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Category: Treatment

  • Canadian Drug Policy Coalition/Canadian HIV / AIDS Legal Network Policy Briefs

    Canadian Drug Policy Coalition/Canadian HIV / AIDS Legal Network Policy Briefs

    Harm Reduction Brief

    Canada is known around the world as a leader in harm reduction. It is host to the first, and only supervised consumption site in North America, Insite, which has saved lives and helped to build a healthier community in one of the most at-risk neighbourhoods in the county. Unfortunately, the federal government has moved away from harm reduction and more towards a criminal approach to drugs. Of course, there is a way forward. In our policy brief, we make the case that not only should the federal government restore the harm reduction model, but expand upon what is already in place. Please click and read below.

    CDPC-HarmReduction-Brief English

    CDPC-HarmReduction-Brief Français

    Overdose Brief

    The tragedy of drug overdose has increased dramatically in recent years. The rise of fentanyl, an extremely potent opioid, has dramatically increased overdose deaths in recent months. Policy change at the federal level is urgently needed. Fortunately, overdoses are preventable. From allowing for easier access to lifesaving medication such as naloxone, to testing the purity level of street drugs, there are several actions the government can take right now to put an end to these avoidable deaths. Our policy brief contains many commonsense policy solutions that the government can enact immediately. Please click and read.

    CDPC-Overdose-Brief English

    CDPC-Overdose-Brief Français

    Cannabis Brief

    Cannabis law is changing around the world. From the United States to Latin America, a wider consensus is growing that cannabis prohibition has failed to prevent both the sale and consumption of the plant for non-medicinal purposes. Public opinion in Canada and worldwide is experiencing a paradigm shift, and the mindset of policymakers needs to change with it. Clearly, an alternative strategy to this broken system needs to be taken seriously. In the following brief, we outline our strategic recommendations on how the federal government can end prohibition, and use its power to begin the process to create a regulatory system that works.

    CDPC-Cannabis-Brief English

    CDPC-Cannabis-Brief Français

  • Drug Policy Abuse: a condition affecting politicians across Canada

    Drug Policy Abuse: a condition affecting politicians across Canada

    A new, debilitating psychiatric condition has been identified today by the Canadian Drug Policy Coalition. Sadly this condition – dubbed “Drug Policy Abuse” – affects a great many politicians across the country.

    You’ve undoubtedly seen the symptoms. Politicians who resist change and disregard data. Who insist on being “tough” and sending a punitive message. Who refuse to discuss alternative approaches to conventional, decades-old drug policy, despite all the evidence of adverse physical, psychological and social consequences stemming from the current approach to drugs.

    These are the signs of Drug Policy Abuse. And CDPC has developed a campaign to draw attention to this crippling condition.

    Check it out the campaign here.

    The good news is, treatment is available for those who are diagnosed and acknowledge that they have a problem. All it takes is an open mind and the recognition that good policymaking – no matter what the subject matter – requires frank and open dialogue informed by evidence. Like the fact that harm reduction and regulatory interventions improve life expectancy and increase the likelihood that problematic users will seek treatment. And that drug use doesn’t go up in jurisdictions that have decriminalized or legalized drugs.

    Fortunately, we do have some bright lights of various political stripes willing to have the conversation. Federal parliamentarians who favour cannabis legalization include not only Liberal leader Justin Trudeau, but also Conservative MP Scott Reid and NDP Deputy Leader Libby Davies. The NDP’s official cannabis policy for 40 years – reaffirmed by current party leader Thomas Mulcair– is decriminalization. Elizabeth May’s Green Party would legalize marijuana and launch a public consultation on the decriminalization of all illicit drugs. Similarly, Liberal Prince Edward Island MP Wayne Easter defends the need for safe injection sites and favours bringing illicit drugs under a regulatory framework given that  “The current drug laws are not working.”

