How Bad Does the Overdose Crisis Have to Get Before Leaders Make It a Priority?

The 2019 federal election was a bitter pill for people who care about the overdose crisis. This national public health emergency wasn’t a major issue for most political parties — or barely a medium one — in spite of the horrific overdose death toll, which has been relentlessly climbing since 2016.

Between January 2016 and March 2019, an estimated 12,800 Canadians died from an opioid-related overdose. That number is now well above 21,000, and it’s likely 2021 will be the deadliest year on record for overdose deaths.

I care deeply about this matter, having lost my 24-year-old son Simon to opioids in 2017. And I despaired during the 2019 election because it felt like we were a long way from getting our elected representatives to take this health emergency seriously.

At the time, I wrote a piece for The Tyee outlining what the federal parties were promising to do about the overdose crisis. Most party platforms promised little. Some didn’t even mention the crisis.

Even so, I was hopeful this time round. Over the last two years, support has grown for ending the failed war on drugs and shifting to a more health-centred approach to problematic substance use — employing measures such as decriminalization to reduce stigma, and safe supply to decrease toxic drug deaths.

Today there is strong support in Canada for decriminalization of drug possession for personal use.

Organizations representing people who use drugs have endorsed this move. So have quite a few public health officers and more than 180 organizations. In addition, close to 50 municipalities — from Daniel’s Harbour, Newfoundland, to Victoria, B.C. — have passed resolutions in favour of decriminalization, or at least consideration of it.

Ontario’s big city mayors have called for it too. And a majority of Canadians (59 per cent) are also onside, according to an Angus Reid poll released in February.

Even the Canadian Association of Chiefs of Police thinks decriminalization for simple possession is the way to go. It’s on record as saying it would be “an effective way to reduce the public health and public safety harms associated with substance use.”

To be sure, decriminalization is not “a magic bullet,” as politicians are fond of saying. But it is a tool in the toolbox — an important one that can help society move towards treating problematic substance use like a health issue rather than a shameful crime.

That said, decriminalization will not do much to stop thousands of Canadians from dying of toxic illicit drugs each year. It may be hard for some people to accept, but there is only one sure way to stop these deaths: by ensuring that people who use drugs have a safe supply of them.

Safe supply is an essential harm reduction tool which keeps people alive. It is not possible to offer treatment and other supports to people who are dead.

Providing a toxic-free supply of drugs can be done through a variety of programs, policies and projects, or more systematically and effectively through legal regulation. At present, alcohol, tobacco and cannabis are legally regulated in our country. Opioids and other substances could be too, with clear controls to manage who has access, to which drug, and through what means. There could be different rules for different substances, based on evidence-based assessments of harms and benefits.

The possibility of legally regulating drugs has not received as much attention as decriminalization, but there is growing support for taking or considering this move from municipalities, public health workers, drug policy experts, and organizations representing families affected by substance use, such as Moms Stop the Harm.

So where do federal parties stand on all this?

The following summaries analyze party positions in regard to the overdose crisis, including issues such as decriminalization and legal regulation, if mentioned. This information was drawn from election platforms and online reports from media and by key organizations.

Liberal Party of Canada

The Liberal party platform is a bit more detailed than it was in 2019 and includes funding figures. It points out that its government has already invested more than $600 million to address the overdose crisis, including $182 million for the Substance Use and Addictions Program. The Liberals further promise to:

• Introduce a comprehensive strategy to address problematic substance use to end the opioid crisis;
• Invest $25 million for public education to reduce the stigma associated with problematic substance use;
• Invest $500 million to support the provinces and territories in providing access to a full range of evidence-based treatment, recognizing that successful treatment is not determined by long-term abstinence;
• Support provinces and territories in creating standards for substance use treatment programs so that Canadians can access quality and evidence-based support when they need it most;
• Support the many lower-risk and first-time offenders by reforming the Criminal Code to repeal relevant mandatory minimum penalties, and requiring police and Crown prosecutors to consider diverting individuals out of the criminal justice system.

The Conservative Party of Canada

The Conservative platform says the party will “tackle the opioid epidemic and help Canadians struggling with addiction.”

Recovery is the Conservatives’ overarching goal, as it was in 2019. However, the party has added harm reduction as an objective this time around and says it will treat the opioid crisis as a health issue. The party’s focus on recovery has been criticized for ignoring the crux of the overdose crisis — the fact that people are dying from drug poisoning. Recovery programs cannot reverse fatalities.

