Full Comment - Profiting from despair： How decriminalization advocates exploited B.C.’s opioid crisis

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00:02:02.960 When David Eby, the NDP Premier of British Columbia, turns around and says,

00:02:12.640 we made a mistake, we need to fix the decriminalization process, you know it hasn't gone well.

00:02:19.120 Hello, welcome to the Full Comment Podcast.

00:02:20.960 My name is Brian Lilly, your host.

00:02:22.680 And today we're going to talk about drug policy, decriminalization, safer supply,

00:02:27.520 issues that are gripping much of the country, not just because they're political,

00:02:31.860 but because of the impacts, both for families dealing with addiction, a loved one who has

00:02:37.700 dealt with addiction or loss, but also because of the impact some of the decisions our politicians

00:02:43.540 are making around drugs are having on our communities.

00:02:46.240 David Eby and the NDP government in BC initially asked for decriminalization of all hard drugs.

00:02:53.000 And less than a year and a half in, they're asking the Trudeau government in Ottawa to recriminalize drugs in public areas.

00:03:02.180 Not completely, but in public areas.

00:03:04.420 Why?

00:03:05.280 Chaos, public disorder, and an outcry from a citizenry that said, this just isn't working for us.

00:03:12.220 Julian Summers is a clinical psychologist, professor at Simon Fraser University,

00:03:16.360 and he deals a lot in the area of addictions, recovery, and monitors what is going on in his home province.

00:03:24.260 Julian, thanks for the time.

00:03:26.040 It's great to be with you, Brian.

00:03:28.400 Maybe this is too big a question to ask off the top, but how did things go so badly with decriminalization?

00:03:36.420 I mean, surely some people would have seen the outcomes ahead of time, but Premier Eby said,

00:03:44.300 well, we need safeguards in place, and maybe they should have been there at the start

00:03:48.240 to stop things like drug use in children's playgrounds or on public transit.

00:03:53.620 Did nobody see this ahead of time?

00:03:55.560 Well, people did see it, and it was unpopular to point out limitations of the BC government's planning.

00:04:13.280 And so many of my colleagues who were concerned and shared my concerns felt pressured to remain silent.

00:04:23.020 And this is due to the organizations that they're working in, whether it's the provincial government itself,

00:04:30.680 our health authorities, and even physicians in private practice were, you know, going back now three years

00:04:38.820 when this kind of got started, were saying, gosh, you know, I'm really glad you're speaking out, but I can't.

00:04:45.260 And, you know, it's some kind of a deficiency on my part that leads me to blurt out things.

00:04:54.540 I didn't think that commenting critically on the government's plans would result in such a severe backlash.

00:05:01.860 Now I've got a clear understanding of why that took place.

00:05:06.060 But the policymaking environment here was quite superficially informed by the science of addiction

00:05:17.000 and relevant evidence elsewhere.

00:05:20.940 The single intervention of decriminalization was regarded as kind of a logical next step

00:05:28.980 in light of the limitations of the war on drugs.

00:05:31.720 As though there are no intermediary possibilities.

00:05:37.240 And in her report, our provincial health officer, Dr. Bonnie Henry,

00:05:42.000 when requesting decriminalization, said,

00:05:45.560 decriminalization on its own, without additional measures at this time,

00:05:50.160 will result in improvements because it will lower stigma,

00:05:54.160 which in my view is a crazy assertion.

00:05:56.720 And that it'll allow police to focus on other things.

00:06:02.080 So we'll see net improvements.

00:06:04.500 We must follow that, she said, by further increasing the regulation and legalization of illicit drugs.

00:06:12.040 Another crazy idea.

00:06:15.020 So, you know, it wasn't popular to point these things out.

00:06:18.500 But increasingly, the government is being compelled to face the reality that they badly miscalculated.

00:06:27.640 To me, it seems that British Columbia, like here in Ontario, Toronto specifically,

00:06:35.700 that the decision making is being guided by activists, more so than thinking things through.

00:06:42.820 In reaction to British Columbia asking for a recriminalization and all the documented social ills that came with it,

00:06:51.720 and the fact that police were powerless to do anything,

00:06:55.100 our mayor, our medical officer of health, our provincial chief medical officer,

00:07:00.180 they're all still defending it.

00:07:02.040 What happened in British Columbia?

00:07:04.440 And they're saying that we need to move forward with this.

00:07:09.120 In fact, Dr. Eileen DeVilla put out a video the other day defending the policy and the request to the federal government

00:07:17.620 to have decriminalization in Toronto saying,

00:07:20.300 well, you know, no one will be able to smoke a crack pipe in a playground or shoot drugs into their arm on transit.

00:07:30.560 And then you look at what the request is, and it's clear that they will,

00:07:34.160 because police would only be able to act if someone was smoking a crack pipe or shooting heroin

00:07:40.660 in a childcare center, a K-12 school, or an airport.

00:07:45.620 And outside of that, they would have no ability to deal with someone causing major distress

00:07:51.320 for transit riders, for parents, for small children.

00:07:55.140 Yeah, I mean, it's hard to understand how someone would say that,

00:08:01.740 especially in close proximity to the testimony that we're hearing from police officers

00:08:06.920 and police representatives giving testimony in Ottawa

00:08:11.560 and stating that, you know, the questions like,

00:08:15.920 well, we hear if people are, patients in hospital are smoking fentanyl and crack

00:08:22.420 in their hospital rooms, fellow patients are concerned, police, what can, you know,

00:08:28.260 surely you can do something.

00:08:29.520 And the response is, well, no, we can't.

00:08:31.800 No, we can't.

00:08:33.420 And so it's hard to kind of, you know, imagine, well, why would someone in a position of authority

00:08:39.340 be saying the opposite in advance of a change?

00:08:45.240 And I think we have to look at money.

00:08:47.180 I think we have to look at the fact that whether it's in our municipal politics,

00:08:54.560 our provincial politics, in our academic institutions,

00:08:59.620 that we have increasingly individuals whose livelihoods and whose careers

00:09:06.140 are related to the flow of public funds,

00:09:10.480 whether it's their salaries, their staff support, their grants,

00:09:13.540 their own salaries as researchers in many instances,

00:09:17.180 and who are dependent on the flow of funds linked to particular policies.

00:09:24.240 Decrim and what's been referred to as safe supply

00:09:27.560 are major thrusts of current federal and BC provincial politics

00:09:33.780 and are essentially purchasing advocates.

00:09:39.300 I remember going back to when it was just a safe injection site.

00:09:43.940 I think it was the Portland Society.

00:09:47.200 Was that the organization in Vancouver?

00:09:49.500 Portland Hotel Society.

00:09:50.500 Yeah, Portland Hotel Society.

00:09:52.680 And they would always bring up, well, we've got peer-reviewed studies.

00:09:59.480 And then you look.

00:10:00.740 And, okay, well, John peer-reviewed George's study,

00:10:07.200 and George peer-reviewed John's, and Mary peer-reviewed this one.

00:10:11.520 And it was just a group passing it around that all have the same ideology

00:10:16.820 and push for this.

00:10:19.320 And I think, you know, the public is compassionate.

00:10:23.340 People have compassion for addicts.

00:10:25.820 And we've been sold on, whether it was safe injection sites

00:10:30.580 that became safe consumption sites, that became safer supply,

00:10:34.480 that became decriminalization.

00:10:36.920 I think the public has a compassion and they want to help.

00:10:41.060 And they're told this will reduce overdose deaths.

00:10:45.560 This will reduce social ills.

00:10:47.460 And then when you say to the activists and the advocates who push this,

00:10:54.660 well, we tried what you wanted and it didn't work,

00:10:57.260 they say, but we haven't tried it long enough, or we need to do more.

00:11:00.580 And that's what they're doing now.

00:11:01.740 And I look at the BC Coroner's report that comes out monthly

00:11:05.720 on unregulated drug deaths in BC.