    At the provincial level, Wildrose Pary leader Danielle Smith in Alberta is in favour of decriminalization of cannabis. In British Columbia, Health Minister Terry Lake points to the success of Vancouver’s Insite supervised injection site in preventing transmission of HIV and other blood borne infections, reducing overdose risks, and connecting drug users to services. And former Attorney Generals Kash Heed and Geoff Plant speak out about the need to regulate cannabis in BC and Canada.

    Municipally, former Vancouver mayor Larry Campbell ran on a platform of implementing supervised injection sites, and city councilors in Toronto have lobbied for such a site in their city. Eight BC mayors including Vancouver’s Gregor Robertson, have called for the legal regulation of cannabis in Canada, as has Thunder Bay mayor – and former police officer – Keith Hobbs. Councillors and mayors at the 2012 Union of BC municipalities convention passed a resolution calling for the appropriate levels of government to “decriminalize marijuana, and research the regulation and taxation of marijuana.”

    Outside of Canada, European politicians are actively supporting harm reduction efforts and Latin American leaders are demanding alternatives to criminalization and the punitive approaches to drugs over the past 40 years. Uruguay plans to legalize cannabis use for adults. Closer to home, two US states – Colorado and Washington – have done the same, thanks to ballot initiatives that passed thanks in part to key endorsements from public officials. More states will surely follow.

    The point is, politicians don’t need to suffer from Drug Policy Abuse. There are jurisdictions exploring alternative approaches to the war on drugs. The conversation is happening.  Unfortunately, though, many politicians in Canada are scared of the conversation and have difficulty considering alternative approaches.

    So for those who cling to outmoded models, it’s time to “Have the Talk”. Go to our campaign site to sign the pledge that you’ll reach out to your elected representatives if they have Drug Policy Abuse problem. The campaign site includes tools to tweet national party leaders as part of a larger conversation to address this nationwide affliction.

    Check out the campaign, watch the videos and spread the word.

  • Aboriginal people in Canada will bear the brunt of Mandatory Minimum Sentences for Drug Crimes

    Aboriginal people in Canada will bear the brunt of Mandatory Minimum Sentences for Drug Crimes

    In early April, the BC Provincial Health Officer released a report that warns that recent changes to sentencing and other justice practices brought about by the enactment of the Safe Streets and Communities Act (SSCA) will have very negative effects on the health of Aboriginal people – changes brought about by the SSCA like mandatory minimum sentences will put more Aboriginal people in prison.

    This report also notes that the SSCA appears to conflict with other federal programs aimed at reducing prison time, specifically section 718.2(e) of the Criminal Code, which requires sentencing judges to consider all options other than incarceration.[i]

    The imposition of mandatory minimum sentences flies in the face of evidence of their ineffectiveness. Convicting people of drug-related offences does not reduce the problems associated with drug use, nor do these sentences deter crime.[ii]

    The overrepresentation of Aboriginal Canadians in this country’s prison system is a national disgrace, made all the more disturbing by its avoidability. In 2011, approximately 4% of the Canadian population was Aboriginal, while 21.5% of the federal incarcerated population were Aboriginal. Since 2006-07, there has been a 43% increase in Aboriginal inmate population, and one in three federally sentenced women are Aborignal. In the Prairies, Aboriginal people comprise more than 55% of the total prison population at Saskatchewan Penitentiary and 60% at Stony Mountain Penitentiary in Manitoba. Provincial rates are even worse; 81% of people in provincial custody in Saskatchewan were Aboriginal in 2005.[iii]

    As the BC Provincial Health Officer’s report argues, the reasons for the overrepresentation of Aboriginal people in Canada’s prisons are multifaceted but are rooted in historical causes like colonialism, loss of culture, and economic and social marginalization by white Canadians.

