Law-and-order approach ignores the evidence

Opinion

Hey there, time traveller!
This article was published 16/11/2022 (769 days ago), so information in it may no longer be current.

Manitoba’s premier promised better health care and less crime in the throne speech delivered Tuesday afternoon. But by failing to embrace a comprehensive approach to the opioid crisis, Heather Stefanson can hardly make good on those promises.

It’s simple — Manitoba needs to embrace a drug strategy that will do more than just arrest or treat those dealing with addiction. Instead, it needs to look to other jurisdictions for a “four-pillar” approach. It’s been proven to be effective in Zurich, Frankfurt and Sydney, and has had some success in Vancouver.

Minister of Mental Health and Community Wellness Sarah Guillemard is using the example of Vancouver’s Downtown Lower East Side as a justification for not embracing a harm-reduction model. After touring a supervised consumption site model on East Hastings Street in early November, Guillemard stated: “Jurisdictions that have formalized supervised consumption sites are not seeing reductions in drug use or overdose deaths.”

The minister spent a couple of hours doing research and came up with that informative insight. Perhaps she should have dug deeper. Instead, she sounds like all the other “stable geniuses” doing health research on “the internets.” Hopefully, she’ll never be in charge of deciding whether to impose mask mandates … but I digress.

Three of the four pillars referenced for dealing with the opioid crisis are enforcement, treatment and prevention. Prevention seems pretty straightforward: make sure that kids stay away from drugs. Except it’s not that easy, is it? There’s a significant correlation between childhood trauma and drug use. Children who have been sexually, physically or emotionally abused are far more likely to have substance abuse issues.

Suddenly, prevention becomes much bigger than just keeping kids involved in after-school programs (although those can be effective, too). And as we know in Manitoba, one of the residual effects of residential school violence has been generational trauma, including sexual, physical and emotional abuse.

This means any discussion of prevention will require a cultural lens, as well.

The enforcement part seems to be something Manitoba’s Progressive Conservatives like to focus on, and it certainly was front and centre in the throne speech: “Our government will continue to tackle the underlying issues of homelessness, addictions and mental health by providing increased supports for front-line law enforcement officers through technology, specialized training, increased police presence and support for more officers.”

Treatment, another one of those pillars, is also an important aspect of health care. In 2019, the Manitoba Liberals, using a freedom of information request, found the average wait time for residential addiction treatment in Winnipeg was 206 days for women and 52 days for men. The average wait time for publicly funded treatment in Manitoba is 52 days overall.

Every day of delay for an addict seeking treatment increases the risk of hospitalization or death. And research shows that overall, opioid addiction costs Canadian taxpayers more $6 billion annually in health-care, lost productivity and criminal justice.

Tuesday’s throne speech include a reference to treatment, in the form of a pledge to provide financial support for up to 1,000 addictions treatment spaces. Whether that will reduce the wait times for spaces remains to be seen.

Treatment is the one pillar many critics in Vancouver see as lacking in that city’s drug strategy. There have been calls for the creation of more public treatment centres.

As well, some have suggested subsidies are required so greater numbers of people are able to attend private centres. Certainly, such an initiative here would help Manitoba’s health care in the long run.

But the fourth pillar, the essential load-bearing element in a comprehensive drug program, is a harm-reduction strategy. Harm reduction includes supervised consumption — supervised injection sites and needle exchanges.

Rather than seeing it for what it is — health care — the Tories continue to clutch their pearls and just say “no,” rather than embrace the evidence.

A recent study from McGill’s Dimitra Panagiotoglou on the effects of overdose prevention sites (OPS) and supervised consumption sites (SCS) in B.C. in 2016 suggests they may not have great deal of direct effect on drug-related fatalities. However, Panagiotoglou’s study does suggest these sites reduce health-care use substantially.

So this is where Stefanson and her government could actually do something about health care. With OPS and SCS use, fewer emergency room visits and fewer paramedic calls are required — both key areas under immense pressure as a result of the drug crisis in Winnipeg.

Not surprisingly, the research suggests both the OPS and SCS that were studied may not have been suitable subjects because of their limited “operating hours, service volume, residence requirements and police presence.”

The key takeaway, then? Stop trying to use police to enforce drug compliance and come up with a harm-reduction strategy with hours and service capacity that actually respond to addicts’ needs. It’s not rocket science. But it is evidence-based.

No one wants to see drug-users dying in bus shelters. Preventing this from happening requires more than just one approach. I think Manitoba’s Progressive Conservatives are fearful that if they say “yes” to a harm-reduction strategy, they’ll lose support from some of the voters they know they can still count on.

The Keystone Party was formed this summer in the wake of COVID-19 restrictions and vaccine mandates. And considering how well the People’s Party of Canada did against federal Conservative Party stalwart Candice Bergen in the last federal election, maybe the provincial PCs feel it’s necessary to consolidate their base to ensure they’ll at least have that support at the ballot box next year.

Shannon Sampert is a communications consultant and former politics and perspectives editor at the Winnipeg Free Press.