the radical plan to tackle British Columbia’s overdose epidemic

By | March 7, 2024

When Traci Letts finally found the perfect shoes for her son Mike — a pair of white Nike sneakers with a hint of green — the store didn’t have the right size. So she went to another.

“They had to be just right,” she said. “He always wanted to dress well.” The high-tops completed an outfit Letts had carefully selected: a gray tracksuit with a white T-shirt; they would be the last set of clothes he would wear. “I knew he would want to steer that way.”

Related: ‘Takes police out of the lives of drug users’: Decriminalization drive takes effect in Canadian province

Mike, whom she remembered as the “kindest and sweetest” of her three children, died Feb. 3 of a toxic overdose. He was 31 years old.

Canada’s westernmost province is caught in an unprecedented public health crisis that has torn families apart and killed nearly 14,000 people due to contaminated, unregulated narcotics.

As grief and frustration mount, two activists are poised to challenge the federal government in a British Columbia court, arguing that they should be allowed to supply pure drugs to users.

Their protracted legal battle has highlighted the widening scale of a national catastrophe – and the increasingly desperate steps activists are taking to stop preventable deaths. When they appear in court Thursday, Eris Nyx and Jeremy Kalicum will argue that Canada’s public health agency is ill-equipped to respond to the unfolding disaster — and that radical action is needed to prevent people from dying.

British Columbia’s opioid toxicity crisis first emerged around 2015, when synthetic forms of opioids and benzodiazepines began appearing in recreational drugs. The phenomenon reflected a global trend of using psychoactive substances to increase shipments and increase the potency of heroin, cocaine and methamphetamines. After more than 500 deaths, the province declared a public health emergency the following year.

Last year was the worst ever, with authorities in British Columbia recording 2,539 suspected overdoses, the vast majority involving fentanyl or fentanyl analogues in their bodies.

Engulfed by a crisis with no clear end, community groups in downtown Vancouver’s east side — where the fatal overdose rate is nearly 30 times higher than the national average — have grown increasingly desperate.

In 2022, the Drug Liberation Front announced it would offer pure cocaine, methamphetamine and heroin to users as part of a “compassion club” to prevent overdose deaths.

“If you label people’s medications in a way that clearly states what someone is putting into their body, people won’t overdose,” Eris Nyx, co-founder of the group, told the Guardian at the time. “No one takes more than he intends to take.”

The group applied for an exemption from Canada’s Controlled Drugs and Substances Act so they could buy and sell drugs. With few options to legally purchase pharmaceutical-grade narcotics, the pair told the Public Health Service of Canada they had to purchase the drugs through the dark web.

This admission led to a rejection of the request.

But despite the legal setback, the activists continued to sell pure drugs at cost from their store on the east side of downtown Vancouver, in open defiance of the law. The experiment was aborted in October, after Vancouver police arrested Nyx and Kalicum (but did not lay charges).

On Thursday, lawyers for the pair will challenge Health Canada’s decision not to approve the exemption, arguing the decision leaves people who use drugs “fully and directly exposed” to the toxicity crisis and violates two clauses of Canada’s charter of rights and freedoms: the right to life and a right to equal protection under the law.

“The deprivation of the person’s life and safety is stark,” the legal team wrote in its submission, calling on the federal court to overturn the decision and allow them to resume drug sales.

The government recognizes the rising death toll from the crisis – and the need for new solutions. But for the government, illegal purchases via the dark web remain a step too far.

“Health Canada cannot tolerate and support serious criminal activity, even in the context of the toxic drug crisis,” the government wrote in its legal submissions.

British Columbia has decriminalized – but not legalized – the possession of small amounts of illegal drugs. There are also safe injection sites in Vancouver, which offer users a space to consume drugs while having the tools to test drug purity and reverse an overdose.

“People wonder why, with decriminalization, the number of overdoses continues to rise. And the answer is very simple and clear. That’s because the supply of drugs has become increasingly toxic,” said Thomas Kerr, a professor of medicine at the University of British Columbia. “We are in what I believe is the most catastrophic public health crisis we have seen in modern times in Canada.”

Nyx and Kalicum’s compassion club gave Kerr and his colleague Mary Clare Kennedy the opportunity to conduct what is believed to be the first-ever empirical, peer-reviewed study of the model.

After following 47 people for 14 months, researchers found that non-fatal overdoses fell by 49%. The number of non-fatal overdoses requiring naloxone, indicating the presence of fentanyl, decreased by 63%.

“Our research shows that this model is promising,” says Kerr. “It’s really a time to not simply repeat what we’ve done in the past. ”

Letts – who volunteers for the advocacy group Moms Stop the Harm – worries that misinformation and moralizing about the nature of addiction are barriers that no court decision can overturn.

“People say. ‘Well, he chose to live like this.’ No, he didn’t choose to live this way,” she said. “You don’t just wake up one day and decide to take an opioid. And even if you want treatment, there’s no magic wand you can wave .When people talk about treatment and recovery, what does that look like?”

For advocates and activists, recovery and treatment – ​​and preventing people from dying from toxic drugs – are two separate issues.

Last year, Conservative leader Pierre Poilievre sparked outrage during a visit to Vancouver when he described the city as “hell on earth,” angering residents who accused him of using a vulnerable community as a political punching bag.

Such rhetoric strips people who use drugs of their humanity, said Letts, who pointed out that narcotics are consumed throughout society.

The people dying are the children of lawyers and doctors. They are hockey players or baseball players. They are the parents who take their children to hockey and baseball. They are family men. They are women trying to get through the day and working two jobs.”

She remembers her son Mike as a hockey and baseball player, an animal lover and a quiet person who loved to cuddle.

“How do you describe what makes your child special? You can’t. It’s the moments together,” she said. “And I will miss that.”

Guaranteed safe delivery of medicine could have saved Mike’s life, she said. While the mounting crisis has dampened her hopes for systemic change, she nevertheless remains hopeful that the trajectory can change.

“In some ways, stigma is the leading cause of death in this country,” Letts says. “And most importantly, most families don’t understand that this could easily happen to them.”

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