00:11:09.020 And I don't know how they can continue to say we need to keep doing this.

00:11:12.700 With the exception of 2019, we've gone up every single year in British Columbia

00:11:18.820 from 370 drug overdose deaths in 2014 to 2,546.

00:11:27.940 I know fentanyl really hit the scene in 2016 and has been growing ever since.

00:11:34.060 But the measures that society has agreed to put in place

00:11:39.020 to try and get better outcomes is not getting better outcomes.

00:11:42.700 Yeah, and it's along the lines of the tactics of the gun lobby in the US

00:11:53.500 that the problem of mass shootings and school shootings and so on

00:11:59.760 isn't that we have too many guns, it's we don't have enough guns.

00:12:03.180 Because we don't have enough guns in the hands of the right people, right?

00:12:07.340 So this is very similar.

00:12:10.180 I've heard that argument, yes.

00:12:11.780 The reason I emphasize the money side is that this whole movement

00:12:19.200 from the perspective of addiction research and what we can do to reduce,

00:12:23.380 to prevent addictions, to help people overcome addictions,

00:12:28.080 is completely missing from the rationale for what we're currently doing.

00:12:33.400 It comes out of a whole different place, as though there was no previous literature.

00:12:37.940 And the main protagonists in BC, we have a government-funded,

00:12:45.360 an industry-funded center, the BC Center for Substance Use.

00:12:50.160 The BC Center for Substance Use was created by people who were formerly the HIV AIDS Center.

00:12:56.600 They essentially rebranded, retitled their initiative, but appear to have preserved the same

00:13:04.700 overall focus on pharmaceuticals, which obviously is integral to the progress that we've made

00:13:11.840 in addressing HIV AIDS, but is a relatively minor component of helping to prevent and treat addiction.

00:13:19.160 To emphasize how sort of odd this policy thrust looks, consider that we're eight years into a declared

00:13:28.580 public health emergency in BC.

00:13:31.160 The only way to perpetuate a mortality crisis is to keep putting people at risk every single day.

00:13:39.440 We have no prevention strategy.

00:13:43.040 It hasn't even crossed the lips of our government leaders, whether on the public service side or the elected side.

00:13:49.280 Everything is focused on supply.

00:13:52.900 If the war on drugs taught us anything, it should be that a focus singularly on try to improve community health

00:14:02.400 by intervening in supply is insufficient.

00:14:05.760 But here we are with an entirely supply-focused strategy.

00:14:11.940 Of course, it's blaming toxic drugs.

00:14:15.020 Not the fact that youth are growing up in despair.

00:14:18.940 Not the fact that people with untreated mental illnesses are increasingly on our streets and succumbing to drug addiction

00:14:25.300 or in SROs, inadequate forms of housing.

00:14:28.880 Nothing to do with the circumstances that are modifiable.

00:14:33.180 I mean, so this is back to the addiction literature.

00:14:34.980 Lots of research shows that, including randomized controlled trials that I've had the privilege of leading,

00:14:41.640 has shown that if we provide people with fundamentally different opportunities that involve changing their circumstances,

00:14:49.180 changing where they live, changing their opportunities to engage in the workforce,

00:14:53.240 to reconnect with their kids and with their families,

00:14:55.720 we see dramatically different results, including crime, addiction, and suffering.

00:15:01.960 But here we have this kind of odd-looking, completely supply-focused initiative.

00:15:08.840 And what makes it worrisome is the people responsible were so convinced that they were correct,

00:15:18.400 that several of them formed their own companies while in public office and while lobbying for safe supply.

00:15:26.160 This includes our former provincial health officer, who formed an opioid company,

00:15:30.820 his deputy, who formed an opioid vending machine company,

00:15:35.240 the chief scientific officer of our major health funding organization,

00:15:40.380 the Michael Smith Foundation, who also was an HIV-AIDS researcher,

00:15:44.540 co-founded the opioid company with our PHO.

00:15:47.220 So hold on.

00:15:48.940 I need to stop you because I'm having trouble believing this.

00:15:53.440 They founded companies to supply opioids to safe supply?

00:15:59.780 Exactly.

00:16:00.740 They were so...

00:16:01.940 They didn't...

00:16:02.940 This is...

00:16:03.840 So this has been reported and is on the record.

00:16:06.220 So did the director, the initial director of the BC Centre for Substance Use.

00:16:11.340 They all worked together on HIV-AIDS, and they were so convinced that the thought that the appearance of conflict,

00:16:24.780 in hindsight, would be irrelevant, that they would likely be seen as the architects of a new era,

00:16:33.080 a new and better era.

00:16:34.320 I think that, you know, having worked with these individuals for many years,

00:16:40.660 I'm now, of course, excommunicated from that particular tribe. 0.60

00:16:45.060 But having worked with them for many years, I think they did it believing they were right.

00:16:50.840 Dr. Bonnie, in her report to Ottawa asking for decrim,

00:16:55.780 says that the world is seeing increases in drug-related hardships,

00:17:01.800 including poisoning fatalities, and BC, and she says,

00:17:05.540 BC is poised to lead the way.

00:17:09.120 So there's really, you know, a lot of evidence suggesting that they really, really believed in what they were doing,

00:17:15.920 that they believed that potential conflicts of interest would never rise to the point of scrutiny,

00:17:22.220 but they badly miscalculated.

00:17:25.500 That's...

00:17:26.140 I'm still dumbfounded at that.

00:17:28.800 That is, you know, we were talking before you joined us off-air about all the, you know,

00:17:36.360 former cops and police chiefs who now own a piece of the marijuana industry,

00:17:42.240 the cannabis industry in Canada.

00:17:43.960 But that's legal.

00:17:45.440 These are health officials forming opioid companies to supply something

00:17:50.040 that we would have thought crazy just a few years ago.

00:17:52.960 I interviewed Dr. Sharon Koivu a few months ago about the problem of safer supply,

00:17:58.920 and she had a unique vantage point from where she is in London, Ontario.

00:18:03.300 And Dr. Koivu is an advocate of harm reduction, if done right.

00:18:09.020 But she said there are four pillars of drug policy,

00:18:13.880 prevention, treatment, enforcement, and harm reduction.

00:18:19.240 And she said, we've forgotten about the other three,

00:18:21.540 and we're just doing harm reduction, and that is hurting people.

00:18:25.540 Would you agree with that statement?

00:18:28.200 Well, so I agree that we've lost track completely of the four pillars.

00:18:33.460 I also agree with your kind of query that we aren't even doing harm reduction.

00:18:41.280 Harm reduction was introduced, and one of the—I say this with some sense of, you know,

00:18:52.320 I guess, authority.

00:18:54.580 My mentor in clinical practice was a psychologist named Alan Marlat.

00:18:59.220 Alan literally wrote the book Harm Reduction

00:19:02.020 and was a major force behind its advent in North America

00:19:06.760 after gleaning some of the early insights from European practices.

00:19:12.120 And I had the privilege of contributing to those books

00:19:15.260 and to doing research involving harm reduction now over many years.

00:19:20.440 The point of harm reduction is to be engaging people where they are,

00:19:25.020 to be non-directive.

00:19:26.880 One of the things we were concerned about

00:19:29.040 was the practice of insisting that people had to hit rock bottom

00:19:32.620 before we would engage with them, which is clearly incorrect.

00:19:36.700 So we could help people make improvements

00:19:39.200 without imposing demands on them,

00:19:43.060 but by giving them opportunities

00:19:45.040 and by listening to their own requests for assistance.

00:19:48.900 What can we help you with today?

00:19:52.820 We took that to the extreme in Vancouver,

00:19:55.880 and here's an example of what harm reduction could be.

00:19:58.760 We went up to people who were living homeless.

00:20:01.420 They'd been homeless an average of 10 years.

00:20:03.820 Most were struggling with very severe addictions

00:20:06.440 and all had concurrent mental illnesses,

00:20:10.200 psychotic illnesses, bipolar disorder,

00:20:13.100 so mood-related swings.

