{"id":270538,"date":"2022-09-15T10:30:00","date_gmt":"2022-09-15T14:30:00","guid":{"rendered":"https:\/\/policyoptions.irpp.org\/issues\/funding-for-abstinence-based-programing-wont-combat-drug-toxicity\/"},"modified":"2025-10-08T00:01:44","modified_gmt":"2025-10-08T04:01:44","slug":"funding-for-abstinence-based-programing-wont-combat-drug-toxicity","status":"publish","type":"issues","link":"https:\/\/policyoptions.irpp.org\/fr\/2022\/09\/funding-for-abstinence-based-programing-wont-combat-drug-toxicity\/","title":{"rendered":"Funding for abstinence-based programing won\u2019t combat drug toxicity"},"content":{"rendered":"<p>In mid-August, <a href=\"https:\/\/news.gov.bc.ca\/releases\/2022PSSG0056-001250\">British Columbia<\/a>\u2019s provincial government announced that 10,000 people had died since 2016 by overdose from an unpredictable and poisonous supply of unregulated drugs.<\/p>\n<p>For many of us working or living in the epicentres of the crisis, these numbers have become somewhat abstract \u2013 but the associated death, grief and worry haunt our psyche. We wait for the next correspondence informing us that someone we know has been taken by the crisis.<\/p>\n<p>Meanwhile, the provincial and federal governments continue to slowly roll out a fragmented strategy, much of which has a loose, undefined connection to the crisis itself.<\/p>\n<p>Their collective approach continues to underfund the supply-side interventions necessary to reduce the death toll, while directing funds to abstinence-based programming that focuses on substance-use cessation. This is an approach that has little relevance to creating a predictable, safe supply of drugs.<\/p>\n<p>The past two years reveal B.C.\u2019s and Canada\u2019s strategy to combat the overdose crisis: to keep living, you must stop using drugs.<\/p>\n<p>The 2021 B.C. <a href=\"https:\/\/www.bcbudget.gov.bc.ca\/2021\/pdf\/2021_Budget%20and%20Fiscal%20Plan.pdf\">budget<\/a> has a section on \u201cSubstance Use and Overdose Emergency Response\u201d \u2013 but it makes no mention of the drug supply. It pledges $330 million toward a \u201cfull spectrum of treatment and recovery services,\u201d including $152 million toward \u201copioid treatment,\u201d a portion of which may include opioid agonist therapy. But this comes with strict diversion protocol and has only a minor effect on the drug supply.<\/p>\n<p><script id=\"infogram_0_92bbf5a9-cfcb-4fb7-9071-ae15ca0bd635\" title=\"Tyson table\" src=\"https:\/\/e.infogram.com\/js\/dist\/embed.js?Kqr\" type=\"text\/javascript\"><\/script><\/p>\n<p>Less than 15 per cent of total investments into the \u201coverdose emergency response\u201d goes toward &#8220;overdose prevention.\u201d The $45 million, dispersed over three years, includes funding for assertive community treatment (ACT) teams, consulting services for health-care workers, additional nursing supports and continued funding for already established supervised injection sites.<\/p>\n<p>In other words, the relatively underfunded \u201coverdose prevention\u201d line item has no clear overlap with creating a predictable, safer supply of drugs. A majority of this funding effectively excludes anyone who desires to continue using drugs, those that struggle to stop and\/or recreational users.<\/p>\n<p>The 2022 B.C. budget <a href=\"https:\/\/www.bcbudget.gov.bc.ca\/2022\/pdf\/2022_Budget_and_Fiscal_Plan.pdf\">update<\/a> provided almost no information about the overdose crisis response. Highlighted under a section called \u201cInvesting in Mental Health and Responding to the Overdose Crisis,\u201d there was an announcement of an additional $10 million \u201cacross three years to the Ministry of Mental Health and Addictions.\u201d This is a newer government department which journalist Rob Shaw\u2019s reporting indicates is effectively <a href=\"https:\/\/theorca.ca\/resident-pod\/ministry-of-air\/\">doing nothing<\/a>. Semantically, it is another conflation of the overdose crisis with mental health and addiction services.<\/p>\n<p>Similarly, in June, the federal government <a href=\"https:\/\/www.canada.ca\/content\/dam\/hc-sc\/documents\/services\/opioids\/federal-actions\/overview\/overview.pdf\">summarized<\/a> its \u201cactions on opioids.