Theo LK (00:05):
You're all aware that there's a crisis going on in Canada, killing thousands of people, but maybe not the one I'm previewing. The crisis I'm talking about is the opioid epidemic, which this year in British Columbia has resulted in over four times more deaths than COVID-19 Neo sounds mean in September. The CBC reported that British Columbia recorded 911 overdose deaths between January and July of 2020. Over that same time period, 395 people died of COVID-19. So why hasn't the prime minister in his government taken sweeping action to solve the crisis as he has done with COVID-19 Neo sound in response to whether or not the government would propose decriminalization, which according to many groups, including today's guest, which saved many lives. Justin Trudeau said that there is no silver bullet to fix the crisis, but has anyone suggested there is one simple answer. Vancouver is pivot legal society agrees.
There isn't a silver bullet, but that they have a science museum. If only the government would act according to their website, pivot works in partnership with communities affected by poverty and social exclusion to identify priorities and develop solutions to complex human rights issues. Our work is focused in four policy areas, police, accountability, drug policy, homelessness, and sex workers rights. Neo sounds today, Caitlin Shane lead drug policy, lawyer at pivot legal society from the state of drug policy in Canada, preview Kaitlin, you are the lead drug lawyer at pivot legal. What are your, what are your main goals at pivot in the drug drug policy section of pivot? What, what do you do and what are you aiming to do?
Caitlin Shane (02:03):
Sure. So the drug policy campaign is sort of focuses on two key goals. The first is decriminalization of simple drug possession, and I can go into that shortly, but it basically means removing criminal sanctions from possessing illicit substances. And then the other goal is ensuring what is referred to as a safe supply of drugs. So that means providing an alternative to folks who traditionally rely on the illicit drug market, which as you may know, is currently very toxic and unpredictable. So it's kind of those two goals going hand in hand and they compliment one another achieving one makes the other more accessible and possible. And so they're kind of a, a package deal from, from my perspective. And then the other kind of important thing to note about the drug policy campaign is that it's very much led and informed by people who use drugs and people who use drugs in the downtown East side, but also increasingly throughout BC. So these goals didn't kind of come out of thin air. They have been at the forefront of the fight against the war on drugs, led by people who use drugs for, for decades.
Theo LK (03:38):
And you recently released a report titled act now decriminalizing drugs in Vancouver. And in that report, in that report, you, you, you make the case for decriminalizing drug possession for personal use. Is that right? Yep. Yep. So all three levels of government, the federal, the provincial, and the municipal municipal government recognized that drug addiction is a health issue and not a criminal issue. Why, why haven't any of these levels of government taken action to decriminalize drug use, even though they themselves recognize that it is a health issue?
Caitlin Shane (04:17):
Well, I mean, that's, that's a good question. And it's kind of a, you know, it's a question that comes up in all of the campaigns that we work on at pivot, whether it's about housing and homelessness, whether it's about decriminalizing sex work, it's, these are things that governments at every level like to pay lip service to like to appear progressive on. And more than anything, love pointing the finger at one another to say this is not the responsibility of the city of Vancouver. This is the province of BC. And then the province of BC says, this is not a provincial issue. It's a federal issue. And each claims that they are unable to act because it's the responsibility of a different level of government. And I mean, ultimately you know, amending Canada's drug laws, which is what it would take to, to formally decriminalize simple possession that is indeed the role of the federal government.
Caitlin Shane (05:20):
The federal government has control over the criminal law over the controlled drugs and substances act. That's their responsibility, but they've already indicated that they're not going to change it. They're not gonna do that. So now we're left to to kind of have to get a little bit more creative and there's other ways to achieve something like decriminalization, what we call defacto decriminalization. So it's kind of like a basic decriminalization without formally amending the laws. But different levels of government can do. And so that's what we've really been focused on because you know, it's, it's been years of, it's been since 2010, really that the city of Vancouver has said, Oh yeah, we support decriminalization. We want it. They're calling on the federal government to do it. And it's just, you know, at this point it's just a slap in the face. It's empty gestures because they're not doing anything about it and they know that they can, but they won't admit it.
So this report aims to set out what exactly the city of Vancouver can do to achieve simple possession decriminalization. And so what that looks like according to the report is to request an exemption from the federal government. So basically asking the minister of health to bar the application of the law against all people in Vancouver. So when we have supervised consumption sites like insight and, and other safe consumption sites across the country, those operate because an application went into the federal government that said, I want this site to exist. I don't want anyone who accesses it, including staff or clients to face possession charges. And then the minister of health said, yes, I'm exempt. So anyone who goes in that space is not affected by the law of possession. So this just takes that principle and spreads it out and says, okay, everyone in Vancouver at all times, wherever they are should not be criminalized because you know, we're in a dramatic opioid crisis. We're now in a COVID-19 crisis. We're just trying to save lives. So what can we do to stop people from dying? Well, we take away the criminal law that is causing death. And so that's sort of what we see as being a solution in this report for the, for the city.
