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Τρίτη, 18 Ιουνίου, 2024

British Columbia recriminalizes drug possession, drawing praise, worry

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VANCOUVER — It was less than two years ago that officials in British Columbia, the epicenter of Canada’s drug overdose crisis, unveiled what they called “bold action.”

The experiment, backed by Canada’s police chiefs, was to decriminalize the possession of small amounts of some drugs — including methamphetamine, cocaine, fentanyl and heroin — for personal use. The approach, officials said, would reduce the stigma that can discourage users from seeking treatment and the criminal records that can prevent them from rebuilding their lives.

If the three-year trial produced results, it could be a template for the rest of the country.

But now, with complaints about public drug use rising and a provincial election looming, they’ve abruptly reversed course. The center-left New Democratic Party government, which championed the policy, last month received approval from Ottawa to recriminalize drug possession in most public spaces.

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“The people who are struggling with addiction are people that we love,” B.C. Premier Da Eby told reporters in April. “But sometimes, tough love is needed.”

Advocates for decriminalization say election-year politics and misinformation have cut short a promising approach before its impact can be properly assessed. Rolling it back now, they say, will only do harm.

“It’s cruel,” former Vancouver mayor Kennedy Stewart said. “And it’s not very Canadian.”

Canada is debating how to respond to a drug overdose crisis that has claimed some 42,500 lives since 2016.

More than a third of those deaths have occurred in British Columbia. The province loses more than six people per day on average — twice as many as in 2016, when officials declared a public health emergency. Unregulated drug toxicity is now the leading cause of death in the province for people aged 10 to 59 — it claims more lives than homicides, suicides, accidents and natural disease combined.

The main driver of overdoses here is a street supply tainted with synthetic opioids such as fentanyl, and increasingly, benzodiazepines, a class of drugs that are unresponsive to the anti-overdose medication naloxone.

“It’s you going to the liquor store thinking you’re going to get alcohol and you’re getting poison, you’re getting turpentine,” said Brittany Graham, executive director of the Vancouver Area Network of Drug Users.

At VANDU’s overdose prevention site in Vancouver’s Downtown Eastside, a neighborhood that’s effectively an open-air drug market, Martin Steward prepared his heroin. The facility proed the rig: A tourniquet to tie off veins, water to dilute the drug, a tiny tin to cook it and a syringe.

The 52-year-old started using crack when he was 12 to cope with trauma, he says. When he’d fixed his hit, he called a peer over to inject it into his neck. The high rushed in. The peer stood by, ready to intervene in case of an overdose.

British Columbia is one of several jurisdictions worldwide to try decriminalization, only to have second thoughts. Lawmakers in Oregon voted in March to make possession of small amounts of illicit drugs a misdemeanor again. Portugal’s decision to decriminalize all drug use in 2001 was initially credited with plummeting HIV transmission rates via syringe and a drop in the prison population. But recently, police have blamed rising use for an increase in crime.

British Columbia has long favored harm reduction. But its critics, many of them ascendant Conservative politicians, argue it enables drug use.

The Conservative Party of British Columbia, gaining in the polls ahead of the October election, says it would adopt Alberta’s strategy. Alberta, which suffered record drug overdose deaths in 2023, has focused less on harm reduction and more on a “recovery-oriented approach.”

Paxton Bach, an addiction medicine specialist at St. Paul’s Hospital in Vancouver, calls the politics unhelpful and demoralizing. What’s needed is not a debate over tactics, he said, but “a comprehensive suite of interventions” that treat the crisis with “the urgency it deserves.”

“No one’s succeeding,” Bach said. “We’re clearly not winning because the numbers don’t lie.”

‘Where was your indignation then?’

Decriminalization began last January. Drugs and trafficking remained illegal, as did possession at airports, playgrounds, near schools and by the military. But rather than imposing criminal penalties on users, police could hand out cards outlining services available.

Some mayors said decriminalization fueled an increase in public drug use. A nurses union complained about usage in hospitals. B.C. United, a right-of-center party, branded the pilot “reckless.” Pierre Poilievre, leader of the federal Conservatives, called it “wacko.”

In March, a Vancouver police official said complaints about public drug use were down. The following month, a deputy police chief said all of the concerns about public consumption “have been realized.”

Authorities tried to tighten the rules in November, barring drug use from more areas and allowing police to seize drugs and make arrests. But the B.C. Supreme Court suspended the measure, saying it would cause “irreparable harm” to users.

Now drugs may be used only at overdose prevention sites, such as the VANDU facility, or shelters or private residences. Police may, in “exceptional circumstances,” arrest people and seize drugs.