\u201d Almost none of the highlighted items overlap with drug supply, other than a small amount of money set aside for substance use and addictions programs (SUAP). These projects vary widely in service provision from mental health awareness to support with quitting tobacco use.<\/p>\n<p>The federal government rejected SUAP proposals such as the one from the <a href=\"https:\/\/www.dulf.ca\/suap\">Drug User Liberation Front<\/a>. This would have seen a \u201ccompassion club\u201d open in Vancouver\u2019s Downtown Eastside, offering safe, tested drugs for consumption in a safe space outside of the medical system\u2019s current monopoly on legalized drugs.<\/p>\n<p>While both levels of government direct very little funding toward any kind of supply-side intervention, municipal police forces continue to <a href=\"https:\/\/bc.ctvnews.ca\/vpd-gang-investigation-yields-major-seizure-of-cash-and-drugs-1.6004700\">boast <\/a>about their supply-side disruptions.<\/p>\n<p>The <em>Crackdown <\/em>podcast team and legal academic Leo Beletsky have <a href=\"https:\/\/www.crackdownpod.com\/episodes\/34-the-iron-law\">outlined<\/a> the nuances of the \u201ciron law of prohibition.\u201d As authorities clamp down on substances that <em>will <\/em>be used, black market drugs become smaller and more concentrated. Those who make them try to evade the watchful eye of the state, and the drugs become less predictable in that process. The typical example is the rise of stronger, unregulated alcohol, such as moonshine, in the era of alcohol prohibition.<\/p>\n<p>When the overdose crisis was declared an emergency by the province in 2016, the primary driver of overdoses was potency and the ability to dose stronger opioids without any level of certainty. Six years on, with variance in restrictions, including border closures during COVID-19, the opioid supply is now adulterated with <a href=\"https:\/\/www.bccsu.ca\/wp-content\/uploads\/2021\/06\/Bulletin-Benzos-and-Opioids.pdf\">benzodiazepines<\/a> and xylazine (a sedative). Neither of these respond to naloxone, and both of which require differing detox arrangements to opioid withdrawal.<\/p>\n<p>This lack of supply-side intervention also puts people who have stopped using drugs at greater risk. Between 2021 and 2022, the two clients on my caseload who went from daily opioid use to cessation of drug use \u2013 illicit or otherwise \u2013 died by overdose within months of their initial period of abstinence. Relapse, or simply the act of using drugs again, is typical for drug users who want to reduce or stop their drug use. Yet, in this context, relapse is a death sentence.<\/p>\n<p>In mid-August, B.C.\u2019s Minister of Mental Health and Addictions Sheila Malcolmson said in a <a href=\"https:\/\/news.gov.bc.ca\/releases\/2022MMHA0051-001252\">statement<\/a> that her heart \u201cgoes out to everyone who is grieving,\u201d but continued to focus on the expansion of \u201ctreatment and recovery.\u201d<\/p>\n<p><a href=\"https:\/\/www.theglobeandmail.com\/canada\/british-columbia\/article-david-eby-enters-race-to-become-next-leader-of-bc-ndp\/\">David Eby<\/a>, who is highly favoured to become the next B.C. NDP leader and premier, has said his focus will continue to be on \u201cresidential drug treatment,\u201d a position he has held on the issue since at least <a href=\"https:\/\/www.vanmag.com\/street-legal-david-eby\">2010<\/a>. More recently, Eby skipped supply side intervention altogether and jumped to \u201c<a href=\"https:\/\/vancouversun.com\/news\/bc-ndp-leadership-race-eby-pitches-involuntary-care-for-severe-overdose-cases\">involuntary treatment<\/a>.\u201d An inhumane practice already studied locally to be <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31379008\/\">ineffective<\/a>, and which risks breeding even more distrust between drug users and the medical system.<\/p>\n<p>There is plenty that could be done to end the overdose crisis and reduce deaths.<\/p>\n<blockquote><p><a href=\"https:\/\/policyoptions.irpp.org\/magazines\/december-2020\/legalize-and-regulate-non-medical-use-of-all-drugs-prioritizing-opioids\/\">Legalize and regulate non-medical use of all drugs, prioritizing opioids<\/a><\/p>\n<p><a href=\"https:\/\/policyoptions.irpp.org\/magazines\/december-2019\/the-cannabis-shift-needs-to-happen-for-opioids-too\/\">The cannabis shift needs to happen for opioids, too<\/a><\/p>\n<p><a href=\"https:\/\/policyoptions.irpp.org\/magazines\/october-2020\/expertise-of-people-who-use-drugs-must-be-central-to-design-of-safe-supply\/\">People who use drugs must be part of design of safe supply<\/a><\/p><\/blockquote>\n<p>If the federal Liberals are unwilling to rewrite the <em>Controlled Drugs and Substance Act<\/em> (CDSA), the health minister could work in tandem with provinces to expedite additional exemptions.