Visions Journal

Heather Hobbs

Reprinted from the Families, Friends and Substance Use issue of Visions Journal, 2024, 19 (2), pp.14-15, 18

As a resident of BC, you likely have a personal connection to what people often call the overdose, opioid or fentanyl crisis. In the last 10 years, over 14,000 people have died in this province1 from overdose. A more accurate way to describe this crisis is to say these deaths are related to unregulated drugs. Overdose and death often happen when we take substances that have an unknown composition and potency.

Why do we allow this to happen? Drugs are unregulated because the current laws that make some drugs illegal are not based in science, but rather, in moral judgments and a particular policy history. 

Dangerous blame

Moral judgments have long been attached to drugs, but they also extend to the people who use them. If you use a drug that is currently illegal or not prescribed to you by a health care provider, you’re likely to be seen by many as irresponsible or criminal. Some people may believe that the only way to be redeemed is to stop using that drug. 

People use drugs for many reasons—for relaxation, pain management, mind expansion, fun and to cope with many kinds of physical or mental challenges, to name a few. If you face societal barriers and lack access to adequate income, a safe and healthy place to live or affordable food and health care, your drug use may increase as an understandable way to cope and survive. Sometimes using drugs can cause problems in our lives and we may need support to change how we use them. Unfortunately, we often face barriers in accessing support if we’re judged, controlled or punished for our drug use. This can increase our risk for harms such as overdose.  

The judgment, stigma and discrimination from using “bad” drugs adds to the pain and trauma we experience from unregulated drug deaths of our friends, loved ones and community members. This may also fuel increased drug use or riskier drug taking practices as we struggle to cope or manage internalized shame and pain.  

A matter of policy 

Currently, there are no quality controls in place to ensure that unregulated drugs come with accurate information about what’s in them. Because of this, it is very hard to access safer drugs or make more informed decisions about our drug use. Instead of taking a sensible approach, our drug policy and laws create stigma and punish people who use drugs. 

Drug policy and drug laws in Canada were created from some very harmful and racist ideas (you can learn more about Canada’s drug laws at drugpolicy.ca/about/history). For example, early lawmakers characterized Indigenous and people of colour as amoral and a threat to the “purity” of white British colonizers. Laws like the Opium and Narcotic Drug Act of 1908 were created to segregate and control Chinese people by punishing their use of opium. The racist roots of our drug laws still have impacts today, as Black, Indigenous and other people of colour are much more likely to be targeted by police and criminalized for their use of substances.

The harm reduction solution

A useful and empathic way to challenge inequities and help build a more caring and just society is through harm reduction. Harm reduction is a grassroots social movement that was started by people fighting for access to information, resources and dignity. They were drug users, people living with HIV/AIDS and other activists who took practical, community-driven action to reduce harms related to social injustice. 

Harm reduction includes principles and practices that can be used by individuals and communities to take care of one another, especially as governments and other institutions fail to do so. 
 

“Harm reduction is grounded in justice and human rights. It focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that people stop using drugs as a precondition of support.”
 

These principles are at the heart of services that use a harm reduction approach to work with people who use drugs and their loved ones. Harm reduction services may include, but are not limited to:

• distribution of naloxone kits and overdose response training 
• free supplies for safer drug use and safer sex
• peer-to-peer outreach
• overdose prevention and supervised consumption sites 
• drug checking to detect contaminants 
• safe supply (providing substances that have been checked or regulated in place of unregulated substances) 

Not surprisingly, harm reduction is subject to the same stigma, discrimination and dismissal as people who use drugs face. This can make it more challenging for drug users to access appropriate services and for advocates to make sure harm reduction is available in our communities. Despite the evidence3 that harm reduction keeps people alive and improves their quality of life, the approach often faces criticism and is misunderstood. Abstinence-based recovery is often still shown in the media and by healthcare providers as the only way to conquer addiction and, therefore, be an accepted member of society. 

A harm reduction approach does not define drug use or drug users as bad or needing treatment or a cure. Harm reduction strategies exist to support you at any stage of drug use you may be engaged in—from daily use of currently illegal drugs to complete abstinence and anywhere in between. Harm reduction goes along with recovery as you define that for yourself. It supports healing, growing and any changes you want to make to minimize problems you think are related to drug use.