A man injects street drugs in an alley in Vancouver's Downtown Eastside on April 7, 2020.JESSE WINTER/Reuters
British Columbia has wrestled down the coronavirus pandemic better than most places, and much of the credit has rightly gone to Bonnie Henry, the province’s Provincial Health Officer.
B.C. was ready early, with a diagnostic test developed by mid-January. The province was also hit early, with some of Canada’s first cases brought home by travellers; Canada’s first recorded case of community transmission and its first nursing home outbreak; and the country’s first COVID-19 death, on March 9.
Yet within a matter of weeks, B.C. had corralled outbreaks in long-term care homes, and the rate of new infections, after rising, fell to low levels and remained there. Compared with Ontario and Quebec, B.C. today has a fraction of the cases and deaths.
But as B.C. succeeds against one public health threat, the province continues its long struggle against another. Thousands of British Columbians have died, and are still dying, of drug overdoses.
It’s been four years since a provincial health emergency was declared. Last year, the situation appeared to be improving, but this spring saw a brutal reversal. In March, illicit drug toxicity killed 112 people. In April, 117 died. That death toll exceeds the 165 people in B.C. who have died of COVID-19.
As society shut down during the pandemic, the risk for people who use drugs jumped. Access to services such as shelters, treatment and supervised consumption sites was limited, and still is. People became isolated. The toxic supply of street drugs, most tainted with fentanyl, worsened.
Canada’s Chief Public Health Officer, Theresa Tam, on Monday warned of fatal overdoses, and that danger goes far beyond the West Coast. In Toronto, 25 people died from overdoses in April, the worst tally in almost two years.
There may someday be a vaccine for COVID-19, but we doubt that humanity will ever be able to eliminate addiction, or its debilitating and deadly consequences. There are, however, approaches that show promise in mitigating addiction’s worst effects – if Canada is willing to take bold steps, as the country has against the novel coronavirus.
Dr. Henry and B.C. are at the fore. Years ago, the province was the first to open supervised drug consumption sites, where people can use their own drugs with medical supervision. It was a radical idea at the time, but it’s now a proven pillar in harm reduction. It is health care, and it saves lives.
Last year, Dr. Henry urged the decriminalization of illicit drugs. That will strike some people as crazy, but it is an approach endorsed by many experts, which is why this page has backed it.
Decriminalization does not mean drugs for sale at the corner store. What it means is people who use drugs would not fear arrest for possessing small amounts for personal use. It’s a recognition that addiction is fundamentally a health issue, not one of criminal justice.
While the move to decriminalize lags, there has been progress on a related front: Access to a safe supply of drugs.
In response to the pandemic, Health Canada and the B.C. government have made changes to broaden medical access to clean opioids such as hydromorphone. Previously, people with entrenched opioid-use disorders could get prescriptions from a doctor to use such drugs under supervision.
Now, people at high risk can access these drugs to use them outside a clinical setting. It is, so far, a temporary measure. Although some doctors have adjusted slowly to the changes, several hundred people have benefited. Dr. Henry wants B.C. to further improve access. Yes, some people will wonder how providing addicts with legal opioids can possibly make sense. But like supervised consumption, a safe supply shows promise as a method to save lives.
There is no single answer to the overdose crisis. A safe supply is not itself a treatment for drug addiction, but it does at least allow someone to stay alive and have a shot at getting treatment. Decriminalization likewise is not, on its own, a cure for addiction. But both approaches can save lives, and in a deadly epidemic, saving the greatest number of lives has to be society’s bottom line.
B.C. is taking the lead in experimenting with these new approaches. The province should continue to do so, by following Dr. Henry’s prescriptions. If B.C. can show progress against this deadly epidemic, as it did with COVID-19, it will be a model for the rest of the country.
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