HOW TO SOLVE THE OVERDOSE CRISIS

Written by Gracie Lowes

Illustrations by Kevin J Mcbride
 In 2018, it is difficult to navigate life without at least some
Hello, My name is Gracie. I am an intern at the Canadian vague awareness of the ongoing overdose epidemic. For many,
Drug Policy Coalition (CDPC). What you are about to read is a Zine this crisis isn’t something contemplated from a distance, but an
I have written in attempts to provide some introductory informa- everyday reality. It has left many people to fear for their safety or
tion on the ongoing overdose crisis and our collective role in car- the safety of their loved ones.
rying out a productive response. Though my role at the CDPC is
only temporary, it gives me the opportunity to observe drug policy In Canada, more people die of overdoses than car crashes
in action. This doesn’t make me an expert; but based on what I’ve annually. Overdosing is currently the leading cause of death for
observed, I believe this text will provide a foundational under- Americans under the age of 50. In 2017, over 70,000 people died
standing of the causes of, and the solution to the current drug of an overdose in North America.
overdose crisis.
The people who are most often affected by this issue are
So, Let’s begin this venture and inquire, “How can we solve some of our community’s most vulnerable and overlooked. The
the overdose crisis?” I hope this investigation proves that the an- immensity of this issue needs to be acknowledged, yet still today
swer may be more simple than expected. attitudes and policy responding to this crisis are generally ineffec-
tive.

Page 1 Introduction
 In 1979, researcher Bruce Alexander conducted a study
called ‘Rat Park’. The study involved putting rats in two different
types of environments with the intention of observing how these
environments influenced the rats’ addiction rates. The first envi-
ronment was incredibly isolating. Rats were kept alone in cages
with only food, water, and an opioid substance. The second envi-
ronment was incredibly stimulating. This environment had food,
water, and an opioid substance, and it also included games, lots of
space and plenty of potential mates ;)

The findings of this study showed that rats kept in the isolat- Drug use and the social barriers that influence problematic
ed environment had high addiction rates and would often over- drug use were in place long before the recent increase in deaths.
dose, while the rats kept in the stimulating environment didn’t
have these same problematic drug use behaviors. You may then ask “Why is it only recently that the number of
deadly overdoses has so dramatically increased?”
What does this reveal to us? Well, in the context of the over-
dose crisis, it reveals that part of the solution has to be social and The most significant factor contributing to this increase is
structural change. Isolating barriers in our community (like stig- the newly contaminated drug supply. In recent years, the synthet-
ma, criminalization, poverty, etc.) contribute to this problem and ic opioid fentanyl has been introduced to the illicit drug market.
reforming/abolishing these barriers need to be part of the critical Fentanyl is 50 times more powerful than heroin and many people
discussion. consuming it are unaware of its presence in their drugs, leading to
unintentional overdosing.

The current drug supply is toxic and 72% of the overdose

deaths in Canada can be attributed to fentanyl. Though many call
the overdose epidemic an ‘opioid crisis’ a more accurate descrip-
tion of the ongoing events would be an ‘opioid poisoning crisis’.
Page 3 The Source of This Crisis
 Omnipresent voice: Sounds like Fentanyl is really harm- This anecdote offers a few lessons on the inefficiencies of
ing people, but THAT’s why drugs in Canada are illegal. We must prohibitory drug policy.
strengthen our unwavering war against them to solve this crisis.
The First Lesson: There is no such thing as a drug-free world
Wait! No no! Omnipresent voice, I understand how you may With Yvonne’s parents representing the Canadian Govern-
have come to this conclusion, but I think your support of harsh ment and the edgy-troubled boy representing drugs, this story
prohibitory laws may be rooted in some misinformation. The War demonstrates that ‘a drug-free world’ is about as realistic as a
on Drugs has done a notoriously poor job at keeping people who world where Yvonne doesn’t date skateboarders. It’s just not gon-
are at risk of overdosing safe and has an unfortunate history of na happen. Despite prohibition laws in most countries, the global
using drug prohibition to intentionally criminalize marginalized value of the drug trade is over $300 billion annually. Despite Ca-
communities. nadian prohibition laws, drug offenses continue to rise and drugs
continue to be consumed in Canada.
Let’s unpack this idea further with a brief allegory (loosely
based on real-life events): The Second Lesson: Prohibitory laws can cause more harm
than drugs
Once upon a time, there was a teenager named Yvonne. As a result of Yvonne’s parents forbidding Yvonne from see-
One day she met and began hanging out with some edgy-trou- ing him, Yvonne started sneaking out after they fell asleep. Her
bled-skateboarder boy. When her parents learned of her new “ac- parents’ ‘boy ban’ had unintended consequences that put Yvonne
quaintance”, they told her she wasn’t allowed to see him anymore in a more dangerous situation than just dating a guy that wore
because they had heard bad things about him. ripped jeans. Drug prohibition is similar. One example of this is
the issue of the currently toxic drug supply. This is only a problem
But despite her parents’ wishes, Yvonne (secretly) continued because of the illicit drug market. People given legal opioids in the
to chill with this dude. hospital after having hip surgery are not afraid of it containing
traces of an unwanted substance. Current drug policy and its lack
of regulation is what creates the opportunity for a toxic supply.

