Transcript DRUG POLICY:

The Politics of Change
A PUBLIC HEALTH OR
CRIMINAL JUSTICE ISSUE
In The Beginning
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DTES (Downtown Eastside)
Origin of Vancouver – Skid Road
Vibrant community – retired, families,
businesses
70’s Decline – Woodwards
80’s Cocaine
90’s Crack/Meth
Four Pillars
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Wide public discussion
2002 – drug policy passed
“Preventing Harm From Psychoactive
Substance Abuse” Website http://www.vch.ca/sis
27 recommendations
What are the motivators behind drug
use and some solutions?
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Vancouver - the four pillar program – Prevention, Treatment, Harm Reduction and Enforcement
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Circumstances that led to harm reduction programs
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Vancouver’s policy and plan for reducing drug-related harm is designed to deal with overdose deaths,
public disorder and root causes of poverty.
poverty;
substandard housing;
high unemployment;
increased availability and low cost of heroin and cocaine;
flight of legitimate business from the area;
de-institutionalization of the mentally ill without adequate support;
structures in the Lower Mainland;
displacement as a result of enforcement initiatives in the 1970s and 1980s that had the effect of pushing
street level drug dealers into the Downtown Eastside from other areas of the city, thereby increasing the
concentration of these factors in this community.
Today's drive-by journalists - little understanding of history
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Attribute the problems of the downtown eastside to the treatment
See a community of addicts and blame it on the individuals rather than lack of housing, programs,
criminal records etc…
Goals
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Reduced individual, family neighbourhood and
community harm from substance use
Delayed onset of first substance use
Reduced incidence (rate of new cases over a
period of time) and prevalence (number of
cases at one time in population of problematic
substance use and substance dependence; and
improved public health, safety and order
Why Harm Reduction? - Insite
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BC - overdose deaths Increase from 39 in 1988 to 201 in 1993 (Insite opened in 2003)
1998 injection drug use - leading cause of death for adult males age 30–49 in British Columbia.
Not always heavy users who overdose - properties / quality of street heroin not known plus
mixing heroin and alcohol increases risks dramatically
We help alcoholics and prescription drug users but dehumanized and vilify addicts as weak and
useless – This is neither productive or useful to society.
Insite (2006)
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Over 7,200 registered users
women 26%,
aboriginal peoples 18%,
Heroin 41% of injections,
Cocaine 27%,
Morphine 12%.
Over 453 overdoses at center > zero fatalities.
Over 4,000 referrals to counselling
40% for addiction counselling.
2 individuals per week are referred to methadone maintenance.
607 average daily visits.
Over 2,000 interventions for abscesses.
Growing problems, same old failed
solutions
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Drug use is a health issue
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If we treated alcohol and tobacco in the same fashion as
marijuana, we would have identical problems with respect
to crime, quality/content and addictions.
Incarceration, increased sentences, criminalization
and prohibition has failed to obtain the desired
results of reducing use and associated crime.
Scientific Evidence
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Constant research
Proper Scientific testing
Peer reviewed
Published in reputable journals
All positive
Website:
http://www.communityinsite.ca/science.html
Scientific Papers
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30% increase in detoxification
Reduced syringe sharing
Improved public order
Reduced public injection drug use and public
syringe disposal
No increase in drug trafficking or
assaults/robbery
Decline in vehicle break-ins/vehicle theft
Scientific Papers Continued
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Large number of O.D.’s – No Deaths
Disease intervention – HIV, Heps
Time for Change is upon us
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The Canadian public is intelligent and educated enough to understand that
there is a problem with current drug policies.
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Although many cannot agree on the approach, there are only two viable directions
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Greater incarceration, policing, criminalization and legislation (which has failed in the
USA) or
A framework of legalization and regulation of drugs
 legalize least hazardous drugs , manage worst AND research to reduce
consumption rates
 Teams of specialists would propose suggestions, treatments that work
 Teams should include specialists from various fields including:
 Medical
 Scientific
 Social
 Addiction
 Enforcement
Who should be in charge?
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Medical officials should be tasked with treating and reintegrating addicts
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In addition:
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Alternatives to harmful addictive drugs can be distributed (Methadone/Buprenorphine)
and education can be used to discourage use
Harm reduction facilities should be expanded for those who are not yet willing to clean
up
Treatment facilities which remove the addict from the drug community need to be
drastically increased
Affordable, safe and clean housing needs to be a priority for those individuals who have
cleaned up
Hospitals for the mentally ill need to be reintroduced in society and funded properly
Law enforcement should be used to deal with criminals and should not be
expected to provide counselling and medical advise to addicts and mentally ill
patients. Locking up drug addicts in prisons where criminals and drugs are in
abundance is simply counterproductive.
