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Cannabis regulation is by no means a simple matter, but it can be done

At the Canadian Drug Policy Coalition (CDPC) one of things we’ve noticed is that any blog we publish on cannabis regulation attracts more attention than any other topic. This is because there’s widespread interest in any discussion of changes to the laws that govern cannabis. Unfortunately when it comes to the nuts and bolts of cannabis regulation – in other words – the how of regulation, interest tends to drop off. This is because regulation is actually rather tedious. This claim is borne out by the length of the proposed regulations for legal recreational cannabis markets in the U.S. states of Washington and Colorado. That’s why I’m going to make a special plea to you our dear readers to stay with me as I say a few words about what regulation might actually entail.

I think it’s fair to suggest that the CDPC favours a model of regulation that draws on the best evidence from public health regulation of alcohol and tobacco. But when it comes to cannabis regulation the devil really is in the details.

There’s no magic bullet that will make all the current problems with cannabis prohibition disappear. But thanks to the Health Officer’s Council of BC, some of the heavy lifting when it comes to creating models for drug regulation has been done. If you’re curious, check out their 2011 report. As you can see from the diagram drawn from their 2011 report, regulations for cannabis should not be so loose that they create a free and unregulated market for cannabis; nor should regulations be so overly restrictive that we end up reproducing the negative aspects of the current underground economy (control by organized crime, etc.).

At the same time we need to be clear about the goals we hope to achieve with a legal regulated market for cannabis. Ideally our regulations will help protect and improve public health, reduce drug related crime, protect the young and vulnerable, protect human rights and provide good value for money. So what are some of the things we’ll need to consider? How about we start with the basics.

Presumably legalization would entail the removal of cannabis from Schedule 2 of the federal Controlled Drugs and Substances Act, followed by its inclusion in the Food and Drug Act. It seems like the next logical thing to do would be to then turn over the regulation of cannabis to the provinces, in the same way that alcohol is currently regulated. We would want to ensure that there is at least some consistency across the provinces so that means somebody at the federal level will have to oversee the regulations as they emerge. That’s the easy part because legalization would ALSO entail consideration of at least the following issues: production, product, packaging, vendor and outlet controls, marketing controls, creation of a system of regulators and inspectors as well as on-going research and monitoring.

For this blog post, I want to focus on production and product controls. Future blogs may consider the other items on the already long list noted above. My comments are phrased as questions to stimulate discussion of regulation rather than to propose firm rules for how a legal recreational cannabis market might operate.

In Canada, marijuana is currently produced in one of two ways – under existing legal medical marijuana guidelines or in illegal circumstances. Growing marijuana takes places in a vast array of situations ranging from a few plants grown for personal use all the way to large-scale industrial size operations with 100’s of plants.

Thus regulating the growth of marijuana for a legal recreational market will not be simple. Many people are very attached to their small-scale gardens and it would be difficult to impossible (as well as undesirable) to eliminate growing marijuana for personal use. At the same time it’s important not to turn the whole thing over to heavily capitalized large scale commercial producers whose main motivation is profit, especially since the range of available strains of marijuana has been the result of innovation by many small-scale growers. Thus, we need to ensure that the best practices in indoor, outdoor, personal, commercial production are preserved while ensuring that cannabis is produced in safe and clean facilities. We will also need to decide who is the appropriate authority for regulating growing operations: municipalities or provinces or some combination of both. Neither seem overly keen on this role so they will require some convincing.

Okay, if your head doesn’t hurt yet lets turn our attention to product controls. Product controls include issues like price, age limits, potency, permissible preparations (edibles, tinctures, etc.), quality control, and labeling and packaging requirements. Price is a key issue when it comes to meeting public health goals. Price can help shape sales and thus use of cannabis, so we want to ensure that pricing reflects what we’ve learned from alcohol – namely that alcohol consumption is sensitive to price and that price must in some way be related to potency. Related to price is taxation – at what point in the chain from seed to sale will cannabis be taxed and at what rate? And what preparations will cannabis regulations allow; plant materials, tinctures and oils, edibles? Right now Canada’s medical marijuana access program only allows for the distribution of plant material. Clearly this is a very limited approach given that the medical cannabis dispensaries have created a range of edible and other products that eliminate the necessity of smoking cannabis. We will also need to decide where we stand on potency: in other words will we put limits on how potent products can be, and given that there are over 100 cannabinoids, how will we decide which ones we want to measure and regulate.

