On Oct. 21, pharmaceutical opioid distributors McKesson Corp., AmerisourceBergen and Cardinal Health, and drug manufacturer Teva Pharmaceuticals agreed to a US$260-million settlement just hours before opening arguments were scheduled to begin in the first opioid-era federal lawsuit in Ohio.
This is the first of hundreds of similar lawsuits filed by cities, counties, Native American tribes and others across the United States and possibly in Canada.
It’s evident that the war on drugs has largely been a failure at the domestic and international levels. Illicit drug trafficking and addiction remain persistently endemic across the world, including in Canada, despite billions of dollars being spent on drug interdiction strategies.
At the same time, governments have done little to eradicate or replace the cultivation of opium and coca in source regions. Neither supply- nor demand-based strategies have been effective, and hundreds of thousands of people have been arrested, charged and imprisoned – or died – over the past several decades.
According to Statistics Canada, more than 12,800 apparent opioid-related deaths occurred between January 2016 and March 2019.
In British Columbia, where an average of four people die of overdoses each day, officials declared the opioid crisis a public health emergency. One-time Vancouver mayor Gregor Robertson lamented: “We are witnessing a horrific and preventable loss of life as a poisoned drug supply continues to kill our neighbours, friends and family.”
In the United States, addiction to prescription opioids — including oxycodone, hydrocodone, fentanyl, morphine and codeine – impacts the lives of millions. It’s estimated that 80 percent of the heroin users in the U.S. started down the path to addiction by misusing prescription narcotics. According to the National Institute on Drug Abuse, overdose deaths rose from 16,849 in 1999 to 70,237 in 2017.
According to the Los Angeles Times, the Drug Enforcement Agency says the number of prescription pills produced and distributed across the U.S. grew from 8.4 billion in 2006 to 12.6 billion in 2012. During that period, opioid-related deaths jumped from 17,000 to close to 24,000 a year.
Vancouver has been at the epicentre of Canada’s drug problem. The effects of addiction are in plain view on Hastings Avenue in the downtown core, steps from a police station and courthouse.
Still, the push towards decriminalization seems to gain momentum as the crisis continues to take its toll. The City of Vancouver, among others, has asked the federal government to decriminalize personal possession of illicit drugs.
The Netherlands is no longer the model for decriminalization or legalization. According to reports by the Dutch police association, conditions are starting to resemble a narco-state with the police unable to combat the emergence of a parallel criminal economy.
After years of referencing the Netherlands as a model for decriminalization, many today point to the experience of Portugal, which in 2001 did away with criminal penalties for simple possession and consumption of illicit drugs. The move was coupled with an expansion of treatment and harm reduction services such as safe injection sites. In Portugal, those caught with drugs appear before dissuasion commissions, which can refer people to treatment or impose monetary fines.
Statistics suggest the approach is working. Portugal has seen dramatic drops in overdose deaths, HIV infections and drug-related crimes, while the number of drug users seeking treatment has increased.
There’s no arguing that the war on drugs waged by law enforcement has been more than an utter failure. It has damaged the lives of millions of people who themselves were victims – victims of poverty, hopelessness, marginalization and challenges with mental health.
So many of the victims were in fact of the same strain of patients that were unnecessarily prescribed opiates by highly-trained physicians, healthcare experts and pharmaceutical giants that are before the courts today.
It seems the public health approach has also failed. Members of the same public health community who advocate for the decriminalization of addiction and its treatment as a public health issue have also contributed to the addiction of millions and deaths of thousands.
Safe injection sites, decriminalization, and substance abuse treatment and control only address one side of the problem. The current public health strategy only looks at the symptoms and not the causes that lead so many millions of depressed, marginalized and hopeless people to resort to drug use.
Justice Kofi Barnes of the Ontario Superior Court of Justice has a strong background in therapeutic jurisprudence. He knows the challenge better than anyone. In his book People, Places and Things, Barnes documents the journey of dozens of addicts, and court officers and criminal justice workers who witness the transformation in the lives of addicts. These accounts reveal the addicts’ depth of darkness and their emancipation through treatment.
Anyone who believes that it’s better to live and survive as an addict is a fool. The moral response is not to place addicts on a life-support of drugs and substances if we can help liberate them.
Politicization tears this social issue into liberal or conservative approaches. But victims can’t be distinguished by their political affiliation. Nor should our response. We need to look beyond the easy enforcement strategies or those that line the pockets of unethical pharmaceutical companies. The answer to addiction won’t be found in the industries of incarceration and prescription.
Sustaining a society that relies on drugs, through legalization, prescription or treatment programs, is a sign of a sick society that just sustains itself. A healthy society would not need drugs.
The question should be how do we improve the lives of peoples so vulnerable to addiction, not just how to keep them alive.
Anil Anand served as a police officer with a Canadian service for 29 years in a variety of roles, including being assigned to Interpol. He has a master of law degree, as well as an MBA, and has taught criminology and community policing courses. His book Mending Broken Fences Policing, looks at the role of contemporary policing in modern society.