00:20:14.880 And we asked them,

00:20:16.120 hey, what can we help you with today?

00:20:19.300 We weren't restricted, though.

00:20:21.040 We said, look, we could go and get a meal.

00:20:24.160 We could help you get your ID.

00:20:25.840 We could help you get reconnected with benefits

00:20:27.960 that you're entitled to.

00:20:29.280 We've also got some apartments.

00:20:31.240 And these were all apartments integrated into healthy communities,

00:20:36.820 so dispersed apartments.

00:20:38.320 Most people said, really?

00:20:40.320 Like, you know, in fact, they said they don't believe us,

00:20:44.260 but in more colorful language.

00:20:46.360 But when they realized we were serious,

00:20:48.700 they said, well, yeah, I mean, where are those places you mentioned?

00:20:52.980 So we offered people that form of harm reduction.

00:20:56.180 They took us up step by step.

00:20:59.540 Next week, we helped them furnish their apartment.

00:21:01.940 We helped them figure out where to buy groceries and cook. 0.95

00:21:06.060 We helped them over time to reconnect with employment.

00:21:09.420 On day one, 82% of the people that we worked with,

00:21:12.680 and this is a sample of 500 people,

00:21:14.560 82% listed resuming paid employment as one of their top priorities.

00:21:21.040 25% had kids under age 18,

00:21:23.800 and over time reestablishing a link with those kids

00:21:27.480 understandably became a top priority.

00:21:29.980 But we go step by step by step.

00:21:32.460 And harm reduction, as a non-coercive, volitional form of helping people,

00:21:39.160 has profound benefits.

00:21:40.600 So those randomized trials,

00:21:42.660 which were conducted in five regions of the country,

00:21:47.300 widely published,

00:21:48.700 have been systematically ignored by governments.

00:21:53.660 Instead, what we do in BC,

00:21:55.100 and what we did in response to the surge of homelessness in recent years,

00:21:58.960 was to double down on grouping people all together in buildings,

00:22:03.720 which we showed was inferior to providing actual harm reduction

00:22:10.340 and actual opportunities to reconnect with healthy communities.

00:22:14.960 So, you know, this is something that has a...

00:22:19.040 Well, that is the exact opposite of where harm reduction is now.

00:22:24.360 I'm sure you heard of the tragic shooting here in Toronto outside a...

00:22:28.460 Yes.

00:22:29.020 ...community health center last summer.

00:22:30.480 Yes.

00:22:30.660 The South Riverdale Community Health Center.

00:22:32.600 And it's home to a safe consumption site.

00:22:35.600 And as I found out later,

00:22:37.540 the federal government had brought in a safe, so-called safe supply.

00:22:41.740 And of course, that helped attract drug dealers.

00:22:44.240 And that was part of what happened with the shooting.

00:22:47.760 But started looking into this organization

00:22:50.960 that said it's there to help addicts.

00:22:53.640 And right on their website,

00:22:55.160 and on printed material that they would pass around,

00:22:57.600 they said that they had a philosophy about being simply respectful of

00:23:02.600 and to people who use drugs.

00:23:05.100 No judgment, no expectations,

00:23:07.660 and no desire for people to stop using drugs.

00:23:11.620 That's the key.

00:23:13.080 That's the key.

00:23:13.680 So, I think a succinct way of saying what I was trying to get at before

00:23:21.140 is that harm reduction began as something that was more like a verb,

00:23:26.780 something that was ongoing,

00:23:28.660 and had a direction of improved health very much as its compass.

00:23:34.420 And it became a series of nouns.

00:23:36.940 We hand out, we exchange needles, so that's harm reduction.

00:23:41.940 We provide consumption sites, so we do harm reduction.

00:23:45.840 It's completely become untethered from any sense of throughput,

00:23:51.400 any sense of progress toward ever more improved health,

00:23:55.860 which includes citizenship, connections with people,

00:24:00.680 general health, all of which are attainable.

00:24:03.980 And we've backed our way into some weird dystopia where,

00:24:08.940 in BC again, our provincial health officer is on record

00:24:12.680 in our legislature on Hansard,

00:24:15.480 saying people with opioid addictions don't recover.

00:24:19.640 Well, if that's your belief, I mean, first of all,

00:24:24.460 if that's your belief, you have no business

00:24:26.820 designing policies related to addiction.

00:24:30.440 But it is so grossly misinformed that, you know,

00:24:34.560 but it helps shed light on why we're in such a terrible place.

00:24:39.960 That's unbelievable that they would say that.

00:24:42.880 I've met people who have recovered from opioid addiction.

00:24:46.120 It's a struggle, but they do, and they can.

00:24:49.640 With the right programs and processes in place.

00:24:53.080 And it feels to me like right now,

00:24:55.240 what we've done is taken something that you described

00:24:58.860 and said, okay, well, you know, it'd be easier.

00:25:01.020 Let's just make sure they've got a steady supply

00:25:03.240 and keep them alive until they die.

00:25:05.420 And, you know, it's aiding and abetting

00:25:08.220 not only addiction, but a diminished life.

00:25:16.080 Very much so.

00:25:17.280 I don't think it's an overstatement to sum it up

00:25:21.340 that we're increasingly producing despair

00:25:26.260 and our leaders have found a way

00:25:29.700 to turn despair into a profit setter.

00:25:32.800 Julian, we have to take a quick break,

00:25:36.480 but I know you've got some fascinating stats

00:25:39.200 on places like Portugal, which people say,

00:25:42.340 well, why don't we just be like Portugal

00:25:44.180 and decriminalize everything?

00:25:46.220 And you've got stats that will, I think,

00:25:48.320 blow the socks off people. 0.93

00:25:49.560 So we'll talk about that when we come back.

00:25:51.460 One of the things that the activists and activists

00:26:04.940 for further liberalizing drugs in Canada

00:26:18.860 will always say is,

00:26:20.500 why can't we just decriminalize everything

00:26:22.260 like we did in Portugal?

00:26:23.340 And my view is that we've got the cart before the horse

00:26:29.640 in terms of how we're approaching this.

00:26:32.140 So, Julian, I want to hear your take on this.

00:26:36.260 We have, in British Columbia,

00:26:38.940 you've gone full decriminalization,

00:26:41.040 hasn't helped with the problem.

00:26:42.920 You've taken, you know, been the leaders

00:26:44.760 in British Columbia, especially in Vancouver,

00:26:48.000 on liberalizing drug laws and policies at every turn.

00:26:51.580 We're not far behind here in Toronto

00:26:53.640 and it's not helping.

00:26:54.960 So what are they doing differently?

00:26:56.560 Because everyone says Portugal's a success story.

00:27:00.280 Have they done it completely different

00:27:02.040 than the rest of us?

00:27:02.840 There's an era in Portugal's approach to drugs 0.93

00:27:07.660 that is important to focus on

00:27:11.480 and it's roughly between 2000 and 2010.

00:27:15.260 The global financial crisis changed social policies

00:27:19.380 around the world, including in Portugal,

00:27:22.260 and the results since then change.

00:27:24.640 So if we go up to the present,

00:27:27.720 the budget for centralized activities

00:27:32.480 addressing addiction was cut by over 85%

00:27:36.700 following 2010.

00:27:38.660 And there's been a slide.

00:27:40.500 But if we go back to the era

00:27:42.040 that Portugal is known for,

00:27:46.300 people who are interested can look

00:27:49.480 at the Portuguese National Drug Strategy.

00:27:51.720 It's available online.

00:27:52.820 And I think it's an extremely informative document

00:27:56.180 for any jurisdiction like ours

00:28:00.620 that's going through a similar crisis.

00:28:04.340 They said in this document

00:28:06.420 that they must make social reintegration

00:28:10.120 the central organizing theme.

