To the casual observer, drug toxicity deaths likely appeared to be on their way out in 2019, but drug user advocates say the short-lived decline in deaths only veiled the continuing crisis.
That has come to bear during the COVID-19 pandemic, when drug toxicity deaths shot through the roof.
The drug poisoning crisis took 32 lives in Burnaby during the first nine months of the year, a number that surpasses the 31 deaths recorded in all of 2019 and that could reach record heights by the end of the year.
Drug user activists say this has only confirmed what they have been saying all along: the crisis was not over. Indeed, Burnaby’s ambulance calls for suspected overdoses increased 45% year over year in 2019.
It was a simple message that is credited with saving many lives: don’t use alone.
But since the pandemic struck, that was overridden by a new message: stay home.
So with an election underway, we spoke to a Burnaby-area candidate from the three main parties – the BC Liberals, the BC Greens and the BC NDP – about how they and their party hope to tackle this issue. (Candidates are listed in order of surname.)
Katrina Chen, BC NDP (Burnaby-Lougheed)
“I would say this has been one of the top priorities for us, and that is why we created the first ministry for mental health and addictions to focus on this issue, because we know this is a crisis,” Chen said.
Chen pointed to the creation of 19 Foundry youth resource centres throughout the province as an example of proactive measures to curb or prevent substance use early in life, as well as the roughly doubling of youth treatment beds and increased access to counselling options.
While the NDP did create the Ministry of Mental Health and Addictions, it has allotted it the lowest funding among all ministries, at $10 million – just 0.05% of the $21 billion spent by the Ministry of Health. By comparison, the premier’s office has a budget of $11 million.
But that misses the funding that goes into the Ministry of Health and others, Chen notes.
“For example, when we are building hospitals and facilities, primary care networks, through the Ministry of Health, that really supports the work of mental health as well,” Chen said, adding that housing is a “huge” part of it.
Chen said the province has worked with provincial health officer Dr. Bonnie Henry, but that has been a point of contention for some advocates. Henry released a plan in April 2019, which pointed to avenues the province could explore to alleviate the crisis.
That includes “de-facto decriminalization of drug users,” involving amending the provincial Police Act to deprioritize enforcement of simple drug possession.
But the provincial government under the NDP has so far declined to do so, instead pointing to the Criminal Code, which is federal jurisdiction. The party’s platform this election, however, does mention, with no details, a “made-in-B.C.” solution if the federal government fails to act on decriminalization.
Chen said she would need to seek more information from the party on the “made-in-B.C. solution.” In an email statement, the NDP said federal decriminalization “makes the most sense,” but “we are also open to developing a made-in-B.C. solution so that people can receive the healthcare they need, and police can be freed up to focus on serious crime.”
Dr. Raymond Dong, BC Liberals (Burnaby North)
“Managing the opioid crisis is multi-pronged; you have to take multiple approaches. And I, personally, support the four pillars approach to delivering care for those with addiction and mental health issues,” Dong said.
The “four pillars” refer to prevention, harm reduction, enforcement and treatment, an approach to substance use developed in Europe in the 1990s.
That, he said, could include looking at prescription medications “before people set off alarms about how many prescription opiates they’re using” and offering more treatment.
“It’s clear that the present government and the present Ministry of Health spends so little … on mental health and addiction. Health-care costs are the No. 1 driver in the annual budget – 40% or more and growing,” he said.
If the $21-billion combined budget between the ministries is a full 365 days, Dong noted the Ministry of Mental Health and Addictions adds up to just four hours.
“That’s very little,” he said. “We need to talk about … treatment, and I think the way out of this is to take a page out of what Alberta’s doing.”
Alberta’s approach has been contentious, with conservatives applauding the treatment-first strategy, while drug user groups and harm reduction advocates say that government’s hostility toward harm reduction is dangerous and deadly for drug users.
“I’m not using their model per se,” Dong said when asked about the Alberta government’s approach to harm reduction, “but they’re actually spending money on recovery, when we’re not.”
Part of the issue, Dong noted, is the stigma around substance use, which drives people to use alone in their homes.
“I think if we bring that out into the open, we can destigmatize it to allow people to feel that they can get help. That’s going to go a long way to encouraging an improvement in the number of illicit poisoning deaths and drug toxicity deaths,” Dong said.
Asked whether he supports decriminalization, Dong said, “I think anything that … brings it out of the darkness, that brings it forward as a medical condition – we treat many other things as medical conditions. Alcoholism is a major addiction, and it’s a medical condition.”
Andrew Williamson, BC Greens (Burnaby-Lougheed)
“Maybe the top-three headlines are a commitment to scale up the safe supply beyond its current level, enhanced funding for harm reduction services and … longer-term decriminalization of (simple) possession of drugs,” Williamson said, noting the harm reduction services would need to be tailored to be COVID-friendly while also ensuring “people have access and don’t use alone.”
While the BC Greens would also push the federal government for decriminalization through the Criminal Code, Williamson noted the party would also seek to deprioritize policing of simple possession through the Police Act, as recommended by Henry.
“I think the BC Greens have said that they really feel like Dr. Bonnie’s recommendations should have been acted on sooner,” Williamson said.
Among the ways to expand safe supply, Williamson pointed to opioid vending machines. The machines are a more low-barrier mode of accessing prescription heroin or hydromorphone, which are held in an internal safe and only dispensed to those whose handprint matches a prescription.
He also pointed to working with the colleges of physicians and pharmacists to “encourage their members to participate” in safe supply programs.
Williamson emphasized the need, as well, to work alongside people with lived experience, including working with drug user groups and advocates.
“Let’s say a person doesn’t have direct experience with that. It can sometimes be hard to generate empathy, because we get caught up in this idea of judgment,” Williamson said. “At the end of the day, it’s another person and another person’s life, so I have a lot of respect and admiration for those people on the frontlines.”