The federal department will now work through details of the request and ultimately decide if the city will become the first jurisdiction in Canada where people can possess and use small amounts of drugs such as fentanyl, cocaine and MDMA, without fear of criminal penalties.
The Globe and Mail reported in April that the city had proposed initial possession thresholds of as much as two grams of opioids including heroin and fentanyl, three grams of cocaine, one gram of crack cocaine and 1.5 grams of amphetamines – the drugs most commonly involved in fatal overdoses.
In its final submission, which was sent to Health Canada on Friday and released publicly on Tuesday, the city has included proposed thresholds for a number of other drugs commonly used for recreational purposes, as well as prescription drugs that are sometimes diverted to the black market.
If approved without amendments, people in Vancouver would not face criminal charges for carrying as much as two grams of MDMA, 30 units of LSD, 20 grams of psilocybin mushrooms, three grams of ketamine and five grams of GHB.
For prescription medications, the city proposes decriminalizing the possession of as much as two grams of hydromorphone, 7.5 grams of sustained release morphine, two grams of oxycodone, one gram of liquid methadone, 120 milligrams of Suboxone, 80 milligrams of clonazepam, 400 milligrams of diazepam, 80 milligrams of Ativan and 500 milligrams of prescription stimulants.
Cole Davidson, press secretary for federal Health Minister Patty Hajdu, said Health Canada is now reviewing the proposal.
“This is an iterative process and Health Canada officials will engage with the applicant and relevant stakeholders, including British Columbia and Vancouver Coastal Health, as necessary to explore how the proposal could be implemented to address Vancouver’s needs,” he wrote in an e-mail.
Vancouver City Council voted unanimously in favour of seeking the federal exemption to decriminalize drug possession last November, with Mayor Kennedy Stewart saying it was an “urgent and necessary next step” in fully embracing a health-focused approach to substance use.
Vancouver has been particularly hard-hit by Canada’s runaway toxic drug crisis, which has killed more than 1,800 people in the city since 2016.
Under Section 56 of the Controlled Drugs and Substances Act, the health minister can exempt from provisions of the act “any person or class of persons … if, in the opinion of the minister, the exemption is necessary for a medical or scientific purpose or is otherwise in the public interest.”
Decriminalization is not legalization; the toxic drug supply would remain unregulated. But the central goal of decriminalization is to “reduce the risks and harms that are associated with the stigmatization and marginalization of people who use drugs,” according to the city’s submission. “The exemption represents an opportunity to better the health outcomes for people who use drugs by reducing the impacts of drug law enforcement for simple possession, reducing stigma and promoting access to life-saving health services.”
Heather Tunold-Roberts, an outreach worker in Vancouver’s Downtown Eastside, is intimately familiar with the harmful effects of drug criminalization. As a drug user in her late teens and early 20s, she was charged with possession and “red-zoned” on multiple occasions – ordered to stay away from the area in which her offences were committed.
That meant staying away from the neighbourhood where she had both her support system and Insite, then Vancouver’s only public supervised drug-use site. Instead, she used alone at home or in another community.
“It pushes people further into the shadows and it increases their risk of sexual and physical violence,” said Ms. Tunold-Roberts, now 29.
Vancouver’s proposed model would be just one component of a multipronged approach that also includes a safer drug supply, housing and income security to reduce the potential harms associated with substance use, according to the city’s application.
People caught with small amounts of drugs would be given a business card for voluntary referral to an overdose outreach team. They would not have their drugs seized. The manufacturing and trafficking of illicit drugs would remain illegal.
Ms. Tunold-Roberts said she would also like to see a mechanism to hold to account police officers who harass drug users.
“I’ve seen many people get their drugs confiscated mid-smoke,” she said. “[Police] grab it with tongs as they’re using, literally lighting up tin foil, snatching it out of their hands.”
The proposed thresholds for the drugs most commonly involved in fatal overdoses were drawn from three longitudinal surveys comprising data from about 1,400 people who used drugs in Vancouver up until the end of 2018. The Vancouver Police Department, the office of Vancouver Coastal Health Chief Medical Health Officer Patricia Daly and expert consultants then agreed on a three-day supply based on the “upper quartile” of personal use.
Consultant Kora DeBeck, an associate professor in the school of public policy at Simon Fraser University and a research scientist with the BC Centre on Substance Use, said these thresholds are highly conservative estimates, given the “astronomical” increase in opioid use in recent years. She added the surveys largely focused on injection drug use and did not take into account people who snort or smoke their substances. The amounts will be evaluated and revised as needed, she said.
The proposed thresholds for MDMA, LSD, psilocybin mushrooms, ketamine and GHB were informed by “anecdotal information from individuals and organizations knowledgeable about use of hallucinogens/psychedelics.” They also took into consideration thresholds in Oregon, which recently decriminalized possession.
The proposed thresholds for pharmaceutical drugs were based on a survey of local addiction physicians and addiction program staff.
Drug-user advocacy groups, including the Vancouver Area Network of Drug Users and the Pivot Legal Society, have said the thresholds for drugs such as opioids are too low to effectively decriminalize the most vulnerable and fail to take into account that drug users sometimes buy in bulk and for other people. They say the city failed to meaningfully include people who use drugs in the policy development process.
“We’re not just stakeholders – the stake we hold is our lives,” said VANDU member Garth Mullins. “All of this is being done as if we’re not adult enough to participate. … We have only ever been able to react to somebody else’s plan.”
Mr. Stewart conceded that consultation was not as robust as he would have liked, but said time was of the essence given that a looming federal election could derail the plans.
“For me, it was always a three-step process: Design the model, get the submission in, and then have ongoing monitoring and adjustment of thresholds,” he said.
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