Please note this is an opinion piece and is not a comprehensive review of the systems in question.

As of January 31^st, the Province of BC have decriminalized drugs for personal use, in quantities below 2.5 grams. This decriminalization is limited to some key drugs: Opiods, Cocaine (powder and crack), Methamphetamine and MDMA.

This change is intended to reduce stigmatization of individuals who are experiencing drug addictions, and to provide a safe platform for them to come forward, without fear of reprisal or charge for assistance. It is important to also note that while individual use is no longer criminal and will not result in arrest or seizure of drugs, it remains illegal to sell drugs or undertake associated activities.

It is also important to note that this is a three year “trial” project to gauge results. Many in the community are, however, questioning how the government could roll such a move back, once it is embedded in both enforcement and the court system.

Many laud this move as aligning closer to the Portugal model, which is perceived to be the most positive treatment model globally. However, there remains a number of differences  between BC and Portugal that will mean this move is likely to see limited results.

BC’s drug offender system has been based upon punishment and criminal sanctions (which changed yesterday), while Portugal’s model emphasizes health-centered approaches and reducing harm. In Portugal, drug use is treated as a public health issue, and drug users are referred to treatment and support services rather than being incarcerated. BC’s system has been criticized for its high rate of incarceration for drug offenses and the lack of access to treatment and support services. In contrast, Portugal’s approach has been seen as successful in reducing drug-related harm, lowering rates of drug use, and reducing the burden on the criminal justice system.

There are some general differences between the two countries that should be considered when looking at how effective this aspect of decriminalization could be:

Funding and resources: Portugal has a well-funded national drug policy and extensive resources devoted to treating drug addiction. Meanwhile, British Columbia faces challenges related to limited funding and access to resources for drug treatment, which is even more acute in remote communities where they struggle to maintain basic health services.

Approach to drug treatment: Portugal embraces a harm reduction approach to drug treatment, prioritizing the health and well-being of individuals over punishment. British Columbia has struggled to adopt a strong full spectrum approach to health care that expands upon the harm prevention approach. It is limited in complex care beds, readily available treatment solutions, public health capacity and poor-quality recovery housing (although this is slowly changing).

Alternate court linkages: Regions of BC have been attempting to implement alternate Court systems for those who are seeking recovery. However, as noted, system capacity, quality and ongoing monitoring remain scant at best with no clearly defined integrated system of care that is accessible to all. Instead, to quote a former policing leader, “We know the system so we can get people in care, if we make some calls” This indicates the system lacks robust entry level opportunities that are accessible to all, instead requiring those with influence to strategize actions to navigate the system to create opportunity.  

“Healthcare for drug users in Portugal is organised mainly through the public network services of treatment for illicit substance dependence, under the Institute on Drugs and Drug Addiction, and the Ministry of Health. In addition to public services, certification and protocols between NGOs and other public or private treatment services ensure a wide access to quality-controlled services encompassing several treatment modalities. The public services provided are free of charge and accessible to all drug users who seek treatment.

There are 73 specialised treatment facilities (public and certified private therapeutic communities), 14 detoxification units, 70 public outpatient facilities and 13 accredited day centres. Portugal is divided into 18 districts. There is full coverage of drug outpatient treatment across all but four districts (districts not covered are located in the north of the country: Viana do Castelo, Bragança, Viseu and Guarda).[i]”

It should also be considered that Portugal has defined personal possession of drugs from a criminal offense to an administrative offense. And defined the disorder as something where treatment options must be provided as a public health issue. Those who choose not to comply can still be penalized through a range of possible actions:

• Fines, ranging from €25 to €150. These figures are based on the Portuguese minimum wage of about €485 (Banco de Portugal, 2001) and translate into hours of work lost.
• Suspension of the right to practice if the user has a licensed profession (e.g. medical doctor, taxi driver) and may endanger another person or someone’s possessions.
• Ban on visiting certain places (e.g. specific clubbing venues).
• Ban on associating with specific other persons.
• Foreign travel ban.
• Requirement to report periodically to the committee.
• Withdrawal of the right to carry a gun.
• Confiscation of personal possessions.
• Cessation of subsidies or allowances that a person receives from a public agency.

So, to say that Portugal has solved drug addiction is inaccurate, what has changed is how their government and  society treats addiction, and the expectations that individuals have some responsibility to comply with the laws in place.

What is missing from a robust response and care system in BC?

• Readily available (walk in off the street), Detoxification units, public outpatient facilities, and day centres (although some providers do supply this service)
• An expectation that treatment will be sought by those experiencing the addiction,
• Penalties that align with consequence for actions, such as repeat offenders, who are required to comply at some point if actions are repeated,
• Addicts in Portugal are aggressively targeted with drug therapy or community service righter than fines. In BC we don’t require therapy (constitutional right to choose) and we do not require community service in many cases,
• Drugs are confiscated when an addict is found in possession in Portugal. They are not arrested, but issued a summons to appear in an alternate administrative system. This process no longer exists in BC and drugs are no longer seized.

I hope the system can be rapidly expanded in BC; that the BC government will understand the world’s most successful model requires accountability on the part of the Addict, and that our complex care offerings are lack-luster, at best.

If this experiment fails, then it is time for change to our approach to health care in BC. It is time for more robust options for care, to demand accountability, and to stop victimizing society because of the lack of integrated approaches to care for those who need it the most.

[i] https://en.wikipedia.org/wiki/Drug_policy_of_Portugal