Health-Centred Approach to Substance Use Bill
Bill to Amend--Second Reading--Debate Continued
February 14, 2023
Honourable senators, I rise to speak in support of Bill S-232. I would like to start by commending the sponsor, Senator Boniface, for the hard work that went into crafting the bill, and I would like to note it was first read in this chamber on December 7, 2021.
It’s time to reframe the problem. For decades, there has been a futile debate about whether self-destructive drug use is a criminal problem or a medical problem. I hope that it can now be clear that it is neither — it’s a political problem. This is from Drugs and Drug Policy in Canada: A Brief Review and Commentary by Diane Riley, PhD, that was prepared for our late and great friend the Honourable Pierre Claude Nolin.
I believe it is important for us to understand the life of an addict. First of all, you have to raise the cash. You’re a sex trade worker. You’re breaking into cars. You’re breaking into houses. You’re strong-arming other people, including addicts, but you put the cash together. Then you have to score. You have to go out and find your seller. You have to scramble through the streets and through the alleys to try and find that one person who will sell the drugs to you. This is not the movies. This is not where everybody is shiny and clean. They’re dirty. They’re smelly. The seller you’re buying from is an addict. That person has no idea what’s in the drugs that he or she is selling to you. And, finally, you get to shoot. You go to an alley, a single room, a washroom. Sometimes you suck up water from puddles into your syringe because that’s the fastest way to get that into your arm.
There’s no messing around here. Once you have the drug, you want to use it immediately. If not, you may get stopped by the police or robbed by other addicts for your fix.
To be clear, in my experience, it is rare for a street police officer to arrest a user. But they’re obligated by law to seize the drugs that that user has, and for the addict, this just restarts the process.
This is not recreational drug use. This is not smoking a joint on Saturday night at the nightclub. This is not having a drink with your friends. It’s an addiction.
Addicts are People of Sand. They have no connections with their roots and no connections with the past or future . . . they live in the moment, in the now . . . they need structure and comprehensive total assistance . . . until we deal with the emotions, everything else is short-term.
This is the opening statement from John Vincent Cain, my predecessor as Chief Coroner for the Province of British Columbia. He was tasked to report on illicit narcotic overdose deaths in British Columbia, and the report was released in September of 1994.
It is quite literally a road map on how to deal with overdose deaths. I quote specifically recommendation 61:
I therefore RECOMMEND THAT the Ministry of Attorney General:
61. Enter into discussions with the federal Ministers of Justice and Health on the propriety and feasibility of decriminalizing the possession and use of specified substances by people shown to be addicted to those specifying substances;
Thirty years/Where’d they go?/Thirty years/I don’t know — to paraphrase a song by Bob Seger.
Decriminalization is not some recent concept. Thirty years ago, when B.C. went from 39 deaths in 1983 to 331 deaths in 1993, the task force was set up.
I was the Vancouver coroner during those years. In 1993, I thought nothing worse could possibly happen, but it did.
In 2001, decriminalization was implemented in Portugal. All reports demonstrate positive results. I recognize that Portugal and their health care system and justice system are way different from ours, but all reports from Portugal are positive. All reports show deaths dropping, the number of people going before the courts decreasing rapidly and the number of people in prison going down.
Finally, British Columbia decriminalized drugs via a health care exemption starting January 31. We don’t know how that will go, but we at least are out there trying.
In all the other provinces and territories, existing laws about illegal drugs apply. Is it a great stretch that this law should apply across the nation? I suggest not, but we all know we’re in the unique position of having 13 separate, independent, individual health care authorities in Canada, each responsible independently, again, of how health care is applied.
While addiction is a national emergency, many provinces have neither the ability nor the will to step into this political morass. It is incumbent upon the federal, provincial and territorial governments to overcome this constitutional issue in favour of life.
The benefits of decriminalization: For this, I give my thanks to the Canadian Healthcare Network and, in particular, Alissa Greer and Caitlin Shane for their report on decriminalizing drug use. It changes the way we think about drugs. It moves from a legal framework to a recognition that addiction is a health and social issue.
This idea, in some people’s minds — somebody wakes up some morning and says, “You know what? I think I’ll shoot up some heroin. That seems like a good idea. And you know what? I think that I’ll quit school, and I’ll leave my house, and I’ll go into the depths of our cities and towns and lead a life of abject poverty, disease and, in many cases, mental illness.”