Okay so I haven’t covered other essential issues like vendor controls, marketing and evaluation and monitoring but I think you get the picture. Regulation is by no means a simple matter, but it can be done. In fact, experience from legal recreational markets in Washington and Colorado will provide valuable insights that can inform Canada’s approach. And regulation has the potential to create conditions where cannabis production and use is a whole lot safer than the current approach – prohibition.

November 20, 2013
Did You Know that Marijuana is Illegal in Canada?

The idea that marijuana is legal in this country is one of the persistent myths about this substance. In fact, marijuana is still illegal and is listed in Schedule 2 of the federal Controlled Drugs and Substances Act. This means that unless you have authorization to use medical marijuana, you cannot possess, sell or produce marijuana without risking a criminal penalty. In fact, under 2012 revisions to the law, you could receive a mandatory minimum prison sentence for growing just six plants if any of a number of “aggravating factors” are present (such as being near a school or having children at the same place as the plants).

Another persistent myth is that police don’t bother to enforce cannabis laws especially possession. It’s true that some police forces have de-prioritized enforcement of possession, but certainly not all.

According to Statistics Canada, in 2012, there were 57,429 police reported incidents of cannabis possession. This number represents police resources that could be better spent elsewhere and this number also represents a ridiculous incursion on the civil liberties of far too many Canadians.

Prohibition of cannabis seems even more regressive when we consider that legal recreational marijuana will soon be available in the U.S. states of Colorado and Washington. In the aftermath of successful 2012 ballot initiative campaigns, both states have released draft regulations to govern the production and sale of recreational cannabis. Changes in these U.S. states were a hot topic at the recent International Drug Policy Reform conference in Denver where speakers from Colorado and Washington outlined the rules for “tightly controlled” markets for recreational cannabis.

Both models of regulation draw on experience with regulating alcohol, although regulations for recreational cannabis will be far more stringent. Both states require numerous controls including age limits, packaging information, and closely controlled documenting of wholesale and retail sales of cannabis to recreational users. Some of the proceeds of taxation will be directed to public health and educational goals.

In Colorado the legalization of cannabis builds on a successful model of medical cannabis developed in that state over a number of years. In fact, during the three-day conference I had an opportunity to visit two medical cannabis dispensaries and an industrial size cannabis garden. Good Medicine and River Rock Medical Cannabis are just two of the companies in Denver that offer patients an array of medical cannabis products ranging from raw plant materials, to oils, and edibles in a myriad of forms. Lessons learned from these operations will be transferred to recreational cannabis when it becomes available for sale on January 1, 2014.

What’s remarkable about the changes taking place in these two states is that they employ full legal regulation, not the models of decriminalization already in operation in other parts of the world. Decriminalization involves reducing or eliminating penalties for possession while still keeping production and sales illegal. Though an important step in the right direction, decriminalization still leaves cannabis in an unregulated market of producers and sellers.

It was clear from visiting the two medical cannabis dispensaries that legalization makes this substance available in a variety of well-labeled forms and gives consumers the option to choose organic products. Security cameras that feed back to state regulators in real-time, monitor the dispensaries and the gardens. The people working in these operations are clearly knowledgeable and professional in the care they take with their products and their customers. Not only does this model work for consumers, but it also provides badly needed jobs.

The scientific evidence suggests that cannabis has a smaller public health impact than alcohol. It seems that the real crime is staying a course that actually makes us less safe and less healthy because right now, marijuana is only available in Canada in an unregulated market. So what’s holding us back in this country? Maybe it’s that drugs are still politically expedient and some politicians don’t seem to have any qualms about using fears about drugs to get votes. At the Canadian Drug Policy Coalition we think it’s time for change and it’s time to challenge regressive and uninformed policies on cannabis. What do you think?

October 29, 2013
Lifesaving Heroin Assisted Treatment Dealt Serious Blow

By Connie Carter and Susan Boyd

On October 3, 2013, federal Health Minister Rona Ambrose announced new regulations that became effective immediately to prevent Health Canada’s Special Access Programme from approving the use of prescribed diacetylmorphine* as a treatment for addiction for a small number of patients finishing the clinical trial SALOME, in Vancouver, BC. Health Canada’s Special Access Programme (SAP) allows practitioners to request access to drugs that are unavailable for sale in Canada.

