heroin at the corner store - microsoft · count the costs (2016) transform drug policy foundation....

January 23rd, 2017

Heroin at the Corner StoreRotary Club of Vancouver

Illicit Overdose Deaths and Rate per 100,000

January 1, 2007 – October 31, 2017. BC Coroners Office, 2017.

The United Nations Gang Photo: The Vancouver Sun (January 17, 2012)

The Bacon Brothers

1000 Crosses, Oppenheimer ParkPhoto: Elaine Brière

Insite (Interior)Vancouver Supervised Injection Site

Mayor Nenshi “Nails It”

No fan of supervised injection sites, Calgary’s Mayor Naheed Nenshi, describes SCS:

“I find that they almost feel like an admission that we’re not able to solve the problem, but that said, my personal

feelings aside, the evidence is absolutely clear. Absolutely clear. They save people’s lives, and our job today has to be to

save people’s lives.”

—CBC News (March 3, 2017)

9

Overdose Deaths per 100,000

10


11


12


13


Resilience is the capacity to deal with change

and continue to develop.“…the ability of human communities to withstand and recover

from stresses, such as environmental change or social, economic or political upheaval. Resilience in societies

and their life-supporting ecosystems is crucial in maintaining options for future development.”

—Stockholm Resilience Centre, definition of Social Resilience

Resilience and Adaptability

Price, Purity and Investment

Public Health ApproachHe

alth

and

Soc

ial P

robl

ems

Strict Legal Regulation

HeroinCocaine

ProhibitionProhibition with harm

reduction/decriminalizationLight Market Regulation

CommercialPromotion

CannabisMethamphetamine

Tobacco

Alcohol

Criminal Profit Corporate Profit

Public Health

The Harms of ProhibitionCriminal Profit

Undermines development and security, fuels conflict

Threatens public health, spreads disease and death

Wastes billions on drug law enforcement

Creates crime and enriches criminals

Promotes stigma and discrimination

Deforestation and pollution

Undermines human rights

Count the Costs (2016)Transform Drug Policy Foundation

The Harms of Corporate PromotionCorporate Profit

Industry-funded research discredits scientific findings about health dangers

Maximizes profit through promotion and misleading safety info

Imperative to expand markets and target specific populations

Cannabis corporate profits (to be determined)

J. Drope, S. A. Bialous, S. A. GlantzTobacco Control, British Medical Journal (2004)

A Public Health ApproachReduces the Harms of Prohibition and Corporate Promotion

Public Health

Use of psychedelics in therapeutic contexts

Prescription of heroin and stimulants

Decriminalization (Portugal, 2001)

Regulation (cannabis, 2018)

Drug checking

Health Officers Council of BC (2011)

Public Health ApproachHe

alth

and

Soc

ial P

robl

ems

Strict Legal Regulation

HeroinCocaine

ProhibitionProhibition with harm

reduction/decriminalizationLight Market Regulation

CommercialPromotion

CannabisMethamphetamine

Tobacco

Alcohol

Criminal Profit Corporate Profit

Public Health

Responses Avail. for Illegal Drugs(Limited)

Enforcement

Education and awareness

Socially stigmatizedthrough criminalization

Treatment and Harm Reduction

Presenter

Presentation Notes

Enforcement on importation, manufacture, distribution and possession Education and awareness Socially stigmatized Treatment Prevention

Regulation of CannabisAge

Degree of intoxification

Volume rationing

Limited places to use

Required training prior to use

Maximum volumes for purchase and possession

Training of supplier

Monitoring of use with driving

Illegal dealers pursued by enforcement

Retail outlets licensed and limited

Appearance of retail outlets

Taxed

Licensing, location and opening hours of consumption facilities

Socially stigmatized

Prevention programs

Treatment

Plain packaging

Warning labels

No advertising or event sponsorships

Presenter

Presentation Notes

The principle of normalisation was developed as a reaction to these dehumanizing policies. There are several different formulations, includingpromoting independence and autonomy;making it possible for people with learning disabilities to have an ordinary life;giving people with learning disabilities the same choices and opportunities as everyone else; andaccepting and valuing what people with learning disabilities can do. [11]Normalisation was a key element in movements both for education and for empowerment. Age Degree of intoxification Volume rationing Limited places to use Required training prior to use Maximum volumes for purchase and possession Training of supplier Monitoring of use with driving Illegal dealers pursued by enforcement Retail outlets licensed and limited Appearance of retail outlets Taxed Licensing, location and opening hours of consumption facilities Socially stigmatized Prevention programs Treatment Plain packaging Warning labels No advertising or event sponsorships

