courts, as is the case with the country’s first supervised injection service, Insite, also located in the Downtown Eastside. In 2011, Stephen Harper’s federal Conservative government went all the way to the Supreme Court to shut down the facility. But the country’s highest court ruled that the move would “prevent people who inject drugs from accessing the health services offered by Insite, thereby putting their health, and indeed their lives, at risk.”
“If the Crown is serious about pursuing these charges, our clients will challenge the constitutionality of banning a life-saving safe supply program during a devastating toxic drug crisis,” DULF’s lawyers said in a statement.
A former legal adviser to Stephen Harper and now a law professor at the University of British Columbia, Benjamin Perrin is confident they can win their case. “As a law professor and former lawyer, I see it as, like basketball, a slam dunk. »
Garth Mullins is worried today that his friends are facing criminal charges for drug trafficking. But he also sees it as an opportunity to prove that the Controlled Drugs and Substances Act is unconstitutional. “It creates an unregulated black market for drugs and people are dying. It could end the war on drugs.”
Meanwhile, Lorna Bird, who was one of the users who received weekly supplies of drugs from DULF, returned to the streets to get her crack. “During the time it lasted, I wasn’t afraid of dying any more,” she says. “Now, every day, I’m playing Russian roulette again.”
This report was made possible thanks to the excellence grants from the Association of Independent Journalists of Quebec.