Ambrose’s comments at the October 3rd press conference misrepresented the extensive evidence supporting heroin-assisted treatment (HAT). She claimed HAT is unsafe and expensive and not in keeping with her government’s National Anti-Drug Strategy. Her comments reflected the Harper government’s refusal to acknowledge the eight peer-reviewed research HAT trials worldwide that have found it to be a beneficial, safe, and cost-effective approach for patients where methadone and other conventional treatments have not worked.

Ambrose promoted the virtues of abstinence-based drug treatment failing to mention that Canada’s system of treatment programs is a patchwork of private and public providers. As the CDPC’s report on Canadian drug policy found, private treatment programs are expensive, and in the absence of national accreditation standards, these programs can vary in quality. Abstinence based treatment is also ineffective for many people with long-wait times for publicly-funded services.

Ambrose’s press conference included supporters who were called upon to back the federal government’s position. One speaker, Marshall Smith, a former political staffer with the BC Liberal Government, described his own struggles with drugs including crystal meth, and his recovery through abstinence-based treatment. Smith currently works for Cedars at Cobble Hill, a privately run drug treatment facility on Vancouver Island. Smith comes from a self-admitted well-to-do family, who can afford private treatment facilities that can cost upwards of $10,000 a month. Every person’s story of recovery and change is important, but with all due respect to Mr. Smith, it’s vital that no one person’s story stand in for the range of experiences with substance use.

Comments at the press conference reflected a narrow view of recovery from substance dependency and assumed that all people will benefit from conventional drug treatment approaches. In a turn about from previous calls for abstinence-only drug treatment, speakers’ called for expanded opiate-substitution programs like methadone. But HAT is only offered to patients who have failed repeatedly with methadone and abstinence-based programs.

Ambrose called Health Canada’s recent decision to approve the use of diacetylmorphine for 20 patients a “loophole” in the Special Access Program regulations. But the Special Access Program is supposed to provide patients with serious or life-threatening conditions, access to drugs on a compassionate or emergency basis and especially when conventional therapies have failed. Under these conditions, many of the seriously ill patients who enter HAT would certainly qualify for access.

No one knows better the concerns of patients in these research trials than SNAP, an independent Vancouver based group comprised of former and current members of Vancouver based HAT research trials (former NPA). SNAP advocates for human rights and access to appropriate health care for its members and has been working since January 2011 to establish permanent HAT programs. SNAP members also have first hand experience with the use of diacetylmorphine. Their experiences confirm the findings of other research studies that this drug is a proven safe and effective treatment for opiate dependency. Patients’ physical and psychological health improved, accompanied by decreased criminal activity and illegal drug use. Given the positive results from studies around the world and here in Canada, the federal government’s refusal to recognize the best treatment for this small groups of patients is an egregious violation of their rights to access to health care.

* Diacetylmorphine is the active ingredient in heroin. It is pharmaceutical-grade product manufactured by a company outside Canada. For the purposes of research trials, it is purchased and imported with permission of the Government of Canada.

October 24, 2013
Voices of the Drug War: Mexico and Canada

In Mexico the drug war has had a devastating impact on communities, families, the social fabric and the economy. Deepen your understanding of the complex roots of this tragedy and hear ideas for new and better ways forward.

Join the Canadian Drug Policy Coalition, Global Exchange and the Movement for Peace with Justice and Dignity for an evening with Javier Sicilia and Teresa Carmona. Both of these outstanding Mexicans have lost children in the drug-war-driven violence of recent years. Both have chosen to forge their tragedies into opportunities to become agents of the changes so urgently needed in Mexico as well as in North America.
Mr. Sicilia and Ms Carmona will share their experiences as both victims of the drug war and founders of an important peace movement. They will lead a discussion on why they are committing the moral weight of Mexico’s Movement for Peace with Justice and Dignity to the call for drug policy reform throughout our hemisphere.

In Canada the drug war has had devastating impacts on individuals, families and communities across the country. Canada’s current drug laws support a lucrative underground and violent drug trade, fuel the spread of HIV and Hepatitis C, disproportionally target marginalized populations, and ensure the availability of illegal drugs to young people in our communities. Bud Osborn poet and Downtown Eastside activist will read and talk about his own journey through the drug war in North America.

Donald MacPherson, Director, Canadian Drug Policy Coalition will moderate the discussion and highlight the opportunities coming towards us to accelerate the movement for ending the war on drugs.

You are invited to attend – Voices of the Drug War: Mexico and Canada

Register here: drugpolicy.ca/javier-sicilia/

Monday, October 28, 7-9 PM
World Arts Room
SFU Woodward’s
149 West Hastings Street
Vancouver, BC

For more info: [email protected]

The Canadian Drug Policy Coalition relies on donations from people like you to operate. Our small team ensures even the smallest contributions go a long way to make your voice heard. Please donate today.

