> Mortality patterns from unintentional poisoning have been of particular interest, as there is evidence in Ontario, Alberta, and British Columbia that substance use has increased in 2020 compared with previous years, while availability and access to harm reduction programs, supervised consumption services, and in-person support services for substance use may have been disrupted during the pandemic. Deaths from accidental poisoning can include different circumstances such as individuals using substances recreationally along with those who mistakenly ingest too much prescription or over-the-counter medications.
Kind of understating things here. There's a toxic drug crisis in this country and it has killed thousands upon thousands in recent years. This was happening well before the pandemic.
Literally 5 people every day in British Columbia are dying due to overdoses, directly related from the fact that the drugs are poisoned, not what they appear, and it has become impossible to ascertain a correct dosage.
This should be an election issue (Canada is having an election issue atm) but sadly it won't be. BC's health officer, who everyone has listened to during this pandemic, has begged the Federal government (the Province and City of Vancouver also begging) to decriminalize drugs to help with this issue, but the Feds have done nothing.
At this point I don't believe real change will happen until the majority of voters are somehow personally affected by this epidemic of overdoses. Canadian society has a very strong puritanical undercurrent to it that is rarely acknowledged. I've heard in casual conversation people say that addicts overdosing is a "problem that solves itself". Until these peoples' views are changed, the suffering will continue.
Drug addiction and overdosing are related but separate problems. While some solutions may impact both, they really should be treated very differently.
Overdoses happen because people are doing hard drugs while alone and/or are getting bad drugs. Prevention of overdosed means not locking up addicts for basic possession. Safe injection sites. Basic communication services such as handing out cellphones to addicts can make a huge difference (the cost of one ER visit will buy 100 cellphones). These things can be done now.
Stopping people from becoming addicts is different. It requires societal change so that people don't land in situations where they are likely to turn to drugs. That means employment programs. That means post-hospital monitoring of patients. That means decent affordable housing. That means much more expensive and long-term efforts.
That assumes drug addicts are not employed and need housing. Those are poverty signals. While many in poverty are drug addicts many in regular society are as well. The long term solution must include all drug addicts.
I think, the problem is deeper. People turn towards drugs when something else in their life is terribly broken and they see no way of fixing it. And I suspect that the ongoing erosion of the middle class has something to do with it. I think the current popular viewpoint that we should just be ok with a growing fraction of the population effectively committing a gradual mental suicide, welcome it and make it easier, is totally wrong.
Totally agreed. I don't believe people are born predestined to become addicts; they may or may not have inherited a propensity for it, but circumstances are generally what pushes someone push over the edge into full blown addiction.
Viewing addiction as a moral failing rather than a maladaptive coping mechanism for a miserable existence and/or untreated mental illness is holding progress back.
For many, the substance one is addicted to generally starts out as something seen as fun and enjoyable. Take alcohol, the most widely celebrated addictive toxin in the world.
Stick with it for a bit, integrate into your life as a crutch (bad social skills, try drinking! need a way to relax, try drinking! bored, try drinking!) and eventually the effects of withdrawal keep you hooked. Even if you think you're not hooked, there's a chance you are.
It's a slide that is very difficult to travel in the opposite direction on. Some people will certainly slide further down due to life circumstances, but that's not really the problem, is it? You can't eliminate the fact that life is eventually going to really suck at one time or another.
The problem is that we allow companies to profit from addictive and usually harmful substances, and they are incentivized to keep people addicted. Alcohol, tobacco, and opiates - the root of an astounding amount of poor health, financial struggle, and early death among otherwise ordinary people.
Addiction isn't a moral failing of the individual as much as it is one of society, but in my opinion, for different reasons.
Your entire 'real truth' doesn't even deal with the fact that many people can use substances without addiction, but some people absolutely cannot. So by your truth anyone who becomes an addict is weak.
> many people can use substances without addiction
My stance is that the majority of people regularly using some substance probably sit somewhere on the spectrum of addiction.
Most people just never bother to quit, because it hasn't caused too much of an interference. Or if it has, they say they'll "cut back." Soon enough they're right back where they started.
Addiction can exist in very subtle ways. It creeps up. It's also highly stigmatized, so nobody wants to admit that they're dependent on a substance.