Theo LK (07:55):
There's a lot of things that you said in there. I mean, my question was kind of as kind of a big question, but it needs to be asked like, why is it, is it, is it just politics? It sounds like the government's playing off of different people and they're giving lip service to people that are in favor of decriminalization, but then they don't actually do anything about it. I, I remember Trudeau was interviewed a couple of weeks ago and he said that decriminalization is not a silver bullet. Is it, is it pivots position that decriminalization is a silver bullet and that's going to solve all of the, all of the problems?
Caitlin Shane (08:34):
No, absolutely not. It's not our idea that it's a silver bullet. It's interesting. Like the push for decrim has been going on for years and years and years. And now that we're finally sort of like getting somewhere with it or like the pressure has mounted to such a degree, I, the government has been forced into a position of like, okay, we need to, we need to like do something. We either need to do it, or we need to say, we're not doing it. Or like the pressure has mounted to a particular place. And what we've seen them do is really shift the dialogue in favor of something called stake supply. And saying, decrim is not a silver bullet. Therefore we're not going to do it. We're going to focus on safe supply. And to me, it's just this whole like it's so obvious that they're just trying to distract us from the advocacy and the work that we've been doing for so many years so that we can, and I'm not saying in fixed supply is incredibly important, but they both are.
They're not mutually exclusive. And so there's, this, this line of decrim is not a silver bullet. So we're not gonna do it. And, and our stance is like, there is no silver bullet, it's an incredibly complex problem. And the solution is going to be complex too. And no one who advocates for decriminalization has ever said, this is going to solve everything. Of course not. It's a harm reduction measure. It's a way to prevent the application of a really harmful law. That's it, it's one tool. It's a necessary tool because it's you know, it comes with a lot of criminalization comes with a lot of stigma that it incarcerates people, it drives drug use underground. It does all these things. So yeah, it's necessary and it's important, but it's not it's not going to change the quality or toxicity of the drug supply. It's not gonna, it's not gonna like, yeah, it's not gonna solve all of our problems, but it's a bit of a, I feel like it's, it's a bit disingenuous when the government says, Oh, it's not a silver bullet, so we're not going to do it. That's like, well, we never said it was, we just want you to do something.
Theo LK (11:00):
What, why, why at pivot, are you putting decriminalization before safe supply? And, and what does safe supply mean in terms of like on the street? Do you have a different definition than what the government intends and how do you see that sort of playing out safe supply versus decriminalization? I mean, if I, if I am a drug user, I would think that I would rather have a safe supply then be decriminalized because I'm not going to die. If I have a safe supply in the same way that I'm going to die. If you know, I have contaminated drugs yet it's made decriminalized.
Caitlin Shane (11:43):
Yeah. Really, really good questions. So I would say that we don't put decriminalization before say supply. I would say that these are two goals that run parallel at pivot and in the downtown East side. I, I would say that they're not mutually exclusive, and I think that they, they both need to be pushed at the same time to present a holistic response to the opioid crisis. So decriminalization, I see as very much a harm reduction measure, a way to move some of the stigma around drug use a way to ensure that people can access supervised consumption sites without fear of getting arrested on the way. So, like right now we have a situation where I can't leave my house with drugs to access the safe spot, the supervised consumption site, where I am encouraged to use drugs. I can't get there without fearing arrest on routes.
So if you remove that, that law and that fear mean that people can access harm reduction services without fear of getting arrested. And, and believe me, that fear of arrest is constantly deterring people from accessing lifesaving harm reduction services. People will not go to an overdose prevention site or insight because they're afraid of getting arrested on the way. They will instead use at home. And right now the vast majority of overdose deaths are occurring when people are using at home alone. So this is again, it's, it's it's a harm reduction measure. It's meant to kind of help lift drug use out of the shadows, ensure that people can get the services they need, the community they need without fear. Now safe supply is really attempting to address, like you said, the toxicity of the illicit drug market, and that's, you know, that's another, another goal, but it's a related goal.
