Deputy Provincial Health Office and Vancouver Police Sergeant Call Addiction a Health Problem, not a Criminal One
For the unconvinced, this method is also smart on our tax dollars. When an individual is given substances that have been poisoned with synthetic compounds, often ambulances are called, Emergency Rooms fill up, and labs get backed up with thousands of toxicology reports; a strain on critical resources. The alternative, Blyth maintains, is allowing those who use to go to a medical professional, or an individual like herself, to use safely.
The harm reduction advocate shares that all of the frontline workers she knows–from the fire department to the City of Vancouver–understand that this change needs to happen. "It's just a matter of the political will at all levels of government."
Both Dr. Mark Tyndall and Sergeant Michael Wheeler confirm this sentiment.
"These events are important because every time we come up with a [solution], the pushback from decision makers and policy makers is that 'the public isn't ready for this’," Dr. Tyndall explains.
"People shouldn't be dying and it's something that's preventable. Police Officers are not used to feeling helpless and I think right now we're starting to feel pretty helpless until some radical changes are made,” Sergeant Wheeler adds.
Frustrated by those who declare the crisis too complicated to solve, Dr. Tyndall reiterates that every death is preventable. "In many cases these deaths are predictable," he says, inviting his audience to imagine the dire circumstances people are being put in. "When I was involved in the late 90's and early 2000's with HIV [work], the only thing we got right was getting people on antiretroviral therapy," the physician reports. "But we knew at that time, that this was not about HIV and getting people off drugs. This was about prevention; this was about housing, this was about treating people's trauma, taking care of people's social needs and not driving people to poverty."
Panelist Patrick Smith, from Culture Saves Lives, echoed Dr. Tyndall. "The best way to help First Nations people through the overdose crisis is sovereignty and self-determination." Smith cites the lost cultural justice of Indigenous communities. "Our people, their beliefs, and customs," he says, have been subjugated by the current system. "So we try to shine the light, and work the principle of equity into SROs and into the alleys, to a very, very deserving population."
"What we're left with in many communities is something that is quite fixable." Dr. Tyndall avows. The overdose death crisis is not due to a sudden influx of drug users, "it's because through prohibition and through criminalization, we drove the market into fentanyl. We created this ourselves."
Considering this, Dr. Tyndall makes a critical note that now is not the time to blame physicians or bar them from prescribing opioids to pain patients. Fentanyl is safely used during surgeries every day in hospitals around the world; it's the illicit version that causes the harm. "We need to make sure that we differentiate the idea that prescription drugs caused this whole problem. Even if they did—which they didn’t—it's obviously not the time to pull back those drugs." For some, his comment was a surprising note that needed expansion, but for which a lack of time at the solutions-based panel made difficult.
Addiction is caused by many things, none of which encompass just drugs themselves. Habitual conditioning of a rewarding behaviour, inadequate conditions for healthy brain development including childhood trauma, and social and/or economic exclusion have a much tighter grip on determining addiction than simply the chemical hooks of endorphin-releasing substances do. (Endorphins being the brain's natural opioids that calm and soothe the body).
That understood, the popular belief that simply prescribing opioids will cause addiction is not only unfounded but dangerous. Certainly, MDs need to be cautious when commencing an opioid prescription (and maintain awareness that not everything requires opioids). But if people are otherwise healthy, economically and emotionally secure, and equipped to deal with trauma's effects on the nervous system, prescription opioids alone are not going to render a person to the streets.
"If we could eliminate fentanyl tomorrow, that probably wouldn't change the number of people dying because there would be something else to take its place," Dr. Tyndall says. "We need an entirely different mindset here." Something he suggests we recognize is that, since it's indisputable that people are dependant on substances, the immediate solution is making sure they have access that won't kill them. Once that happens, he suggests, we can then move individuals along on a trajectory of treatment and recovery.
"I'm a cop. I've been a cop for 16 years and I am on board with everything this panel is saying," Sergeant Wheeler endorses. "That is also becoming the mindset of my entire department," he adds. If those who are tasked with enforcement believe there is a better way, then clearly we should go down that path, the officer suggests. "That's a pretty big barrier that's coming down. The next step is for those other levels [of government] to start falling in line and come to a realization that something new has to be done."
In the interim, the Police Sergeant offers immediate solutions the public can start with today: "We don't want people afraid to try to save themselves or someone else's life because they think they're going to get arrested," he says. It's a VPD policy that they will not attend that call. "So please, if you see someone in a crisis, call 911, you're not going to get arrested for being in possession of a substance."