October 13, 2013
Illegal Drugs Get Cheaper, More Potent

Sometimes my work as a drug policy analyst is really hard to explain to my non-drug policy friends. Most of the research findings about drug policy that I deal with on a daily basis fly in the face of conventional wisdom about drugs, drug users and drug laws. One of these pieces of conventional wisdom taught routinely to Canadian high school students is that drug law enforcement is necessary to keep the supply of illegal drug under control, and to discourage young people especially, from using these drugs.

Change in estimated heroin price and purity in the context of the annual drug control budget in the United States. Source: Global Commission on Drug Policy

As any of you in the field of drug policy reform know, despite the claims by police, drugs are now more available, higher purity and more potent than they were 20 years ago. So says a recent publication in the British Journal of Medicine Open, entitled, “The temporal relationship between drug supply indicators: An audit of international government surveillance systems.” Whew that’s mouthful. Authors of this study at the BC based International Centre for Science in Drug Policy culled from two decades (1990 to 2010) of government databases on illegal drug supply, and found the supply of major illegal drugs has (with a few exceptions) increased. With the exception of powder cocaine, the purity and/or potency of illegal drugs in the U.S. generally increased. Their findings also confirm that the price of illegal drugs generally decreased.

These findings once again throw into question the effectiveness of current government drug policies that emphasize supply reduction at the expense of other goals. These deficiencies are aptly illustrated by the World Drug Report, an annual publication of the United Nations Office on drugs and Crime that relies on reports of police drug seizures (i.e. size and estimates of drugs found in raids) along with police-based estimates of crop size (i.e. for cannabis and coca) to evaluate the effectiveness of drug policies. The larger the seizure, the more enforcement officials assert the effectiveness of their approaches. But the findings described above suggest that no matter how hard we try to apply supply-side drug enforcement, drugs are still widely available, cheap and increasingly potent.

As the authors of this study suggest, new measures of the success of drug policies are urgently needed. Rather than using measures of drug supply, its time for governments to assess the effectiveness of their drug policies by using indicators of drug-related harm like overdoses, rates of blood-borne disease transmission (i.e. HIV or Hep C) and emergency room visits…you get the picture. And as the Global Commission on Drug Policy reports, supply-side drug enforcement actually exacerbates the problem of drugs by driving people away from supports and services, at the same time as it creates a growing underground market in drugs.

Sounds sensible, but Canada has poor quality data for measuring the health of people who use drugs. The Canadian Alcohol and Drug Use Monitoring Survey is small and relies on the use of land-lines. There’s no national level data on drug overdoses like there is in the U.S. This lack of data seemingly reinforces the proposition that if you can’t count it, it’s not a problem.

We do know how many people are arrested for drug crimes (57,000 plus for cannabis possession in 2012). But these measures only tell us about police priorities, though they do suggest that the criminalization of people who use drugs is a major way Canada attempts to limit drug use – an approach shown to be less than effective at stopping drug use and a key driver of stigma and discrimination.

So it’s time for all of us to sit down with our friends and family and explain that the conventional maxims of drug policy fail to keep us safe, do not limit the supply of drugs and overlook the health and other needs of people who use drugs. Clearly it’s time for a new approach.

October 10, 2013
9/30

It’s 9/30 and way past time for the federal government to get moving on safer consumption services.

September 30, 2013 (9/30) marks the two-year anniversary of Canada’s Supreme Court decision that unanimously granted constitutional protection to Vancouver’s supervised injection site, Insite. To mark this important anniversary, the Canadian Drug Policy Coalition is spearheading a campaign to let our federal government know that there is widespread support for safer consumption services. In conjunction with the Canadian HIV/AIDS Legal Network and PIVOT Legal Society, we’ve created a sign-on letter to federal Minister of Health Rona Ambrose. Our letter demands that the federal government get going in the right direction to support the scale up of these important and life-saving services.

That decision recognized the improved public health and public order that stems from the implementation of this service. The Court also recognized that, under the Canadian Charter of Rights and Freedoms, people who need such life-saving health services should not face possible criminal prosecution and imprisonment for attempting to use them. The decision created an important precedent supportive of expanding similar services in other communities.

An overwhelming amount of research evidence on supervised injection sites (SIS) has been published in a wide range of scientific and medical journals since Insite first opened its doors in 2003. The evidence of Insite’s positive benefits is conclusive and these services should be scaled up where needed across Canada. Indeed numerous localities are working towards this.

