Opinion

Canada's drug crisis has killed at least 23,000. What has Justin Trudeau done about it?

Justin Ling: The Liberals' platform offers little to tackle Canada's most deadly epidemic

More than 23,000 people have died in this country from drug overdose and drug poisoning in just the last five years.

We’ve lost more people to this drug crisis than to COVID-19. Our life expectancy has stalled due to the scores of lives, particularly young ones, lost to the epidemic. It’s likely 2021 will be the deadliest year on record—beating last year’s record, which in turn beat 2018’s record high, which surpassed 2017’s horrifying death toll.

And it’s time we stop pretending Justin Trudeau is taking this crisis seriously. At every turn, his Liberal government has offered half-measures. Worse yet, they find themselves largely unchallenged on it. The indifference can only be explained by political expediency.

Canada’s opposition leaders, to their credit, are at least rowing in the right direction. 

On Tuesday, International Overdose Awareness Day, Trudeau was asked by reporter David Akin whether he would follow expert advice and take the first step of decriminalizing opioids for personal use and regulate the supply of the deadly drug.

In a roundabout answer the Liberal leader said: No.

Even if those policies would seem unthinkable just years ago, they are measures that experts say need to happen for every other harm reduction tactic to be fully efficient, to bring drug users out of the shadows and into society, and to end the costly and ineffective war on drugs.

But Trudeau has refused to go down that road. His former health minister and attorney general, Jane Philpott and Jody Wilson-Raybould, advocated for decriminalization around the cabinet table and got a blunt response. 

Decriminalization is not popular when you poll it,” Philpott told me, after she and her colleague were pushed out of the Liberal Party caucus.

***

In order to understand an epidemic, you must be able to measure it—a lesson we’ve learned all too well recently, glued to our computers and televisions awaiting updated COVID-19 data. But Canada’s indifference to the opioid epidemic means we have a criminally incomplete picture of it.

According to the Public Health Agency of Canada 21,174 people have died from opiods. That data, however, only stretches from January 2016 to December 2020: The agency won’t release data from the first quarter of 2021 until the end of September. Manitoba still hasn’t supplied its data from the last quarter of 2020. Quebec and British Columbia report non-opioid overdose deaths, but other provinces do not.

The Trudeau government promised repeatedly to improve national overdose reporting. It failed to do that. Health Minister Patty Hajdu’s talking points, posted online, even note that “in order to have an effective response to the ever-changing crisis, a strong understanding and evidence-base is required to make informed and timely decisions.” The talking points laud their own outdated, underreported, and inconsistent work.

The hardest-hit provinces are reporting this data, even if Ottawa won’t deign to collect it. And the numbers show things are getting worse. Much worse.

British Columbia has reported that 1,011 people died between January and June of this year (a 33 per cent increase over last year.) Saskatchewan reported 221 deaths between January and August (already two-thirds of last year’s total deaths.) Ontario counted 638 deaths between January and March. (57 per cent higher than the same period last year.)

These numbers would be even more gruesome if not for the drug Naloxone, which is remarkably effective in reversing the effects of drug poisonings. Yet the United States is experiencing an acute shortage of the drug, and there are signs it’s coming to Canada: Harm reduction advocates in Winnipeg say they have received incomplete shipments in recent weeks. A lack of Naloxone could send deaths skyrocketing.

Even with Naloxone, there are tens of thousands more injuries and permanent disabilities that have come as a result of this endemic problem. 

It’s important to understand why these people are dying. For a long time, we exclusively referred to “overdoses.” But that word papers over a much more insidious reality of this crisis: Deaths rarely come from simply taking too much.

“It’s not an addiction problem,” Donald MacPherson, director of the Canadian Drug Policy Coalition, once told me. “This is a supply-side problem.

I looked over MacPherson’s shoulder, in his office at Simon Fraser University, as he showed me graphs charting heroin use and drug poisoning deaths in Vancouver. The drug use would stay relatively steady, but deaths would rocket up and down—up in the 1990s, then back down; way up in 2015, and it hasn’t come back down since.

Because there is no quality control, consistency in potency, or purity testing, it’s nearly impossible to guarantee that the drug a user uses one week is the same drug they’re using the next.

This government’s strategy is actively making that problem worse, as it focuses on busts, arrests and prosecutions to disrupt a remarkably resilient supply chain. Police interdiction and supply chain busts means even one’s long-time dealer may change their supply with little notice. Or when a dealer is taken off the street, a user in crisis may turn to someone new and less trustworthy.

The advent of fentanyl, and its hyper-potent cousin carfentanil, have driven scores of deaths. But increasingly potent methamphetamine and other synthetic opiates are increasingly driving poisonings.