So the idea is providing an alternative to people so that they don't have to rely on the toxic, illicit drug market. And, and definitely there's sort of, I would say like a spectrum of, of safe supply. So the way that, like, as we began to talk about drug use as a quote unquote public health issue, I think it's, it's an important step away from talking about it as a criminal issue. But when I talk with my clients and people who use drugs, many of them say that this whole narrative of public health has really over medicalized people and has turned them from criminals into patients and, and sick people and people who need to be fixed. And, and that doesn't work for a lot of people. You know, people have different reasons for using drugs. It doesn't, it doesn't mean that they're sick, helpless, or need you know, need an intervention, a coerced intervention, like people come to it for all different reasons.
And some people do identify as, as it being a sickness, but it's, it's not the case for everyone. And so with safe supply, you have, you kind of run the spectrum of what people want. Some people just want to you know, have low barrier access to clean drug. That's all they want. If you ask kind of people in power government, some doctors that are going to say no, it needs to be a heavily regulated situation where people are checking into a place three times a day and they're getting a prescribed amount and they're going to be monitored while they use and dah, dah, dah, many more barriers. And that's not going to work for everyone. It's going to work for some people, but it's certainly not going to work for everyone. And so I think our perspective of seed supply is again, driven by what people in the community want, which is to ensure that there's safe supply access for everyone. Someone should not be prevented from getting the drugs that they need because it's set up in such a way as to be entirely exclusive, I guess, is what I would say. So it's, it's not one size fits all, something for everyone.
Theo LK(16:21):
That's interesting. I think of other government run programs like alcohol and that is it's highly controlled. And then I think about I think about drugs marijuana's become legal, but then when we think about drugs like heroin and meth, don't you think it's quite a large step up to then decriminalize or potentially even legalize drugs like that when they are so, so much stronger and having access to those drugs, especially for young people and people that do have mental health issues or severe trauma that giving access and making it so easy is, is going to kind of encourage that drug use. And so that advocates of decriminalization maybe want it controlled, but going further than that is, is not going to really help the problem.
Caitlin Shane (17:26):
Yeah. So I think I think absolutely like it needs to be, and it needs to be regulated. And I guess, I, I'm not saying that it should be a free market or you know, heroin at every corner store. Like that's not, that's not the argument. It is. When I'm talking, ensuring that people have access to what they need, I'm talking about regulating drugs in such a way as to be tailored to the individual. So you're absolutely right. Like there's a difference between regulating cannabis and regulating heroin. We're talking about two entirely different substances, different rates of like dependence that can result, et cetera, et cetera. So that's going to regulating heroin is going to look very different from, from regulating cannabis. And, and it is, it is going to be more restricted than, than cannabis is again, not saying people should be able to walk into a store and buy heroin, but I think it needs to be regulated in a way that someone who is experiencing dependence or someone who has been using heroin every day for the last 10 years and who is going to use it again today, whether it's from the street or from this Depot clinic, whatever it is that needs to be facilitated, right?
Like, so we need to look at the individual and what does that person situation, are they a long time heroin user? Are they going to continue to use heroin today? No matter what that person's access will and should look very different from the access of a 16 year old, who's never used heroin before and wants to get high, right? Like, there's, there's gotta be a difference in a gradation that looks at the individual and, and kind of their circumstances. And then the assessment is made for that person.
Theo LK (19:38):
What about programs to prevent people from getting on drugs in the first place? I mean, I know you mentioned that you think that people should have access and sort of almost no matter what, in a sense, not, no matter what, but it shouldn't be the governments or other people's prerogative to determine if you should be on using drugs or not that some people use it maybe recreationally and there shouldn't be judgment. Is that sort of the position of drug users you've, you've met,
Caitlin Shane (20:11):
But, but I mean, not, no, no. I think that's a bit overly simplistic because I think that access is meant to be yeah, ultimately like the person who is using the substance knows best, but also that's like contingent on a lot of things. So like, like I said, that the person who's been using heroin every day for 10 years is absolutely going to know better than any doctor what works for them and what doesn't like at this point, this is a person who like, like you, like anyone who has been using a, and he knows what works for their body and what doesn't and who who's aware of what's going to happen tomorrow. If they don't, they don't have what they need. But I mean, as far as like less experienced drug users go or people that are looking for solutions, the idea is that that access will be mediated by you know, health professionals and that's that's where we're family or community, like, it's, it's a, it's an entirely different way of looking at drug use. And it's, it's meant to be sort of like a way to think about it outside of criminalization, where the person is just like, you know, spearing arrest and, and like, I don't know how to say, I think it's, it's, it's, it's not so much that any person can walk into any place and get whatever they want, but it's about looking at the factors of that individual and, and with assistance from others, getting what they need,
Theo LK (21:55):
What about the access to mental health care and support in, in the rest of their lives so that, you know, people aren't going on in the first place, isn't it, shouldn't that be part of the strategy? So there's decriminalization, there's safe supply, but then there's a whole other aspect that should probably go with it at the same time. How come pivot doesn't group, that, that, that aspect with your strategy? Okay.
