When NDP Leader David Eby announced this month that the province would open B次元官网网址渟ecure facilitiesB次元官网网址� to provide involuntary care for people with severe drug addiction or mental health problems, it represented a moment of policy unity with the rival B.C. Conservatives ahead of the fall election.

But for drug policy advocate DJ Larkin, the consensus was loaded with irony B次元官网网址� since the province currently isnB次元官网网址檛 able to supply enough beds even for those who want treatment, let alone those who donB次元官网网址檛.

B次元官网网址淭his shift toward involuntary treatment is a knee-jerk reaction,B次元官网网址� Larkin, whoB次元官网网址檚 the executive director with the Canadian Drug Policy Coalition, said in an interview. B次元官网网址淚t is quite obviously a political move to try to create a simple solution to a problem that requires multiple interventions.B次元官网网址�

With more than 15,000 lives lost to toxic drugs since the declaration of a public health emergency in B.C. in 2016, the province has been at the cutting edge of debate, science and policy about how to deal with the crisis.

Critics, including Larkin, say the issue itself has been tainted by politicization.

BC Green Leader Sonia Furstenau has accused the major parties of using B次元官网网址渄ehumanizing rhetoricB次元官网网址� against drug users, while former chief coroner Lisa Lapointe has called plans for involuntary treatment unrealistic and lacking scientific justification.

Advocacy group Moms Stop the Harm has branded the NDP governmentB次元官网网址檚 rollback of a drug decriminalization project as B次元官网网址渓udicrous,B次元官网网址� while others say drug users are being scapegoated.

B次元官网网址淭he politicization is devastating,B次元官网网址� said Larkin, executive director of the Canadian Drug Policy Coalition, a group of more than 50 organizations. B次元官网网址淭his rhetoric has really positioned people who use drugs as being the problem.B次元官网网址�

Larkin said B.C.B次元官网网址檚 three-year decriminalization project and the implementation of safer supply alternatives to toxic street drugs had not been designed in a way that would be successful.

B次元官网网址淩ight now, we find ourselves at a crossroads where harm reduction and policy change is getting blamed for where we are, and thereB次元官网网址檚 no evidence to support that. That is not correct,B次元官网网址� Larkin said.

B次元官网网址淲e havenB次元官网网址檛, however, taken robust-enough steps to be able to support programs like that to actually get the benefit that we need.B次元官网网址�

GRIM BACKDROP FOR POLICY PUSH

The B.C. election campaign comes after the province suffered a record 2,551 drug deaths linked to the unregulated market in 2023.

The crisis has been the grim backdrop for a range of policy initiatives, including the decriminalization pilot allowing adults to carry up to 2.5 grams of opioids, cocaine, methamphetamine or ecstasy for personal use without facing charges. It relied on an exemption granted by Health Canada under the Controlled Drugs and Substances Act to permit open drug use in some public spaces.

There are also safer supply programs which provide prescription alternatives to toxic illicit drugs.

In July, Provincial Health Officer Dr. Bonnie Henry recommended exploring the idea to expand this to provide alternatives to opioids and other street drugs without a prescription. Ex-coroner Lapointe has also advocated for non-prescription access to controlled drugs.

But B.C.B次元官网网址檚 safer supply programs have come under criticism after police said some of the prescribed drugs, such as the opioid hydromorphone, were finding their way into the hands of illegal drug dealers.

Eby has repeatedly shot down suggestions for non-prescription safer supply, and in April he announced that drug use in public spaces including parks, public transit and hospitals was being recriminalized.

Leslie McBain, co-founder of the policy advocacy group Moms Stop the Harm, was part of the working group on the decriminalization pilot project. She called the NDPB次元官网网址檚 rollback disappointing, saying it was B次元官网网址渏ust politicalB次元官网网址� and that the group had not been consulted.

B次元官网网址淚t also is ludicrous, because the people who are out there doing that in public places have no other place to do it because there isnB次元官网网址檛 enough housing, because there arenB次元官网网址檛 enough safe consumption services or overdose prevention sites,B次元官网网址� she said.

Lapointe said that while it is difficult to measure the effectiveness of decriminalization, it was B次元官网网址渘ot a failure.B次元官网网址� She said statistics from the coroner now show fewer people dying post-decriminalization.

B次元官网网址淭here is a trend down in fatalities, and at this point, the last data that they released was the end of July, they are showing the lowest rate of death in this province since 2020. ThatB次元官网网址檚 post-decriminalization, and the number of youth dying has also reduced. That is significant.B次元官网网址�

She said there is B次元官网网址渓ittle evidenceB次元官网网址� to support the effectiveness of involuntary care, so cautioned about relying on it for an B次元官网网址渁nswer to this very complex public health emergency.B次元官网网址�

The leaders of the NDP and B.C. Conservatives argue their plans are compassionate to those suffering with addiction, and would address public safety issues.

Eby pledged B次元官网网址渟ecure facilities to provide involuntary care under the Mental Health ActB次元官网网址� for those with severe addictions who are mentally ill and have sustained a brain injury. That was a shift in the partyB次元官网网址檚 platform, which had previously focused on harm reduction.

