CMHA resisting stigma: A call for a compassionate public health approach to drug policy and services

CMHA BC’s Statement on recriminalize use of illicit drugs in public spaces

Since 2016, when the toxic drug crisis was recognized as a public health emergency, we have lost over 14,000 community members and loved ones in BC to an unpredictable supply of illicit substances cut with a myriad of unknown and dangerous additives. This incredible loss makes the recent surge in stigmatizing and harmful narratives about people who use drugs even more difficult to witness. The Canadian Mental Health Association BC Division (CMHA BC) maintains its position that we must address this crisis with a compassionate public health approach, not through the criminal justice system.

CMHA BC understands the need to balance public use with community safety but is disheartened to see decriminalization become the target when the issue of public use is rooted in much deeper societal challenges, such as the housing and homelessness crisis and income inequality. As a mental health organization, we also cannot ignore the relationship between unaddressed trauma, untreated mental health conditions and this crisis.

Now that decriminalization has been reversed for public use, it is imperative that the Provincial Government ensure the rapid and widespread expansion of safe consumption sites across all communities in BC. This includes ensuring there are enough safe consumption sites within urban areas to address the need and expanding safe consumption initiatives to rural and remote communities where these services remain extremely limited. With 86% of illicit drug deaths occurring inside [1], banning public use without providing safe indoor alternatives will only lead to more catastrophic loss of human lives.

In addition to harm reduction initiatives to keep people alive, the Provincial Government must continue to build out and scale interconnected systems of care for people with substance use disorder that are low-barrier, evidence-informed, voluntary and non-coercive in nature and can address the needs of a diverse and varied population. This means providing:

• Immediate access to low-barrier detox services
• A spectrum of trauma-informed substance use treatment services in communities across BC, ranging from community-based outpatient to bed-based treatment modalities
• Post-treatment aftercare and ongoing recovery supports
• Medication-assisted supports (e.g., opioid agonist therapy, prescribed alternatives, etc.)
• Ongoing access to stigma-free primary health care services
• Ongoing access to community-based mental health and substance use supports, including counselling and/or psychotherapy
• A variety of housing options across the housing continuum, using Housing First principles [2]
• Adequate income and disability support for people to meet their basic needs

The Provincial Government has taken important steps and gained momentum towards interconnected systems of care, and given this recent policy reversal, we must not slide backwards. We have a moral imperative to give people the agency, the tools, and the support for them to be able to work towards wellness. We cannot expect someone to get better if they cannot meet their basic needs. We must continue to marry harm reduction with treatment and recovery initiatives that also address mental health and cannot lose sight of the very important social determinants of health like housing and income.

Last week, CMHA BC celebrated Mental Health Week, which was centred on the power of healing through compassion. CMHA BC is discouraged by the resurgence of stigma around substance use and the related regression in drug use policy across Canada. Stigmatizing and dehumanizing people living with mental health or substance use health-related illnesses have deadly consequences. As we approach a provincial election in the fall, we call on our allies and supporters to centre compassion by resisting this stigma and ensuring that we are moving forward with building the voluntary systems of care we need for everyone to be healthy and well.