What are the benefits of moving
drugs into the health field
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Save tax dollars spent on enforcement and reinvest in education, treatment and harm reeducation
Eliminate the stranglehold which the criminal element has on sales and distribution of drugs (thereby reducing the level of drug
related harm through overdose and gateway activity
Empty jails
Improve society by treating addicts as human rather than annoyances.
Removal of employment barriers due to criminal records will help to eliminate poverty and create a more productive society
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Greater investment and research into various treatments
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Methadone or buprenorphine for heroine and other opiates
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Pharmacotherapy and behavioural treatment for cocaine and crack
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Through investment in these types of solutions
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Users able to lead productive lives, maybe not rocket scientist but better than lying huddled in the street or in a cell
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reduce risks associated with injection drug use.
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Methadone $10 a day vs. $141.78: per prisoner/per day in provincial jail
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What about the children?
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denying sex education to teens in Africa, and refusing to distribute condoms creates a public outcry in the west but when
we deny grown adults access to clean needles and refuse to give our children honest information about the effects of drugs,
we consider it protecting. No different than the aversion to sex education.
As with sex education, by keeping children ignorant they are left susceptible to myths, criminal influence and overdose, Make them
aware of the risks and they have the tools to make their own decisions
Remove the glamorous act of rebellion
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Summary of recommendations
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Public education
Employment training and jobs
Supportive and transitional housing
Easily accessible healthcare
Legislative and regulatory changes to create a regulatory
system for all currently illegal drugs
Control potentially harmful substances
Limit the control that organized criminals have over the
drugs
So why does there continue to be a drug problem in
Vancouver?
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Inadequate treatment facilities
A focus on criminalization and incarceration
Inadequate housing / specifically affordable or subsidised
Criminal records which prevent users from reintegrating into
Communities of users who are excluded from society
Poverty, no hope, lack of employment
AIDS and Hep C as a disincentive to addicts - hopelessness
Why is the criminal justice model
unsustainable?
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Increasing animosity towards our police,
fear of repercussions has driven addicts and recreational users underground making it harder for
those individuals to seek help
Criminalized users are unable to easily return into normal society
Medical field is unable to pursue rational treatments (programs like insite), due to government
restrictions
High number of minorities and vulnerable members of society incarcerated because of drug use
False belief that locking addicts up will force them to quit, when in reality it increases their ties
with criminal elements
Correction Service Canada
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"drugs are part of prison culture and reality"
"many needles in the prisons"
In prison - extent of injection is difficult to determine but we know that clean needles and syringes are
not available.
The spread of disease in prisons adds to the hardships of addicts when they return to society –
AIDS and Hep C is epidemic with injection drug users, society turns a blind eye on these citizens
because they are considered “undesirables”, this only helps to spread disease throughout the
prison population and thereby the public at large.
Criminalization does not significantly reduced use or cut down on the prevalence of drugs on our
streets, it has made more criminals and more addicts.
Costs of incarceration?
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Federal Average daily cost of prisoner - 2004/2005 –
approx. $259.05 per day or $87, 665 to 93,458.00 per year.
Federal female prisoner: $150,000-$250,000 / per year
Provincial prisoner: $141.78: per prisoner/per day ($51,749 per
year)
Alternatives - probation, bail and community supervision $5$25/day.
None of this includes the cost of lost revenue to the country by
not having the individual in a working environment. In addition
society bears the burden of caring for any dependents.
Wrap up
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We will eventually need to move these issues into the public health field, society cannot
realistically lock these people up indefinitely or lock up every drug user and seller, why
wait to change.
Increased health costs can be offset by legalization and sales, no one grows their own
tobacco, no different with legal pot. (bonus - likely get rid of grow ops).
Criminals will have to get real jobs - Lose profit center, police can then focus on
prostitution, money laundering, violent crime, etc…
What about the children? By not informing them and not differentiating between
heroin and pot we are failing our children and leaving them susceptible to criminals.
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Educate them to be more informed than their parents. and better prepared to make the right
decisions.
Where is the logic in locking up non-violent drug offenders? Can we not come up with
better medical options? Treatment already involves drug substitution.
The longer we wait the more entrenched beliefs become, when will we get politicians
and the public to reverse their stereotypes and look for rational solutions.