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Healthcare over handcuffs: Canada’s bold drug policy

Jul 12, 2022


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For decades, many have argued that cannabis is a gateway to harder drugs.

It’s an old and contested cliché. But for the purposes of this article, we’re not talking about a gateway for drug users. We’re talking about policymakers. Specifically, those in Canada who have developed a reputation for pioneering programmes to mitigate the impacts of illicit drug use.

In June 2018, Canada became the second country (after Uruguay) to fully legalize adults’ recreational use of cannabis—subject to conditions such as the strength of approved cannabis, not driving while under the influence and restrictions on advertising or marketing. Up to that point, some states had legalized cannabis for medicinal purposes, while others had merely decriminalized possession.

For the uninitiated, decriminalization removes sanctions but does not make the activity or drug legal.

Prime minister Justin Trudeau’s more ambitious Cannabis Act had multiple aims: keep drugs out of the hands of children; take profits away from organized crime; free up police time spent on low-level drug crimes; protect public health; and increase government tax revenues.

It was a controversial move, not without risk, and some experts warned against full-blown legalization. But, four years on, there are indications the policy has worked. Criminal convictions for cannabis-related crimes among youngsters have dropped, releasing police and criminal justice resources. A widely predicted increase in cases of cannabis-induced psychosis has not materialized.

But it’s not all good news. Cannabis use across Canada has increased from 22% to 27%, and those benefiting economically from the expanded market are predominantly white and male in a country lauded for its diversity and inclusivity. Some academics also point out that, just four years after the policy was introduced, data on the long-term impact of legalization is still raw: a big caveat when attempting to measure the success or failure of health outcomes.

But the policy’s popularity has emboldened Canada’s politicians—and they have now turned their attention to harder drugs. In early June, British Columbia, Canada’s third most populous province, announced it would temporarily decriminalize several illicit drugs. These include opioids such as heroin, cocaine, MDMA and methamphetamine of Breaking Bad fame.

From January 2023 for three years, adults will be allowed to possess a combined weight of 2.5 grams of these drugs without fear of being arrested, charged or having the items seized. The drugs themselves will remain illegal: it is the possession of small quantities for personal use over which no action will be taken.

Policymakers globally are impressed with, yet slightly fearful of, Canada’s chutzpah because nobody knows what will follow. For years, some academics, public health practitioners, addiction charities and senior police officers have espoused the potential benefits of relaxing traditional hard lines on hard drugs—only to be thwarted by politicians and public servants nervous about possible outcomes and loss of votes. As Britain’s longest-serving post-war prime minister, Tony Blair, will tell you: at the ballot box, it often pays to be “tough on crime, tough on the causes of crime”.

So when Ronald and Nancy Reagan intensified Richard Nixon’s “war on drugs” with the 1980s slogan “Just Say No”, the battle lines were drawn and most states responded to mass production by organized crime by taking a zero-tolerance stance. But the harsh reality is that the Western world is losing the war on drugs when assessed against some crucial metrics.

Specifically, deaths by drug overdose are on the rise across some areas, which is why Canada has opted to trial decriminalization. British Columbia is in the midst of an opioid overdose crisis: more than 2,000 people across the province lost their lives to this scourge last year, and at least 9,000 have died since 2016.

With such losses in mind, you might think decriminalizing hard drugs such as heroin is counter-intuitive. But policymakers in British Columbia believe that by removing the threat of criminal action against recreational drug users, many will reach out for life-saving health and social services support that could prevent deaths. Instead of being arrested, those found possessing illicit drugs will receive advice on support programmes.

Vancouver’s mayor, Kennedy Stewart, said the trial marks a fundamental rethink of drug policy and favours “healthcare over handcuffs.” Carolyn Bennet, Canada’s federal minister for mental health and addictions, said: “For too many years, ideological opposition to harm reduction has cost lives. We’re doing this to save lives.”

It’s a high-risk experiment—more so than the decision to decriminalize cannabis—and Canada’s policymakers know it. Which is why the three-year project will be closely monitored and, if necessary, amended to prevent a drug crisis.

The rest of the world will observe with interest. Privately, I’m told, some states believe British Columbia is inviting trouble, not least because organized crime gangs and cartels have beefed-up global supply chains in recent years and could meet any surge in demand—potentially flooding cities and markets with powders, crystals and tablets. The worry is that, even if drug deaths decrease, wider drug use could increase across British Columbia (as we have seen with cannabis across Canada) and perhaps even surge.

One experienced US drug policy expert, who spoke on condition of anonymity, told me, “Personally, it just doesn’t feel like the right time to try this because organized crime’s supply chains remain strong globally. Recreational users will no longer worry about the consequences of possessing or taking hard drugs, so demand could spike.

“But I’m open-minded. You have to admire Canada’s bravery. Other states are too worried about the potential consequences. But this way politicians, policymakers, law enforcement and researchers will observe a real-life trial and see what happens when you decriminalize at scale. If that tackles death rates, that’s a clear benefit.”

Canada has built a reputation for innovative and forward-thinking public policy. But the margin for error here is small. Many eyes, I fear—not all well-meaning—will now turn towards British Columbia…


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