Category: Harm Reduction

Dr. Mark Tyndall – Supervised Injection sites are the lightning rod of harm reduction

I sat down with Dr. Mark Tyndall at the 21st Annual Canadian Conference on HIV/AIDS Research(CAHR) in Montreal this April. The theme of the conference was turning points and meeting new challenges. Tyndall is no stranger to confronting challenges and he is known as a national leader in HIV prevention and care. He worked for over a decade in Vancouver at UBC and the BC Centre for Excellence in HIV/AIDS, also as the head of Infectious Diseases at St. Paul’s Hospital. He now calls Ottawa home and serves as the head of Infectious Diseases at the University of Ottawa.

“supervised injection sites have become a lightning rod of harm reduction, but we all know and recognize that they are a very important way to try and engage people in some kind of continuum of care…and the need is still quite large.”

Having been at the forefront of Vancouver’s supervised injection site (INSITE), Tyndall knows that supervised sites and harm reduction services need to be scaled up.

Tyndall says that there is a public health crisis in Ottawa, similar in some cases to what he saw in Vancouver a decade ago. The big question he asks is, do we need to repeat the same research process and make many of the same mistakes, or can we learn from places like Vancouver, Frankfurt, and Sydney and implement harm reduction and supervised injection sites efficiently. Tyndall was a speaker at a press conference we held in Montreal during CAHR looking at injection sites Nationally, and he also contributed to the Toronto Drug Strategy report that we wrote about this spring. Please get connected and leave your comments to let us know what you think needs to happen in your community.

May 16, 2012
Health authority releases new cannabis harm reduction resource

Last week, Vancouver Coastal Health and the University of Victoria’s Centre for Addictions Research of BC published a valuable resource for individuals who use cannabis recreationally.

Take Care with Cannabis is a user friendly, concise, accessible one-page information source that outlines the potential risks of smoking and ingesting cannabis. Intended to protect the well being of individuals, Take Care with Cannabis provides insight into the impact of using the plant on a smoker’s lungs, cognitive abilities, and brain development during adolescence and early adulthood. It discusses how to stay safe when using cannabis and how to avoid toxic effects.

Take Care with Cannabis

John Carsley, Medical Health Officer for co-author Vancouver Coastal Health said,

“It’s our responsibility as health care professionals to ensure that anyone who chooses to use cannabis has clear information about how they can take better care when using.

While cannabis is illegal in Canada, the reality is that a significant portion of the population uses it. And when they use it, it’s our desire to see them be as safe as possible.”

‘Harm reduction’ refers to policies, programs and practices that aim to reduce the negative health, social and economic consequences of using legal and illegal psychoactive drugs, without necessarily reducing drug use. Raising awareness about the realities and benefits of harm reduction for individuals, families and communities is core to the work of the CDPC.

We know that the more informed people are, the more support there will be within communities for a comprehensive approach to reducing the harm from drug use.

We hope you will join us to get the word out and help scale up harm reduction in communities across Canada.

May 2, 2012
Mark Haden: A Drug Educator’s Apology

Mark Haden is a drug educator. He has spent the last twenty-five years providing public education on drugs and working with addiction counselling services in Canada. Today he works as a supervisor at the Pacific Spirit Community Health Centre in Vancouver.

Haden knows that the Canadian Federal government spends approximately six million dollars a year educating parents, teachers, young people, law enforcement and communities about the risks and laws surrounding substance use. He also knows that drug education plays a key role in defining our relationships to mind altering substances.

“We have overemphasized the harms of drugs, we have neglected to mention the benefits of certain drugs and we have omitted mentioning the harms that drug prohibition causes….”

Reflecting on the complexity of the relationships we have to drugs, Haden feels that we do a disservice to young people by perpetuating certain myths and maintaining a system that fails to achieve healthy results. During a brief interview in his office, Haden suggested a number of regulatory tools that could be useful in redefining our relationship to drugs and drug education. He advocates for a public health approach that is rooted in human rights and harm reduction and proposes an alternative to prohibition and criminalization.