Turn the page to unpack the final layer>>>

Page 5 Past and Current Policy Hurts
The Third Lesson: Drug laws are not always well intentioned
In the story I told, Yvonne’s parents justified their embargo
These examples demonstrate how the creation and the
against this boy because they had “heard bad things about him”,
maintaining of prohibitory drug laws have a habit of being rooted
but this was only partly true. The real reason they didn’t want
often in discrimination rather than good intentions. These exam-
Yvonne dating him was more complicated than that. They were
ples are really just the tipping point though.
also worried Yvonne wouldn’t want to spend time with them any-
more. They didn’t know how to react to the first signs that their
The enforcement of drug laws disproportionately affects
daughter was growing up.
People of Colour. In Canada, according to a 2017 study by the UN,

Black people that do not have a history of criminal convictions are
The Canadian Government similarly had other motivations
three times more likely to be arrested for the possession of drugs
besides wanting what’s best for its citizens. Unfortunately, when
than white people with similar backgrounds.
creating harsh drug laws, Canada’s hidden agenda wasn’t only
infantilizing but also more... racially motivated.
See folks! These drug laws aren’t only ineffective at protect-

ing our community from harm, they may never have actually been
The Opium Act of 1908 had little to do with the dangers of
intended for that purpose in the first place.
opium and a lot to do with William Lyon Mackenzie King’s dislike
of Japanese and Chinese people.

The history of alcohol probation in Canada is a much longer
and harsher one for Canada’s Indigenous Peoples than settler Ca-
nadians. On-reserve alcohol bans lasted over 15 years longer than
off-reserve prohibition.

In the United States, Black communities were more com-
monly associated with crack cocaine (although Black people don’t
actually make up the majority of crack consumers or dealers).
Drug laws in the United States reacted to this association by mak-
ing penalties for having crack cocaine far harsher than powdered
cocaine, despite being pharmacologically identical.

Page 7 Drug Prohibition: A Tool of Oppression

 Omnipresent voice: But I thought we couldn’t afford to regu-
late drugs and provide public health focused care.

Wrong! We can’t afford not to!

Canada is still widely in a state of drug prohibition, with

some exceptions being made to substances like alcohol and, only
recently, cannabis.

This prohibition costs the Canadian government over $2.7

billion annually in charges associated with policing, courts and
corrections for non-violent drug offenses. This is a staggering
amount of money spent on enforcing an ineffective and immoral
war against people who use drugs. In the next section of this Zine,
we are going to talk about the types of resources that need to
be available to correct this overdose crisis. By ending the war on
drugs there will be at least an added $2.7 billion in the budget to
provide these life-saving services to people who use drugs.
Page 9 An Expensive Failure
 Omnipresent voice: So, it sounds like prohibition and a one Harm reduction in the context of drug use:
size fits all abstinence-based approach doesn’t work.” Supervised consumption sites, distribution of naloxone, pro-
viding accurate information on how to reduce the potential harms
Correct! This is where harm reduction comes in! of drug use and access to clean injection materials are just some
examples of services and resources that acknowledge the impor-
Harm reduction is a framework. The harm reduction frame- tance of providing opportunities for those who use drugs to do so
work is one that focuses on reducing the negative consequence in the safest way possible.
of potentially risky behaviour rather than only promoting absti-
nence. This approach is one that looks at drug use as a matter of
public health rather than criminality. Harm reduction centres on
Harm reduction is something that most people use daily, but the voices and needs of those most deeply affected by the ongo-
unfortunately, this type of approach when it comes to stigmatized ing overdose crisis.
behaviour, such as drug use, isn’t adopted nearly enough.
By fostering an understanding of the harm reduction ap-
proach, it is clear that there are many ways to incorporate such a
framework in the services provided to people who use drugs.