Leonard Krog, mayor of Nanaimo, cheered the reversal. Decriminalization, he said, gave people “the green light to use and consume drugs all over the place” and failed.

“People are living in hell on the streets,” Krog said. “And they’re making it hell for many others.”

Proponents of decriminalization say it was too soon to conclude it failed — and there’s eence that it was doing what it was intended to do: Reduce criminal penalties for possession.

In Vancouver, drug possession seizures dropped 76 percent in the first nine months of the experiment, authorities reported in March, compared to the previous four-year average.

British Columbia suffered at least 2,511 overdose deaths in 2023, a record. More than 750 people died of an overdose in the first four months of this year. The death rate so far this year is lower than in the previous three.

Health advocates say people were using drugs in public long before decriminalization. Concerns about it should not be dismissed, they say, but could be tied to other factors, including an increase in homelessness. Overdoses are unlikely to fall, they say, unless authorities target the toxic drug supply.

Supporters of decriminalization say the debate has been riddled with misinformation, some of it spread by politicians, who have falsely accused officials of legalizing drugs and permitting their use on playgrounds.

“We’re in an election year here in British Columbia and federally there’s a lot of political discourse going on,” said Bonnie Henry, the province’s top doctor. “We need to call out people when they’re being incorrect.”

Decriminalization was never intended to solve the crisis on its own, its supporters say. They’ve called for more measures: offering untainted drugs, improving access to treatment, opening more overdose prevention sites and addressing the drivers of use.

Data on public drug use during the pilot is scant.

“Under decriminalization, drug possession and open drug use were not … a police matter,” Vancouver Police Sgt. Steve Addison said. “For the most part, reports about drug possession and drug use did not result in police attendance because police had no authority to deal with it.”

In the leafy Vancouver neighborhood of Kerrisdale, friends Debra Bailey and Sharene Shuster pored through photos of their children.

Bailey’s daughter Ola, she said, was a “little life force.” Photos show her in her black and red cadet uniform, traveling from Saint-Malo to San Diego, jumping off a diving board at the age of five. She died of an overdose in 2015. She was 21.

Shuster’s son Jordan, born profoundly deaf, earned his way onto the honor roll at the private school where future Prime Minister Justin Trudeau taught him French. He died of an overdose in 2018 at 25.

Shuster, a real estate agent, and Bailey, a retired teacher, lament the rollback of decriminalization. Most overdose deaths, they note, occur in private spaces, one of the few areas drug possession is still allowed.

“There’s going to be more shame, more hate, more using alone,” Shuster said. “And the death rate is going to go up.”

Bailey says some of the lawmakers now weighing in have taken an interest only recently, and for political gain. “What have you done for the last nine years?” she asked. “Where was your indignation then?”

‘The more you know, the less you know’

The tones sounded shortly after 5 p.m. “Vancouver Fire Rescue 23 respond,” a computer-generated voice blared through Fire Hall No. 2 in the Downtown Eastside. “Emergency. Medical aid. Overdose. East Hastings Street and Main Street.”

A rescue crew raced to the scene. A 55-year-old man lay on the sidewalk, mouth agape, limbs splayed. A bystander had given him naloxone. Crew members checked the man’s blood oxygen and pulse. They watched the clock, ready to try more naloxone.

Hall No. 2 is one of the province’s busiest fire stations, receiving nearly 1,800 calls each month. Many are for overdoses.

The work is different from when Capt. Trevor Felts started his career 24 years ago. “We weren’t really trained to treat overdoses,” he said. “That kind of just wasn’t a thing. … And then over the years things just progressed.”

To cope with burnout, Vancouver Fire Rescue Services Chief Karen Fry said, firefighters at Hall No. 2 are limited to 81 shifts before they’re rotated out. By then, she said, many have a “glazed over” look.

They call their postings “tours,” as if they’re military deployments.

“You have to reset your brain to come down here,” said Capt. Matthew Trudeau, who’s completed two tours at Hall No. 2. “Firefighters want to help … and so when you come down here each day and it’s not getting better … I found that really hard.”

While the firefighters aided the 55-year-old man, several people within eyesight were openly using their own drugs.

The man came to. He had been using down, he said — heroin. The rescue crews asked if he wanted to go to the hospital. Naloxone wears off quickly. He could go down again. He shook his head.

“You need to be careful,” a woman who works in the area told him. “You’re overdosing every day. What’s going to happen to you the next time you overdose? We would miss you.”

The crisis, firefighter Mickey Fabiano says, defies easy solutions.

“Before I was down here, I thought there was a way,” the Vancouver native said. “Now, I feel like I wouldn’t know where to start, how to properly fix it. Now, I feel like the more you know, the less you know.”

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