Caitlin Shane (22:24):
Well we do, I mean, decriminalization, I think I've explained in the report that that needs to be paired with access to all sorts of other supports, of course, drug policy doesn't exist in a silo. It's deeply connected with lack of housing, lack of income assistance racism and colonialism, a lack of police accountability. It's all of these things that are deeply connected with drug use and the, the state of drug policy in Canada. So I would never suggest that, again, that there's some sort of silver bullet either in decriminalization or, or in decriminalization plastics supply I've always been a strong advocate that, that there needs to be an entire shakeup in the way that services are provided in the way that income flows in our country. Like that's, that's incredibly important. And in order to you know, maximize the effects of decriminalization and safe supply, a hundred percent people should also be you know, adequately housed and a proper level of income. And so, you know, I have my drug policy campaign, but we also have a housing and homelessness campaign, and we also have a police accountability campaign. And each of our reports and our advocacy and our work is, is connected so that we can ensure that all of our all of our projects and of work are sort of nuance in that way.
Theo LK (24:12):
I wanted to talk to you about the Portugal model. Now I know that in my social sphere, I hear, you know, Oh, the porch, the porch Portuguese have decriminalized drugs, and they've kind of solved all the problems, but the situation is a little bit different than that in real terms. Can you describe what the Portugal model is and how it's played out in, in reality?
Caitlin Shane (24:40):
Yeah, so the Portugal model is kind of the most celebrated example of drug decriminalization worldwide. So you hear a lot of people calling it the Portugal model, and they basically you know, decriminalized small amounts of drugs for personal use. And, but, but they didn't exactly just do a way with enforcement or, or any form of like sanction for people who possess small amounts. What they did is they replaced the criminal regime with what we call an administrative regime. And so they, they made it so that if, if a person was in possession of of some street drugs they could still face things like fines or a ticket. And they were forced into something called a dissuasion commission, which is basically like a commission comprised of like a doctor. And I think a social worker and someone else that the person who is whatever apprehended or, or intercepted goes before the dissuasion commission, and then chats it out with that commission about what is the, what is the best step forward?
And you know, if you ask, if you ask like government, they'll say, this is you know, the perfect solution, we put people in treatment or recovery or whatever, but, but when you actually talk to drug users in Portugal, and there's a fantastic report that I think should be you know, I think it should be the, the, the number one document that we're looking at when we're talking about the Portugal model and it's it's evaluation, cause it's written by who use drugs in Portugal. And those folks are saying like, yeah, of course there was a lot of benefits that came with the Portugal model. Absolutely. No one's saying that it's a terrible system that doesn't work and, you know, rates of incarceration went down, people's health and safety improved people's access to education and housing and community went up. Rates of HIV went way down.
Rates of overdose went way down. So there's a lot of positive things that came from the system don't get me wrong. But people use drugs in Portugal. We're saying that the, the number one issue is that for the most marginalized drug users. So we're talking about racialized drug users, poor drug users, drug users, who are unsheltered. These folks continue to face police harassment and violence on the daily basis. And they are disproportionately the ones who are coerced into attending the dissuasion commission disproportionately forced to attend compulsory treatment that doesn't work. Oftentimes for people who have longstanding substance use, like the compulsory nature of it, it must be voluntary and collaborative like it, coercive treatment has been shown time and time again to be ineffective and to actually cause harm. So this report from people who use drugs in Portugal, tells a bit of a different story and says, but by all means, we need to decriminalize, but we need to do a way with certain elements of the Portugal model need to ensure that police are not sort of the gatekeepers of health services. And so this is kind of where that piece of like, yes, we need health services. Yes, we need access to housing and, and a full range of state provided services. But police should not be the ones who are determining whether that person has access to them. A person's access to those services should not depend on whether they get caught possessing drugs, right? Like open the doors to those services without simultaneously continuing to criminalize people for carrying drugs. That's the way I see it.
Theo LK (29:14):
I want to touch on the safe supply aspect. Most street drugs come from organized crime. How do you see the government playing a role in safe supply is the government in this case, if we had to say, save a supplier, are they producing all of these drugs? And they become the supplier, they're making a crystal meth, they're making heroin, they're making all of like crack cocaine. Is that how you see it?
