How can we address the drug crisis in Canada?

Last month, Ottawa’s Legislative Assembly unanimously passed a motion asking the federal government to implement a comprehensive strategy to address the drug crisis gripping the city. Only days later, the Emergency Task Force on Addiction and Mental Health announced the creation of a new committee that is tasked with developing a strategy.

These events suggest that the city is addressing a serious problem and is determined to do something about it. The debate is far from over, though, as Ottawa must commit to many of the same social changes happening across the country. This means accepting the need for mental health reforms as a fundamental component of effective drug policy.

In 2014, a study commissioned by the National Council on Problem Gambling found that 18 percent of Canadian adults (presumably Ontario residents) had “experienced a clinically significant episode of mental health or substance use disorder during the last year.” The study also found that for almost half of Canadians, anxiety disorders and cocaine use are common symptoms of drug use, and that many Canadians are affected by substance abuse in ways that go beyond substance use.

These findings are backed up by Health Canada data that shows that 64 percent of Canadians who purchased cannabis over the counter at the beginning of 2018 were under age 25, while about 75 percent of Canadians who purchased the most potent form of the drug that year were under the age of 25, and 88 percent were under age 25.

How did we get here? Canadians can probably agree that it started with the legalization of marijuana. When recreational marijuana became available in October 2018, almost 2 million people across the country bought a gram or two in the few months since. This was much greater than the 1.5 million who bought a gram or two of cannabis before the medical marijuana laws were changed in 2001.

Even if the purpose of legalization was to reduce access to marijuana, more people are taking more marijuana, and access is available to more people, resulting in a greater need for treatment. And just a day before the legislative assembly passed its motion, it was reported that the number of overdose deaths in Ontario had risen to 692 in 2018 alone, with use of fentanyl identified as a factor in hundreds of cases.

Even more concerning than the scale of the increase in opioid deaths across the country, however, is the fragmentation of the opioid crisis: The overdose deaths are being met with more fatal overdoses, despite the emphasis on opioid antidote medication that’s mandated by law. The public health crisis has become a health crisis as well.

These are not isolated incidents. Canada’s Minister of Health, Ginette Petitpas Taylor, said in a recent speech that between 2011 and 2015, the opioid overdose rate in Canada increased by 90 percent. However, she said, “it is important to note that the population could not have absorbed the additional 2 million users since that time.” Of that population, 3 million people — around half of those at risk — are in Ontario.

Fentanyl is the main offender. It’s 90 times more potent than morphine and 50 times more potent than heroin. The results are devastating. The Automated Records Center (ARC) on Canada’s National Prescription Drug Monitoring System (PNDS) registered almost 300,000 drug overdose deaths from 2015 to 2016. Of those, 45 percent were due to opioids, of which almost 60 percent were fentanyl and synthetic opioid analogues.

When Ontario decides to commit resources to addressing drug abuse, the bill will come out of the Legislative Assembly. When Ontario decides to commit resources to reducing overdose deaths, and when Ontario decides to allocate drug education programs in schools, then the appropriate provincial or federal legislation must follow. The Canadian province of Ontario should lead this discussion.

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