Five Ways to End the Toxic Drug Crisis. From the Frontlines

Today is International Overdose Awareness Day, a day of collective grief, loss and solidarity. It is a day to look back at the last five years of the neglected public health crisis and reaffirm our commitment to putting an end to the preventable deaths.

It is a day to demand change from our leaders, especially the federal politicians seeking our votes.

The Harm Reduction Nurses’ Association is a non-profit organization that represents nurses and harm reduction advocates from across Canada. As part of our work, we see our patients die, and deal with the terrible toll these needless deaths are taking every day. We watch as families and communities struggle with loss and pain.

Our advocacy efforts are focused on ensuring the rights and dignity of people who use drugs — not only the patients we care for, but our friends, our families and ourselves.

From 2016 to 2020, over 21,000 deaths occurred in Canada due to a poisoned drug supply.

This is a crisis of injustice, with an inequitable distribution of deaths. For Indigenous people, racist and colonial policies have resulted in disproportionate rates of drug poisoning deaths, targeted criminalization and incarceration.

As harm reduction nurses, we bear witness to these deaths and the impacts on grieving communities across Canada.

The COVID-19 pandemic has contributed to an unbelievable intensification of drug poisoning deaths, with an increasingly toxic and unpredictable drug supply. It has also made life worse for people who use drugs, who face greater economic precarity and housing security and reduced access to health services.

The drug poisoning crisis is currently claiming the lives of 17 Canadians every day — about one death every hour and 20 minutes.

Over 6,200 Canadians died of overdose in 2020, a 60-per-cent increase from 2019. Data from the first few months of 2021 suggests that this rate shows no sign of decreasing; in some parts of the country, more people have died from the toxic drug supply than from COVID-19.

The federal election is an opportunity for political parties in Canada to devote the same attention and resources they allocated to addressing COVID-19 into ending deadly and misinformed drug policy.

The Harm Reduction Nurses’ Association calls on every federal party leader in Canada to endorse and commit to the following evidence-informed, ethical and pragmatic interventions.

Decriminalization

The ongoing criminalization of people who use drugs is rooted in colonization, racism and systemic oppression. Drug prohibition fuels the toxic drug supply, driving up the volatility and inconsistency of illegal substances.

As nurses working on the frontlines of this crisis, we see firsthand the harms generated through criminalizing drug use. The decriminalization of currently illegal substances is supported by a substantial body of national and provincial drug policy experts and scientists. It is time for all federal party leaders to make ending the war on drugs a priority in this election and beyond.

Safer supply

Nurses have a unique perspective on the inadequacy of pilot safer supply programs, which rely on medical diagnoses and prescription pads to address the toxic drug supply.

At present, safe supply is widely inaccessible even in provinces that have embraced the approach publicly. People who use drugs should not have to rely on a stigmatizing health-care system to obtain uncontaminated substances that may save their lives. A public health approach that does not subject individuals to prescriber gate-keeping would ensure equitable, low-barrier access to a consistent safe supply of drugs.

We call on federal party leaders to commit to a de-medicalized model for safe supply that centres and affirms the lives of people who use drugs.

National harm reduction support

Although health care has been enshrined as a universal right for all Canadians, access to harm reduction is under attack across Canada. Supervised consumption sites have been closed, or forced to rely on private donations.

Harm reduction services in Alberta in particular are being dismantled by a government keen to risk the lives of its people on the basis of ideology and rhetoric.

Life-saving programs like injectable opioid agonist therapy are rarely funded, and existing programs are at risk of losing funding.

We call on federal party leaders to tell Canadians how they plan to safeguard and expand harm reduction in provinces experiencing deadly regressive policies.

Indigenous-led, decolonized responses to the crisis

The criminalization of Indigenous people is intrinsically tied to the ongoing consequences of historical and current colonial policy in Canada. We are in a crisis of racism in the criminal justice system and health-care services, with few low-barrier options for culturally safe and Indigenous-led supports for on-reserve, rural and urban Indigenous communities.

We call on federal party leaders to describe how they will work with Indigenous people who use drugs and Indigenous communities on decriminalizing drug policy. Further, we ask party leaders how they will prioritize self-determining, Indigenous-led and developed harm reduction and support initiatives.

Listen to people who use drugs

Lastly, the Harm Reduction Nurses’ Association is committed to a spirit of collaboration with people who use drugs. They are the experts and should be given the means and support to lead us out of this devastating emergency.

People who use drugs are not adequately consulted, engaged and compensated for their invaluable experiences and insights. The Harm Reduction Nurses’ Association calls on federal party leaders to put an end to tokenizing behaviours and commit that all future policy development will include the people most impacted by that policy.

Today is International Overdose Awareness Day. The time for politicians and decision-makers to send their thoughts and prayers is over.

Every overdose death is preventable. Every overdose death is a policy failure.

Today we stand in unity with all those grieving the loss of a loved one and call on Canada’s leaders to put an end to toxic drug policy.

The Harm Reduction Nurses’ Association open letter was signed by more than 35 experts and 26 organizations across Canada working on drug policy reform and saving lives. For a full list, go here .