VANCOUVER—Portugal was in the throes of a drug crisis two more than decades ago when Dr. João Goulão was tasked with helping to do something about it.
One of the central measures taken was to decriminalize certain amounts of hard drugs. At the time, the country had an estimated 100,000 heroin users, and HIV numbers were raging; today, Portugal has managed to cut the number of users down to 25,000.
Now, decriminalization is coming to Canada, but Goulão cautions that it takes more than that to make an impact.
Last week, the federal government granted an exemption asked for by British Columbia’s government to decriminalize possession of small amounts of hard drugs, such as cocaine and heroin, in the province starting next Jan. 31.
In an interview with the Star Goulão, Portugal’s director-general for intervention on addiction, said the decision presents an opening for B.C. to mitigate the damage illicit drugs inflict on people.
“It is crosscutting your society,” he said of Canada’s drug problem. “I believe this is kind of a window of opportunity.”
Under the three-year exemption, those found with less than 2.5 grams of hard drugs will not be charged, nor even have their drugs confiscated. The decision has been criticized as not allowing the full 4.5-gram threshold asked for by the B.C. government.
Advocates hope the move will result in fewer overdose deaths by people using alone in secret for fear of being judged. (Toronto has also asked for an exemption to decriminalize small amounts of illicit drugs.)
Vancouver, having long wrestled with drug use among residents, has been in the grips of a devastating overdose crisis since 2016, with more than 9,000 deaths as of March of this year. On Thursday, the B.C. Coroners Service reported another 161 deaths in April.
Goulão said decriminalizing drugs alone is not the answer. It must be supplemented with other measures — in Portugal, habitual users are pressured to go into treatment if they are caught with small amounts of drugs too often.
When apprehended, if the drugs are below the decriminalized limit — which varies depending on the substance and calculated based on personal use over a 10-day period — the person found with them has a meeting with an administrative authority to discuss their drug use, how common it is and what needs they may have.
If they are found in possession or using drugs again within a certain time frame and refuse treatment, they can lose their driver’s licence, ability to travel abroad, or face other consequences, Goulão said. They may also need to prove they are attending counselling sessions.
Most people are not found to be “problematic” drug users, Goulão said.
Facilities to help people stop using drugs are mostly government-run, free and open-door, which allows for spontaneous decisions to get into treatment.
There is also a need for co-ordination among services meant to help people who use drugs, he said. When he’s visited Vancouver and Toronto in recent years, he said, there seemed to be problems with co-operation between agencies.
“There was, at the time, a lack of co-ordination between the different responses,” he said. “It seems that any of those responses were for themselves — they are not focused on fulfilling the needs of the citizen.”
Ottawa’s granting of an exemption through Health Canada was received somewhat begrudgingly by advocates for those drug users who say the amount is not high enough and could actually endanger people.
Gord Johns, a New Democrat MP from Vancouver Island, was behind a bill in Ottawa aiming to allow drugs for personal use right across Canada.
The Liberal government granted the exemption to B.C. just before the house was due to vote on Johns bill, ultimately rejecting it. Johns called the move “cynical” and slammed Ottawa for doing little else to try to save lives nationwide: “Twenty-seven thousand people have died as a result of toxic overdose, they haven’t tabled any comprehensive legislation to respond to this crisis.”
Johns said his bill drew on suggestions from the government’s own Expert Task Force on Substance Use.
Dr. Thomas Kerr, a professor and head of the social medicine division at the University of B.C., said decriminalization could lead to drugs being made more potent, to carry the same strength while getting under 2.5 grams. It could also result in people having to interact with drug markets more, as they buy smaller amounts to stay under the threshold.
“They’ve kind of blown it, in a way. It’s unfortunate,” Kerr said. “It’s an opportunity to do some good and unfortunately it got whittled away.”
He said the 2.5-gram threshold will not likely affect overdose deaths. The priority needs to be getting a safe supply into the market, among other measures, Kerr said, cautioning Canadians not to be distracted from finding ways to save lives by the decriminalization news.
The model in Portugal is not without its flaws, he said, particularly as it can end up forcing people using substances such as marijuana into its system.
“It’s not a slam dunk. I think people sort of assume the Portuguese model has been a great success, I don’t think that that’s really conclusive,” he said. “I think there’s some likely benefits, but I think there’s some debate about that.”
The Star asked to speak to someone from B.C.’s Ministry of Health about any next moves post-decriminalization. An emailed response from the Ministry of Mental Health and Addictions stated that the new plan would break down the barriers preventing people from getting to “life-saving services” by removing the fear of criminalization.
“B.C.’s exemption includes progressive and innovative approaches that have been guided by public health, including no mandatory treatment referrals, no issuing fines or other administrative penalties, and no drug seizures,” said the email from public affairs officer Kendra Wong.
Instead, people found in possession of drugs will be given information on treatment and recovery options, among other information.
The email added that the province is working on building mental-health and addictions care “from the ground up” with a $500-million investment, but few details were given.
Whatever direction B.C. and the rest of Canada take after the exemption takes effect next year, Goulão said it’s important that administrative bodies co-ordinate their efforts.
As well, he said, it’s important that our approaches recognize that drug users are human beings living with challenges not unlike those of other people.
“I think it’s important to consider that drug addiction is a disease with the same dignity as other diseases,” he said. “We have worked a lot in trying to lower the stigma. I believe decriminalization contributed a lot.”
Jeremy Nuttall is a Vancouver-based investigative reporter for the Star. Follow him on Twitter: @Nuttallreports