Though 2020 was characterized primarily by the catastrophe of COVID-19, Canada’s public health landscape was marked by significant milestones—both forward and backward—in the fight to end the drug war. This year saw a growing movement toward racial justice and calls to abolish the police, while the pandemic violently exacerbated many social and structural inequities facing people who use drugs. Here are some of the most notable wins and losses.
Safe supply: While safe supply was at the top of activists’ agendas long before COVID, the urgency of this issue finally received greater attention in 2020. Due to the pandemic, more funding became available for new safe supply pilots (in addition to the five previously funded across British Columbia, Ontario and New Brunswick). Notable exemptions were also approved—such as for pharmacists to allow these providers to refill, renew, transfer and deliver relevant drugs. Various regulatory and institutional bodies also publicly endorsed the principles of safe supply—including Canada’s Minister of Health and the Ontario College of Physicians and Surgeons.
Perhaps most significantly, British Columbia actually did the damn thing—implementing a province-wide safe supply program in the early weeks of the pandemic. It has since expanded prescribing ability to registered nurses, including psychiatric nurses, in a bid to increase access to safer alternatives to illicit drugs. While not without issue, BC’s program provides a proof of concept to the rest of the country that safe supply can and should be part of the care continuum—with or without COVID.
Decriminalization: As with safe supply, people who use drugs and other frontline harm reductionists have been calling for the decriminalization of drugs for personal use for decades. However, 2020 was the year that the feasibility and the appeal of decriminalization seemed finally to enter Canada’s collective consciousness. Vancouver became the first municipality to apply for a city-wide exemption for drug possession—receiving unanimous support from an often politically divided City Council.
And with calls from over 170 organizations across the country, including the Public Prosecution Service of Canada, encouraging the pursuit of non-criminal approaches to drug possession, national decriminalization seems closer than ever.
New Overdose Prevention and Supervised Consumption Sites: Despite historical pushback against supervised consumption sites (SCS) and overdose prevention sites (OPS, which in Canada are more resource-limited than SCS, generally focused solely on overdose reversals), 2020 saw some jurisdictions welcome these services for the first time. Saskatchewan opened the only federally exempt inhalation site, and hopes to open an Indigenous-led SCS in 2021. In Québec, Gatineau was approved for an OPS while Québec City will be seeing its first SCS. Despite pushbacks and dramatics from opponents who put property over people, Vancouver—which opened North America’s first sanctioned SCS back in 2003—approved its first OPS to be located outside of the Downtown Eastside community or a healthcare center.
Psychedelics: This year, psychedelic-assisted therapy became a reality when four terminally ill Canadians were granted an exemption that allowed them compassionate access to psilocybin to treat anxiety. Not long after, some health care providers were granted exemptions to use psilocybin themselves in order to develop therapies without fear of prosecution. These steps may pave the way for psychedelic-assisted therapy to one day be recognized as a component of comprehensive mental health care—and ultimately for the decriminalization and legalization of psychedelics.
The catastrophic overdose toll of COVID-19: The pandemic greatly exacerbated the overdose crisis, with record numbers of deaths recorded in 2020. It also increased the toxicity and adulteration of the illicit drug supply which contributes to these deaths. At least 3,897 people lost their lives to overdose in Canada in 2020. Despite the implementation of new safe supply programs, death rates surged far past what they were in years prior. Additional urgent public health actions—such as legalization, widespread safe supply and an increase in harm reduction services—are all needed to save lives.
Closures of OPS and SCS: The closures of two life-saving sites—along with pared-down hours, range and capacity for sites that did stay open—were immense setbacks to people who use drugs. Nova Scotia’s HaliFIX Overdose Prevention Site was abruptly shut down, which led to approximately two months without services for Halifax drug users. A “new” OPS called ReFIX was located adjacent to a large men-only shelter, creating access concerns for women and other marginalized groups.
Meanwhile, the United Conservative Party in Alberta shut down the busiest SCS in North America. At the time, it was the only site that had inhalation booths. Funding mismanagement was cited as the reason for the closure, even though ultimately no criminal charges were laid. These appalling decisions amidst dual public health crises manifest as violence against people who use drugs.
To advocates in the US, it may sometimes seem like we have drug policy up here in Canada all figured out. And yes, some of our policies are comparatively progressive. But this year has shown us how much more radical activism is still needed. While mourning those we’ve lost, we must continue the fight in 2021.
This article was written by the board of Canadian Students for Sensible Drug Policy.