00:28:13.200 They went about doing that by,

00:28:15.460 first of all,

00:28:16.240 They, like us in BC,

00:28:19.160 were not criminalizing, air quotes,

00:28:21.720 people for possession of drugs

00:28:23.540 before they made the legal change.

00:28:25.920 There were very few people

00:28:27.800 being arrested and prosecuted.

00:28:30.380 But they made the change

00:28:32.380 to decriminalize possession

00:28:33.940 so that police officers

00:28:36.280 could more easily approach people

00:28:39.260 who were obviously in distress

00:28:41.160 and urged them

00:28:43.600 to accompany the police officer

00:28:45.640 to a dissuasion commission.

00:28:47.420 So this is a place

00:28:48.340 where people could sit down.

00:28:50.300 They were treated with respect.

00:28:52.380 And they were encouraged

00:28:54.280 to follow the advice

00:28:56.740 of dissuasion commissions

00:28:57.820 that was advice

00:28:59.900 that they reached

00:29:00.660 in collaboration

00:29:01.700 with the individual.

00:29:03.300 But it's basically around,

00:29:04.380 look,

00:29:05.140 we know that you deserve better.

00:29:07.780 We are alarmed

00:29:10.880 by you're using drugs in public.

00:29:14.580 We're alarmed by the fact

00:29:15.940 that you have no means

00:29:17.200 of supporting yourself,

00:29:18.420 no means of protecting yourself.

00:29:20.900 We want to help you address that.

00:29:23.200 We're not here to say

00:29:24.880 that you must stop using drugs.

00:29:27.000 We are here to say

00:29:28.200 that we cannot collectively

00:29:30.700 accept that that's your life.

00:29:34.100 It has impacts on the community

00:29:35.840 that you live in as well.

00:29:37.780 How are they going to achieve that?

00:29:39.840 They had apartments

00:29:41.260 and places for people

00:29:42.800 to move into

00:29:43.640 that were acceptable,

00:29:45.280 that were decent,

00:29:46.020 that were safe.

00:29:47.140 They had therapeutic communities

00:29:48.760 that people could go to

00:29:50.160 in order to practice

00:29:51.520 over a period of time

00:29:52.900 living without drugs.

00:29:55.340 And also therapeutic communities

00:29:56.860 include a focus on trades

00:29:58.500 and helping people

00:29:59.300 to learn things

00:30:00.140 that they can then take with them

00:30:01.500 after they leave

00:30:02.340 and as the basis

00:30:03.700 for, among other things,

00:30:05.960 keeping themselves

00:30:07.140 on the right track.

00:30:09.260 So the change in the law

00:30:11.680 was a relatively minor component

00:30:13.900 of what contributed

00:30:15.500 to their success.

00:30:16.800 Their success includes

00:30:18.020 a dramatic reduction

00:30:19.720 in public drug use,

00:30:22.120 in drug-related fatalities,

00:30:24.180 and in drug-related crime.

00:30:25.980 And that's really

00:30:26.640 what they're lauded for.

00:30:28.040 But the idea

00:30:29.320 that somehow

00:30:30.540 a change in law

00:30:32.500 can account for that

00:30:34.860 is really missing the point.

00:30:37.260 And it's stunning to me

00:30:38.980 that decision makers

00:30:40.080 have recommended legalization

00:30:43.300 or decriminalization

00:30:44.540 as though that was

00:30:45.740 the magic bullet.

00:30:47.580 They clearly have not bothered

00:30:49.960 to read the Portuguese

00:30:51.020 national strategy.

00:30:52.600 Or look at what worked

00:30:54.300 and what didn't in Portugal.

00:30:55.360 They look at that one thing.

00:30:58.080 And it's funny,

00:30:59.240 you mentioned

00:30:59.980 that they weren't

00:31:01.120 prosecuting people

00:31:02.200 for simple possession

00:31:03.720 prior to making

00:31:04.740 that legal change.

00:31:07.080 The push

00:31:09.740 for decriminalization

00:31:11.180 by our health authorities

00:31:12.880 in Toronto

00:31:13.420 is, well,

00:31:14.500 we have to end the stigma

00:31:15.480 and people shouldn't be charged

00:31:17.020 with simple possession.

00:31:18.820 But it's right

00:31:19.840 in their own application

00:31:21.360 to the federal government

00:31:22.580 that in 2021,

00:31:24.320 the last year

00:31:25.020 they had stats for

00:31:25.800 when they submitted this,

00:31:27.660 that there were 617 people

00:31:30.360 charged with possession.

00:31:33.060 And only 36 of them

00:31:35.900 were charged

00:31:36.300 with possession alone.

00:31:37.260 The rest,

00:31:37.980 it was an add-on charge

00:31:39.360 to public disorder,

00:31:41.760 assaults,

00:31:42.760 various things.

00:31:43.960 And, you know,

00:31:45.360 much the same

00:31:46.240 as it was for marijuana

00:31:47.280 prior to it becoming legal.

00:31:48.700 The cops aren't going around

00:31:50.380 busting you

00:31:51.220 for having

00:31:54.120 a small amount

00:31:55.120 of drugs on you.

00:31:56.280 They're busting you

00:31:57.280 for something else

00:31:58.180 and then they add that on.

00:32:01.200 And, you know,

00:32:02.820 it's back to

00:32:04.380 where we started

00:32:05.100 the conversation.

00:32:07.240 Without any tools,

00:32:09.300 we're going to have

00:32:10.380 the public disorder

00:32:11.920 and chaos

00:32:12.500 that you've experienced

00:32:13.620 in parts of British Columbia

00:32:15.400 where the police

00:32:16.620 just have no ability

00:32:17.820 to do anything

00:32:18.720 for people

00:32:20.160 who are in distress,

00:32:22.800 who are using drugs openly

00:32:24.180 in places

00:32:24.900 that will scare

00:32:26.060 children,

00:32:27.640 seniors,

00:32:28.440 parents,

00:32:29.720 students trying

00:32:30.220 to go to school.

00:32:30.860 So, again,

00:32:33.280 it is this vicious cycle

00:32:35.300 where we just keep saying

00:32:36.620 make drugs easier to get,

00:32:38.440 but there's no treatment.

00:32:40.780 There's no prevention.

00:32:43.500 It's frustrating.

00:32:45.580 So what would a good model

00:32:47.640 look like for you?

00:32:51.140 Well,

00:32:52.140 so we,

00:32:52.800 you know,

00:32:53.940 the end of decriminalization

00:32:56.120 or the beginning

00:32:58.660 of the end

00:32:59.220 of decriminalization

00:33:00.200 is not

00:33:01.000 a really

00:33:02.260 big cause

00:33:03.080 for celebration.

00:33:04.840 We've essentially

00:33:05.980 squandered

00:33:07.060 years now

00:33:08.820 and are

00:33:10.220 inching our way

00:33:11.180 back

00:33:11.840 to

00:33:12.600 a position

00:33:13.820 we were in

00:33:14.920 a year

00:33:17.380 and a half ago,

00:33:18.940 but with

00:33:20.040 far

00:33:20.820 greater damage

00:33:22.240 socially

00:33:23.520 than we had

00:33:25.240 in the meantime.

00:33:26.980 We,

00:33:27.600 so the things

00:33:28.280 that we need

00:33:28.980 are,

00:33:29.340 immediate

00:33:30.380 triage.

00:33:31.340 We need

00:33:31.660 immediate

00:33:32.240 assessments

00:33:32.860 of people

00:33:33.580 who are

00:33:34.620 at high risk.

00:33:36.000 And high risk

00:33:36.720 can be

00:33:37.280 people are

00:33:38.560 visibly using

00:33:39.360 drugs.

00:33:39.860 This is in

00:33:40.360 encampments

00:33:41.460 and in other

00:33:42.160 places.

00:33:43.080 In the city

00:33:43.700 of Edmonton

00:33:44.360 right now,

00:33:44.980 there's a

00:33:45.340 navigation center.

