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Author: Canadian Drug Policy Coalition

  • OPEN LETTER: Urgent action to ensure equitable application of public health protections

    OPEN LETTER: Urgent action to ensure equitable application of public health protections

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    There is growing concern among people who live and work in high-risk and high-density settings in the province that not enough is being done to prevent a deadly outbreak of COVID-19 amongst these populations. Marginalized communities, including people who use drugs, those affected by homelessness, and those who are incarcerated will disproportionately bear the burden of the virus, while receiving the fewest supports to ensure their health and safety.

    BC Yukon Association of Drug War Survivors, along with many other groups from around the province including the Union of BC Indian Chiefs, Pivot Legal Society, Canadian Drug Policy Coalition, Disability Alliance BC, BC Government and Service Employees’ Union and health professionals are calling on the Province to use its emergency powers to do the following:

    1. ensure that the level of Provincial attention and resources provided to prisons, homeless shelters, reserves, and high-density and high-risk hubs such as the Downtown Eastside is the same as that being offered to the rest of the population, including in long-term care settings;
    2. recommend that the Minister of Health order the immediate suspension of municipal bylaws that sanction the displacement of people sheltering in public spaces;
    3. recommend that the Minister of Public Safety and Solicitor General direct police forces immediately, and for the duration of both public health emergencies (overdose and COVID-19), to cease the enforcement of simple possession and related offences; and
    4. ensure that prescribers and their colleges are following the new Guidelines for Risk Mitigation in the Context of Dual Public Health Emergencies to saving lives.
  • Preparedness, prevention and control of COVID-19 in prisons

    Preparedness, prevention and control of COVID-19 in prisons

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    “People deprived of their liberty, such as people in prisons and other places of detention, are likely to be more vulnerable to the coronavirus disease (COVID-19) outbreak than the general population because of the confined conditions in which they live together for prolonged periods of time. Moreover, experience shows that prisons, jails and similar settings where people are gathered in close proximity may act as a source of infection, amplification and spread of infectious diseases within and beyond prisons. Prison health is therefore widely considered as public health.

    The response to COVID-19 in prisons and other places of detention is particularly challenging, requiring a whole-of-government and whole-of-society approach, for the following reasons:

    1. Widespread transmission of an infectious pathogen affecting the community at large poses a threat of introduction of the infectious agent into prisons and other places of detention; the risk of rapidly increasing transmission of the disease within prisons or other places of detention is likely to have an amplifying effect on the epidemic, swiftly multiplying the number of people affected.
    2. Efforts to control COVID-19 in the community are likely to fail if strong infection prevention and control (IPC) measures, adequate testing, treatment and care are not carried out in prisons and other places of detention as well.
    3. In many countries, responsibility for health-care provision in prisons and other places of detention lies with the Ministry of Justice/Internal Affairs. Even if this responsibility is held by the Ministry of Health, coordination and collaboration between health and justice sectors are paramount if the health of people in prisons and other places of detention and the wider community is to be protected.
    4. People in prisons and other places of detention are already deprived of their liberty and may react differently to further restrictive measures imposed upon them.”

    Source: World Health Organization

  • Rights in the time of COVID-19: Lessons from HIV for an effective, community-led response

    Rights in the time of COVID-19: Lessons from HIV for an effective, community-led response

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    “In times of fear and panic, some countries may resort to politically-driven, restrictive, stigmatizing and punitive measures. These may include compulsory blanket travel restrictions, quarantining large groups of people, combining people who have and people who do not have the virus, publishing the names and details of people who have the virus, using stigmatizing language such as “super-spreaders” or criminalizing people who may have breached restrictions or transmitted the virus to others.”

    “From the HIV epidemic we have learned that restrictive, stigmatizing and punitive measures can lead to significant human rights abuses, with disproportionate effects on already vulnerable communities. They can often undermine epidemic responses, sending people with symptoms underground and failing to address the underlying barriers that people face in attempting to protect their own health and that of their community. Indeed, for COVID-19, the World Health Organization does not advise implementing compulsory large-scale restrictive measures such as disproportionate or overly restrictive bans on travel or free movement.”

    Source: UNAIDS

  • Operations Manual: COVID-19 Management in Housing

    Operations Manual: COVID-19 Management in Housing

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    Purpose: this document provides guidance for implementing and operating COVID-19 facilities for vulnerable populations (homeless and under-housed residents who are unable to self-isolate) in the Vancouver Coastal Health (VCH) region.

  • Expanding access to diacetylmorphine & hydromorphone in Canada

    Expanding access to diacetylmorphine & hydromorphone in Canada

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    Abstract: The increasing incidence of fatal opioid overdose is a public health crisis in Canada. While buprenorphine/naloxone and methadone are the standard first-line of opioid substitution options, limitations, including difficulty achieving long-term retention for some people who use opioids, are well known. For this group, injectable diacetylmorphine or hydromorphone can achieve positive outcomes, including high retention rates, reduced use of unregulated opioids, and reduced criminal activity.

    In May 2019, Health Canada announced changes to increase the accessibility of diacetylmorphine and hydromorphone, and in September 2019, the CIHR-funded Canadian Research Initiative in Substance Misuse released a national clinical guideline for diacetylmorphine and hydromorphone as additional frontline substitution options.

    While these developments present opportunities for scale-up, significant financial, structural, and practice barriers continue to impede access. This commentary explores the current state of policy and practice for diacetylmorphine and hydromorphone as opioid substitution options in Canada, outlines the rationale for rapid expansion of access, and highlights clinical and policy changes that must be undertaken or the death toll will continue to rise.

  • Sex and Coronavirus Disease 2019 (COVID-19)

    Sex and Coronavirus Disease 2019 (COVID-19)

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  • Risk Mitigation in the Context of Duel Public Health Emergencies

    Risk Mitigation in the Context of Duel Public Health Emergencies

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    This guidance aims to support individuals who may be at increased risk of overdose, withdrawal, craving, and other harms related to their substance use. As the effects of the pandemic continue, the drug supply may become significantly more adulterated and toxic, based on limited importation and availability, and illicit substances may become significantly more diffcult to procure.

    Individuals seeking illicit substances to prevent withdrawal risk both overdose and exposure to and transmission of COVID-19. Individuals with unstable housing (those who are homeless or living in a shelter, single room occupancy (SRO), or supported housing unit) may face additional challenges physical distancing or self-isolating, in order to reduce community spread of COVID-19.

  • COVID-19 and Ceremonial Spiritual Practices

    COVID-19 and Ceremonial Spiritual Practices

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    Participating in ceremonies and spiritual practices can be an important part of First Nations individual, family, and community health.

    These guidelines were developed with consultation from public health professionals, First Nations health professionals and Knowledge Keepers / Traditional Healers.

  • Safer Drinking Tips During COVID-19

    Safer Drinking Tips During COVID-19

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    During the global Coronavirus (COVID19) pandemic you may have difficulty accessing alcohol. Liquor stores may limit hours and/or numbers of people in the store, move to delivery only, and/or stop accepting cash.

    Everyone is different but for some people who drink very heavily, stopping all at once or cutting down too fast can be dangerous.