The NDP said it would add more than 400 mental health beds for involuntary care at new and expanded hospitals.

B次元官网网址淭hese are the people who we see in our streets, lying face down on the sidewalk, or involved in incidents with people where theyB次元官网网址檙e threatening or sometimes setting fires or other disturbing conduct in communities,B次元官网网址� he said at a news conference. B次元官网网址淭heyB次元官网网址檙e not being cared for in our system right now (and) the system is not adequately responding to this group of patients,B次元官网网址� he said, adding that involuntary care was just one part of the NDP plan.

B.C. Conservative Leader John Rustad has also promised involuntary treatment and secure facilities. But he criticized EbyB次元官网网址檚 approach, saying it would take hospital beds from other people.

B次元官网网址淢y perspective is we need to build out capacity,B次元官网网址� he said in an interview.

B次元官网网址淚tB次元官网网址檚 going to be a big process. ItB次元官网网址檚 not going to happen overnight, but it is the only way to solve this problem. Clearly, the paththat (B.C.) has been on with decriminalization and safe supply B次元官网网址� which is not safe, itB次元官网网址檚 very dangerous drugs B次元官网网址� is not working.B次元官网网址�

Rustad has also said the Conservatives would shut down injection sites in Richmond, B.C., calling them B次元官网网址渄rug dens,B次元官网网址� echoing terminology used by federal Conservative Leader Pierre Poilievre.

The Greens, meanwhile, have said they want to expand prescribed safer supply of opioids and other drugs, and to explore a non-prescription model, strategies endorsed by Lapointe, who stood with Furstenau when the party unveiled its polices on Tuesday.

Lapointe said the province would be B次元官网网址渟etting ourselves up for a disasterB次元官网网址� if emphasis shifted to involuntary care.

B次元官网网址淭here are wait-lists for detox, there are wait-lists for recovery. If people canB次元官网网址檛 access the voluntary care that theyB次元官网网址檙e trying to access, how can we then incarcerate them involuntarily when thereB次元官网网址檚 no evidence that that would be successful,B次元官网网址� she said during the news conference.

MIXED RESULTS FOR DRUG STUDIES

Research on the efficacy of strategies employed in B.C. has produced varied results.

A study published in JAMA Internal Medicine in January found an almost 63 per cent B次元官网网址渞elative increaseB次元官网网址� in the opioid overdose hospitalization rate across B.C. after the introduction of safer supply.

In an interview with The Canadian Press in April, study co-author Shawn Bugden said they were not trying to imply B次元官网网址渃ausalityB次元官网网址� and the result may be due to various reasons, such as the unregulated market.

Another study, published in the British Medical Journal the same month, found that one day or more of prescription opioid dispensation was associated with B次元官网网址渟ignificantly reduced all-cause mortalityB次元官网网址� and overdose deaths over the next week.

In response to the push for involuntary care, Larkin cited a Swedish study published in 2022 in the journal Drug and Alcohol Dependence. It found a B次元官网网址渧ery highB次元官网网址� risk of dying immediately after discharge from compulsory care.

Some community leaders, however, say they are juggling mental health and addiction issues as well as public safety concerns and crime.

Kelowna, B.C., Mayor Tom Dyas said implementing mandatory care was B次元官网网址渘ecessary.B次元官网网址� He told a panel at the recent Union of B.C. Municipalities convention that his city saw 2,274 overdose calls in 2023, a 25 per cent increase from 2022.

B次元官网网址淚n reality, allowing these individuals with mental health and addiction issues to suffer on our streets is just not compassionate,B次元官网网址� he said.

He said any politicization is unintentional.

B次元官网网址淚tB次元官网网址檚 a reality that all of our communities are facing, that our residents are facing, that our businesses are facing,B次元官网网址� he said.

Larkin said a main reason for public concern about the crisis is that there are B次元官网网址渟imply more people in public spaces.B次元官网网址�

B次元官网网址淭he issue of homelessness has been become conflated with public drug use,B次元官网网址� Larkin said, adding that the drug supply is also more unpredictable and contaminated with benzodiazepines, which are sedatives and tranquillizers.

B次元官网网址淭hat causes people to be extremely sedated, potentially for hours,B次元官网网址� Larkin said. B次元官网网址淪o, it doesnB次元官网网址檛 necessarily mean that people are using more or there are more people who are having to use drugs in a public place, it just means people are more visible, because theyB次元官网网址檙e going to be outside and look very sedated for a long time.B次元官网网址�

The pandemic is largely to blame, Larkin said, explaining it prompted a B次元官网网址渄ramatic change toward more volatile and potent drugs.B次元官网网址�

Lapointe said regulation was B次元官网网址渃ommon senseB次元官网网址� but one of the biggest issues is that there B次元官网网址渁renB次元官网网址檛 enough physicians to prescribe.B次元官网网址�

B次元官网网址淩egulating drugs is not a radical idea. It is irresponsible to allow thousands of people to die across our country without stepping in,B次元官网网址� she said. B次元官网网址淩egulation is common sense.B次元官网网址