Written by Dr. Barbara Watts on November 13, 2018 for CanadianHealthcareNetwork.ca
(Reprinted with permission)
Dr. Barb Watts
Currently in Canada, if you are caught in possession of any number of psychoactive drugs you are criminally charged. This is supposed to protect people by acting as a deterrent.
Unfortunately, we know from extensive experience and research, that this just does not work. Adolescence is a time of increased risky behaviour and decreased judgment. In Canada, 5.5% of youth use prescription opioids recreationally, 40% of youth aged 12-17 and 83% of youth aged 18-24 drink alcohol, 25% use cannabis, 3-5% use cocaine, 3.5% use ecstasy and up to 6% use stimulants not prescribed to them. (Statistics Canada, 2015 CTADS)
Adults and adolescents already in the grip of moderate to severe substance use disorders have lost the ability to choose. By definition, they will harm themselves and their families, in order to obtain the needed substance. Substance use hijacks the motivational centres of the brain, supplanting all other goals, even as the pleasure of using diminishes.
The futility of trying to stop drug use by punishing users is increasingly being recognized by the criminal justice system and law enforcement.
Many U.S. and Canadian large urban areas have instituted a system to divert drug users into treatment programs. Drug treatment courts attempt to replace punishment for drug possession and drug related crimes, with treatment. Certainly this has been more effective than punishment with fines and jail sentences, but the treatment provided is exclusively abstinence based and the accused must plead guilty to the charge in order to access drug treatment court. The consequences of a criminal charge and/or conviction are lifelong, adversely affecting someone’s chances of employment, professional education, travel, volunteer work and even citizenship.. And it is clear that medication assisted treatment is the most effective treatment for opioid use disorder.
Decriminalizing the possession of drugs for personal use is not the same as legalizing all drugs. Legalizing a drug means it is legal to sell the drug and the government can regulate and control the industry.
Decriminalization, on the other hand, simply means it is not a criminal offence to possess the drug for personal use. It is still illegal to sell the drug.
Instead of judging and punishing our patients with substance use disorder (SUD), we need to take them into our health care system and help them to recover.
Since prohibition does not deter many people from using illegal drugs, we need to switch to a public health approach to SUD. We need to provide evidence-based treatment, including social supports and medication assists. We need to make it possible for our loved ones with SUD to recover from the horrors of uncontrolled SUD and enter back into a productive and fulfilling life.
Portugal has shown how successful this strategy for dealing with substance misuse can be. In 2001 they decriminalized possession of drugs for personal use, while simultaneously instituting treatment and social support initiatives to deal with their burgeoning heroin problem. Today Portugal has seen dramatic drops in problematic drug use, HIV and hepatitis infection rates, overdose deaths, drug-related crime and incarceration rates.
The organizations calling for the decriminalization of drugs include the World Health Organization (WHO), the Global Commission on Drug Policy, the Lancet Commissions, the American College of Physicians, the Canadian Public Health Association (CPHA), the Canadian Society of Addiction Medicine (CSAM), the Toronto Board of Health and the Canadian Drug Policy Coalition (CDPC) among others.
It is time the Canadian Medical Association and all the provincial medical associations called for decriminalization.
Barb Watts is a family doctor with 35 years experience. She retired from solo family practice a number of years ago. Since then she works part time in the ER in Orangeville and takes the winters off to travel somewhere warm and spends the summers at her cottage in Northern Ontario. She is a board member for Families for Addiction Recovery.
Opinions expressed in this article are those of the writers, and do not necessarily reflect those of CanadianHealthcareNetwork.ca or its parent company.
Originally published by Canadian Healthcare Network