    These concerns were echoed in an October 2012 report by the Correctional Investigator of Canada entitled, Spirit Matters: Aboriginal People and the Corrections and Conditional Release Act (CCRA, 1992).[iv] This report speaks to the lack of resolve on the part of the Correctional Service of Canada (CSC) to meet the commitments set out in the CCRA. The CCRA contains Aboriginal-specific provisions to enhance Aboriginal community involvement in corrections and address chronic over-representation of Aboriginal people in federal corrections. Included among these requirements were the establishment of Healing Lodges that emphasize Aboriginal beliefs and traditions and a focus on preparation for release.[v]

    The report found that in BC, Ontario, Atlantic Canada and the North there were no Healing Lodge spaces for Aboriginal Women. In addition, because Healing Lodges limit intake to minimum-security offenders, 90% of Aboriginal offenders were excluded from being considered for a transfer to a Healing Lodge. The report concludes with a critique of the lack of action by the Correctional Service of Canada: “Consistent with expressions of Aboriginal self–determination, Sections 81 and 84 capture the promise to redefine the relationship between Aboriginal people and the federal government. Control over more aspects of release planning for Aboriginal offenders and greater access to more culturally-appropriate services and programming were original hopes when the CCRA was proclaimed in November 1992.”[vi]

    The implications of Conservative government changes to sentencing practices are clear: rising rates of incarceration of Aboriginal people, higher rates of substance use problems combined with a lack of commitment to alternative healing paths means more federally and provincially sentenced Aboriginal people will end up in Canada’s prisons where they will not receive the services they need.

  • Training Drug Users and Bystanders to Treat Overdose Saves Lives

    Training Drug Users and Bystanders to Treat Overdose Saves Lives

    Drug overdose is a growing public health crisis that now kills more adults per year in the United States than motor vehicle accidents. In cars, seatbelts and airbags save lives. When it comes to opioid overdose a safe and non-abusable medicine called naloxone can restore breathing and avert death. Pragmatic doctors and health officials want anyone who uses opioids like heroin—and anyone likely to be around during an overdose—to have access to this life-saving drug, and know how to use it.

    In Massachusetts, researchers led by Dr. Alexander Walley at the Boston University Medical Center set out to discover the results of a state-supported overdose education and naloxone distribution program on deaths from overdose. We sat down with Dr. Walley to discuss the findings.

    What did your research find?

    This study demonstrates that overdose education and naloxone distribution is an effective public health intervention to address the growing overdose epidemic. We found that communities that received overdose education and naloxone reported significantly fewer deaths than communities that received no training. We also observed that the higher the cumulative rate of program implementation, the greater the reduction in death rates. In other words, the more people at risk or in contact with people at risk for overdose who were given naloxone, and trained to prevent, recognize and respond to an overdose, the lower the overdose death rates.

    Why are overdose education and naloxone delivery programs like these so important?

    Since the beginning of the Massachusetts overdose education and naloxone delivery programs, there have been more than 1,700 overdose rescues using naloxone. While we do not know how many of these people may have died if they had not received naloxone, it is likely that many of them would have. These rescues have inspired many us to maintain hope that all overdose deaths can be prevented.

    People who have recently stopped using opioids—whether because of jail time or treatment—are at increased risk of overdose, and we’ve heard inspiring stories of overdose reversals in these cases. While opioid addiction is a treatable disease, it is a chronic disease where relapse is unfortunately part of the natural history. Preventing overdose allows people to continue their progress towards recovery, and may enable them to seek out other lifesaving services.

    What barriers stand in the way of implementing programs like this in other parts of the United States?

    I’ll start first by listing features of the program in Massachusetts that contributed to its success and would support broader implementation: one is the use of a nasal delivery device for naloxone, allowing naloxone to be administered through the nose, instead of by injection. The other is a standing order issued by the health department that permits non-medical personnel to deliver overdose education and distribute naloxone. Without this order, a doctor would need to be present each time naloxone is given out. To date, there are still large parts of the country with no access to a lifesaving naloxone distribution program; though this program locator tool can help you find out if there is one near you.