00:33:46.560 People are

00:33:46.960 brought from

00:33:47.460 encampments

00:33:48.140 voluntarily

00:33:49.980 and they

00:33:51.300 have access

00:33:51.960 in one

00:33:52.960 place

00:33:53.400 to

00:33:54.460 immediate

00:33:55.460 respite

00:33:56.060 if they

00:33:56.440 want that,

00:33:57.480 respite with

00:33:57.980 their pets,

00:33:59.160 respite with

00:33:59.620 their kids,

00:34:00.720 but they

00:34:01.120 also have

00:34:01.600 access to

00:34:02.500 the entire

00:34:03.580 suite

00:34:04.840 of publicly

00:34:06.100 funded services,

00:34:07.520 health care,

00:34:08.300 social support,

00:34:09.300 getting your

00:34:09.920 ID right away

00:34:11.320 before you

00:34:11.900 leave. 0.99

00:34:12.860 Indigenous

00:34:13.220 supports are

00:34:14.100 there for

00:34:15.400 Indigenous

00:34:16.000 peoples.

00:34:16.520 And it's

00:34:18.560 all in

00:34:18.920 one spot.

00:34:20.000 So we

00:34:20.320 need to

00:34:20.840 have an

00:34:21.680 immediate

00:34:22.180 integration

00:34:22.920 and an

00:34:23.980 assessment of

00:34:24.580 people.

00:34:25.200 We're losing

00:34:25.860 people who

00:34:27.020 are struggling

00:34:27.520 with serious

00:34:28.160 mental illnesses

00:34:28.880 and we

00:34:30.060 need time

00:34:30.640 to assess

00:34:31.220 that.

00:34:31.720 Then we

00:34:32.260 need places

00:34:33.060 to direct

00:34:33.720 them.

00:34:34.060 This is like

00:34:34.500 the dissuasion

00:34:35.000 commissions.

00:34:36.040 We need

00:34:36.360 things like

00:34:36.880 therapeutic

00:34:37.320 communities.

00:34:38.420 Most of

00:34:38.820 the people

00:34:39.260 who are

00:34:39.640 dying of

00:34:40.120 poisoning

00:34:40.500 are unemployed

00:34:41.600 and have

00:34:42.380 been unemployed

00:34:42.900 for some

00:34:43.380 time.

00:34:44.220 They're also

00:34:44.640 young and

00:34:45.240 they tend

00:34:45.580 to be

00:34:45.960 young men.

00:34:47.520 The construction

00:34:48.740 sector, by

00:34:49.700 the way, we've

00:34:50.060 been lied

00:34:50.560 to.

00:34:51.140 It's not

00:34:51.560 primarily

00:34:52.080 construction

00:34:52.680 workers.

00:34:53.280 It's primarily

00:34:53.780 unemployed

00:34:54.280 people.

00:34:55.280 But the

00:34:55.740 construction

00:34:56.100 sector does

00:34:56.900 play a

00:34:57.320 potential role

00:34:58.120 as a

00:34:59.320 potential trade

00:35:00.560 focus in a

00:35:01.440 therapeutic

00:35:01.760 community.

00:35:02.600 We need to

00:35:03.400 be mounting

00:35:04.000 these

00:35:04.520 immediately,

00:35:05.620 places where

00:35:06.100 people can

00:35:06.600 go, get

00:35:08.040 some respite,

00:35:08.840 get some

00:35:09.180 support, and

00:35:10.140 learn trades

00:35:11.480 and learn ways

00:35:12.480 of earning

00:35:13.240 money that

00:35:13.840 they can then

00:35:14.440 use after

00:35:14.940 they leave.

00:35:15.500 We need

00:35:16.460 to dismantle

00:35:17.760 our SRO

00:35:18.360 empire.

00:35:19.960 We need

00:35:20.180 to stop

00:35:20.620 single-room

00:35:21.960 occupancy hotels.

00:35:22.880 Thank you.

00:35:23.600 Our response

00:35:25.240 to mental

00:35:26.340 illness and

00:35:27.560 homelessness,

00:35:28.700 including

00:35:29.220 addiction,

00:35:30.080 has been to

00:35:30.960 create buildings,

00:35:32.720 whether they're

00:35:33.720 old buildings,

00:35:34.760 the old

00:35:35.260 single-room

00:35:35.680 occupancy hotels

00:35:36.380 that used to

00:35:36.840 be used by

00:35:37.640 itinerant workers,

00:35:38.680 or new

00:35:39.460 buildings, which

00:35:40.200 are essentially

00:35:40.820 towers of

00:35:42.080 bachelor

00:35:42.480 apartments,

00:35:43.660 with consumption

00:35:45.060 sites in the

00:35:46.060 building.

00:35:46.760 This is just

00:35:48.100 further to our

00:35:49.580 ability to

00:35:50.560 generate money-making

00:35:52.440 opportunities,

00:35:53.240 development

00:35:53.620 opportunities,

00:35:54.300 on the backs

00:35:55.620 of a social

00:35:56.440 crisis.

00:35:58.400 We need to

00:35:59.260 get away from

00:35:59.800 that and

00:36:00.640 recognize that

00:36:01.620 the thing that

00:36:02.440 helps people

00:36:03.020 recover is not

00:36:04.140 simply being

00:36:05.120 housed, and

00:36:05.780 it's certainly

00:36:06.300 not being housed

00:36:07.540 in a building

00:36:08.140 where everyone

00:36:09.000 else is a

00:36:09.520 drug user and

00:36:10.400 there's a

00:36:10.700 consumption

00:36:11.060 site.

00:36:11.720 The thing

00:36:12.200 that's helped

00:36:12.720 people the

00:36:13.260 most has

00:36:14.320 been joining

00:36:15.520 healthy communities

00:36:16.420 where people

00:36:17.060 are treated

00:36:17.640 with respect

00:36:19.180 and treated

00:36:20.740 as though they

00:36:21.360 have responsibilities

00:36:22.360 as citizens

00:36:23.320 as well.

00:36:24.260 People rise to

00:36:25.180 that challenge.

00:36:26.620 Well, they've

00:36:27.320 got people next

00:36:28.260 to them who

00:36:28.860 are going to

00:36:29.680 work, and

00:36:30.340 then you're

00:36:31.880 like, oh,

00:36:32.260 well, yeah,

00:36:32.860 I should go to

00:36:33.660 work as well,

00:36:34.360 as opposed to

00:36:35.060 the guy in

00:36:36.140 the room next

00:36:36.900 to you says,

00:36:37.400 why do you

00:36:37.840 want to do 1.00

00:36:38.160 that, loser? 0.99

00:36:38.740 I got a good 0.98

00:36:40.020 score, let's

00:36:40.600 go downstairs

00:36:41.100 to the

00:36:41.480 consumption

00:36:41.840 site.

00:36:42.680 Exactly.

00:36:43.780 Exactly.

00:36:44.920 You've mentioned

00:36:46.880 several times

00:36:47.540 getting ID, and

00:36:48.320 I think it's

00:36:49.260 such a small

00:36:51.280 thing, but if

00:36:51.940 you have not

00:36:52.400 been around

00:36:53.160 people living

00:36:55.340 and dealing

00:36:55.880 in these

00:36:56.300 situations,

00:36:57.300 then why does

00:36:58.100 that matter?

00:36:59.760 But it matters

00:37:00.500 tremendously, because

00:37:01.300 if you've

00:37:01.920 fallen that far

00:37:03.320 that you're

00:37:03.680 living in an

00:37:04.440 encampment,

00:37:05.040 which we seem

00:37:06.680 to just accept

00:37:08.080 that people

00:37:08.720 now live

00:37:09.700 in tents

00:37:10.280 and live

00:37:12.040 in conditions

00:37:12.580 that we

00:37:14.080 spent decades

00:37:15.060 trying to

00:37:15.480 ensure never

00:37:16.140 existed, if

00:37:17.520 you're living

00:37:17.880 in that

00:37:18.240 situation, chances

00:37:19.080 are you've

00:37:19.580 lost your

00:37:20.000 ID.

