Public Health and Human Rights Approach to Substances

With over 17,000 fatal opioid poisonings between 2016 and March 2020, our current drug policies based on prohibition have clearly not worked. Therefore, there is a growing interest in exploring new policy alternatives that will end the loss of life and that are based on equity, social justice, evidence, and a focus on the underlying determinants of health. 

Approaches based on public health and human rights result in drug policies that focus on promoting and protecting health, as well as preventing disease, injury, and disability. For example, supervised injection and overdose prevention sites achieve these aims, whereas arrest, prosecution, and incarceration for substance use do not. People who spend time in jail are more likely to overdose upon release and suffer destabilizing social and psychological consequences that negatively impact their health and wellness, whereas supervised injection sites help connect people to vital support services like housing and counselling, and prevent death.

Two white tents in a park
Moss Park temporary overdose prevention site; Toronto; 2018

A public health and human rights approach to drug policy ensures that the harms associated with policies and laws are not disproportionate to the actual harms of the substances themselves.1 Take for example cannabis: the overall harms of a jail sentence on a person’s health and wellbeing are much greater than the actual harms of consuming cannabis, yet low-income and racialized communities have long been targeted by punitive drug laws that have thrown people in jail for possession. Therefore, this policy approach is not in line with a public health and human rights approach.

“A public health and human rights approach includes the perspectives of people who use or are affected by problematic substance use, and ensures that a continuum of interventions, policies, and programs are implemented that are attentive to the potential benefits and harms of substances, as well as the unintended effects of the policies and laws implemented to manage them.”

~ Canadian Public Health Association

A public health and human rights approach takes into account a whole range of factors determining whether a person is healthy or not and whether they are treated with fairness and equity. It is a holistic, comprehensive approach that not only addresses the traditional physical, biological, and psychological factors contributing to wellness, but also the social determinants of health—such as wealth distribution, education, housing, and social inclusion—and the determinants of social and health inequities, such as power imbalance, racism, classism, ageism, and sexism.

A public health and human rights approach recognizes that problematic substance use is often a sign of underlying issues and inequities; emphasizes evidence-based, pragmatic initiatives; and takes into consideration social justice, equity, and respect for human rights.2 It supports evidence-based prevention strategies (specially targeted at children and youth), high-quality mental health services, easy-to-access treatment options (including substitution treatment), recovery, social support, rehabilitation, harm reduction, and reduction of stigma and discrimination. To support human rights, this approach means that access to these services should also be equitable.

[1] [2] Canadian Public Health Association

About Regulation Project

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