    The two main barriers to the expansion of these initiatives are that insurance companies do not cover the nasal delivery device that allows naloxone to be administered through the nose, and prescribers (doctors, nurse practitioners and physicians’ assistants) are not yet adequately educated on prescribing naloxone. We’ve created a website, prescribetoprevent.org, to help facilitate naloxone prescribing.

    What message would you send to officials in countries like Russia and China where the death toll from drug overdoses continues to climb?

    Preventing needless deaths from opioid overdose is a bridge issue – it’s a cause that people from different perspectives on treatment and harm reduction can agree and work together on. It can be a starting point from which we can work together in addressing the harms associated with drug use.

    What happens now?

    We keep implementing and evaluating this program and ones like it. In Massachusetts, overdose education and naloxone have been delivered to heroin users, prescription opioid users, patients in emergency departments, and the people who are most likely to respond to an overdose including: people who are incarcerated, family members, social service providers, police officers, and firefighters. It is important to determine how these programs should be tailored to different populations to maximize their reach, effectiveness and sustainability. That’s what we’re working on now.

    This blog post was originally published on the Open Society Foundations website.
  • Cheap, Easy, and Lifesaving—Naloxone Treatment for Overdose

    Cheap, Easy, and Lifesaving—Naloxone Treatment for Overdose

    How much does it cost to save a life? That question got a clear and striking answer this week in the case of overdose from heroin in the United States. A study published in the Annals of Internal Medicine found that distribution of the overdose antidote naloxone—a safe, non-abusable, and inexpensive medicine—to one in five heroin users in the United States could prevent as many as 43,000 deaths. The cost of distribution would be equivalent to some of the cheapest, most effective, and most accepted medical interventions, like checking blood pressure at a doctor’s office.

    The study used mathematical modeling to assess whether giving out naloxone was “worth it”—that is, to determine how much naloxone distribution would cost per “quality-adjusted” year of life gained. This is the measure used by economists and policymakers to compare health interventions and decide which ones are affordable. The naloxone study also investigated assumptions that patient advocates would rather not acknowledge—like whether it would be cheaper to let illegal drug users die, or to put them in jail. Those are ugly questions, but ones that certainly run through the minds of opponents of health services for drug users worldwide. The answer was that naloxone saves lives with costs far below what health or prison systems pay. For example, screening for cancer with colonoscopy costs over $50,000 per quality adjusted life year gained in the United States, and screening for HIV costs around $40,000.

    Naloxone distribution saves lives for as little as $400.

    The other question, of course, is whose lives are deemed worth saving. Drug overdose now kills more adults a year in the United States than motor vehicle accidents, or deaths from choking or accidental falls. Most of us have seen safety messages related to driving, choking, or minding our step, but naloxone and other measures to prevent overdose remain unknown to many at risk. As noted in an editorial in the same journal, co-authored by officials from the National Institute on Drug Abuse and the FDA, making new and easy-to-use formulations of the medicine can help. However, action can be taken now to make the medicine available to heroin users—actions that will prevent thousands of needless deaths, and spare family and friends who may have to watch helplessly as their loved ones stop breathing.

    – Daniel Wolfe

    Daniel Wolfe is director of the International Harm Reduction Development Program at the Open Society Foundations. This blog post was originally published on the Open Society Foundations website.

  • The Insite Story: Transforming Health Care Services through Leadership, Risk Tolerance and Innovation

    The Insite Story: Transforming Health Care Services through Leadership, Risk Tolerance and Innovation

    It has been said that “an essential aspect of creativity is not being afraid to fail.” A PricewaterhouseCoopers’ survey conducted among the Times 1000 leading companies found that one of the common characteristics among the most innovative companies is that they take a balanced view of risk-taking behaviours. But a recent Conference Board of Canada survey conducted among Canadian health care executives confirmed that Canadian health care leaders have low tolerance for risk. Boards are perceived to be more risk-averse than executive teams by a fairly wide margin. As seen in the chart below, 57 per cent of respondents agreed or strongly agreed that their executive teams are risk-tolerant, compared to the 37 per cent who agreed or strongly agreed that their boards are risk tolerant, a difference of 20 points.

    blog-121812-2At a recent meeting of the Centre for the Advancement of Health Innovations in Vancouver, Insite, North America’s first legal supervised injection site for drug users, exemplified the importance of adopting a balanced approach towards risks. Insite’s leaders have taken bold actions, many of which carried significant risks, to implement innovative and transformative health care services.