00:37:21.120 You've been

00:37:21.940 on the

00:37:22.440 streets for

00:37:22.840 so long, you

00:37:23.380 no longer

00:37:24.020 have it.

00:37:24.820 And when you

00:37:25.160 don't have

00:37:25.520 ID, you

00:37:26.020 can't get

00:37:26.420 government

00:37:26.920 services, you

00:37:27.700 can't get

00:37:28.300 a place to

00:37:29.380 live, even

00:37:29.980 if you

00:37:30.320 somehow get

00:37:31.100 the money.

00:37:31.500 Yeah, it's

00:37:33.100 a key insight.

00:37:35.180 When I was

00:37:35.980 in Edmonton's

00:37:37.240 Navigation

00:37:37.700 Center myself,

00:37:39.300 the area,

00:37:42.820 table really,

00:37:44.120 where government

00:37:45.800 ID is produced

00:37:47.400 and provided

00:37:48.080 on site was

00:37:50.240 the most

00:37:50.840 popular in

00:37:51.580 general, the

00:37:52.100 most popular

00:37:52.760 service that

00:37:54.080 people access

00:37:54.760 because of the

00:37:55.700 reasons you

00:37:56.140 mentioned.

00:37:57.380 And we need

00:38:00.080 to be thinking

00:38:00.620 about the

00:38:01.280 pathway back.

00:38:02.740 A very small

00:38:04.160 outfit in

00:38:04.940 Victoria supports

00:38:07.140 people living

00:38:07.840 rough in the

00:38:08.540 city on

00:38:09.120 Pandora Street

00:38:10.260 and concentrated

00:38:12.860 areas.

00:38:13.960 And one of

00:38:14.300 the services

00:38:14.760 they offer

00:38:15.440 are back

00:38:16.800 taxes.

00:38:18.200 So they'll

00:38:18.740 go and help

00:38:19.920 people clear

00:38:21.040 off the

00:38:22.060 previous years

00:38:22.920 of taxes and

00:38:24.880 declarations.

00:38:26.300 And it might

00:38:27.860 seem like an

00:38:28.940 odd thing to

00:38:29.840 do, but it's

00:38:31.240 one of those

00:38:31.920 big bureaucratic

00:38:34.200 steps that

00:38:35.880 essentially means

00:38:37.220 that now the

00:38:38.460 slate is clear.

00:38:39.900 If you were to

00:38:40.780 poke your head

00:38:41.340 back up as a

00:38:42.160 citizen, find a 0.95

00:38:43.800 place to live,

00:38:44.700 find a place to

00:38:45.520 work, you're

00:38:47.180 not going to be

00:38:48.520 received by the

00:38:49.480 CRA as some

00:38:51.540 kind of an

00:38:51.980 alien with

00:38:52.680 miscreant with

00:38:54.340 problems to

00:38:55.680 address.

00:38:56.500 You're now

00:38:57.540 operating with a

00:38:58.660 clean slate.

00:38:59.600 And people

00:39:00.040 embrace these

00:39:01.180 opportunities.

00:39:02.500 And then you've

00:39:02.940 got an opportunity

00:39:03.820 to access

00:39:05.260 programs,

00:39:06.720 including funding,

00:39:08.280 refundable tax

00:39:09.120 credits,

00:39:10.100 payments.

00:39:10.340 Exactly, exactly,

00:39:11.900 exactly.

00:39:12.560 All of these

00:39:13.320 things that

00:39:14.280 despair and

00:39:15.740 mental illness

00:39:16.480 and addiction

00:39:17.280 lead us away

00:39:19.340 from in terms

00:39:20.040 of our

00:39:20.340 attention and

00:39:21.460 our loss of

00:39:22.500 attention just

00:39:23.220 further compounds

00:39:24.260 our own

00:39:25.100 problems and we

00:39:26.020 enter proverbial

00:39:27.380 vicious cycles.

00:39:29.340 We haven't

00:39:29.840 talked much

00:39:30.480 about safer

00:39:31.000 supply.

00:39:31.520 It's been

00:39:31.740 mentioned, but

00:39:33.020 given that

00:39:33.680 British Columbia

00:39:34.460 is further down

00:39:35.560 this road than

00:39:36.600 other parts of

00:39:37.460 the country, I

00:39:38.760 do want to ask

00:39:39.340 about it because

00:39:39.920 the federal

00:39:40.340 government is

00:39:41.420 all in on

00:39:43.320 safer supply.

00:39:44.960 They have made

00:39:46.140 it clear that

00:39:46.780 they're going to

00:39:47.420 push this

00:39:47.860 forward.

00:39:49.120 There is a

00:39:50.160 new site that's

00:39:51.340 been identified by

00:39:52.340 the federal

00:39:52.740 government for a

00:39:53.880 so-called safer

00:39:54.480 supply location

00:39:56.060 in Brampton,

00:39:57.440 just west of

00:39:58.580 Toronto, that's

00:39:59.720 causing an awful

00:40:00.460 lot of anxiety

00:40:02.300 in the community.

00:40:04.740 Doesn't seem to

00:40:05.680 matter to the

00:40:06.500 local Liberal

00:40:07.080 MP or

00:40:08.000 other

00:40:09.280 people that

00:40:10.760 are pushing

00:40:11.120 this.

00:40:12.220 What's BC's

00:40:13.300 experience been?

00:40:14.540 Because when I

00:40:15.740 write about it,

00:40:16.440 when colleagues

00:40:17.740 like Adam

00:40:18.220 Zivo write

00:40:18.720 about it,

00:40:19.120 we're told,

00:40:19.760 no, this isn't

00:40:20.900 true, everything's

00:40:21.560 fine.

00:40:22.640 And then you

00:40:23.000 get the

00:40:24.480 deputy police

00:40:25.580 chief of

00:40:25.980 Vancouver going

00:40:26.820 before the

00:40:28.320 House of Commons

00:40:28.920 and saying,

00:40:29.560 well, actually

00:40:30.000 most of the

00:40:30.720 pills we're

00:40:31.180 getting are

00:40:31.760 diverted safe

00:40:32.440 supply.

00:40:32.840 It's a very

00:40:37.840 dangerous set of

00:40:39.220 policies.

00:40:40.100 It should

00:40:42.080 strike everyone

00:40:44.200 as sound

00:40:47.320 common sense

00:40:48.220 that drugs

00:40:50.380 such as

00:40:51.500 opioids,

00:40:53.500 crystal meth,

00:40:55.180 whether used

00:40:56.460 alone or in

00:40:57.420 combination,

00:40:58.720 are harmful to

00:41:00.520 human health.

00:41:02.000 This is

00:41:02.920 pretty, you 0.98

00:41:04.200 know, abundantly

00:41:06.200 established

00:41:06.980 scientifically.

00:41:08.360 The physiological

00:41:09.180 aspects of

00:41:12.900 drug-related

00:41:13.760 harms are well

00:41:14.760 understood.

00:41:15.680 The psychological

00:41:16.560 and social

00:41:17.760 harms are well

00:41:18.880 understood.

00:41:20.420 So this is

00:41:21.060 far from

00:41:22.180 benign.

00:41:23.020 This doesn't

00:41:26.720 really have

00:41:27.300 much to do

00:41:27.860 with science.

00:41:28.760 The advocacy

00:41:29.400 for so-called

00:41:30.260 safe supply

00:41:31.000 doesn't have

00:41:31.520 much to do

00:41:31.960 with science.

00:41:32.560 It has to

00:41:33.080 do with

00:41:33.640 other things

00:41:34.520 including

00:41:35.660 financial

00:41:37.400 opportunities.

