Outcomes of our current approach to substances

The system is failing and fuelling overdose deaths, violence, and high-level organized crime.

(Mural by Shawn Hefele)

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The policies that governments create directly affect individuals and communities. Drug control policies are no exception. However, since we began trying to control drugs, we have based our policies on long-held moral beliefs rather than evidence. Many who are beginning to recognize that the current policies have failed to address serious concerns related to substance use have begun the overdue process of examining the outcomes of our current approach more closely. 

Furthermore, the onset of the COVID-19 pandemic has exposed how people engaged in substance use are in an especially vulnerable position as it has reduced the capacity of governments to provide life-saving support during times of global crisis. COVID-19 has disrupted illegal drug markets, making them more dangerous than ever. The requirement to physically distance to prevent transmission of the coronavirus has increased the risk of overdose for people who use drugs as more people are using alone. Consequently, overdose deaths have increased across Canada in Ontario and British Columbia, where more than 100 overdose deaths were reported in March alone

The Overdose Crisis and Unregulated Drug Market

North America is now several years into its worst opioid poisoning crisis with no end in sight. Data released by the Public Health Agency of Canada in December 2019 show that at least 4,614 people in Canada died of opioid overdose in 2018, an increase of 11% from the previous year. Between 2016 and March 2019, there were at least 12,813 opioid-related deaths in Canada. Of those, 74% were male, and 88% were between 20 and 55 years old. 70% of the overdose deaths involved fentanyl or fentanyl analogues, and 76% also involved non-opioid substances.

(Interactive Graph)

While the majority of opioid poisoning deaths are in British Columbia, Ontario, and Alberta, no province or territory has escaped the crisis. Statistics Canada recently reported that life expectancy in Canada has stopped rising because of overdose—a remarkable finding underscoring the urgency of this crisis.

(Interactive Graph)

One connection between Canada’s drug policies and the opioid poisoning crisis is a surprisingly logical one. It is related to a concept known as the “Iron Law of Prohibition,” a term describing how increased policing leads to more potent illegal drugs.1 Because drug traffickers are at risk of arrest and criminal penalties, they are incentivized to deal in stronger, smaller drugs that can be imported and hidden more easily.

OpioidRelative Strength for Equal Volume Compared to Morphine
Diacetylmorphine (Heroin)2 – 5x
Fentanyl50 – 100x
Credit: Washington Post

Because of prohibition, less dangerous smokable opium is no longer available in Canada as it was in the 19th century. It was replaced by the stronger heroin, which in turn is now being replaced by a mix of chemicals including the more potent and dangerous fentanyl and carfentanil. Both are imported from clandestine labs in places like China and have saturated the unregulated drug market, which lacks oversight to ensure the quality and safety of the substances being sold.

Crime Rates, Drug Crime, and Organized Crime

Everyone wants to live in a safe and healthy society. For much of Canada’s recent history, concerns about public safety related to substance use have led governments to increase the scope of laws covering drugs, the severity of punishments, and the scale of policing. Although police and governments claim that drug policy and funds are directed at stopping high-level production and selling of criminalized substances, statistics reveal that it is the youth, the poor, and marginalized users who are most vulnerable to arrest, not high-level traffickers.2

(Interactive Map)

In 2016, there were 95,417 drug arrests in Canada. Of those, 73% were for drug possession, showing that a large portion of police and court resources are targeting low-level offences.3 Moreover, overall crime rates have been decreasing since 1990, yet police-reported drug offences have sharply increased despite drug use patterns remaining essentially unchanged.4 Criminal organizations play a large role in the production, importation, and distribution of drugs in Canada, which forms the most lucrative activity of these groups. Laundering money obtained through the drug trade remains a large problem in Canada and contributes to rising real estate prices and housing instability.

