Author: Donald MacPherson

Groundbreaking EU study supports use of heroin-assisted treatment

On Friday, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA ) released a groundbreaking report examining heroin-assisted treatment for chronic heroin users, once thought to be untreatable.

Photo Credit: Jay Black

The report, New heroin-assisted treatment, provides the first state-of-the-art overview of research, examining the latest evidence and clinical experience on the topic in Europe and internationally. The findings show that for the small minority of entrenched opioid users who repeatedly fail to respond to prescriptions of other substitute drugs such as methadone, supervised use of medicinal heroin can be an effective second-line treatment.

The study’s findings show that Supervised Injectable Heroin (SIH) treatment can lead to: the ‘substantially improved’ health and well-being of this group; ‘major reductions’ in their continued use of illicit ‘street’ heroin; ‘major disengagement from criminal activities’, such as acquisitive crime to fund their drug use and ‘marked improvements in social functioning’ (e.g. stable housing, higher employment rate).

From the report:

‘New heroin-assisted treatment is an issue that has attracted much attention, controversy and often confusion’, says EMCDDA Director Wolfgang Götz. ‘With Europe at the forefront of investigating and implementing this novel approach, the EMCDDA is proud to present the findings of the major contemporary research studies on the topic and the clinical and policy experiences of countries providing it. Our purpose in doing this is not to advocate, but to inform. We hope that this report will help policymakers and practitioners draw their own conclusions about this type of treatment within their own national context’.

What do you think about expanding heroin-assisted treatment to communities in Canada? Do you think it’s time to scale up harm reduction and provide evidence-based treatment options for our most entrenched drug users? We want to hear from you.

April 25, 2012
Toronto Drug Strategy Consumption Room Feasibility study released

Dr. Carol Strike and Dr. Ahmed Bayoumi (photo by Yuri Markarov)

In 2005 when the Toronto Drug Strategy was approved by Toronto City Council one of the main recommendations was to complete a needs assessment and feasibility study on the implications of establishing supervised consumption sites in Toronto.

The independent research project – expanded to include Ottawa – was carried out over four years by Dr. Ahmed Bayoumi, a physician and research scientist at the Center for Research on Inner City Health at St. Michael’s Hospital, and Dr. Carol Strike, an associate professor in the Dalla Lana School of Public Health at the University of Toronto.

The study recommends establishing injection sites, three in Toronto, two in Ottawa, that are fixed sites and should be integrated within existing service settings.

Download Report

The study does not call for the establishment of consumption sites for people who smoke drugs but does call for more research on how best to provide supervised consumption through inhalation. Evaluation and the importance of a comprehensive approach to substance use is also noted.

On September 30, 2011, the Supreme Court of Canada upheld the right of Insite, currently Canada’s only supervised injection site located in Vancouver, to remain open.

Read the full research report here and let us know what you think.

April 12, 2012
A Plague of Prisons: Ernest Drucker with a Lesson for Canada

On April 9, the Canadian Drug Policy Coalition along with End Prohibition, PIVOT Legal Society, the Vancouver Area Network of Drug Users (VANDU) and Western Aboriginal Harm Reduction Society will host free public event featuring author and professor, Ernest Drucker.

Ernest Drucker

The event will begin at 7pm at Pivot Legal Society’s offices, 121 Heatley Street in Vancouver.

Author of Plague of Prisons: The Epidemiology of Mass Incarceration in America, Earnest will be speaking about the war on drugs in the USA and the potential consequences of the Canadian Conservative government’s new crime legislation.

To get you warmed up, below is a segment of a book review written by Craig Jones, PhD, Former Executive Director, John Howard Society of Canada previous to the passing of the Omnibus Crime Bill C10.

Every student of epidemiology learns the story of the Broad Street pump (London, Summer 1854), which marks the birth of epidemiology. In A Plague of Prisons, Ernest Drucker uses that story as a metaphor to explain the explosion of incarceration in the United States that followed the 1973 enactment of the Rockefeller drug laws and to illustrate how political decisions act as vectors – pumps – and how these vectors can create a social epidemic of gargantuan proportions, such as the United States coming to incarcerate 1 out of every 4 incarcerated persons in the world.