Haden is adamant that it is time to explore alternate regulatory frameworks that will actually make certain drugs harder to attain for young people, not easier. He admits that different drugs have different properties and risks and suggests that we consider each one separately, with different approaches taken to reducing the harms of each drug.

Haden believes that if we can open up discussion about drug use and create public health policies, we can also begin to develop healthy social norms that can minimize their associated harms. “We don’t drink alcohol with breakfast,” he says. If we stop the violence of prohibition and start telling the truth about drugs, then we can begin to develop healthy social habits around drug use.

Mark’s website has an extensive list of regulatory tools as well as many more resources for understanding and shifting our relationship to drugs towards a public health approach.

April 16, 2012
NAOMI Research Survivors: Experiences and Recommendations
On March 31st, 2012 the NAOMI Patients Association (NPA) will celebrate the completion of their first research report, NAOMI Research Survivors: Experiences and Recommendations. To mark the occasion, they are having an open house on Saturday, March 31st at noon at the Vancouver Area Network of Drug Users (VANDU), 380 East Hastings Street, in the Downtown Eastside (DTES) of Vancouver, BC where they will be sharing their report and celebrating their achievement. All are welcome and snacks and copies of the report will be available.

The Background

Dave Murray

In January 2011, Dave Murray organized a group of former participants from the North American Opiate Medication Initiative (NAOMI) heroin-assisted treatment clinical trial in the Downtown Eastside of Vancouver, now known as the NAOMI Patients Association (NPA).

The NPA is an independent group that meets every Saturday at the Vancouver Area Network of Drug Users (VANDU) offices. The NPA has reached out to all former NAOMI participants in the heroin stream of the clinical trial and offers support, education, and advocacy to its members. Although attendance at weekly meetings varies, the highest attendance at a meeting was 44 members. On average, 15 members gather each week.

The NPA is also associated with the British Columbia Association of People On Methadone (BCAPOM).

Mission of the NPA

The mission of the NPA is stated as:
We are a unique group of former NAOMI research participants dedicated to:
- Support for each other;
- Advocacy;
- Educating peers and the public;
- Personal and political empowerment;
- Advising future studies (heroin and other drugs) and permanent programs;
- Improvements in consent and ethics;
- The right to a stable life and to improvement in quality of life.
The NPA’s goal is to see alternative and permanent public treatments and programs implemented in Canada, including heroin assistance programs.

The Research

In March of 2011 the NPA decided to undertake their own research project focused on their experiences as NAOMI research participants. They met with me, Susan Boyd, a drug policy researcher and activist, and decided to work together to conduct focus groups, brainstorming sessions, and writing workshops with NPA members. The NPA adopted the words below to further guide their own research project. They are written by long-time DTES activist Sandy Cameron who passed away last year, from his poem, Telling Stories.

Telling Stories
We need to tell our own stories.
If we don’t tell our stories,
people with power
will tell our stories for us.
It is from this place that the NPA began their own research, to tell their own story in their own words.

NPA Research Findings

Five primary themes emerged from the research:
- Beneficial outcomes of being a participant in NAOMI,
- Problematic outcomes of being a participant in NAOMI,
- Ethics and Consent,
- Creative writing/Everyday life, and
- Recommendations for other research projects and programs.
The NPA’s report, NAOMI Research Survivors: Experiences and Recommendations, expands on these themes and much more. The full report is available here.
March 21, 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
Restorative Justice: An Alternative to Bill C-10

Last night retired Yukon Judge Barry Stuart, a vocal supporter of restorative justice , held a dialogue on Bill C-10 in a Centre Block Senate Committee room on Parliament Hill in Ottawa. The gathering was attended by representatives of the John Howard Society, Salvation Army, Somali Mothers Association, Victims of Crime, Penal Reform International and a number of other organizations and individuals with personal experience with correctional facilities and the criminal justice system. Senator James Cowan , a member of the legal and constitutional affairs committee, was also in attendance.