Caitlin Shane (29:45):
So the, so, and this gets into sort of like a level of inner regulation workings, but is probably not my forte, but I mean, we, we do have examples of safe supply already in Canada where it's not the government who's producing the substance, but, but there has been you know, the same as any like regulated drug. Yeah. A pharmaceutical company put in, I'm not saying pharmaceutical companies are like angels, but you know, a company produces the substance according to certain standards that are approved by health Canada. And then it's accessed by people. So we have like we already have the Crosstown clinic in Vancouver, which is a place where a small group of people are able to access prescription grade heroin. And this is one of the more sort of like medicalized clinics, I would say on the safe supply spectrum.
And so there's been a lot of, a lot of pushback from some people who use drugs who say like this model is too stringent for me because it's basically you know, three times a day, the person goes to this building in the downtown East side, they're witnessed while they're injecting. They have to hang out there for a time afterward. They're like subject to tests and analysis by doctor. My understanding is it's gotten a little bit more accessible during COVID ironically, but yeah, so, so, so it works for some people and the, and the people that have been retained in this program are, you know, their, their health has dramatically, dramatically improved. The quality of their lives has totally improved. But it's not, it's not gonna work for everyone, but that's a program where prescription grade heroin is produced and distributed out of this clinic in Vancouver. And it's sort of like regulated, I guess, by the government in the way that other drugs are
Theo LK (32:03):
With COVID-19, we've seen, seen a lot of deaths across Canada, but the opioid epidemic crisis has seen many, many, many more deaths as a result. Has, have you seen the, the, the federal government change their stance or make any progress because of these mounting deaths?
Caitlin Shane (32:26):
Yeah, it's, it's really interesting. Cause it's like the opiod crisis has been a declared emergency in BC for four years now. So it was kind of this strange thing where I think a lot of people in the downtown East side are sort of like, yeah, we've been living in an emergency for four years and no one has really come to help us despite us like pounding down the doors and getting no response. And the other thing I'll say is that with, with COVID, there was sort of this interesting PEM government response to COVID where, and, and it wasn't, it wasn't a perfect response, but it was like we saw way more coming from government in the first week or two of COVID then we have ever seen in response to the opiod crisis. So it was a really, I think like at the same time, as we were all kind of like processing COVID, we were also processing this recognition that you know, government cares about some people and not others.
And we were sort of seeing responses that we were told were impossible for the last four years suddenly becoming possible. And so that was really like, I think we all kind of knew it, but it was really hard to to bear witness to cause you're like, Oh, wow, okay. Yeah, you really don't care about drug users, but the government has, you know, they've done some things in COVID that were allegedly impossible prior to COVID. And so they've, they've kind of like improved you know, they've made it possible for nurses to prescribe heroin where they they couldn't do that before. So there's been an expansion in, in, in medical professionals that that can prescribe. So there's been like, you know, things that have changed in this time. And I think it's an important time for advocates of decriminalization and seek supply to really step on the gas in this period, because I think we have a bit of a window.
Theo LK (34:54):
What would you say to somebody? And I think there's a fairly large group of people who might say something like this is that I don't want my tax dollars going to some random person on the street who made a choice to use drugs. It's not my responsibility to, to bail them out and pay for their drug use. What would you say to somebody like that?
Caitlin Shane (35:14):
I would say, well, you're already paying way more when that same person is getting arrested and thrown into jail. Like if you want to get into the economic argument for decriminalization, it's there, you look at Portugal has an entire economic analysis of how this has relieved taxpayers of a particular financial burden, post decriminalization. So people are like the, the cost of you know, one person let's say a person overdoses. They are brought to the hospital in an ambulance. Let's say they were found to have more than a small amount of drugs on them. So then they get arrested, like the bills that have been racked up for taxpayers in that single instance far surpasses what, what, like peanuts they'd be paying for that same person to just be able to go to a clinic, access, a safe supply of drugs and walk out the door without issue like it's from an economic perspective. It's no question.
Theo LK (36:27):
You said, you mentioned there's a window where you think decriminalization advocates and safe supply advocates, housing advocates have to lobby the government to get more measures passed. What is now that you've released this report? What are the next steps going forward?
Caitlin Shane (36:43):
It's going to be pushing at pushing out all levels of government and I'm no asking for meetings and calls and you know, getting the community to you know, echo this call. Cause I think having numbers is probably the most important thing. So it's really about getting some broad consensus and we've been working with a group, a national decriminalization strategy group, which is comprised of folks all across the country to kind of consolidate our call and to really define what decriminalization would look like in Canada. So kind of like I guess like a Canada model as compared with a Portugal model.
Theo LK
Thanks so much, Caitlin.
Caitlin Shane
Thanks.