Supervised consumption services (SCS) have been proven to:

• decrease overdose death and injury;
• decrease risk behaviours associated with HIV and hepatitis C infection;
• increase access to health services for people who are most marginalized;
• save health care costs; and
• decrease open drug use and publicly discarded drug use equipment.

Furthermore, the evidence shows that such services do not increase crime, nor do they increase drug use.

There are over 90 SCSs operating around the world today, and considerable research about the positive public health and safety outcomes of SISs. There is also broad agreement among health professionals that SCSs should be part of a comprehensive continuum of health services for people who use drugs.

INSITE, Vancouver BC

On September 30, 2011, the Supreme Court of Canada (SCC) ruled that it would infringe constitutional rights to security of the person to deny an exemption from the provisions of the Controlled Drugs and Substances Act so that Insite could operate without staff or users fearing criminal prosecution when using this health service. The Court declared unequivocally: “Insite saves lives. Its benefits have been proven.” The Court also stated: “Where, as here, a supervised injection site will decrease the risk of death and disease, and there is little or no evidence that it will have a negative impact on public safety, the Minister should generally grant an exemption.”

All across Canada organizations of people who use drugs, front-line organizations, researchers, professionals, and community members who work with people who use drugs, are demanding increased access to supervised consumption services. It is unacceptable that a decade after Insite first opened, Vancouver remains the only city in Canada with a sanctioned supervised consumption service – and only one such service of this sort, which numerous studies have demonstrated is simply inadequate to meet local needs.

It is unethical, unconstitutional and damaging to both public health and the public purse to block access to supervised consumption services which save lives and prevent the spread of infection.

It’s time to stand up for people’s lives and take the leadership to ensure that supervised consumption services become a part of the continuum of care for people who use drugs in Canada.

September 18, 2013
Overdose Awareness Requires Federal Attention

Today the White House based Office of National Drug Control (ONCDP) released a letter in honour of International Overdose Awareness Day (August 31^st). The take home message of the letter emphasizes Obama’s support for overdose initiatives and announces the release of the new toolkit on opioid overdose. As the letter states:

“This toolkit builds upon our efforts to expand prevention and treatment. It also promotes the use of naloxone, a life-saving overdose reversal drug which we believe should be in the patrol cars of every law enforcement professional across the nation. Please join us in spreading the word about overdose prevention by sharing a link to this toolkit on your social media platforms.”

Let’s be clear about one thing: in the slow-moving world of drug policy reform, this is a major step forward. Prior U.S. administrations condemned the use of naloxone to treat opioid overdoses and this one supports it use. In fact, check out the outgoing head of the ONDCP Gil Kerlikowske’s interview with the Washington Post. Kerlikowske mentions the importance of naloxone in this interview and talks about the necessity of evidence-based drug policy reform. This interview comes on the heel’s of yesterday’s announcement that the U.S. Federal government will allow marijuana legalization laws to proceed in Colorado and Washington.

I don’t want to romanticize the US approach. That government still supports Plan Colombia, an expensive and wasted effort to eradicate coca growing. But change is definitely in the air.

Unfortunately, the Canadian federal government is nowhere near making similar pronouncements or providing any sort of open support for overdose prevention and treatment initiatives. The CDPC has written to Health Minister Rona Ambrose to emphasize the need for a national overdose strategy that includes harm reduction approaches like take-away naloxone programs. These programs train overdose witnesses to respond effectively to overdose and to prevent them from occurring in the future.

The math is simple on this one – these programs save lives, so why I ask is Canada now falling behind the US on these initiatives? International Overdose Awareness Day is an opportunity to honour those we’ve lost to overdose but it’s also a time to reflect on how we can do better in Canada.

August 30, 2013
How a Prorogued Parliament Could Help Harm Reduction

Today the Conservative government prorogued the Canadian parliament. What this means is that the current legislative agenda, on hold when parliament recessed for the summer, is now dead. This move does not come as much of a surprise given the recent cabinet shuffle that signaled some shifts in direction for the current government, and prorogation will give them a chance to reboot its legislative and parliamentary agenda.

This is potentially good news for those of us who have been watching the progression of Bill C-65 (Respect for Communities act). The extensive provisions of Bill C-65 promised to make it more difficult to implement new supervised injection services in Canada because of the myriad levels of approval that service providers would need to demonstrate in their applications (potential service providers must make an application to the federal Minister of Health for an exemption to the Controlled Drugs and Substances Act if they wish to shield clients and staff from potential drug charges). Now that Bill C-65 is dead it gives us some breathing room to continue to work on getting more supervised injection services in Canada.