    Insite was created to provide needed services to a population group that has suffered social stigma, abuse and social exclusion in Canada: drug-addicts. Before Insite, there were very few effective solutions to protect drug users from HIV and drug overdose but Insite has changed this reality.It offers clean injection supplies, withdrawal management support, detoxification areas and transitional recovery housing. A team of mental health workers, counsellors, nurses and physicians work with people with drug addiction to educate, intervene when necessary, plan a path to recovery and assist with re-integration in the wider community.

    And the results are outstanding: thirty-three per cent of Insite users are more likely to go to detox if they use the site once a week; 70 per cent are less likely to report syringe sharing, thus reducing HIV risk behaviour; and fatal overdoses within 500 metres of Insite decreased by 35 per cent after the facility opened compared to a decrease of 9 per cent in the rest of Vancouver. The benefits also extend to the heath care system and society: it has been estimated that supervised injection can save $14 million and 920 life years over 10 years due to a reduction in HIV, hepatitis and other medical interventions.

    Despite these proven benefits, Insite has had to fight legal battles to prove legitimacy. In 2006, the federal government deferred the decision to extend Insite’s special exemption from the Controlled Drugs and Substances Act, citing a lack of evidence to support the benefits of supervised injection. In a brave demonstration of leadership, Insite’s supporters took the matter to the Supreme Court of Canada, which in 2011, ruled unanimously to uphold Insite‘s exemption, allowing the facility to stay open indefinitely. Over the past nine years, more than one million injections have taken place at Insite under supervision and with clean equipment. It is the busiest supervised injection site in the world with over 1,200 visits every day.

    Insite’s leaders did not run away or gave up on their vision when the many obstacles appeared; they relentlessly focused on implementing change and appropriately and effectively managing the risks associated with a program of this nature. And these efforts have paid off: by partnering with the local health authority, Insite has been able to effectively bringing innovative health care services to marginalized populations who were previously unreachable.

    The program continues to work with low-income people to bring more opportunities for this hard-to-reach population to control their addictions and access effective, culturally appropriate chronic disease management and disease prevention programs. Insite’s daring leaders were not paralyzed by fear of failure. They are transforming health care services by demonstrating that the “best health care solution lies in treating all people humanely”.

    – Jeannette Lye

    Jeannette is a graduate of the School of Public Administration at Dalhousie University and in addition holds a Master of Science in Cultural Psychology from Brunel University and an undergraduate degree in psychology from Acadia University. This blog post was originally published on ConferenceBoard.ca

  • The Missing Link in Overdose Prevention

    The Missing Link in Overdose Prevention

    Long-established medical practice supports prescribing pre-loaded syringes of epinephrine to people having severe, life-threatening allergic reactions to allergens such as bee stings, nuts and shellfish. Patients, including children, are taught how to use them and carry them with them at all times in order to administer the drug without delay when they have a reaction. It “buys time” to allow the person to get to emergency medical care for monitoring and further treatment if needed. Epinephrine is considered an emergency drug and in most circumstances is administered by trained medical personnel in health care settings. However, the risk of death from a severe allergic reaction, when seconds count, outweighs the risks associated with dispensing the drug for unsupervised use by lay people in the community.

    For about thirty years, the harm reduction approach has been advocated by some in Canada as a means of promoting health and preventing needless injury and death among people who use drugs. It accepts that, whatever one’s beliefs about drug use and the people who use drugs, at any given time some people will use drugs unsafely. It holds that preventing unnecessary morbidity and mortality is best accomplished by a continuum of strategies which include educating drug users about the drugs they use, the risks involved, ways to mediate those risks, and the availability of supports to reduce or cease risky use.

