The BC Humanist Association is calling for an end to moralistic approaches to drug policy in its response to the Health Committee's consultation on the overdose and drug toxicity crisis.
In 2016, the BCHA presented to the Health Committee calling for the government to end its endorsement of faith based recovery programs. This coincided with the organization supporting Byron Wood’s human rights complaint over his right to secular treatment options. The BCHA also filed a submission to the draft mental health and addictions strategy in 2018 highlighting similar concerns.
Add your response before Friday, August 5, 2022 at 3:00 PM PDT.
PART A: Government Response
What actions should government take to address the ongoing overdose and drug toxicity crisis?
Recommendations
There have been many recommendations from individuals and organizations closer to the crisis than ours, including reports like the Coroner’s Death Review Panel in March 2022. That report outlines a number of priority actions: providing a pathway to safe supply, an illicit drug toxicity action plan and establishing an evidenced-based continuum of care. Simply put, we recommend the government listen to the experts who have been calling for more serious action, particularly around the need for safe supply and decriminalization.
Explanation
Six people are dying every day from the drug toxicity crisis. Rather than rise to the urgency that this statistic calls for, we are all once again responding to a consultation on what is to be done about the crisis. But the Government knows what needs to be done. It’s been told repeatedly by past consultations, the Public Health Officer, the Chief Coroner, expert panels, civil society and by drug users.
The recommendations from the most recent Death Review Panel in March 2022 provided clear steps, including timelines, that have seemingly been entirely ignored by this Government. It called for the development of a plan for a safer drug supply by May 9, 2022. This was not done. It called for a 30/60/90 Day Illicit Drug Toxicity Action Plan with Ongoing Monitoring. There is no evidence this work is underway over 130 days later. Finally, it calls for an Evidenced-Based Continuum of Care. This latter recommendation is seemingly the sole focus of the Government as in her statement in response to the news 195 people died in May, the Minister of Mental Health and Addictions only touted the creation of new treatment and recovery options in Prince George and Abbotsford. Notably the Minister did not mention whether these clinics were ‘evidenced-based.’
While many actions that need to be taken are out of the provincial government’s control, for example the end to criminal prohibitions on drug use, the Government does have the ability to redirect resources from enforcement and toward community programs and services. In her 2019 report, Stopping the Harm, Dr Bonnie Henry called on the province to stop criminalizing people who use drugs. She identified clear actions the Minister of Public Safety and Solicitor General could do immediately, without waiting for action by the federal government, to end enforcement of drug prohibitions.
In its actions to combat these crises, the Government should adopt a compassionate and human rights based approach that is based on the best available evidence. In practice that means listening to recommendations from experts and those with lived experiences. For example, the report Decriminalization Done Right: A Rights-Based Path for Drug Policy highlights how the health, human rights and dignity of people who use drugs can be properly centred in our provincial drug policy.
As we will address in the subsequent questions, there is a lot the Government can and should do immediately. The biggest issue is seemingly that the Government is continually choosing not to do anything, or to do as little as possible, while too many people continue to die.
PART B: Improving Care
How should government and institutions improve services, support, and resources in response to the ongoing overdose and drug toxicity crisis (this includes, but is not limited to, prevention, harm reduction, treatment, and recovery)?
Recommendations
We’ll focus these recommendations on treatment and recovery. As we've previously written, the government should:
- Expand support for secular, evidence-based addictions treatment programs and ensure no public support is given to faith-based programs
- Regulate and inspect addictions treatment facilities to protect patients' freedom of and freedom from religion
- Inform physicians, mental health professionals, social workers, employers, unions and judges of secular, evidence-based addictions treatment programs and their duty to protect a person with an addiction from religious coercion.
Explanation
According to the Supreme Court of Canada, the Government has a duty of religious neutrality (Mouvement laïque québécois v. Saguenay (City), 2015 SCC 16, [2015] 2 S.C.R. 3). This means it should not endorse religion nor coerce individuals into religious practice. Yet the 12 Step Method, which is prevalent in an overwhelming majority of recovery and treatment facilities, is inherently religious. Half of the steps reference God or a higher power. Bill Wilson founded Alcoholics Anonymous (AA) and popularized the 12 Step Method on an explicitly Christian view of alcoholism as a moral failing. Efforts to establish secular 12 Step approaches have often been met with hostility by the AA hierarchy.
Surveys of the religiosity of British Columbians suggest that 26% do not believe in a higher power and as many as 69% do not practise a religion or faith. Further, many of those who do practise a religion in BC are not Christian. Additionally, thorough studies and analyses of 12 Step interventions have failed to demonstrate its effectiveness. This should be unsurprising as the method is based on a dated and dogmatic approach to treatment.
Publicly funded treatment options should be available and welcoming to all British Columbians and should be held to the highest standard of evidence and patient care. Numerous reports over the past decade have highlighted concerns with the lack of oversight of residential treatment facilities.
Sadly, our recommendations here are largely just a reprint of submissions we made four years ago when the Government was developing its mental health and addictions strategy. We encourage you to reread that submission.
PART C: Addressing Toxic Drug Supplies
What should be done to address the harm done by the increasingly toxic and unpredictable illicit supply of drugs?
Recommendations
We support the many and growing calls for a safe supply.
Explanation
Current efforts by the Government to tackle the toxic drug supply in BC have been woefully inadequate compared to the scale of the crisis we collectively face. The time for small, pilot projects is over. The solution to a toxic drug supply is to replace it with one that is safe.
PART D: Other
Do you have any other recommendations for the committee?
Recommendations
Fundamentally, the government’s response to the overdose and drug toxicity crisis should be based in recognizing the dignity and autonomy of all British Columbians. It should abandon moralism and centre the human rights and dignity of people who use drugs.
Explanation
Prohibitions on drugs and alcohol in Canada were largely based on a European Protestant Christian morality, coupled with reactionary anti-Asian racism. It was amid this atmosphere in the early 20th century that religious abstinence based treatment approaches, notably the 12-Step Method popularized by Alcoholics Anonymous. Of the 12 steps, fully half directly reference God or a higher power and the 11th step explicitly calls adherents to use prayer to “improve our conscious contact with God.”
This worldview sees substance use as an inherently problematic moral failing. This view was secularized but remained moralistic as substance use came to be viewed as a disease to be treated. But even a cursory look at human history shows that substance use is common across all cultures and societies. Recognizing this, and our nation’s commitment to multiculturalism, a human-centred approach would seek to end the prohibition and criminalization of substance use and rather facilitate the safe use of substances. This is the approach we've adopted with respect to alcohol and, more recently, cannabis.
Adopting such an approach would entail the government revising its entire philosophy with regards to ending the overdose and toxic drug crisis. Rather than a continual focus on treatment and recovery, the first focus would be on supporting people where they are. The recommendations of Decriminalization Done Right are informative: Laws, policies and practices that stigmatize, pathologize or punish people who use drugs should be abolished; and those resources currently used to enforce such rules should be redirected to community-led programs that promote the health and human rights of all peoples.
Such an approach would be consistent with the Government's stated commitments to the rights of Indigenous Peoples. The moralistic approach is deeply enmeshed with settler colonialism and the desire to impose a Christian morality on these lands and the peoples residing in them. Adopting a rights-based approach, by contrast, would recognize the dignity of all peoples who live here and maintain space for culturally-appropriate approaches to substance use.