Drucker’s book can be read in three ways: as an undergraduate introduction to the explanatory power of social epidemiology; as a non-technical analysis of how the United States achieved its historically unprecedented rate of incarceration; and as a warning to Canadians on the propensity of criminalization of non-violent drug users to become a contagion with multi-generational consequences. The book’s timing is apt: Canadians are enacting the political mistakes that produced the plague of prisons in the United States. What were those mistakes?

A Plague of Prisons

There were three elements embedded in the Rockefeller drug laws that transformed a public health issue into mass incarceration and transmitted that contagion to the entire country. These include the decision to criminalize drug use; the political reliance on punishment as the appropriate response; and, the attack on judicial discretion through mandatory minimum sentences.

Of the three, the criminalization of drug use featuring large-scale arrests of low-level drug users primed the pump that fueled the contagion of self-sustaining criminality.

There are important differences in the way criminal justice is done between the United States and Canada – some of those differences will insulate Canada from the worst effects of the plague of prisons. But there are a couple of lessons for Canadians too.

The first is that criminal justice policy is too often made in a consequentialist vacuum – that is, without deliberation over downstream effects on families and particularly children of the incarcerated who will likely be the next generation of the incarcerated.

The political imperatives that pushed US policy makers into adopting mandatory minimum sentences appealed to the short-term interests of private prison contractors, correctional officer unions, victims’ advocates, judges and prosecutors. Policies enacted for short-term political opportunity have long-term economic and social consequences, a long tail, but these are of little moment compared to the immediate electoral advantage.

The children of the incarcerated – who are at higher risk of incarceration themselves – have no one to speak for them, at least no one with the clout of correctional officer unions or private prison contractors.

The second lesson is that it is hard to reverse bad policy ideas once they take hold in the public imagination – even once the fiscal costs become unsustainable and the policy itself is clearly failing. As is now clear, the proliferation of mandatory sentencing regimes across the United States has pushed several jurisdictions – Texas, California, Ohio, Florida and New York – to the brink of insolvency, yet they have not achieved rates of crime reduction greater than those jurisdictions that did not embrace draconian sentencing practices.

Worse, the sentencing regimes are hard to unwind because they have created a political constituency where prisons have become a source of high-income, non-polluting jobs.

The third lesson Canadians should heed is that – in seeking to increase the burden of punishment – criminal justice systems engender a self-perpetuating underclass of non-violent but ever more marginalized persons who, because of onerous pardon requirements, may never be reintegrated. They simply cycle through the prison system and transmit the contagion of criminality to their children and family members.

This is a cautionary tale. Canadians would be wise to be more attentive to Drucker’s warnings on the self-sustaining dynamic that emerges out of deliberately growing the rate of incarceration for electoral advantage.

April 5, 2012
Insite withstands test of international drug control conventions

At the 55^th meeting of the Commission on Narcotic Drugs held in Vienna March 12 – 16^th Damon Barrett, Human Rights expert at Harm Reduction International spoke candidly in the plenary session regarding the erroneous statements made by the International Narcotics Control Board (INCB) in their recent annual report (2011) concerning Vancouver’s supervised injection site, Insite.

In paragraph 437 of the report the INCB clearly states: “drug injection and consumption outlets that allow illicit drug possession and use are not in line with the international drug control conventions”. This is an outright falsehood and the United Nations Drug Control Program’s own legal advice commissioned in 2002 admits as much. It can be read here.

Insite Press Conference

The fact that the INCB still carries on trumpeting this false information ten years after the UN’s legal opinion was sought makes a mockery of the INCB’s integrity and credibility.

Here is the offending paragraph from the INCB report:

437. In September 2011, the Supreme Court of Canada handed down its judgement with respect to the applicability of the Controlled Drugs and Substances Act to a supervised drug injection facility in Vancouver. The facility had been allowed to operate due to an exemption to the application of the law for “medical or scientific purposes” that had been granted by a previous Government. The Court ruled against the Government’s decision to refuse to extend the injection facility’s legal exemption, thereby allowing the facility to continue to operate. The Board reiterates that under international law, provisions of national law cannot be invoked to justify non-compliance with the international drug control treaties to which a State has become a party. The Board further reiterates its position that drug injection and consumption outlets that allow illicit drug possession and use are not in line with the international drug control conventions, to which Canada is a party.

