Interior Health is recommending that municipalities monitor the effects of decriminalization on public consumption over a six-month period before implementing or modifying bylaws that ban the use of illicit drugs in public.
That is according to an April 14 letter – signed by all six IH Medical Health Officers – and sent to all municipalities across the health authority, a copy of which was obtained by RadioNL.
It comes about three months into B.C.’s three-year drug decriminalization pilot that began on Jan. 31.
“This would allow staff to monitor the situation to determine if there is in fact an increase in public drug use and give council the time to seek sound public health advice,” the letter said.
“This letter does not replace formal consultation with your local Medical Health Officer on a proposed bylaw related to substance use in public areas.”
The letter comes the same week where Kamloops council voted to bring in bylaw amendments that ban the use of illicit drugs in all public parks and facilities. That bylaw amendment will require consultation with Interior Health and sign off from B.C. Health Minister Adrian Dix before the city can formally adopt it, as it affects public health policies.
Medical Health Officer, Dr. Carol Fenton, who signed Friday’s letter, told NL Newsday she opposed the banning of illicit drug use in public places, suggesting she felt it was a step too far.
“What I see is city council is talking about what I would call a ‘big hammer,'” Fenton said. “A bylaw is a fairly restrictive intervention. Let’s start with understanding the problem; why are we seeing unwanted behavior? We are seeing it, let’s understand where that is coming from.”
Her comments drew the ire of Kamloops councillor, Bill Sarai, who alleged that IH only offers solutions that are “enabling” and that the drug crisis in Kamloops has only gotten worse over the past five years.
“Every solution they come up with is to keep letting them use, and we will keep supplying them with material to use but the aftermath or pregame is played out on our city streets, city parks, and in our playgrounds – that has to change,” Sarai said, noting treatment options in Kamloops are few and far between.
“If you look at what they’ve been preaching to us, throughout the province, especially in Kamloops was the four pillars of harm reduction: prevention, harm reduction, enforcement, and treatment. Out of the four, all we get here is harm reduction,” he added.
“These plans that they’ve brought forward of the allowing 2.5 grams and all these four pillars, it all started in Downtown Eastside. We are not Downtown Eastside and nor do we want to become one. If we continue on the path of hearing this type of pushback that we’re using ‘the hammer,’ we’re going to become Downtown Eastside.”
IH MHOs ‘available for consultation’ to address local needs
In their letter Friday, Interior Health says its Medical Health Officers remain available for consultation to support conversations that are specific to local needs.
“This letter is in follow up to the recent exemption in B.C. to the Controlled Drug and Substances Act granted by Health Canada,” it said. “This exemption is to decriminalize adults in possession of small amounts of certain controlled substances. Decriminalization is an evidence-based strategy to reduce the harms currently associated with using substances.”
“Decriminalization does not change or condone the criminality of specific unwanted and unsafe behaviours such as intoxication, violence, or theft in the community. Although decriminalization allows people to have a certain amount of illegal substances with them, decriminalization is not expected to change substance use behaviours.”
It also said that Medical Health Officers do not promote substance use in public spaces, pointing to its work on both tobacco and alcohol, but noted that punitive approaches likes tickets or fines could lead to jail time if a person is unable to pay.
“These harms also include stigma and shame that force people to conceal their substance use and use alone, increasing their risk of dying from substance poisoning,” the letter said.
“People from all walks of life use substances, both the ones that are illegal (heroin, cocaine, fentanyl, etc.) and those that are legal (alcohol, cannabis, caffeine, prescribed fentanyl, etc.). The vast majority of people consume their substances either in private (e.g. at home or at a friend’s house) or in a designated consumption space (e.g.
bars/restaurants, supervised consumption sites).”
It noted that a small group of people may be forced to use substances in public spaces as they don’t have access to alternative spaces as they’re either homeless, or have an “unsafe home environment”, or they don’t have access to a supervised consumption site.
“As such, one important strategy to decrease consumption in public places is to offer safe and appropriate consumption spaces such as overdose prevention sites or supervised consumption services,” the letter added. “It is important to note that while some communities do have overdose prevention sites, the hours are usually limited to weekday business hours, which may not reflect the times that people want or need to use substances.”
“In addition, most communities in the Southern Interior do not have an overdose prevention sites that supports inhalation or smoking, which is the most common mode of consumption leading to substance poisoning.”
The Medical Health Officers also noted that interventions implemented by health authorities or provincial programs to prevent or address public substance use – like ensuring there are places to use, better social programs and housing, and peer support programs and solutions (like community clean-up teams) are more likely to be successful with municipal support.