    For example, research from Australia has shown that needle exchange programs prevented 32,000 HIV infections and almost 100,000 Hepatitis C infections in the first decade of the 21st century, saving over AU$1 billion – which represents a five-fold return on investment.  Despite decades of robust evidence supporting the efficacy of harm reduction, in general health care providers have been “slow adopters” of harm reduction strategies.

    In September 2010, the College of Physicians and Surgeons of Ontario (CPSO) described widespread addiction to strong painkillers, known as opiates, as a “public health crisis” in Ontario. Earlier this year, a potent long acting opiate known as OxyContin was removed from the Canadian market and replaced with a new formulation called OxyNeo, which is made with a time release coating which is more difficult to bypass, making it less accessible to people using it without a prescription. This has resulted in fewer people using the drug, but not fewer people addicted to opiates.

    Research from the United States shows that many former Oxycontin users turned to more readily accessible opiates such as fentanyl and heroin after Oxycontin was taken off the market there.Reports from police and addiction workers suggest the same is now happening here in Canada. One of the problems with this is that people have had to change from opiates with a precisely known strength to others with variable potency. The risk of overdose has increased as a result. Recognizing this, Ontario Health Minister Deb Matthews announced in April 2012 that her government was increasing resources to address opiate addiction, including distribution of “emergency overdose kits across the province.”

    Similar to the way in which we provide emergency epinephrine to people with life-threatening allergic reactions, distributing a drug called naloxone, which reverses opiate overdoses, has been saving the lives of people who have overdosed on opiates since 1995 in the UK and Germany. There are 150 such programs in 19 American states but so far only Toronto and Ottawa have naloxone distribution programs up and running in Ontario, eight months after the health minister’s announced support of the strategy.

    Naloxone distribution involves providing opiate users with education on overdose prevention, first aid, CPR, as well as naloxone administration in an overdose situation, which “buys time” to get someone to emergency care. The OHRDP received Ministry of Health funding to create a detailed guidance document, which they have compiled building on the work of the Toronto and Ottawa pioneers. It is replete with supporting documentation, current statistics, training manuals, sample protocols and medical directives (required legally to prescribe and dispense this medication to lay people). The naloxone has been purchased and is ready to be used by trained lay people.

    Few health care providers would argue that the opiate addiction crisis has gone away. Small communities are dealing with issues like heroin which they have never seen before. What is different in small communities is that the people using substances are much more dispersed and invisible (for more information, see “Below the Radar”). While it may be reasonable in large cities to focus overdose prevention in places where there are high concentrations of drug users, small towns need a more widespread system of interventions because the people affected are not to be found in a few highly visible areas.

    For example, Peterborough ranks seventh highest in the province for opioid related deaths.  Peterborough Police Chief Murray Rodd has warned that “already we are seeing an increase in heroin and fentanyl in our city,” which he is concerned will lead to “even more overdoses in the coming months”.  A network of Peterborough agencies is poised to roll out an evidence-based overdose prevention program, which includes naloxone training – the first for an Ontario county which includes many rural communities where 911 response times are longer than is common in large cities.  Supported by the local Medical Officer of Health, the police service and EMS, it will only reach the people it needs to if local health care providers get behind the initiative. One hopes that they will do so without delay, as the project will undoubtedly save lives and provide a model for other small and rural communities.

    One of the reasons we study epidemiology (what is causing injury and death) is to use that information to plan programs which will prevent unnecessary injuries and deaths. Health providers have an obligation to understand evidence based interventions available around opioid addiction and to use them to reduce deaths. Some may ask “is this really needed?” but when overdose death rates are so well documented, the answer is obvious. Saving even one person from a needless overdose death should be considered important. She is someone’s daughter, maybe someone’s mom. While the needs of opiate users may not resonate with health care providers in the same way as the needs of people severely allergic to bee stings, when we have an evidence-proven lifesaving intervention, we are obligated to offer it widely and without delay.