Damon Barrett set the record straight for the INCB with this statement:

The recent Canadian Supreme Court decision on Vancouver’s safe injection facility is criticized as running contrary to article 27 of the Vienna Convention on the Law of Treaties. This states that national law cannot be used to justify non-compliance with international legal obligations. This is true. But the Canadian Supreme Court Case was decided on the basis of Canada’s Charter of Rights and Freedoms, a constitutional document. As the Board is aware, article 3(2) of the 1988 Convention relating to the requirement to criminalize possession for personal use is subject to States parties’ constitutional principles. Similar wording is used in relation to the penal provisions of the 1961 Single Convention. In addition, in 2002, the UNDCP legal affairs team stated in an opinion on the matter that such interventions do not breach the conventions.

INCB-legal-brief

Vienna International Centre

As such, there is no conflict between the Canadian Supreme Court ruling and the drug conventions. These provisions of the treaties, however, and the UNDCP opinion are not referred to in the Board’s analysis of the case. We would welcome clarification of the Board’s view of the Canadian Supreme Court decision in the light of these terms of the drug conventions and its view of the 2002 UNDCP opinion.

To Canada’s credit the Canadian delegation also spoke up and let the plenary know that Canada was indeed in full compliance with all of the international treaties pertaining to drug control. Now that this mater is settled in the international arena, we look forward to our Justice Minister Nicholson reaffirming these facts for the Canadian public.

April 2, 2012
Thinking outside the box in Mexico City

“There’s a crack in everything, that’s how the light gets in”

Leonard Cohen

That is how I started my presentation at the most amazing drug policy reform conference in Mexico City, organized by Mexico Unido Contra la Delincuencia (Mexico United Against Crime) February 12 – 14^th, 2012. I played a song from Canada’s most famous poet, Leonard Cohen, which included the words, “There’s a crack in everything, that’s how the light gets in.” Mexico is certainly in need of some light. The long dark tunnel that is their present war on drug cartels continues to see death and despair permeate their news on a daily basis.

Gillian Maxwell, CDPC’s Executive Committee member and I attended this important drug policy dialogue together in Mexico. The conference brought some of the leading thinkers in drug policy reform globally, NGOs from Mexico, academics from Mexican universities and members of the business community from Monterrey and Mexico City.

The organizers were determined to “think outside the box,” and search for alternatives to the war on drugs that their government is waging on the cartels that is literally killing thousands of people in their country.

Over 53,000 have died since 2006, others put the figure closer to 60,000.

Held in the magnificent Museo Nacional de Antropología the conference had an historic air to it. Surrounded by thousands of years of Mexican history the intractable problem currently facing the country was put into perspective by centuries of history, energy and artifacts in the Museo. One can feel the frustration with the continuing violence of the drug war. But Mexico is at a tipping point. The country may be getting close to breaking away from its historic path and taking a major leadership role in charting a new way forward with its Latin American allies.

Those who attended the conference heard many reasons to take a new direction and consider alternative approaches to drug policy in Mexico. Ethan Nadelmann, Executive Director at the Drug Policy Alliance in the US, urged Mexican participants to do what is best for Mexico and not to wait for the United States to change its direction. He spoke of the historic leadership position that Mexico has in the region and the opportunity to lead other Latin American countries as they question the prevailing ideology of the war on drugs. This was echoed by other speakers from the US including Jack Cole from Law Enforcement Against Prohibition and former Judge, James Gray from California.

As a citizen of a US border state I had to admit that Canadians often have the same discussion – how can we change any of our drug policies independently of the Americans? But in fact, it was our good sense that lit the way for the US to abandon alcohol prohibition in the 1930s. And I believe we can do it again by designing an exit strategy for the war on drugs.

Mexico is in the strongest of moral positions to call for an end to the drug war.

There is movement afoot. Two weeks before the conference in Mexico, Guatemalan President, Otto Perez Molina called for all Central American leaders to consider decriminalising drugs in an upcoming regional meeting. Cesar Gaviria, Colombia’s former President then presented at the conference and clearly called for legalization of drugs as a new way forward in the region.

