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SHOW NOTES
Summary
The criminalization of substance use causes demonstrable harms: it isolates people who use drugs, pushes them to use in riskier ways, and deters them from seeking help when they need it. Even so, the possession of illicit street drugs for personal consumption is still criminalized in British Columbia and the rest of Canada.
In this episode, addiction physician Dr. Christy Sutherland and journalist David Ball discuss the years-long overdose crisis in British Columbia, how the criminalization of substance use negatively impacts lives and health, and what role clinicians can play in reducing these harms in the absence of systemic change.
Lineup
In this episode, you’ll hear:
- 3:22 – Dr. Bonnie Henry – Provincial Health Officer, Province of British Columbia
- 12:32 – Amber Streukens – Peer Health Navigator with ANKORS and Rural Empowered Drug Users Network (REDUN)
- 19:22 – Scott Bernstein – Lawyer and Director of Policy at the Canadian Drug Policy Coalition
Pearls
Here’s what listeners can take away from this episode:
- Family medicine is a community-based discipline. That means advocating for addressing the larger issues impacting patients’ health, including the toxic illicit drug supply, and changing the social isolation of people who use illicit drugs — which can put patients at risk.
- By treating drug use as a criminal justice issue instead of a public health issue, people will be less likely to access live-saving medical care: they may avoid calling 911 in the event of an overdose or informing their family doctor of their drug use.
- When people are released from incarceration, risk of overdose death increases 8-fold following release; risk of HIV and Hepatitis C increase.
- Most overdose deaths occur to people who do not use opiates daily. No pharmacologic intervention to protect this population from death: for example, it wouldn’t be appropriate to start someone who uses opiates once a month on Opioid Agonist Treatment. It’s hard to find a medical solution to prevent deaths caused by criminal justice policy.
- As clinicians we follow people over time, sometimes also taking care of their loved ones. When we see a harm caused by a system, we have a powerful voice to ask for change to address the root cause, to improve quality of life and to reduce the risk of mortality.
Resources
Organizations
Online learning
- BC ECHO on Substance Use (Online, interactive sessions delivered via Zoom with didactic and case-based portions; currently offering an Opioid Use Disorder series and Alcohol Use Disorder series)
- BCCSU’s Provincial Opioid Addiction Treatment Support Program (Online, self-paced, free)
- BCCSU’s Addiction Care and Treatment Online Certificate (Online, self-paced, free)
Guidance
- BC Centre on Substance Use. A Guideline for the Clinical Management of Opioid Use Disorder [Internet]. 2017.
- BC Centre on Substance Use. A Guideline for the Clinical Management of Opioid Use Disorder — Youth Supplement [Internet]. 2018.
- BC Centre on Substance Use. A Guideline for the Clinical Management of Opioid Use Disorder—Pregnancy Supplement [Internet]. 2018.
Additional resources
- Office of the Provincial Health Officer. Stopping the harm: Decriminalization of people who use drugs in BC [Internet]. Victoria (BC): Government of British Columbia [2017].
- BC Centre on Substance Use. FAQ: Pandemic Prescribing in the context of Dual Public Health Emergencies [Internet]. Vancouver (BC): BCCSU [2020].
- BC Centre on Substance Use. Opioids: A survivor’s guide [Internet]. Vancouver (BC): BCCSU [2019].
- 24/7 Addiction Medicine Clinician Support Line provides telephone consultation around the clock to health personnel who are involved in addiction and substance use care and treatment in BC
- The Rapid Access to Consultative Expertise (RACE) line is available to provide specialist clinical advice Monday to Friday between 8am and 5pm Pacific time
Banner photo by William Sun from Pexels