With the exception of caffeine of course. Most people will openly admit their addiction to caffeine.
Yeah I mean addiction has a pretty concrete definition despite your enthusiasm that every use of 'substance' lies on a 'spectrum' and therefore you can't say anything at all about addiction because 'everyones addicted' to something to some degree? c'mon
FWIW since I started referring to this as poisonings (instead of overdoses) I've found folks to be much more amenable to conversation. Nobody likes the idea of the wicked poisoning the vulnerable.
How do folks respond when they find out many addicts clearly choose to take the "poison" for more complex highs? despite knowing the risk, despite cheaper priced "non-poison" offerings.
The dosage makes it poison, so it is an overdose if a properdose was sort and personally misjudged.
With nuance, I guess? Depends on the conversation.
I'd say that there's more agreement than disagreement. Here 70% of the overdoses are related to drugs cut with unpredictable levels of fentanyl. I'd say I've seen consensus on that being a "bad thing(tm)", and consensus that the criminals cutting street drugs with fentanyl are "bad guys(tm)".
I guess to your point about junkies making bad decisions, my peer group skews older, we've already said everything we can say about junkies making bad decisions 30+ years ago. It's true, but it makes for stale conversation and seems kind of orthogonal to, or at least adjacent to, the current fentanyl situation.
>BC's health officer, who everyone has listened to during this pandemic, has begged the Federal government (the Province and City of Vancouver also begging) to decriminalize drugs to help with this issue, but the Feds have done nothing.
Alright, I'm going to poke the bear. How would decriminalization help? I'm assuming that by decriminialization, you mean legalizing the consumption, but not sale of drugs. If so, that doesn't solve the problem of the production of drugs, which IMO won't result in the changes that you want to see (drug users dying).
My wife actually asked this of some professionals working in this space yesterday at a local awareness event (she works in community services, unrelated to drug policy). The answer (paraphrased) was it doesn't directly stop the poisonings. It's in the spirit of harm reduction to open up more support channels. One example given was about going to the hospital and honesty with health professionals. Currently there's disincentives for an addict to disclose their addiction due to legal actions that get triggered upon disclosure. Removing those legal triggers could (would?) allow for more supervision without legal consequence to hopefully reduce the overall harm. It gave us something to chat about.
I don't know if the federal government plays a role here, but the duty to report type laws for professionals are typically at a provincial level. That being said, as far as I know, they are fairly consistent across provinces.
One example provided, which I've not fact-checked and might be limited to BC, was that disclosing addiction during a hospital visit opens up a file with child welfare services.
Portugal decriminalized all drugs in 2001 and saw a massive drop in all the secondary issues associated with drug use - overdose deaths, disease, etc. In fact they went from among the worst in the EU to among the best over a decade or so, and saw no material increase in drug use. In fact drug use in Portugal remains below the EU average. [1,2]
Portugal situation is a bit more nuanced than 'decriminalized all drugs' implies. Drugs are still very much illegal and cannot be owned or traded. Not even marijuana. What changed is that possession of small quantities of drugs no longer leads to prison, but may lead to administrative penalties.
> In July 2001, a new law maintained the status of illegality for using or possessing any drug for personal use without authorization. The offense was changed from a criminal one, with prison as a possible punishment, to an administrative one if the amount possessed was no more than a ten-day supply of that substance.[2] This was in line with the de facto Portuguese drug policy before the reform. Drug addicts were then to be aggressively targeted with therapy or community service rather than fines or waivers.[9] Even if there are no criminal penalties, these changes did not legalize drug use in Portugal. Possession has remained prohibited by Portuguese law, and criminal penalties are still applied to drug growers, dealers and traffickers.[10][11] Despite this, the law was still associated with a nearly 50% decrease in convictions and imprisonments of drug traffickers from 2001 to 2015.[12]
> The offense was changed from a criminal one, with prison as a possible punishment, to an administrative one if the amount possessed was no more than a ten-day supply of that substance.
Indeed this is the difference between decentralization and legalization.
They did a lot of things yes! Very true. I advocate for the whole model.
Are you sure? Litmus test ;) Are you for de-legalization of marijuana?
