Population-level data from the Public Health Agency of Canada has shown a substantial increase in opioid-related illnesses and deaths since the start of the COVID-19 pandemic. During the first year of the pandemic, the agency measured a 95% increase in apparent opioid toxicity deaths. Multiple explanatory variables — the inaccessibility of harm reduction services, new social stressors, and an increasingly toxic drug supply — exacerbated an endemic public health crisis. In response to record-breaking death rates, several municipalities — and, to date, one province — have explored the harm reduction impacts of decriminalizing the personal possession of all illicit substances. This approach advances a policy framework that treats substance addiction as a public health issue, contending that its criminalization has wrought unintended socioeconomic consequences.
Municipalities are leading the decriminalization movement. In May 2021, the City of Vancouver became the first city in Canada to submit a request for an exemption from the Controlled Drugs and Substances Act (CDSA). If a municipality’s exemption request is granted by the Minister of Health, Mr. Jean-Yves Duclos, people who use drugs (PWUD) will be allowed to carry small amounts of illicit substances for personal use within the city’s boundaries, without fearing criminal repercussions. Toronto was the second city to submit a request (in January, 2022). Last Tuesday, Edmonton became the third city to pursue this policy pathway and city staff are now preparing their submission to Health Canada.
Provinces have also pioneered this course of action. After Vancouver became the first Canadian city to submit its request, the province of B.C. followed suit — lodging its documentation several months later (in November, 2021). While outlining the plan, B.C.’s Provincial Health Officer, Dr. Bonnie Henry, cited a desire for coordination among the province’s police detachments.
If the Minister of Health grants exemptions to Toronto, Edmonton, and British Columbia, the Liberal government will be countersigning a new public health approach. This will increase activist calls for Minister Duclos to proactively issue a nation-wide exemption from section 4(1) of the CDSA, which criminalizes the simple possession of scheduled substances. Under section 56 of the act, the federal Health Minister has the power to exempt jurisdictions from any provision, without needing to amend or pass legislation in Parliament. A consistent, coast-to-coast policy approach would eliminate the need for the federal government to consider exemption requests on a case-by-case basis.
So far, the Liberals have not publicly endorsed the granting of provincial and municipal exemptions to federal drug law. In response to the City of Toronto’s January application, the Minister of Mental Health and Addictions, Ms. Carolyn Bennett, stated that the government recognizes “the different approaches cities, provinces, and other organizations are taking,” to the opioid crisis. The Minister indicated that the government is generally “supportive of their work to find innovative solutions.” In a recent press conference in Edmonton, Prime Minister Justin Trudeau was even more reserved in his remarks. While indicating that the government will thoroughly review all exemption requests, the Prime Minister carefully highlighted its support for supervised consumption sites.
So, what explains this Liberal reticence to pursue the decriminalization of simple possession on the national level?
Beyond the fear of antagonizing centre-right voters, particularly older voters (many of whom grew up experiencing the spillover effects of America’s War on Drugs), the answer may lie in Canada’s epidemiological data. The Public Health Agency of Canada reports that the distribution of drug poisoning deaths is regionalized. In 2021, British Columbia, Alberta, and Ontario accounted for 88% of all accidental apparent opioid toxicity deaths. In other words, the opioid crisis has not affected Canada in a uniform manner — the Liberals (most likely) fear jeopardizing swing votes in federal ridings that have been comparatively less affected by skyrocketing death counts.
If the current set of exemption requests are granted (which is by no means guaranteed), the Liberal government would be implementing a health-oriented framework in the urban epicentres of the crisis. However, granting ad hoc exemption requests represents an inefficient, and drawn-out bureaucratic approach. The Liberals may need to get off the fence and take a position. If the party favours the decriminalization model, the Trudeau government should probably implement a two-pronged course of action. In the short term, Minister Duclos could issue a section 56 exemption that implements the de facto decriminalization of simple possession for every Canadian. In the long-term, the Liberals could introduce legislative amendments to the CDSA, repealing section 4(1).
The Liberals’ current passivity represents a dearth in leadership. Crisis-ridden jurisdictions are being forced to lead new public health initiatives, and ad hoc exemptions will exacerbate jurisdictional disparities in the health outcomes of PWUDs. The current state-of-affairs places administrative burdens on municipalities and provinces, increases multi-level bureaucratic inefficiencies, and requires a significant investment of public resources — at all levels of government. This is not a time for federal foot-dragging. If the Liberals want to lead, they can’t do it from the backseat.