With over 30 people in attendance, each comment and topic brought up by attendees could have had its own discussion session. Yet there were four key themes of the night.

Mr. Stuart and Eva Marszewski, of Peacebuilders International Canada, started the discussion off by talking about the need for community involvement in justice issues. Ms. Marszewski talked of how Peacebuilders had created a pilot program that brings offenders into discussion circles with community members. This allows the community to decide what the offender should do to make amends and be accountable. The project has been so successful that the provincial courts have fully funded an office for their work in downtown Toronto.

Barry Stuart expanded on Ms. Marszewski’s points by arguing that 75 percent of his former workload as a judge could have been handled much more inexpensively by health experts and involved community members.

One of the themes of the night was participatory democracy, or as Mr. Stuart referred to it, “creating a safe place to allow a community to do the work to make it a community.” There were many people at the table who openly claimed little expertise in in this approach, but Mr. Stuart repeated that this is a civil society issue, a human rights issue , and that everyone has expertise in human understanding.

Another theme was society’s “addiction to punishment,” as one United Church representative put it. The idea of jail time equitable to a victim’s revenge seemed to be ingrained in the values and belief system of many citizens. But as some pointed out, victims are often merely seeking accountability, and see no other alternative to the criminal justice system. Yet many proponents of stronger sentencing are unaware of alternative methods, such as the Gladue Approach , which both save money and reduces recidivism.

Overall, it was agreed that a difficult, nebulous and morally difficult conversation needed to be had focused on the purpose of the justice system. This effort would have to understand what real justice is, what the effects of crimes are and what motivates offenders.

The largest theme of the discussion was the problems that Bill C-10 will create.Issues such as the fears of greater prison overcrowding, a further clogged justice system, cuts to already inadequate community funding and other preventative programs, the growing private prison lobby in Ottawa and how victims and offenders will both become further victims as funding squeezes reduce access to justice were all discussed.

There wasn’t a whole lot of optimism here, as Bill C-10 is almost certain to pass and begin contributing directly to these problems. However, this discussion led into to the final theme of the night: unity.

The sheer amount of problems that so many groups have with Bill C-10 has seemed to unite people. Many long-time activists felt that even five years ago, such a diverse group of individuals and organizations would not be in the same room together. Mr. Stuart described how he had grown tired of everyone meeting in a room, getting a big morale boost, and then going back to their separate communities. Mr. Stuart noted that there were many legislators and ordinary citizens who had “cracks of doubt” with Bill C-10.

He declared it was time for a national restorative justice organization that could effectively harness this diverse movement for criminal justice alternatives and create new windows for those with second thoughts.

The real work is just beginning.

February 23, 2012
Where’s the beef: does the Senate have an aversion to evidence-based policy?

Today’s testimony focused on part 4 of Bill C-10, which would amend the Youth Criminal Justice Act. Specifically, these amendments would allow a judge to lift the publication ban on cases involving defendants as young as 12 years old, introduce dissuasion and deterrence as principals of Canadian youth justice, and make it easier to incarcerate youth convicted of violent crimes.

The committee heard from a number of lawyers and children’s advocates, including Marvin Bernstein of UNICEF Canada, Mary-Ellen Turpel-Lafond, President, and Sylvie Godin, Vice-President of the Canadian Council of Child and Youth Advocates, and Judge Barry Stuart, former Chief Justice of the Yukon.

These witnesses unanimously protested nearly all of the proposed amendments to the Youth Criminal Justice Act. They claimed that allowing judges to lift publication bans would have disastrous long-term consequences for young people.

They also argued that, in the case of young offenders, a violent crime can mean throwing a snowball, throwing water on someone, or threatening a classmate. Bernstein, Turpel-Lafond and Godin also told the committee that, in their opinion, the proposed amendments were in contravention with the UN Convention on the Rights of the Child, to which Canada is a signatory.