    -Kathy Hardill

    Kathy Hardill is a Primary Care Nurse Practitioner at a clinic which includes patients whose health is made vulnerable through homelessness, poverty and other risk factors. This blog post was originally published on HealthyDebate.ca
  • Coalition Spotlight: Canadian HIV/AIDS Legal Network

    Coalition Spotlight: Canadian HIV/AIDS Legal Network

    The HIV epidemic is one of the most crucial public health issues of our time. What at one time seemed to be an insurmountable challenge has been abetted by education, research, innovation, and an immeasurable amount of hard work. The tools to curb the spread of HIV and improve the lives and health of those living with the disease are now more widely available, but the possibility of fostering an AIDS-free generation still faces a number of obstacles, most of which relate to unrealized human rights, access to medicine, harm reduction, and unjust laws.

    One of most prolific groups working on solving the problems that are currently hindering the fight against HIV/AIDS is the Toronto-based Canadian HIV/AIDS Legal Network. Celebrating its 20th year of operations this December, the Canadian HIV/AIDS Legal Network is Canada’s leading advocacy organization dedicated to legal and human rights issues related to HIV/AIDS. The network’s mission is to promote the human rights of those living with and vulnerable to HIV/AIDS, in Canada and abroad, through research and analysis, advocacy and litigation, public education and community mobilization.

    One such issue that the Legal Network is currently working on is the matter of syringe exchanges in Canadian prisons. Syringe exchange is critical to any comprehensive strategy to prevent the spread of infectious diseases, but the distribution of sterile injection equipment is not currently permitted within any Canadian prison — despite the overwhelming evidence of the benefits of prison-based needle and syringe programs (PNSPs) around the world

    To challenge this policy, the Canadian HIV/AIDS Legal Network, along with Prisoners with HIV/AIDS Support Action Network (PASAN), CATIE, the Canadian Aboriginal AIDS Network (CAAN) and Steven Simons, a former federal prisoner, launched a lawsuit on September 25th against the Government of Canada over “its failure to protect the health of people in prison through its ongoing refusal to implement clean needle and syringe programs to prevent the spread of HIV and hepatitis C virus (HCV) in federal institutions.”

    Rates of HIV and hepatitis C among Canadian prisoners are 10 to 30 times higher to that of the overall population. Although illicit drug use is strictly prohibited within correctional facilities, its prevalence is an undeniable fact.

    While the question of giving prisoners access to clean injection equipment might at first glance seem counterintuitive, it’s actually quite straightforward given the evidence that PNSPs benefit prisoner health, and in turn, the public health at large.

    For more information on the court case and PNSPs, visit the Canadian HIV/AIDS Legal Network’s website for the campaign – Prison Health Now.

    In addition to matters directly related to drug policy such as PNSPs, the Canadian HIV/AIDS Legal Network deals with issues such as discrimination, Aboriginal communities, women’s rights, sex work, income security, and so forth (click here for a complete list).

    Other current campaigns and activities include:

    Positive Women: Exposing Injustice

    A 45-minute documentary film that tells the personal stories of four HIV-positive women, “Positive Women Exposing Justice” explores the reality of the criminalization of HIV non-disclosure in Canada. For more information, visit the film’s website.

    HIV Non-Disclosure and the Criminal Law

    On October 25th, the Legal Network released several publications analyzing two recent Supreme Court rulings on cases of HIV non-disclosure. A summary of the decisions and a longer analysis are available here.

    Making Good on Canada’s Pledge: Affordable Medicines for All

    For many years, the Legal Network has spearheaded a global campaign to reform Canada’s Access to Medicine Regime (CAMR), which would allow Canada to ensure greater access to affordable, generic medicines for AIDS and other health issues in developing countries. Central to this campaign is Bill C-398, which if passed will fix and streamline CAMR, allowing medications to get to those most in need.