<\/p>\n<p>The two levels of government could fund community appropriate <a href=\"https:\/\/www.bccsu.ca\/wp-content\/uploads\/2019\/02\/Report-Heroin-Compassion-Clubs.pdf\">compassion clubs<\/a> and disrupt the toxic supply of drugs, while opening access to a predictable supply of diverse drugs.<\/p>\n<p>Governments could listen to community-based feedback that the 2.5-gram threshold of decriminalization coming to B.C. in 2023 is not enough. It could even generate more harm than good if it compels the Vancouver Police to pursue personal possession charges again (currently there is no clear threshold on VPD discretion to avert possession charges).<\/p>\n<p>The province could fund local manufacturing of heroin and fentanyl. It could also reduce the bureaucratic burden on clinics and physicians by removing the need for special authorization related to fentanyl prescriptions being covered by pharmacare. It could also increase access to medicalized <a href=\"https:\/\/www.theglobeandmail.com\/canada\/article-a-new-program-in-vancouver-sells-regulated-fentanyl-to-help-prevent\/\">powdered fentanyl<\/a>.<\/p>\n<p>To date, little funding has been used to stop overdose deaths, despite the announcements conflating the overdose crisis with other social issues. Direct strategies to reduce deaths and non-fatal overdose harms are long overdue.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In mid-August, British Columbia\u2019s provincial government announced that 10,000 people had died since 2016 by overdose from an unpredictable and poisonous supply of unregulated drugs. For many of us working or living in the epicentres of the crisis, these numbers have become somewhat abstract \u2013 but the associated death, grief and worry haunt our psyche. [&hellip;]<\/p>\n","protected":false},"featured_media":281092,"template":"","meta":{"_acf_changed":false,"content-type":"","ep_exclude_from_search":false,"apple_news_api_created_at":"2025-10-08T04:01:46Z","apple_news_api_id":"5c50c82e-46dd-427c-bbb5-d11f955a9bae","apple_news_api_modified_at":"2025-10-08T04:01:46Z","apple_news_api_revision":"AAAAAAAAAAD\/\/\/\/\/\/\/\/\/\/w==","apple_news_api_share_url":"https:\/\/apple.news\/AXFDILkbdQny7tdEflVqbrg","apple_news_cover_media_provider":"image","apple_news_coverimage":0,"apple_news_coverimage_caption":"","apple_news_cover_video_id":0,"apple_news_cover_video_url":"","apple_news_cover_embedwebvideo_url":"","apple_news_is_hidden":"","apple_news_is_paid":"","apple_news_is_preview":"","apple_news_is_sponsored":"","apple_news_maturity_rating":"","apple_news_metadata":"\"\"","apple_news_pullquote":"","apple_news_pullquote_position":"","apple_news_slug":"","apple_news_sections":[],"apple_news_suppress_video_url":false,"apple_news_use_image_component":false},"categories":[9357,9377],"tags":[],"article-status":[],"irpp-category":[4251,4286],"section":[],"irpp-tag":[],"class_list":["post-270538","issues","type-issues","status-publish","has-post-thumbnail","hentry","category-politiques-sociales","category-sante","irpp-category-politique-sociale","irpp-category-sante"],"acf":[],"apple_news_notices":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Funding for abstinence-based programing won\u2019t combat drug toxicity<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/policyoptions.irpp.org\/fr\/2022\/09\/funding-for-abstinence-based-programing-wont-combat-drug-toxicity\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Funding for abstinence-based programing won\u2019t combat drug toxicity\" \/>\n<meta property=\"og:description\" content=\"In mid-August, British Columbia\u2019s provincial government announced that 10,000 people had died since 2016 by overdose from an unpredictable and poisonous supply of unregulated drugs. For many of us working or living in the epicentres of the crisis, these numbers have become somewhat abstract \u2013 but the associated death, grief and worry haunt our psyche. 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