One year ago, the federal government was told that if it wanted to stem the tide of overdose deaths from a toxic drug supply, it needed to regulate that supply.
“Regulation of drugs will have the greatest impact on ending the drug toxicity death crisis,” the expert task force on substance use told the government in its final report.
A year later — as deaths continue to climb — that significant recommendation has not been implemented, along with other key recommendations from the task force’s two reports, including immediately scaling up a safer drug supply and decriminalizing drug possession across the country.
“The main thrust of the second report is if you want to stop killing people, you have to actually get in and regulate it,” said Dr. Kwame McKenzie, a co-chair of the task force and CEO of the Wellesley Institute.
“We were also saying that we believe business as usual is part of the crisis, and that our war against drugs actually ended up being a war against the people who use drugs,” McKenzie said.
“If the deaths are going up, then we haven’t done enough. It’s as simple as that. We haven’t done enough, and we need to do more.”
Canada is in the grips of an overdose crisis, driven by a drug supply tainted with powerful opioids. Commissioned by the government, the task force said last year “it is time for a paradigm shift in policy,” noting Canada has the “fastest growing rate of overdose mortality in the world.”
More than 7,500 people died last year, according to the Public Health Agency of Canada, which estimates that deaths may remain high or increase this year.
There has been some movement from the government in the year since the task force delivered its final reports. An exemption has been granted to decriminalize possession of small amounts of drugs in British Columbia for three years starting next year, and Ottawa has also invested millions of dollars in pilot projects for safer supply and other services that advocates say is not nearly enough.
But a signature recommendation of the task force has not been implemented: to “immediately develop and implement a single public health framework” for all psychoactive substances including drugs that are currently illegal, along with tobacco, alcohol and cannabis.
“This framework should aim to minimize the scale of the illegal market, bring stability and predictability to regulated markets for substances, and provide access to safer substances for those at risk of injury or death from toxic illegal substances,” the task force wrote in its report.
“There is clear urgency for this work.”
McKenzie pointed to alcohol becoming more potent and dangerous during the Prohibition era, when it was made in small batches to make it easier and cheaper to transport, and said the same has been happening with illicit drugs.
“We have got smaller, more potent drugs, and the next person is trying to make a smaller drug that’s more potent than the last one,” he said.
“That’s how we’ve ended up with these cheap, very potent drugs that kill people.”
Ideally, a person should be able to walk into a controlled setting like a pharmacy and purchase a drug that is currently illegal, said Donald MacPherson, a task force member and executive director of the Canadian Drug Policy Coalition.
“We have two of the most dangerous drugs in the world readily available to people — alcohol and tobacco — and we trust people to manage their use,” he said.
He said a “very small proportion” of Canadians use illicit drugs, while the harms due to the toxic supply are disproportionate to that number of people.
“It’s time to create a level playing field and that’s what that recommendation was trying to get at,” he said. “Our regulations around psychoactive substances are haywire. You can buy alcohol in the supermarket, but you can get arrested if you have a gram of cocaine on you.”
MacPherson said he’s unaware if any work has been done on the recommendation. “To not implement these recommendations is to continue to do more of the same, and more of the same is going to give us the same results: tens of thousands of people are going to die because of a toxic drug market,” he said.
MacPherson has met with Mental Health and Addictions Minister Carolyn Bennett, and said “I know Minister Bennett is using (the report.) In her meetings with us, she’s aware of it, she’s got it, she’s written notes about it.”
He said he also knows that work is underway on establishing national standards for treatment services and resources, another task force recommendation.
McKenzie said it’s not even clear if the government has accepted the recommendation on regulation. He said the task force gave the government a “blueprint” based on the evidence, and said it’s incumbent on the Liberals as well as provincial governments to show their work.
“If people aren’t going to pull out the blueprint of the expert task force, then we need to see from the feds and provinces an alternative blueprint because people are dying,” McKenzie said.
He did credit the government for progress made to date, while saying he’d like to see more funding and resources for services for racialized groups and the LGBTQ+ community.
Bennett’s office referred the Star’s questions to Health Canada, which did not respond as to whether the government supports all of the recommendations.
“Health Canada is reviewing the recommendations of the task force to inform the path forward,” the agency said in a statement, while also saying that “work is still ongoing” regarding implementation.
“They need to be brave,” said Natasha Touesnard, executive director of the Canadian Association of People who Use Drugs, of the government’s lack of action on the task force’s recommendations.
She stepped down as a co-chair of the task force near the end of its work due to the lack of other active drug users on the panel. Touesnard said the task force delivered a “kick-ass report” that she wishes the government would have acted on immediately given the rising number of overdose deaths.
“Every time I think it’s going to happen, it doesn’t, and it hurts me, to think that they don’t think that much of us and second to that, that they’re OK with us dying,” she said.
“Maybe in 10 years somebody might pick (the report) up and dust it off and think, ‘Why the hell didn’t we do this?’”
Jacques Gallant is a Toronto-based reporter covering politics for the Star. Follow him on Twitter: @JacquesGallant