    For more information on Bill C-398, visit the Canadian HIV/AIDS Legal Network Medicines for All website.

    On December 4, 2012, at 7:00 p.m., philanthropists, funders, members, community organizations, people living with HIV/AIDS, and allies will gather at the Law Society of Upper Canada (Convocation Hall) in Toronto to celebrate the Canadian HIV/AIDS Legal Network and honour the recipients of the 2012 Awards for Action on HIV/AIDS and Human Rights. Click here for more information on the event.

    The Canadian HIV/AIDS Legal Network is a Canadian Drug Policy Coalition partner in change, working towards a better drug policy for Canada based on evidence, human rights, social inclusion and public health.

  • 21st Century Justice: The Economics of Public Safety

    21st Century Justice: The Economics of Public Safety

    Every day, most of us make certain assumptions. We assume that we are generally safe in our homes and on our streets. We assume that the government services that we rely upon will continue unimpaired. We assume that our lot, as individuals and as a community, will improve over time. We don’t expect a collapse of our economic or political systems.

    If we didn’t harbour certain assumptions, we wouldn’t have time to take care of the day-to-day business of living. Yet, hovering around us is a cloud of headlines that should cause us to rethink our basic expectations.

    For the last four years, the world’s economy has experienced a multi-dimensional crisis. Massive American long-term debt, bankrupt state and local governments, a Eurozone threatening to unravel – these are just a few of the factors that force a rethinking of some of our assumptions.

    Most Canadians have been fortunate to have suffered less than the citizens of some other developed countries. But we are not immune to financial ill-health and its impact on the quality of our lives. We have an aging population, one that will place increasing demands on the country’s health care system and other ‘entitlements’, and we can look forward to intense competition between ministries and agencies for funds to keep operating, let alone expanding.

    Looking outside our own borders, we can see examples of the impact of financial hardship on criminal justice and public safety. In England and Wales, a reduction of more than 20,000 police is in progress. Many American jurisdictions have already undergone significant downsizing in police services, driven by shrinking tax bases. In the field of corrections, The United States Supreme Court has ordered California to reduce its prison population by more than 30,000 inmates, in direct response to overcrowding.

    In this country, Chief Justice McLachlin has spoken out about high legal fees as an insurmountable obstacle, for those without the means, to justice. In British Columbia, legal aid lawyers have, on occasion, withdrawn services to emphasize the inadequacy of that system’s budget. Unavailability of Sheriffs has in some instances caused unscheduled court closures. Bill C-10’s financial impact is debated endlessly, and the cost of RCMP policing services is driving active consideration of municipally-based alternatives.

    Our crises don’t seem to have the blunt effect of those in the U.S. and elsewhere. We have the advantage of time to think about alternatives and options before we are forced to confront British or American-style consequences.

    To give focus to the discussion of our options, the planners of the 2013 Canadian Congress on Criminal Justice has determined that the theme for next year’s event  (October 2-5 in Vancouver) will be 21st Century Justice:  The Economics of Public Safety.  The 2013 Congress is a joint undertaking of the Canadian Criminal Justice Association (www.ccja-acjp.ca) and the British Columbia Criminal Justice Association (www.bccja.com), and next year’s event will be the 34th of these biennial gatherings.

    Recently a Call for Papers to be presented at the Congress was published on the CCJA’s website, and in its quarterly magazine, Justice Report. The Call for Papers creates an opportunity to contribute directly to conversation about justice reform, a reform movement that will increasingly be pushed along by the need to find affordable and sustainable alternatives.

    Pierre Trudeau talked, more than 40 years ago, about Canada as a “Just Society”. If we truly aspire to create and sustain a country that can claim to be a just society, we need to think long and hard about the shape of our justice system, its effective and efficient functioning, and our ability to sustain and improve public safety. It is time to check our assumptions.