Judge Barry Stuart, a pioneer in restorative justice, had particularly severe warnings for the committee, claiming that if they went down this road, and further criminalized young people, that they would never attain the goals of improving victims’ rights and engaging communities in offender rehabilitation. Rather, the “tail-end” of the criminal justice system would suck up all resources that could have far greater impact on justice and public safety if spent elsewhere.

Many Conservative senators repeated standard responses to the testimony of these witnesses. Rather than asking questions, their cross-examination seemed more an attempt to discredit their testimony. This behaviour has seemed most often on display when the committee is hearing from academic experts and legal professionals, whereas it changes to a more conciliatory tone in the presence of law enforcement officials.

In response to the very real problems outlined in regards to Bill C-10, Senator Wallace once again repeated his favourite line: “But when Ministers Toews and Nicholson appeared before this committee, they assured us that the bill will only target violent, repeat offenders, organized criminals, and child abusers.”

Senator Wallace seems to believe that simply repeating this mantra will make it true, despite the mountains of evidence given by representatives of children’s advocacy groups, the Canadian Bar Association, the Assembly of First Nations, as well as independent academics and many others. Unfortunately, the CDPC was not permitted to add its voice to this overwhelming chorus.

The comportment of these Conservative Senators—Boisvenu, Lang, Frum, Dagenais, and Wallace—seems to indicate that they don’t understand the fundamental purpose of their own position: to give a sober second thought to proposed legislation one step removed from the dictates of electoral politics. Indeed, during hearings today Senator Lang went so far as to claim that “one might argue the nuances or the details, but it’s the spirit of the law that matters.” Perhaps no one told Senator Lang that the nuances and the details of the law are precisely what a senate committee is meant to discuss.

Perhaps this disdain for evidence is what prompted Judge Barry Stuart’s remark that the Senate, “probably spends more time weighing evidence on which military aircraft to purchase than on weighing evidence on what is best for our youth.”

February 22, 2012
Challenging prohibition: a missing perspective

Tonight the Senate Committee on Legal and Constitutional affairs heard from a huge variety of witnesses, from researchers at the Canadian Center on Substance Abuse to Chief Ron Evans of the Norway House First Nation to representatives of the RCMP.

In all, ten witnesses were called. Nearly every witness—including those representing law enforcement—made it clear that a variety of approaches are required to stem drug-related crime, not just enforcement.

However, not a single witness dared question the efficacy of drug prohibition itself. This important framework was in fact almost entirely missing from the discussion. And with the Senate declining to hear from the Canadian Drug Policy Coalition’s Director, Donald Macpherson, it is unclear if such a perspective will be raised in the hearings to come.

Witness after witness in today’s hearings sung the praises of harsher sentencing for drug crimes, even though there is no evidence that this approach works to either deter or rehabilitate individuals. What we do know is that prohibition continues to fill the coffers of organized criminals.

Gwendolyne Landolt, Vice President of the Drug Prevention Network of Canada, went so far as to claim that prohibition was indeed a successful policy given that alcohol consumption decreased during the prohibition era in the United States from 1920 to 1933. However, as evidenced by a recent report from the Health Officers Council of British Columbia, this is actually like comparing apples to oranges.

During prohibition, there may have been a decrease in alcohol consumption, but there was in fact a marked increase in organized crime.

After prohibition, alcohol was not only legalized, but drinking was heavily promoted by the alcohol industry.  Senator Joyal came closest to questioning this failed prohibition approach when he brought up the open letter recently signed by four former BC attorneys general.

In that letter, the attorneys general compare the violence and bloodshed during prohibition to the current situation in British Columbia, where organized crime turns a healthy profit through marijuana and synthetic drugs.  Despite the misinformation put forward by witnesses such as Ms. Landolt, who claimed that young people who use drugs can never hope to participate in society, the fact is that substance use takes place on a spectrum, ranging from beneficial, through recreational, to problematic. The majority of Canadians who use or have used drugs do not suffer from problematic effects or harmful abuse. Perhaps it’s time our lawmakers took these facts into consideration, and produced policy based on health, regulation and human rights.