Regulation of HeroinAge

Degree of intoxification

Volume rationing

Limited places to use

Required training prior to use

Registration of purchasers

Licensing of users

Tracking of consumption habits

Drug consumed on location of sale

Prescription only

Maximum volumes for purchase and possession

Training of supplier

Monitoring of use with driving

Illegal dealers pursued by enforcement

Retail outlets licensed and limited

Appearance of retail outlets

Pharmacy specialist required

Price and profit controls

Taxed

Licensing, location and opening hours of consumption facilities

Socially stigmatized

Prevention programs

Treatment available

Plain packaging

Concentration of product is restricted and labeled

Warning labels

No advertising or event sponsorships

Clean needles and health informationprovided with purchase

Presenter

Presentation Notes

Fears about this model increasing the prevalence of use have not been observed. Paper in Lancet looking at Zurich that showed heroin prescription was associated with a reduction of new heroin users and improved health and social conditions for existing heroin users. Also data coming out of Portugal that demonstrated that the sky didn’t fall when they decriminalized all drugs

Consumers Union Report 1972

“On the central issue of narcotics addiction, accordingly, Consumers Union recommends (1) that United States drug policies and practices be promptly revised to insure that no

narcotics addict need get his drug from the black market; [...];(3) that other forms of narcotics maintenance, including opium, morphine, and heroin maintenance, be made avail-able along

with methadone maintenance under medical auspices on a carefully planned, experimental basis.”

—Consumers Union Report on Licit and Illicit Drugs (1972)

Vince Cain Report 1994

On legalization:

“Canadian laws and United Nations conventions control this matter, but that ought not detract from the reality of the situation in British Columbia. We have the problem, and we must do what we can about it, now. Consequently, I am recommending the establishment of a commission to examine and challenge

those legal aspects of the problem, […].”

—Report of the Task Force into Illicit Narcotic Overdose Deaths in British Columbia, Office of the Chief Coroner (1994)

Vince Cain Report 1994

“The problem must be looked at with regard to not only the aspect of deaths from heroin and cocaine, but rather the entire

smorgasbord of available illicit narcotics, both so-called ”soft” and “hard” drugs. Simultaneously, I am recommending the

decriminalization of simple possession of specific “soft” and “hard” drugs, […].”

—Report of the Task Force into Illicit Narcotic Overdose Deaths in British Columbia, Office of the Chief Coroner (1994)

City of Vancouver 2005

“Recommendation 24: That the Federal Government initiate a process of reviewing Canada's legislative, regulatory and policy frameworks governing illegal drugs with regard to their effecti-

veness in preventing and reducing harm from problematic drug use and their effectiveness in enabling municipalities to better address

the harm from the sale and use of these substances at the local level AND establish a process with broad participation to consider

regulatory alternatives to the current policy of prohibition for currently illegal drugs.”

—Preventing Harm From Psychoactive Substances (2005)

Lancet Commission 2016

“Decriminalise minor drug offences—use, possession, and petty sale: The long experiences in Portugal, the Czech Republic, and other countries with decriminalisation of minor drug offences

demonstrate the benefits of treating minor infractions without recourse to criminal sanctions.”

—Lancet Commission on Public Health and Drug Policy (2016)

Lancet Commission 2016

“Scientific approach to regulatory experiments: We believe that the weight of evidence for the health and other harms of criminal markets and other consequences of prohibition catalogued

in this Commission is likely to lead more countries (and more US states) to move gradually towards regulated drug markets—a

direction we endorse.”

—Lancet Commission on Public Health and Drug Policy (2016)

British Medical Journal 2016

“Evidence and ethics should inform policies that promote health and respect dignity. It is no surprise, then, that

(there have been calls for reform, including from the World Health Organization, UNAIDS, the UN Development

Programme, and the UN human rights agency, as well as non-governmental organisations, former heads of

state, UK parliamentarians, some law enforcers, and medical journals.)”

—The war on drugs has failed: doctors should lead calls for drug policy reform (Nov 14, 2016)

• Acknowledge the catastrophic failure!

• Stop pretending that more of the same will work!

• Mount a true emergency response - replace the toxic drug supply through public health mechanism

• Stigma a big problem – then decriminalize

• Support safe tables for collaboration on alternative regulatory approaches.

• Engage the brightest minds in creating a new regulatory system. We can do it!

Governments Need to:

Thank you!

drugpolicy.ca

heroin at the corner store - microsoft · count the costs (2016) transform drug policy foundation....

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