Prison and Incarceration

Prisons in Canada disproportionately house people of colour, Indigenous people, and women. In 2017, the Office of the Correctional Investigator reported that Indigenous people made up 26.4% of the federal prison population, despite representing only 4.3% of all Canadians. For the last three decades, there has been a yearly increase in the federal incarceration rate for Indigenous people, and the number of Black prisoners increased by almost 90% between 2002 and 2013.5

In 2013, 47% of women in provincial prisons in British Columbia were racialized women, and half of them were there for drug offences. The over-representation of Indigenous and racialized people in prisons, and a higher percentage of women serving time for drug offences, are disproportionate to their drug arrest rates, their drug use rates, and their involvement in the illegal drug trade.6 The Office of the Correctional Investigator also noted that Indigenous over-representation in prisons is “systemic and race related” and is exacerbated by the Canadian criminal justice system and colonial history.7

Increased Violence

Criminals don’t have to play by the rules. Because there are no standards and regulations governing how the illegal market operates, violence is often the tool for resolving disputes, for enforcing payment of debts, and for expanding market share. Contrary to conventional thinking that increasing drug law enforcement will reduce violence, evidence strongly suggests the opposite: drug prohibition contributes to drug market violence and higher homicide rates.8

Stifling Medical Research

Making drugs illegal limits their potential medical uses and benefits, also limiting research into potentially beneficial, lifesaving, and life-enhancing uses. It is much harder for researchers to obtain funding to study the potential health benefits of a substance when it is classified as “prohibited.” This roadblock also discourages researchers from starting on this research in the first place, which is a huge opportunity lost in the advancement of science. But as we begin to change the way we think about currently illegal substances, the willingness to study them as medicine will also follow.

We are now in what has been described as a “renaissance” of research into psychedelic substances as medicine. Beginning around the 1940s, the discovery of the powerful psychological effects of some psychedelics, like psilocybin and LSD, led to a large program of government-funded research into the potential medical uses of these drugs. However, concern with the non-medical use of these substances in the 1960s led to restrictions to access and the curtailing of research funding, effectively ending this promising research.

In recent years, private funding has led to a rapid growth in research into psilocybin for the treatment of end-of-life anxiety, MDMA therapy to treat PTSD, and other promising uses, such as ayahuasca and ibogaine for treating addiction. While it is good that this is now taking place, the moratorium on such research set back beneficial uses of these and other drugs by decades. Similarly, research into the medical benefits of cannabis is now only beginning, despite hundreds of years of anecdotal experience suggesting benefits.

Increasing the Negative Effects of Drug Use

Perhaps the most paradoxical outcomes of our current policies—intended to improve the human condition by controlling substances—is the fact that these policies have done the exact opposite: they have exacerbated the negative effects of substance use, including in the following ways:

  • Increasing the spread of infectious diseases like HIV and hepatitis C by limiting the provision of sterile needles, opioid agonist treatment, and clean inhalation equipment—including within prisons
  • Creating stigma and fear among people who use illegal drugs, discouraging them from accessing prevention and care services
  • Driving people who use substances to spend money meant for housing, food, and transportation on drugs, leading to poorer health outcomes
  • Forcing individuals who use drugs to engage in illegal activities (like sex work) to buy substances they are dependent on
  • Further marginalizing people who use drugs with difficult health, psychological, and social problems
  • Providing ineffective school-based education about stubstances for young people
  • Increasing ecological harms of herbicides, unregulated laboratory chemical waste, and energy consumption to supply an illegal market
  • Spending large sums of money on law enforcement and criminal justice approaches (which have proven to be ineffective), while there is a scarcity of resources for education, public health, and social development

[1] Alchian, Armen Albert (1983). Exchange & production: competition, coordination & control. Belmont, CA: Wadsworth Pub. Co. ISBN0-534-01320-1

[2] More Harm than Good., p.47

[3] Boyd, Susan. Drug Use, Arrests, Policing, and Imprisonment in Canada and BC, 2015-2016.

[4] Ibid. Note that cannabis use rates have been increasing since 1990, but still remain significantly lower than the early 1980s.

[5-7] More Harm than Good.

[8] Werb et al. 2010 (in MHTG, pg. 60)

About Regulation Project

The Regulation Project is an international collaboration to advocate and educate for the legal regulation of drugs.