Governments have talked endlessly about addressing addiction and ending users’ reliance on drugs—but no country, not even those which imprison drug users and publicly execute drug dealers, have found a solution to that problem. 

Plenty of governments, including Trudeau’s, have obsessed with clamping down on the supply of drugs, especially the more potent types. They have been complete and total failures. This government can’t even restrict the ample supply of fentanyl and heroin in federal prisons, where they control everything that goes in-and-out of the institutions.

The consensus is mounting that the solution will not be ending demand, but ensuring a safe supply.

And behind that consensus is an unlikely coalition of medical experts, police officers, harm reduction experts and grassroots activists. 

Together and separately, they have called for treating this crisis like a health issue, not a criminal one. Virtually every expert in this space has called for a serious expansion in the supply of safe, regulated drugs. Many have called for outright regulation, production and cultivation of some of these drugs—perhaps emulating the legalization of cannabis, or in a more controlled, regulated manner.

They include:

  • The Canadian Public Health Association: “Criminalization of those who use these substances remains the principal tool to control their use and is unsuccessful. An alternative approach—a public health approach—is required.”
  • The Canadian Association of Chiefs of Police: “Evidence suggests, and numerous Canadian health leaders support, decriminalization for simple possession as an effective way to reduce the public health and public safety harms associated with substance use.”
  • Horacio Arruda, Quebec’s director of public health, said he was “in favour” of decriminalization.
  • Patricia Daly, Vancouver Coastal Health chief medical health officer: “Legalization and regulation of all psychoactive substances would reduce people’s dependence on the toxic illegal supply, criminal drug trafficking, and illegal activities that people with addictions must engage in to finance their drug use.”
  • The Health Canada Expert Task Force on Substance Use: “Regulation of drugs will have the greatest impact on ending the drug toxicity death crisis and minimizing the scale of the unregulated drug market.”
  • Bonnie Henry, British Columbia chief public health officer: “The current regulatory regime is ineffective, harmful, and stigmatizing.”
  • Mylène Drouin, regional public health director of Montréal, responded when asked about her support for decriminalization and the expansion of a safe supply of drugs: “My answer to both of your two questions is yes.”
  • John Horgan, premier of British Columbia: “Criminal prohibitions are ineffective in deterring drug use, and criminalization of drug possession directly leads to both individuals and systemic stigma and discrimination that prevent people from seeking services.”
  • The mayors of eight major cities in British Columbia, including Vancouver, have demanded an exemption to allow Canada’s third-largest city to: “Move away from criminal sanctions and towards a health-focussed approach to substance use.”
  • The Canadian Centre for Substance Abuse and Addiction: “The evidence is growing to support various approaches to decriminalization as effective ways to mitigate the harms of substance use and the policies and practices used to deal with it, especially those harms associated with criminal justice prosecution for simple possession.”

Not on that list: Justin Trudeau.

***

“We’re treating it as a medical problem,” Trudeau said on Tuesday.

But that isn’t true.

In 2020, police in Canada laid more than 30,000 charges for drug possession (not including cannabis), a number that remained largely unchanged from 2019.

More than 4,000 people are in federal prison on drug offences alone.

To his credit, Trudeau has proposed removing all mandatory minimum sentences for drug crimes from the Controlled Drugs and Substances Act. But, to his detriment: That bill is not law, because it was killed when he triggered an early election nobody wanted.

“We have moved forward significantly on measures around safe supply to fight the opioid epidemic,” Trudeau said Tuesday. That, too, stretches the truth.

In his party platform, released Wednesday, Trudeau boasts spending $600 million to date on the drug poisoning crisis. (By contrast, the federal government budgeted about $160 billion on the COVID-19 pandemic over a year-and-a-half.) Little of that money, however, is targeted to the measures that are most effective.

Canada has only committed $50 million to safe supply projects in British Columbia, Ontario, Quebec, New Brunswick and Nova Scotia. (With half the money going to Ontario.)

A set of talking points for the health minister even notes that some of the $600 million spent includes money for law enforcement—not exactly in keeping with a health focus.

It’s indisputable that some of the measures Ottawa has funded—whether they be to provide a regulated, controlled and tested supply of heroin or fentanyl; or to offer pharmaceutical analogues—work. Study after study have confirmed that they save lives, vastly reduce overdoses, and deny profit for criminal enterprise. As one study put it bluntly: “The availability of a safer, unadulterated supply of opioids decreased [users] need to access the illicit drug market, significantly reducing their overdose risk.”

But it’s becoming abundantly clear that these programs Ottawa is funding are running up against barriers that Ottawa itself refuses to bring down. Study after study has found that barriers, particularly criminalization, have limited the efficacy of these programs that Trudeau keeps touting.