February 16, 2012
Discretion in Bill C-10 Part II: Ministers versus Judges

Today’s Senate committee hearings into Bill C-10 focused on testimony from three lawyers regarding amendments to the International Transfer of Prisoners Act: Nathalie Des Rosiers, General Counsel of the Canadian Civil Liberties Association, Fannie Lafontaine, a law professor at the University of Laval, and John Conroy, a lawyer in the Fraser Valley.

These lawyers were very concerned with the expansion of ministerial discretion over the repatriation of Canadian prisoners. They argued that the bill would make it easier for a minister to deny the transfer of prisoners for what amounts to arbitrary reasons.

Mr. Conroy brought up the example of the Goulet case, where Minister Toews’ decision not to repatriate a prisoner convicted of a drug crime was deemed unreasonable by a federal judge. The decision cited twelve previous ministerial decisions since 2008 that were also deemed unreasonable, showing a problematic pattern in politicized decision-making over prisoner transfer. In these cases, the minister ignored the evidence put forward by officials at the Ministry of Public Safety; as Mr. Conroy put it, “It’s as if the minister doesn’t trust his own ministry.”

The three lawyers made it clear that there were many good reasons to repatriate prisoners. Chief among them was that in serving a sentence elsewhere, and returning to Canada upon release, the offender neither has a criminal record in Canada, nor is required to check in with correctional authorities.

Lawyers argued that public safety is far better served when prisoners are repatriated, since, in the words of Mr. Conroy, it allows Correctional Service Canada to “get to know” the offender through risk evaluations, follow ups, and the increasingly long leash of parole prior to full release. Furthermore, Canadian prison objectives prioritize the rehabilitation and reintegration of offenders, which is not the case in many other jurisdictions including the United States, the source country of 85% of transfers to Canadian prisons.

But for Conservative members of the committee such as Senators Lang, Runciman, Boisvenu, Dagenais, and Wallace, these arguments are akin to “hug-a-thug” rhetoric that privileges offenders over victims.

As Senator Lang argued, these offenders “knew the consequences of the crimes they were committing” and should therefore serve out their sentences in the jurisdiction where they committed the crime.

These senators claim that Canadian prisons are too lax, and it is only for this reason that Canadian offenders would want to return home. For instance, according to Senator Lang, prisoners in the US must serve 85% of their sentence before being eligible for parole, and in many cases the sentences are harsher than those for the same offences in Canada. Lang ignored the fact that the length of a prisoner’s sentence does not change once he or she is repatriated to Canada. From these comments, it seems that what these Conservative senators are really saying is Canada should not only have harsher sentences, but the Canadian Criminal Code’s principal objectives of rehabilitation and reintegration are not to be respected.

But Lang does have a point: the United States has very harsh sentences. As I mentioned in a previous post, California’s “3 strikes and you’re out” law has put thousands of drug offenders behind bars for life. And in the US federal system as a whole, over half of inmates are serving time for drug offences.

In watching the committee hearings unfold, I am struck by the way the bill’s proponents seem to desire that our system of justice should do nothing but dole out retributive punishment. Supporters of Bill-C10 consistently show contempt for the Canadian justice system, and a preference for policies that we know do not work. For this reason, they want ministerial discretion over prisoner transfers to be greater, at the expense of judges and officials at Correctional Services Canada whose job it is to determine the likelihood that a criminal will reoffend.

The real question seems to be who should be in charge of passing judgment on Canadians: elected officials, whose jobs depend on being popular, or the judiciary, who are meant to use objective criteria? We must remember that democracy requires the rule of law to be respected and applied equally to all.

As the Goulet case shows, ministerial discretion in the case of prisoner transfer is a threat to Canadian democratic values.

February 16, 2012