But dead does not necessarily mean buried. The CDPC will be watching closely when the Harper government announces its new legislative agenda in the fall. There’s always the chance the Harper government could reintroduce the bill in either its current form or as a revised attempt to muzzle harm reduction in Canada. Stay tuned. You know we will be.

In the meantime, September 30, 2013 (9/30) is the second anniversary of the Supreme Court of Canada’s decision that allowed Insite (Vancouver’s supervised injection site) to stay open. The CDPC is working with our partners across the country to encourage local groups to host events and activities that mark this important occasion and raise the profile of safer consumption services in Canada. We hope you will join or help organize one of these events in your community.

For organizations: Consider creating a mock injection site open to the public and the media and ask local supportive nurses to be on hand to answer questions. You might also want to do something simple like creating a media release making the case for these services in your city.

For individuals: Send a letter to the local paper expressing your dismay at the lack of support for safer consumption services in your region or write an editorial for you local paper and along the lines of the letter suggested above. Visit your local MP, mayor, or other politicians and make the case for these services in your community. Let them know that the safety and health of every member of your community is important and that’s why you support these services. And don’t forget to the write letters to the Prime Minister’s Office expressing your concerns about the lack of federal support for harm reduction services.

We are creating a tool kit of ideas for this day so contact Connie Carter if you would like more information.

August 19, 2013
The Harm Reduction debate: Political Expedience vs Progress

On June 24th, the Urban Health Research Institute released a report on 15 years of data on drug use in the city of Vancouver. The results of their analysis are significant, but predictable to those who work in the field – harm reduction has saved lives and led to a decrease in drug use, while the war on drugs had failed to do either.

Since the mid 1990’s, the number of people sharing needles has fallen dramatically while usage of needle exchange services and methadone treatment programs has increased. This means that far fewer people are getting HIV and Hep C from drug use and fewer are dying of overdoses because of services like Insite. Such would not have been possible without key champions and advocates from across the spectrum including health, municipal, and police officials, and of course organizations of people who use drugs including VANDU.

An equally apparent takeaway from this report is that the “war on drugs” in Vancouver has completely failed to meet any of its objectives. Data from the same 15 years shows that despite the millions spent on drug enforcement and interdiction, drug availability and pricing has remained unaffected and stable.

The findings in this report also illuminate the many misperceptions about harm reduction services that we often see in the media. One such misperception is that harm reduction services are somehow the opposite of abstinence-based drug treatment. In fact, when people access harm reduction services, including unused drug use supply distribution and methadone, they are often taking the first step towards abstinence and recovery.

The Conservative Party of Canada is capitalizing on these misperceptions to support and promote the introduction of Bill C-65, the Respect for Communities Act. This legislation, if passed, will make it more difficult to set up life-saving supervised injection services in other parts of the country and is part of a sustained attack on harm reduction programs by the government’s National Anti-Drug Strategy.

We know from talking with people from across the country, that many Canadians are concerned about this hostility to well-established harm reduction services, which are supported by organizations such as the United Nations Office on Drugs and Crime, UNAIDS, and the World Health Organization.

It’s time to take a deeper look at the myths about harm reduction and expose them for what they are – politically expedient and uninformed dismissals of well-researched and successful health care services. It comes down to a rather obvious choice: Do we want people to use drugs openly in our streets or in other unsafe and unhygienic conditions, or do want to provide services that have shown to engage people in life-saving health care and drug treatment? It’s as simple as that and the Urban Health Research Institute’s report underscores this point with a wealth of data.

Harm reduction services are based on a pragmatic, non-judgmental approach to the provision of health services that respects the dignity of people who use drugs and values their human rights. Because these services have minimal requirements for involvement, they are often the first points of entry to other health and social services.

Harm reduction is not the only approach to problematic substance use but it is a major means of preventing the transmission of disease, overdose and death, connecting people to services and opening a pathway to change. These services have key secondary benefits such as increased access to health services, housing referrals, referrals to drug treatment, counseling, education, and testing for HIV and HCV.

So next time you hear politicians saying they favour drug treatment over harm reduction consider the possibility that these services are part of the same continuum and ask them why they keep repeating these myths despite the existence of so much evidence to the contrary.

July 5, 2013