Steve Rolles, from the Transform Drug Policy Foundation laid out Transforms’ prize winning strategy paper, A Blueprint for Regulation that is one of the most well thought-out arguments for moving to a legally regulated regime for all psychoactive drugs.

Nuno Capaz, a Sociologist at Instituto da Droga e da Toxicodepencia in Portugal outlined how Portugal decided to decriminalize all drugs for personal possession some 10 years ago and how that has been a success in terms of overdose prevention, HIV prevention and access to treatment. In addition, drug use itself has not increased and across many demographics has actually decreased.

The second morning of the conference, Javier Sicilia came into the room and was graciously received by the conference organizers. Sicilia, a poet and journalist who lost his son to drug war violence has been leading a movement for peace and dignity in Mexico convening marches in the street and calling for the Mexican population to join him to protest the violence that is the daily reality in Mexico today.

Sicilia attended the conference to learn how drug policy might have some answers to his questions. We met and hugged each other and conversed with rudimentary bits and pieces of language and many gestures and agreed to meet again to work on a plan for peace. Very cool!

There were many other speakers from the Netherlands, Australia, the US, and the indefatigable Senator Larry Campbell from Canada. The United Nations Office on Drugs and Crime also gave an incredibly uninspiring, formulaic presentation that could only be called “maintain the status quo propaganda” and actually defended the drug war effort with its collateral damage of 50,000+ deaths.

At the end of the three days in the Anthropology Museum, the directors of the MUCD pronounced the conclusions of the conference from their perspective. They were indeed a radical departure from the status quo.

Among the eight key points, they called for Mexico to take a public health approach to drugs, and they asserted that countries must be allowed to take a sovereign approach to addressing drug problems that are in the best interests of their people. They also called for Mexico to move gradually towards a model of regulation and control of currently illegal drugs. Sound familiar? This is the same discussion that many Canadians and Americans are having.

The movement for change is growing. If countries like Mexico can begin to move towards their own made-in-Mexico plan then surely Canadians can figure out a way out of the war on drugs. As with alcohol prohibition, perhaps the US needs Canadian ingenuity and leadership once again to lead the way. Let’s be those leaders.

March 15, 2012
Bill C-10: The work has just begun

Last Thursday at midnight, the Senate approved the Conservative Omnibus Bill C-10, The Safe Streets and Communities Act, with only minor amendments. This marked a very sad day for Canadians, and for our sense of justice and fairness for all people.

Bill C-10 was never really intended to be a piece of legislation that represented a direction that was well thought out or designed to build on what is arguably one of the better criminal justice systems in the world. No, instead Bill C-10 was designed as a regressive, punitive, highly political, and ill conceived amalgamation of crime legislation that will set the country back in ways that we will only come to discover over the next decade or two. We assume the legislation will be passed by the House of Commons in the coming days. That will be another sad day.

But, in the midst of all of the madness, there have been some remarkable activities over the past few months, as organizations and individuals placed Bill C-10 under a microscope.

For one, a coalition of Canadians has evolved to occupy the discussion and speak out against this legislation. What we have learned from these people over the past month during the Senate hearings into C-10 has been profound. Canadians are deeply concerned about this legislation and how it will impact our youth, Aboriginal peoples, those with mental health and addictions and other vulnerable populations.

National Chief Shawn A-in-chut Atleo of the Assembly of First Nations and the Assembly of Manitoba Chiefs eloquently articulated their knowledge that Bill C-10 will accelerate the over-incarceration of Aboriginal Peoples. Politicians, researchers, service providers, criminal justice veterans and ordinary Canadians have all come out in increasing numbers to voice their concern that Canada is taking the wrong path with this legislation.

And we have also learned that the world is watching in disbelief as our government takes us down this path. Veterans of the drug war from Law Enforcement Against Prohibition , some who actually drafted the legislation that brought mandatory minimum sentencing to the U.S. like Eric Sterling from the Criminal Justice Policy Foundation in Washington DC, have spoken out loudly to warn Canadians not to go down the road that Americans took some 30 years ago with this form of legislation for drug offences.The Global Commission on Drug Policy also added their voice sending a letter directly to the Senate asking them to reconsider the direction Bill C-10 would take drug policy in Canada.

The community that is forming around issues of justice, drug policy, fairness and a concern that we develop effective, evidence-based responses to problems related to drugs in Canada is growing at an amazing rate.

