CMHA Wants to Decriminalize Opioids to Solve Opioid Crisis

Nick Murray

The Canadian Mental Health Association (CMHA) is calling for Canada to treat opioid addiction as a health issue, not a criminal one. They're calling for care where currently Canada uses corrections.

According to a national policy paper released by the CMHA on April 17th, decriminalizing opioid drugs is a key ingredient in solving the opioid crisis that is killing thousands of people.The policy paper was developed by a team of mental health policy and research experts across the country, in response to heightened rates of opioid related incidents.

Dr. Patrick Smith, national CEO of the CMHA, says that "criminalizing people who use drugs stigmatizes substance use, fosters a climate in which they feel unsafe in accessing life-saving interventions and treatment, and further marginalizing those living in poverty or at social disadvantage."

the war on drugs doesn’t work and it’s time we lay down our weapons and start getting people help.
— Patrick Smith, National CEO of CMHA

CMHA recommends decriminalizing all illegal substances for personal use with the goal of aligning Canadian drug laws with public health. Decriminalization means that possession, use and acquisition of illegal drugs would no longer be criminal offences. This differs from legalization, in that producing, supplying and selling would still carry the weight of criminal sentencing.

CMHA points to Portugal as evidence that decriminalization works. Portugal decriminalized psychoactive substances for use in 2001 and increased access to treatment by 60% in the first ten years. They also reduced the number of people arrested or incarcerated for drug-related offences by 60% by 2015.

In order to get it right in Canada, Smith says "decriminalization must be accompanied by significant investments in health promotion, harm reduction and treatment measures."

Smith points to social inequalities being an overlooked part of the problem of opioid use. The logic is that social inequalities cause psychological pain and trauma, which is linked to substance abuse and mental illness. The opioid crisis disproportionately affects people who have low incomes, are unemployed or disabled, as well as those living in indigenous communities.

16 Canadians a day were hospitalized in 2016. Opioid abuse now takes the lives of more Canadians than HIV did, at the peak of it's crisis in 1995.

CMHA would also like to see more investment into affordable housing, childcare, education and employment. These "social determinants of health" would address environmental stressors like poverty and housing insecurity, which increase the risk of opioid use and addiction. They also recommend researching, funding and improving access to treatment for Opioid Use Disorder, universal access to psychotherapy, exploring cannabis as an alternative form of pain management, recognizing indigenous healing practices, and increasing access to methadone and buprenorphine/naloxone treatment for withdrawal.

"Better training and education are needed, especially for management of chronic pain" Smith said.

The paper also recommends a National Pain and Addictions Strategy which would include investment in research and investment and clinical care targeted toward finding safer pain management approaches. This treatment could include opioids, but would also include an "exit plan".

CMHA thinks Canada should increase access to overdose prevention sites and supervised consumption sites. The goal with these sites is to provide public education, save lives, reverse accidental poisonings and reduce the spread of communicable diseases by providing sterile supplies. They also recommend using teleconferencing to supervise people who use drugs alone in private residences.

CMHA also recommends researching and supporting innovative plans that offer prescription-grade drugs as an alternative to the "contaminated drug supply".

Smith says Canada is headed in the right direction, as far as developing and expanding harm reduction initiatives.

"It's not an easy road, but with the right supports, recovery is possible" he added.