How can this framework also be adopted in the policy around

drug use?
Harm reduction in our everyday lives: Well, as we begin to talk about some of the different options
Riding a bike in a city can be an overwhelming experience for reshaping drug policy we should try to return to the question
and without the proper gear and knowledge, it can also be very ‘Will this policy reduce harm?’ As we’ve discussed, current drug
dangerous. An abstinence approach to this type of danger would policy has given way to a toxic drug supply and the ongoing over-
result in making it illegal to ride bikes. A harm reduction approach dose crisis. It also puts people in prisons and limits resources that
to this is instead to encourage or mandate that people wear hel- could help people make safer choices. Prohibition policies do not
mets, building bike lanes, educating bikers on the importance of reduce harm and so they are not policies that efficiently serve our
signaling and enforcing that bikers follow the proper rules of the community.
road. Having these things in place saves lives and a similar ap-
proach should be taken when it comes to drug use. Let’s look at two policy alternatives that may have a better
chance of protecting people and communities affected by drug
use.
Page 11 Harm Reduction
Decriminalization
Decriminalization does not mean that drug use is entirely
legally permissible. What it actually means is that people won’t
gain a criminal record or be imprisoned as a result of possessing
small amounts of drugs for personal consumption. The traffick-
ing of drugs and selling of drugs under a decriminalization policy
remains a prosecutable offense. In some cases, even personal
consumption of drugs might still have legal repercussions (such as Some Pros of Decriminalization:
fines or referrals to treatment programs), but drug use is viewed - Incarceration rates drop
more as a civil infraction rather than a criminal one. - Helps remove stigma
- Helps remove barriers of care
In 2001, Portugal decriminalized all drugs. People who are - It saves the government money
found holding small amounts of drugs for personal consumption
may be asked to meet with a committee of social workers, doc- In countries where this practice has been adopted, addiction and
tors, and lawyers to discuss harm reduction and treatment op- overdose rates have dropped significantly.
tions and may be fined, but cannot be put in jail or given a crimi-
nal record. Since the implementation of this policy, Portugal has The Pros of Legal Regulation:
had a dramatic decrease in problematic drug use, injection-relat- - All of the same benefits of decriminalization. Plus…!
ed infections, overdoses, and incarceration rates. - An available non toxic drug supply
- Problematic drug use could be treated as a health problem
Legal Regulation
rather than a problem of criminality
Legal regulation supports the regulation of drugs through
- Less demand for an illicit drug market = less criminality and
the government, allowing the manufacturing and sale of substanc-
violence associated with the drug trade
es in a controlled manner. Legal regulation can be carried out in
many different ways. At its core, it is about removing any type of
legal penalty from the consumption or selling of drugs if it follows
the proper protocol of the regulatory policy in place.

Legal regulation is a very general description of a practice

that can be implemented in various ways. Provincial differences
in the legalization of cannabis is one way this is demonstrated in
Canada.
Page 13 Policy Alternatives
 So now we ask the question, what policies will reduce harm
in Canada?

Decriminalizing drugs has been an incredibly successful pol-

icy measure in Portugal. In Canada, decriminalizing drugs would Pop Quiz:
help eliminate some of the social barriers that put people who What type of drug policy should Canada implement? Legal
use drugs in danger, it may even prevent or help people recover Regulation or Decriminalization?
from problematic drug use (remember the Rat Park study?). De-
criminalization is a policy that requires less complicated logistics Answer:
than legalization, so Canada has the capacity to put this policy into Both!
action right away. It would free up a massive amount of money
spent on enforcing the current ineffective state of prohibition, and Decriminalization is a great short-term solution. It can be
that money could instead be used to provide harm reduction and put into action quickly and could kick off the long journey that is
health care and treatment services. ahead when it comes to protecting vulnerable people in our com-
munity. Legal regulation should be a longer-term goal. Regulating
Canada’s overdose crisis has a key feature, though, that drugs is the only way to make sure that people have the opportu-
Portugal’s did not. The recent increase in overdose deaths in Can- nity to make informed decisions about what they choose to con-
ada can be attributed to an unsafe supply and decriminalization sume.
leaves supply in the hands of criminal organizations who care little
about safety. Legal regulation, on the other hand, deals directly
with this problem.

Page 15 Policy Moving Forward

 We began this Zine on a mission to solve the overdose crisis.
I said the answer may be more simple than expected and sev-
enteen pages later I stand by that statement. There are aspects
of this solution that are certainly nuanced - policy change, harm
reduction services, and the complexity of eliminating of socially
and economically isolating barriers- but I firmly believe that all of
these fall under the same simple compassionate approach.

This overdose crisis has proven that our community too

often doesn’t place proper value on the health and lives of some
of our most vulnerable members. The overdose crisis is a public
health crisis and has to be treated with the urgency of one. A com-
passionate approach is one where we listen to those most deeply
impacted by this crisis and that honors and shows care for those
most deeply impacted. A compassionate approach is also the eth-
ical approach, the economic approach, the effective approach and
it is the approach necessary for ending this crisis.

Page 17 A Compassionate Solution

Canadian Drug Policy Coalition

CDPC is a coalition of over 70 organizations and 3000

individuals working to support the development of
drug policies in Canada and Internationally, that are in-
clusive of people who use drugs and those harmed by
criminalization, based on scientific evidence, guided by
public health principles, and respectful of the human
rights of all.
Join the coalition at drugpolicy.ca