00:41:38.820 When we

00:41:39.300 wrote a

00:41:39.720 review,

00:41:40.720 we've been

00:41:42.180 asked by many

00:41:42.700 governments to

00:41:43.260 write reviews

00:41:43.760 over the

00:41:44.180 years,

00:41:45.360 and one

00:41:46.580 we wrote

00:41:47.100 for Alberta's

00:41:48.200 legislature,

00:41:49.140 or I should

00:41:49.820 say Alberta's

00:41:50.320 Ministry of

00:41:50.680 Health,

00:41:51.520 was a

00:41:52.940 we pointed

00:41:54.980 out that

00:41:55.400 there were

00:41:55.780 some key

00:41:56.360 gaps in

00:41:57.420 knowledge

00:41:57.960 related to

00:41:58.960 what would

00:41:59.320 happen,

00:41:59.820 and there

00:42:00.320 were some

00:42:00.740 key gaps in

00:42:01.540 terms of

00:42:02.100 the implications

00:42:02.800 for the

00:42:03.220 future.

00:42:03.880 What's the

00:42:04.200 exit plan?

00:42:05.360 How much

00:42:05.760 is it going

00:42:06.060 to cost

00:42:06.480 per person

00:42:07.140 per year?

00:42:07.880 So we can

00:42:08.300 look at

00:42:08.840 this investment

00:42:09.640 versus

00:42:10.020 alternatives that

00:42:10.900 have already

00:42:11.360 been well

00:42:11.860 costed and

00:42:12.520 shown to be

00:42:13.140 effective.

00:42:14.300 None of

00:42:14.800 these questions

00:42:15.300 have been

00:42:15.680 answered.

00:42:16.800 So we put

00:42:17.300 this review

00:42:18.100 out there,

00:42:18.980 and within

00:42:19.740 a week,

00:42:21.920 safe supply

00:42:22.560 advocates,

00:42:23.540 not claiming

00:42:24.520 to be

00:42:24.920 safe supply

00:42:25.380 advocates,

00:42:25.900 not divulging

00:42:26.680 that they

00:42:27.080 received funding

00:42:28.180 related to

00:42:28.880 safe supply,

00:42:29.940 had written

00:42:30.700 an open

00:42:31.280 letter saying

00:42:32.960 no one

00:42:33.700 should read

00:42:34.160 this review

00:42:34.860 because it's

00:42:35.640 low quality.

00:42:37.280 They convened

00:42:38.500 press conferences

00:42:39.420 and media,

00:42:41.140 mainstream media,

00:42:42.560 ate it up.

00:42:44.060 Summers et al

00:42:44.980 write low

00:42:45.900 quality review,

00:42:47.840 nobody should

00:42:48.420 read it.

00:42:49.200 And they

00:42:49.760 didn't.

00:42:50.120 They didn't

00:42:51.120 report on

00:42:51.800 it in their

00:42:52.580 coverage.

00:42:53.540 They just

00:42:53.820 said,

00:42:54.700 well,

00:42:55.000 people are

00:42:56.620 upset.

00:42:58.020 That's news.

00:42:59.360 They didn't

00:42:59.860 point out that

00:43:00.700 the people who

00:43:01.460 were upset

00:43:02.160 are funded

00:43:03.100 to advocate

00:43:04.060 for safe

00:43:04.660 supply.

00:43:06.260 We were

00:43:06.960 further

00:43:07.360 attacked,

00:43:07.960 the same

00:43:08.360 organization,

00:43:09.220 this was

00:43:09.740 centrally

00:43:10.240 organized by

00:43:10.900 the BC

00:43:11.280 Center for

00:43:11.900 Substance

00:43:12.320 Use.

00:43:13.080 They took

00:43:13.600 the extraordinary

00:43:14.540 step of

00:43:15.480 beginning to

00:43:16.120 contact

00:43:16.920 conference

00:43:17.820 organizers,

00:43:18.380 where I

00:43:18.900 was scheduled

00:43:19.460 keynote speaker,

00:43:21.320 urging them

00:43:22.020 to uninvite

00:43:22.880 me.

00:43:23.840 Oh,

00:43:24.020 man.

00:43:24.840 So,

00:43:25.860 at that

00:43:26.740 point,

00:43:27.380 I knew

00:43:27.960 crystal clear

00:43:29.000 this has

00:43:29.900 nothing to

00:43:30.660 do with

00:43:31.140 science or

00:43:32.320 scholarly

00:43:32.980 debate.

00:43:34.100 This is

00:43:34.560 irrational.

00:43:36.100 Why would

00:43:37.080 somebody be

00:43:37.740 behaving so

00:43:38.580 irrationally?

00:43:39.880 And it's

00:43:40.180 because they've

00:43:41.040 got something

00:43:41.640 to hide.

00:43:42.380 I'm sure

00:43:45.800 you've

00:43:46.060 watched some

00:43:46.480 of the

00:43:46.840 movies or

00:43:47.480 documentaries

00:43:47.960 about the

00:43:48.840 opioid crisis

00:43:49.660 in the

00:43:50.040 states and

00:43:51.140 Big Pharma's

00:43:51.920 role in

00:43:52.360 that.

00:43:53.540 And what

00:43:53.860 is shocking

00:43:54.360 to me is

00:43:55.680 that we've

00:43:56.180 got our

00:43:56.620 governments

00:43:57.920 all suing

00:43:58.860 Big Pharma.

00:44:00.580 They settled

00:44:01.060 with Purdue

00:44:01.580 a little while

00:44:02.100 ago.

00:44:03.140 And then we

00:44:04.060 turned around

00:44:04.440 and we gave

00:44:04.840 them contracts

00:44:05.580 to provide

00:44:07.180 the same

00:44:07.560 drugs.

00:44:09.180 Yeah.

00:44:09.300 We've

00:44:11.280 turned from

00:44:11.880 labeling them

00:44:13.380 as pushers

00:44:14.040 and evil

00:44:15.040 to becoming

00:44:16.400 their pusher

00:44:17.220 through our

00:44:17.960 government.

00:44:19.560 Identification

00:44:20.280 with the

00:44:20.760 aggressor.

00:44:21.720 Yeah.

00:44:22.360 As you

00:44:23.220 said earlier

00:44:23.740 with cannabis,

00:44:25.180 many people

00:44:25.880 in positions

00:44:26.900 of authority,

00:44:27.740 especially on

00:44:28.340 the elected

00:44:28.840 side,

00:44:29.740 are looking

00:44:31.320 for their

00:44:31.700 next gig.

00:44:32.860 What's

00:44:33.620 going to

00:44:33.840 happen after

00:44:34.680 I leave

00:44:35.300 office?

00:44:36.520 And we

00:44:37.100 can speculate,

00:44:38.560 but the

00:44:39.240 pharmaceutical

00:44:39.760 industry is

00:44:41.460 a proven

00:44:43.040 sector that

00:44:46.440 legislators and

00:44:47.720 regulators orient

00:44:48.860 to.

00:44:49.200 When the

00:44:49.980 Stanford-Lancet

00:44:50.760 Commission undertook

00:44:52.300 their detailed

00:44:53.180 analysis of the

00:44:54.300 opioid crisis in

00:44:55.380 North America,

00:44:56.080 they include

00:44:56.460 Canada and

00:44:57.180 the U.S.,

00:44:58.340 they identified

00:44:59.440 chiefly regulatory

00:45:01.700 failures as

00:45:03.580 contributing factors.

00:45:04.800 And what they

00:45:05.140 meant was people

00:45:06.600 moving from

00:45:07.400 positions in

00:45:08.140 organizations like

00:45:09.040 the FDA back

00:45:11.060 into industry or

00:45:12.340 the other way

00:45:12.880 around or into

00:45:14.220 positions in

00:45:14.960 academic centers,

00:45:16.080 often medical

00:45:16.740 programs.