When asked about safe consumption sites and decriminalization for simple possession at a press conference, Leader Erin O’Toole indicated he would not stand in the way of the sites, but did not express support for decriminalization, choosing instead to say that he would like to see “more judicial discretion” for people who use drugs. The Conservative platform also promises to:

• Invest $325 million over the next three years to create 1,000 residential drug treatment beds and build 50 recovery community centres across the country;
• Support innovative approaches to address the dual crises of mental health challenges and addiction, such as land-based treatment programs developed and managed by Indigenous communities as part of a plan to enhance the delivery of culturally appropriate addictions treatment and prevention services in First Nations communities;
• Partner with the provinces to ensure that naloxone kits are available for free across Canada.

Green Party of Canada

The Green party platform is much more comprehensive when it comes to substance use than it was in 2019. It promises that the party will:

• Declare the drug poisoning crisis a national public health emergency;
• Decriminalize possession of illicit drugs for personal use and legislate this change;
• Create a national safe supply of drugs of choice;
• Invest in an integrated system of decriminalization and access to meaningful services for those persons who are seeking treatment;
• Provide amnesty for those convicted of simple possession of cannabis;
• Move to legally regulate currently illegal drugs based on the best available evidence regarding harms and benefits as a step towards treating problematic drug use as a health issue, as is the case with alcohol and tobacco.

There are additional details about each commitment in the platform.

New Democratic Party

The NDP platform says “there is much more we can do to save lives and support those struggling with opioids,” although it offers up almost exactly the same commitments the party made in 2019. There is one significant addition relating to safe supply.

The NDP platform promises to:

• Declare a public health emergency and commit to working with all levels of government, health experts and Canadians to end the criminalization and stigma of drug addiction;
• Work with the provinces and health professionals to create a safe supply of medically regulated alternatives to toxic street drugs, support overdose prevention sites and expand access to treatment on demand for people struggling with addiction;
• Launch an investigation into the role drug companies may have played in fuelling the opioid crisis and seek meaningful financial compensation from them for the public costs of this crisis.

While the NDP commitment to end criminalization is somewhat vague, the party has been much clearer about its intentions in a letter to an advocacy group, stating that “a New Democratic government will introduce legislation to decriminalize substance use in Canada and expunge criminal records for possession.”

The letter also says that, if elected, the party would “work with the provinces and territories to extend low-barrier access to a safe supply of regulated substances to every region of the country,” and move “towards a consistent framework for regulating substances through evidence-based assessments of their potential harms.”

Bloc Québécois

The Bloc Québécois platform does not mention the overdose crisis. It didn’t in 2019 either. However, the party is on record as supporting legal regulation and says it is prepared to support a bill decriminalizing simple drug possession, “in order to allow an exhaustive study in committee.”

On decriminalization and legal regulation

The NDP and Greens support decriminalization and would legislate this change rather than relying on ad hoc or discretionary measures that fall short of full decriminalization. The Bloc would support a decriminalization bill in order to allow for further study.

The Liberal government indicated it was deliberating over decriminalization after the Canadian Association of Chiefs of Police came out in favour of it. But that was a year ago and there is nothing in the current platform to suggest the party intends to go down this road or fund overdose crisis measures in a way that would make a difference. The Conservatives do not support decriminalization.

The Green party and Bloc have indicated they support legal regulation. The NDP has promises to move towards regulating substances, although it is not clear how the party would go about this. Would it support more projects and programs or pass legislation? The strategy is not outlined.

A few final thoughts

Liberal and Conservative thinking on this crisis hasn’t really changed much. Both parties are sticking with drug policies that aren’t working. Meanwhile, thousands of Canadians continue to die each year.

It’s good to see stronger or clearer positions on decriminalization from the NDP, Greens and Bloc, as well as movement on legal regulation, but will these parties endeavour to boost the profile of this health emergency in Parliament? The overdose crisis wasn’t really a big issue for any of the parties during the last session.

At this point, I’m wondering what it’s going to take. Overdose deaths since 2016 will likely surpass COVID-19 deaths in the next year. Will that be enough to make the overdose and drug poisoning crisis more of a priority for federal politicians? Or do we need to surpass the 1918 Spanish flu death toll of 50,000?

How bad does it have to get before our elected representatives put this health emergency at the forefront of their agenda and do everything in their power to reform our failed drug policies to save lives?