I know thousands of people who are addicted. Not a single one has ever said, “Damn, that was a decision that I made, and I wouldn’t change it.” Not one.
How will this decriminalization affect us? For starters, it will save us a ton of money because we spend so much money on police, courts, prisons, our social workers and our clinics, and everyone is overworked.
I had supper a couple months ago at Firehall #3. Their T-shirt says, “This isn’t hell, but we can see it from here.” It’s right in the Downtown Eastside. I had supper with these men and women, and we never finished supper because the bells kept going off and they kept calling out. One of them said to me, “I saved the same person five times, and you know what? I’m losing my humanity.”
Decriminalization in Portugal has reduced the demands on and the costs to the system — health care, emergency rooms. When we opened the one supervised injection site in Vancouver, I was stupid: I should have opened 20 of them when I had the chance. When we opened it, visits to St. Paul’s Hospital emergency ward dropped dramatically because we were dealing with them on the site — bruises, infections, you name it. But we had nurses there, and they could deal with them, and they weren’t having to go to the emergency room. That money can be spent in so many other ways — health care clinics, more doctors, more treatment, more care.
Decriminalization positively impacts people’s lives. The vast majority of the addicted are mentally ill, poor, homeless, racialized, abused — you name it, and it’s happened to these people, over and over again.
Fewer criminal records means that at some point the addict will not be stigmatized with a criminal record for what is a health issue and may be able to get a job. Decriminalization, with an understanding of the good Samaritan law that we passed here, will reduce the fears that many still have about calling emergency services in an overdose situation. Decriminalization is harm reduction.
There’s a fear that drug use will increase if decriminalization comes into effect. I go back to what I said earlier: “This seems like a good idea, why don’t I just go down and crank a little bit of heroin.” This is not supported by evidence, and in fact, in most instances, the drug use has decreased. Decriminalization is not a silver bullet, and in fact, as I learned from the supervised injection site, there is no silver bullet when it comes to addiction.
If we choose not to move in this direction, what is the result? Think of these cities: Whitehorse, Yukon Territory; Orangeville, Ontario; Port Moody, British Columbia; Saint-Constant, Quebec; Cochrane, Alberta; Corner Brook, Newfoundland; New Glasgow, Nova Scotia; Yellowknife; two thirds of the population of Nunavut; Dieppe, New Brunswick; Moose Jaw, Saskatchewan; Brandon, Manitoba; and Summerside and Stratford, in Prince Edward Island. You may ask: What do these Canadian cities have in common? Nothing, except their population.
Imagine, if you will, that any one of these cities disappears — gone, no more. Each city relates approximately to the number of people who have died between January 2016 and June 2022 from opioid toxicity.
People respond to numbers, so here are a few more: In 2016 there were eight deaths per day in Canada. In 2018, there were 12 deaths per day in Canada. From January to June 2022, there were 20 deaths per day — virtually one every hour, every day, every week, every month — 32,632 people gone. Mothers, fathers, sisters, brothers, aunties, uncles, friends — gone right here in this country that we love and we’re so proud of.
Passing this bill won’t stop addiction. Passing this bill will stop the criminal effects of addiction. Passing this bill will send a message to the other place that we will not let this issue die. I urge you to find it in your hearts to move this bill forward with the urgency it demands.
Finally, honourable senators, this will be my last speech in this most amazing of places. I requested no tributes, and I will not speak other than now. I will miss this place, the friends I’ve made, the experiences I’ve had and the feeling this place makes a difference. I leave the Senate knowing that more than ever it has a role in the governing of Canada, that this place constructs bills, examines and amends bills that make Canada a better place. This is and will be the chamber of sober second thought. God speed to all of you. Thank you.
Senator Campbell, would you take a question?
Absolutely.
I wish I had more time, because I know you don’t want tributes, but Senator Campbell, you just established exactly why your presence here has been so vitally important.
Thank you for the years and years of work that you put into this. Thank you for inspiring Da Vinci’s Inquest, which brought it home to many people in ways they might not otherwise have known about. And thank you for all the work I know you’ll continue to do. I suspect my time is up, so I want to ask: Why is this your last speech?
It’s a classic example of ageism.