00:45:18.100 And this

00:45:18.500 fluidity was

00:45:20.260 part of the

00:45:21.000 problem,

00:45:21.600 part of what

00:45:22.060 gave, because it

00:45:22.760 incentivizes people

00:45:23.920 to be thinking,

00:45:24.700 well, you know,

00:45:25.500 I'm low in the

00:45:26.280 polls now, but

00:45:28.020 if I can grit my

00:45:29.160 teeth and get to 0.87

00:45:30.180 the end of my

00:45:30.740 mandate, I'll

00:45:32.180 likely have an

00:45:33.360 opportunity to

00:45:34.300 pursue work in

00:45:35.840 this area or

00:45:36.680 that area.

00:45:38.160 And unfortunately,

00:45:39.720 that appears to

00:45:40.740 be part of

00:45:41.500 what's happening

00:45:42.080 here.

00:45:44.000 Unbelievable.

00:45:45.040 So as a

00:45:46.160 clinical psychologist,

00:45:47.460 I'm sure you've

00:45:48.760 dealt with people

00:45:49.760 who have

00:45:50.360 addictions, not

00:45:51.640 people who are

00:45:52.680 living on the

00:45:53.380 street, living

00:45:53.920 rough, but

00:45:55.360 people who

00:45:56.180 otherwise seem

00:45:57.300 to have their

00:45:57.760 life together.

00:45:59.780 What, in your

00:46:01.220 experience, is

00:46:01.900 there something

00:46:02.300 that works with

00:46:03.020 them in

00:46:03.800 overcoming their

00:46:04.620 addiction?

00:46:05.900 Yeah.

00:46:06.360 I mean, I'm

00:46:07.620 surrounded in my

00:46:10.040 world by people

00:46:11.240 who have

00:46:11.540 experienced

00:46:12.040 addictions and

00:46:12.820 people who are

00:46:13.500 experiencing

00:46:13.980 addictions, and

00:46:15.420 including a lot

00:46:16.980 of work with

00:46:17.460 people who go

00:46:18.180 through court.

00:46:20.780 And part of our

00:46:22.360 work has included

00:46:23.100 the drug treatment

00:46:24.140 court, the

00:46:25.720 community court

00:46:26.440 that operates in

00:46:27.620 the downtown east

00:46:28.720 side of Vancouver,

00:46:29.820 and also voluntary

00:46:30.960 programs.

00:46:31.940 So along the

00:46:32.740 lines of what I

00:46:33.120 was mentioning

00:46:33.520 earlier among

00:46:34.540 people who are

00:46:35.700 living homeless.

00:46:37.740 And the things

00:46:39.520 that work overall

00:46:41.340 are opportunities

00:46:43.380 to find and

00:46:45.140 establish and

00:46:46.460 nurture meaning.

00:46:48.560 People, when

00:46:50.260 we're experiencing

00:46:51.040 addictions, one

00:46:52.780 of the most

00:46:54.460 frustrating, agonizing

00:46:58.120 components is the

00:46:59.300 experience of loss

00:47:00.360 of control, an

00:47:01.360 inability to

00:47:02.500 control something

00:47:04.180 that we know is

00:47:05.420 harmful to us and

00:47:06.560 often harmful to

00:47:07.460 other people who

00:47:08.460 we care for.

00:47:10.280 And the thing

00:47:12.760 that makes the

00:47:13.300 biggest difference

00:47:14.120 for many people

00:47:15.580 are the elements,

00:47:19.400 the changes that

00:47:20.120 occur that require

00:47:21.720 often other people.

00:47:23.140 They require us to

00:47:24.140 make choices, but

00:47:25.160 they also, you

00:47:26.140 know, if you're

00:47:26.560 living homeless and

00:47:28.240 you don't have

00:47:28.860 opportunities for

00:47:30.740 support from people

00:47:31.680 around you, you

00:47:33.160 are completely

00:47:34.620 dependent on

00:47:36.680 someone, ideally,

00:47:38.880 somebody representing

00:47:40.020 society via our

00:47:41.820 government, entering

00:47:43.360 your world and

00:47:44.500 offering you things

00:47:45.840 that are completely

00:47:47.820 reasonable, in fact,

00:47:49.220 that we say people

00:47:50.180 are entitled to,

00:47:51.420 like safe, decent

00:47:52.880 housing, like food

00:47:54.540 security, like

00:47:55.780 opportunities for

00:47:56.640 employment.

00:47:58.520 And when we

00:47:59.260 provide those

00:48:00.160 opportunities to

00:48:00.880 people, basic

00:48:02.640 opportunities, well,

00:48:04.860 less and less basic,

00:48:07.640 less and less

00:48:08.200 guaranteed, but we've

00:48:10.040 shown that it is

00:48:11.140 abundantly possible

00:48:12.440 to reach out to

00:48:13.940 people and provide

00:48:15.060 those opportunities

00:48:15.940 and they will

00:48:17.700 flourish.

00:48:19.100 They will, it may

00:48:19.960 take time, but we

00:48:21.020 will see improvements

00:48:21.940 right away.

00:48:22.560 We saw in the

00:48:23.920 first year of our

00:48:24.960 randomized trials

00:48:25.920 that compared to

00:48:27.100 people who received

00:48:28.540 usual services in

00:48:29.760 Vancouver, the

00:48:31.100 people who we

00:48:31.840 began assisting in

00:48:33.420 one year had 71%

00:48:35.620 fewer offenses than

00:48:37.500 the people that were

00:48:38.400 receiving, you know,

00:48:39.460 what's currently

00:48:40.280 available.

00:48:41.140 71% fewer, less

00:48:42.560 crime, 45% fewer

00:48:44.540 medical emergencies,

00:48:45.420 and those things

00:48:46.740 contribute also to

00:48:48.280 the bottom line

00:48:49.100 financially, which

00:48:50.820 helps illustrate that

00:48:52.320 intervening, the

00:48:53.340 financial cost of

00:48:54.880 intervening, is about

00:48:56.280 the same as the

00:48:57.100 cost of essentially

00:48:58.080 leaving people

00:48:58.860 homeless.

00:49:00.080 So we've run out of

00:49:01.140 good reasons, good

00:49:02.360 empirical reasons,

00:49:03.840 good humanitarian

00:49:05.440 reasons to sustain

00:49:07.460 the status quo.

00:49:08.820 I hope some of the

00:49:09.880 silver lining in this

00:49:10.940 really dark storm that

00:49:12.120 we're in is that we

00:49:13.480 have an immense amount

00:49:15.340 of information available

00:49:16.960 to guide us.

00:49:18.280 We talked about

00:49:18.920 Portugal.

00:49:19.660 We can also talk

00:49:20.680 about evidence shown

00:49:22.160 in Canadian regions

00:49:23.700 that the same kinds

00:49:25.180 of transformations are

00:49:26.120 possible, but it

00:49:27.000 requires us to spend

00:49:28.600 differently.

00:49:30.620 Well, it sounds like

00:49:31.440 spending on hope is

00:49:32.560 better than spending on

00:49:33.920 despair.

00:49:34.500 Well, well put.

00:49:35.540 Julian, thanks so much

00:49:36.380 for the time today.

00:49:37.320 My pleasure, Brian.

00:49:38.120 Great talking to you.

00:49:39.440 Full Comment is a

00:49:40.600 post-media podcast.

00:49:41.720 My name's Brian Lilly,

00:49:42.660 your host.

00:49:43.280 This episode was

00:49:44.260 produced by Andre

00:49:45.020 Pru with theme music

00:49:46.040 by Bryce Hall.

00:49:47.180 Kevin Libin is the

00:49:48.240 executive producer.

00:49:49.520 Remember, you can

00:49:50.040 subscribe and please

00:49:51.120 do subscribe to Full

00:49:52.180 Comment on Apple

00:49:53.020 Podcasts, Spotify,

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00:49:56.560 Help us out by

00:49:57.360 leaving us a review,

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00:50:01.540 Thanks for listening.

00:50:02.400 Until next time, I'm

00:50:03.420 Brian Lilly.

Full Comment - May 06, 2024

Profiting from despair： How decriminalization advocates exploited B.C.’s opioid crisis

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