A November 2020 review, commissioned by the Canadian Institutes for Health Research (a government agency) found that “restrictive laws and fear of discipline by professional bodies appear to limit access to safe supply.” The health experts cited the “immediate need” to scale up these programs and rectify the barriers. The Canadian AIDS Treatment Information Exchange reported recently that, when it comes to these safe supply programs, “uptake has been limited across Canada.”

British Columbia, which offers far-and-away the most support and services for drug users of any province or territory, estimates that some 50,000 drug users are not being reached by any of the current programming. Only about 3,300 people are on the kind of safe supply programs Trudeau keeps bragging about. It’s a tragically small number, and yet it is far and away better than every other province.

B.C’s relative success has only been enabled because of a consensus from every authority involved—except Ottawa—to fully commit to the public health approach. The premier, mayor, and chief of police are all on the same page in rejecting the criminalization of drug possession.

Last year, Premier John Horgan and Mayor Kennedy Stewart called on Ottawa to issue a total exemption from the criminal prohibition on drugs for the city of Vancouver. To date, Ottawa has dragged its heels on the request.

Other cities are stepping up, too. Interim Toronto Police Chief James Ramer told me earlier this summer that “our officers do not lay simple possession charges. I provided that direction last fall, and we’re not doing that.”

***

Capping off his self-congratulatory answer on Tuesday, Trudeau tried to score political points on his competitors.

“I was pleased to see many other parties, including the Conservatives, talk about the opioid epidemic, but they won’t go as far as safe supply and that is certainly something that we have invested in and will continue to stand for,” Trudeau said.

Pointing fingers is a bold strategy from a Prime Minister on whose watch more than 30,000 have died.

What’s more, the Liberal platform offers no new course of action or strategy. It commits $500 million to the provinces and territories on treatment, and not much else.

And Trudeau is right—the other party leaders have talked seriously about the epidemic. Erin O’Toole told reporters recently: “People with addiction should not be the focus of the criminal justice system. People that are dealing and that are preying on people with addiction should be the focus.” (That’s a far cry from 2019, when then-leader Andrew Scheer told me “the focus of government should be getting people off dangerous and harmful narcotics, not on maintaining a life of addiction.”)

While it’s true O’Toole hasn’t committed to decriminalization, per se, nor a safe supply program—which he should be rightfully vilified for—his platform does cement his position that “the last thing that those suffering from addiction should have to worry about is being arrested.” 

It’s worth noting the kilometers he has travelled, away from the Conservative’s past policies of mass incarceration to fight drug use. He has dragged his party from doggedly regressive to modestly progressive, and deserves some credit for it.

What’s more, O’Toole would revise Canada’s addictions and substance abuse strategies to reorient them to treatment and recovery and devote $325 million to expanding treatment capacity.

And it’s conspicuous who Trudeau doesn’t mention, of course: Jagmeet Singh has endorsed drug decriminalization since first throwing his hat in the ring to lead the NDP.

I asked Singh recently what exactly differentiates his position from Trudeau’s record. “He’s been in power for six years, and this crisis has only gotten worse,” Singh said. He called it a “waste of resources” to continue throwing criminal justice measures after drug users. The party confirmed to me that he would decriminalize drugs if elected, making him the only one of the three with a serious plan to avoid thousands of more deaths.

Green Party leader Annamie Paul, similarly, supports drug decriminalization. “I do not understand the government’s rationale for not immediately decriminalizing possession and working with the provinces to ensure a safe supply of drugs, and increased social and health supports for users,” Paul said in a statement.

I do not understand either.

***

For the past year, Trudeau has bent over backwards to laud and celebrate public health experts. On the campaign trail, he has admonished his competitors for their supposed distrust of science and expert advice. 

Yet, when it comes to Canada’s other public health crisis, he constantly ignores and dismisses that advice: Stop arresting people for drug possession. Stop trying to use police and courts to end an epidemic. Find ways to vastly expand the access to a safe supply, in order to supplant more deadly or contaminated sources of these drugs. And find legal, regulatory, avenues to allow users to source and share safer drugs to reduce overdoses, poisonings and deaths.

Whenever he is asked about the crisis—each and every time—he offers an insulting platitude: “There is no one silver bullet to counter the opioid epidemic.” Yet to look at his record on the crisis: Justin Trudeau is talking about silver and offering us brass.

So let’s stop pretending. Let’s stop pretending that the status quo will result in anything but another 10,000 dead. Let’s stop pretending that this government is proposing any new or serious solutions. Let’s stop pretending that Trudeau and his Liberal Party would prioritize these people over their own electoral fortune. Let’s stop pretending anything short of drastic action is necessary.

Let’s stop pretending.