We want to keep this momentum going, for all of us.

The work of the Smart Justice Network,

John Howard and Elizabeth Fry Societies of Canada, Canadian HIV/AIDS Legal Network, Canadian Harm Reduction Network, the TRIP! Project, the Canadian Civil Liberties Association , and so many others needs to continue. Together we can build a vision, and an evidence-based drug policy for the future.

We have been working with our partners, Leadnow.ca and others to accelerate this process. How can we keep this movement going, building strength and capacity? We’d love to hear your thoughts.

Bill C-10 has caused thousands of Canadians to pause and think about the choice the federal government has made to use the criminal law to address what are really complex health, social and economic issues in Canada. The Safe Streets and Communities Act will not help us build healthy, vibrant and inclusive communities. But we know together, we can.

Won’t you join us in this work? We want to hear from you.

March 6, 2012
The Global Commission on Drug Policy salutes Stop the Violence BC and sends a message to the Senate

The Global Commission on Drug Policy is comprised of significant world leaders that are calling for change in the way we approach problem drug use and the war on drugs. Today the Global Commission appealed, in an open letter to the Canadian Senate to reject the introduction of mandatory minimum sentences for minor marijuana offenses as proposed in Bill C-10, which is being debated by the Canadian Senate. In addition, the Commission recommends Canadians evaluate possibilities around taxing and regulating cannabis as an alternative strategy to undermine organized crime and improve community health and safety.

“The Global Commission supports Stop the Violence BC’s suggested approach of regulating marijuana under a public health framework,” said Ilona Szabo, spokesperson for the Secretariat of the Global Commission on Drug Policy.

“Mandatory minimum sentences and further reinforcement of prohibition are not rational or prudent solutions.”

Kudos to Stop the Violence BC (STVBC), a coalition of health professionals who have been consistently pointing out the absurdity of criminalizing the production, sale and possession of cannabis in British Columbia.The evidence clearly shows that cannabis prohibition actually increases harms to individuals and communities across Canada. STVBC is calling for a rational process of change that would see cannabis become a regulated and controlled substance and taken out of the unregulated illegal drug market. The Canadian Drug Policy Coalition is a member of the STVBC Coalition and is also calling for the end to the criminalization of people who use drugs.

Throwing people in jail does nothing to help communities address problematic substance use or help individuals access health services should they need them.

The winds of change are blowing and public opinion supports this change. Keep in touch with us and check out STVBC.organd see what you can do to work towards a drug policy for Canada that is based on principles of public health and human rights and scientific evidence.

February 29, 2012
Calling for community health and safety in BC.

This fall the Canadian Drug Policy Coalition joined the recently formed Stop the Violence Coalition BC (STVBC), a coalition of law enforcement officials, legal experts, public health officials and academic experts from the University of British Columbia, Simon Fraser University, University of Victoria, and the University of Northern BC.

http://stoptheviolencebc.org/

The STVBC coalition is working to engage British Columbians in discussion about how the current policy of cannabis prohibition is working to achieve the goals of reducing availability and use of cannabis in British Columbia and minimizing the involvement of organized crime in the illegal cannabis market. The STVBC Coalition is calling for a new model of regulating cannabis to be considered – regulating and taxing cannabis within a legal framework.

The CDPC applauds the leadership taken by STVBC in bringing this discussion to light in British Columbia. CDPC is committed to evidence informed public discussion with a goal of developing more effective drug policies for Canada. For too long there has been a taboo on discussion and dialogue about viable alternatives to drug prohibition, a policy framework that has thwarted experimentation and innovation in policy development. Given the normalization of cannabis use in Canadian society as a common recreational substance, the enormous scale of the cannabis market within Canada and concerns over health and safety within the cannabis market this report is a significant contribution to the public discussion on how best to minimize harm within the cannabis market.

Here is a copy of the second report issued by the Stop the Violence BC coalition. It focuses on the impact of drug law enforcement on cannabis availability and the expansion of organized crime in BC. The report recognizes that cannabis prohibition laws are ineffective when it comes to decreasing rates of availability and price, and suggests ways to better protect community health and safety. More details at www.stobptheviolencebc.org >>

December 25, 2011