A person caught with three days worth of illicit drugs will not face criminal sanctions in Vancouver should a proposal by the city to decriminalize simple possession be approved.
The city on Monday submitted its second submission to Health Canada, this one outlining proposed threshold limits on what would constitute personal possession.
The initial recommendations permit up to two grams of opioids such as heroin and fentanyl, three grams of cocaine, 10 rocks (one gram) of crack cocaine and 1.5 grams of amphetamine – the substances most commonly involved in fatal overdoses.
These recommendations may change after detailed risk assessments and consultation with people who use drugs. Additional substances, such as psychedelics, are expected to be added in coming weeks.
To determine the threshold amounts, the city hired as a 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. Dr. DeBeck drew from three longitudinal surveys comprising data from about 1,400 people who used drugs in Vancouver up until the end of 2018, producing estimates for the maximum, upper quartile and median volumes of drugs used per day.
The city, working with the Vancouver Police Department, the office of Vancouver Coastal Health (VCH) Chief Medical Health Officer Patricia Daly and expert consultants, then landed on a three-day supply based on the upper quartile of personal use.
Dr. DeBeck said the consumption volumes derived from the surveys are highly conservative estimates, given the “astronomical” increase in opioid use in recent years, and the fact the surveys largely focus on injection drug use, not accounting for people who snort or smoke their substances. There is also the “cheque day effect” to consider; research has shown drug use to increase in the days after social assistance payments.
Addictions physicians who spoke with The Globe said it is common for opioid users to use about a gram per day, with some using less and others using upwards of three grams per day.
Dr. DeBeck said the recommended threshold is a starting point that must be evaluated and revised as needed.
“Policy-wise, it’s always easier to start conservative and move open, whereas if you start too big, you can’t put the cat back in the bag,” she said. “This is a measured, thoughtful, well informed approach to rolling this out, certainly with the plan, intention and proposal in place to monitor, evaluate and reconsider as it’s moving forward.”
The submission notes that “there is no ideal threshold for a given substance,” as a typical quantity for personal use varies by substance and person, and that setting the threshold too low could exclude and further stigmatize people who consume larger quantities and are generally at greater risk of overdose.
Ted Bruce, former executive director of population health for VCH and project manager for Vancouver’s exemption application, said should police encounter someone with an amount of drugs under the threshold, the officer will likely provide that person with a card with information on how to access VCH’s overdose outreach team.
“Then they will leave the individual on their own and not seize their drugs,” Mr. Bruce said.
Possession above the threshold would not automatically constitute possession for the purpose of trafficking.
“There is a big anxiety on the part of drug users that if a police officer comes across them with drugs even under the threshold, they may then try to charge them with possession for the purposes of trafficking,” Mr. Bruce said. “That should not be possible under our system in Canada because there has to be very explicit identifiers towards the trafficking. We want people to know that.”
Diversion approaches will also be considered for people whose substance use exceeds the threshold amount, such as conditional charges or referrals to Drug Treatment Court or the Downtown Community Court.
The city is expected to submit information to Health Canada on its health care response and risk mitigation efforts in coming weeks, and finalize the application around mid-May.
Mayor Kennedy Stewart announced last November that the city would move to decriminalize drug possession in an effort to fully embrace a health-focused approach to substance use.
Under Section 56 of the federal Controlled Drugs and Substances Act, the Minister of Health 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.”
This exemption has been used to allow for the operation of supervised drug-use sites and to conduct research or clinical trials that involve controlled substances. More recently, it has permitted pharmacists to prescribe, sell and transfer prescriptions for controlled substances so people with substance-use disorders can continue to get medications amid the pandemic.
In February, B.C. Minister of Mental Health and Addictions Sheila Malcolmson also wrote to federal Health Minister Patty Hajdu to inquire about such an exemption to decriminalize provincewide. The province has not provided any updates on that proposal.
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Andrea Woo