PS. I always assumed that decriminalization and legalization are synonyms because it never crossed my mind that possessing a tiny quantity of a substance, even illegal, can lead to jail. I'm all for decriminalization of 'personal use' quantities of any given drug.
No, I think any drugs that have been measured and studied to be less harmful than alcohol should be completely legal. And so that is, checks notes all of big ones. [1]
I see decriminalization as a minimum. I do also think a legalization or decriminalization strategy should take into account the harms associated with these substances and offer programs to mitigate social and individual harms.
Appreciate the honesty :) Consider that those with a more conservative position are highly suspicious of underspecified language ('decriminalization', without explicit scope modifiers), which only seem to serve to open the floodgates, and then in a few short years we end up with schools pushing heroin to kids behind their parent backs. All in the name of 'harm reduction' and 'undoing stigma'.
Yep, that's definitely true. In my opinion, for most drug addictions, it is in fact a symptom of a situation than the problem itself. For some people with certain biologies, I suppose that may not be entirely accurate. However one of my favorite studies compares the experiences of GIs before the war, in Vietnam, and when they got back.
Table 1 shows that before the war, 11% of the group surveyed used narcotics. In Vietnam it spiked to 43%. When they got back? 10%. [1]
For most of them, it was heroin. They literally cold turkey quit heroin when they got back from Nam.
What all this tells me is that telling addicts they can’t have drugs and sending them to prison won’t stop them from doing drugs. What will is making them not want to do drugs by changing their situation.
The Vietnam story is definitely an interesting datapoint. They went to Vietnam, had easy access to heroin (it was a war zone, certain civilian rules no longer applied) and fell to the vice. Not sure why you discount the possibility that the primary motivations of cold turkey quitting heroin were the elimination of easy access to heroin and the stigma of living the rest of their lives as heroin addicts.
Prison for drug use is cruel punishment, but therapy & community service (hello Portugal) are entirely reasonable (and effective!) approaches to the problem.
That's what is typically meant by "decriminalization".
Unfortunately decriminalization is only a bad half-solution and all of those who profit off of both sides of the drug war will continue to exist, as will the inconsistent, contaminated, or mislabeled doses that are most fatal.
It is absolutely imperative that we legalize nearly all recreational drugs along with regulatory measures to ensure that these medications are available OTC as standardized individually-packaged doses.
The minimization of harm from drug abuse does also depend on broader societal factors (e.g. wealth inequality), and the transition will be complex, but there are measures to be taken that could drastically cut down on overdoses deaths in no more than a few weeks.
Illegality of drugs results in riskier behaviours (ie. hiding that you're using, using alone) that result in higher chances of overdose. Decriminalization is thought to yield safer use of drugs that will reduce deaths.
There is also a broader issue of stigma. If the illegal stigma around drug use goes away, and addictions are treated more like a medical issue, it is thought that it will be more normalized for drug users to get help instead of shying away.
On the opposite side there is also a stigma around medical professionals helping "addicts" that are breaking the law and many doctors are reluctant to touch these sort of health issues with a 10 foot pole. Decriminalization could help do away with this problem and pave the way to prescription of a safe supply of drugs.
Drug users having a prescribed safe supply of drugs is the ultimate solution to the core problem here of a utterly toxic drug supply.
It depends on which version of "decriminalization" one subscribes to. If it means not locking people up for possession then that can keep people out of the prison cycle. It means people will be less afraid to ask for help with their addictions. But if decriminalization means all drugs can be openly bought and sold, THAT won't help. Marijuana is one thing, but allowing carfentanil or rohypnol to be easily acquired by all would end very badly.
Kind of understating things here. There's a toxic drug crisis in this country and it has killed thousands upon thousands in recent years. This was happening well before the pandemic.
Literally 5 people every day in British Columbia are dying due to overdoses, directly related from the fact that the drugs are poisoned, not what they appear, and it has become impossible to ascertain a correct dosage.
This should be an election issue (Canada is having an election issue atm) but sadly it won't be. BC's health officer, who everyone has listened to during this pandemic, has begged the Federal government (the Province and City of Vancouver also begging) to decriminalize drugs to help with this issue, but the Feds have done nothing.