British Columbia Premier David Eby promised his government would not abandon people with drug addictions when he rolled back decriminalization in the province. There would be better, more consistent care for people who are addicted to drugs, he said, including overdose-prevention services and addictions specialists attached to every major hospital.
That commitment, made in April, is running into an easily predictable challenge: public health officials in B.C. say more addictions specialists and overdose-prevention services are needed for the plan to succeed, but finding people to deliver the services is a significant and well-documented issue. In a report in March, the province’s auditor general found that staffing shortages have hampered overdose prevention and supervised consumption services.
B.C. is not unique, of course. Across the country, cities and towns are confronting an unprecedented surge in overdoses due to toxic drug supply, and mental health and addictions services are stretched thin. Promising more treatment is vapourware, unless qualified human resources have been secured.
British Columbia launched Canada’s first decriminalization pilot project in January, 2023, in response to skyrocketing drug deaths from an increasingly toxic illicit supply. More than 14,000 people in the province have died since 2016.
The province initially had broad support for decriminalization, but it ignored recommendations from experts to build in limitations to protect public safety. When those warnings proved correct and illicit drug use in parks, hospitals and other public places became problematic, B.C. was forced into retreat.
The provincial government’s initial remedy was legislation passed last fall that aimed to curb public use of illicit drugs, but the B.C. Supreme Court issued an injunction pending a Charter challenge that could take years to resolve. With a provincial election set for this fall, Mr. Eby’s government was unable to bring in reforms that should have been in place from the start.
Under decriminalization, adults in British Columbia were not being arrested or charged for possessing small amounts of certain illegal drugs most commonly associated with overdoses, and were allowed to use those drugs in most public areas. Now, police once again are authorized to force people to stop using or leave the area if they are caught consuming in most public places, including hospitals, restaurants, transit, parks and beaches.
Concerns about public safety were widespread and growing. A video of a group smoking drugs in a Tim Hortons went viral, capturing public frustration. But it was the situation in hospitals that delivered the final blow to the pilot project. Nurses reported multiple instances of exposure to unknown, potentially toxic drugs, and of substance use in a perinatal unit.
As a result, hospitals were a central feature of B.C.’s post-decriminalization policy.
When Mr. Eby recriminalized the use of hard drugs in public places, his Health Minister Adrian Dix vowed “immediate action” to make hospitals safer, with a province-wide, zero-tolerance response to illicit drug use in hospitals.
On the flip side, Mr. Dix said there would be more help for patients struggling with addictions. Specifics of how those supports will be delivered, however, are elusive.
Very few acute-care facilities in B.C. currently have overdose prevention sites, but the province has not spelled out which hospitals will have to add them, or when. Those addiction specialists that are supposed to be in place in every major hospital? The provincial government won’t say what qualifications they will have.
The task force that is supposed to be overseeing the changes in hospitals is still working out its terms of reference. None of that sounds like immediate action.
B.C. has been on the leading edge of harm reduction in Canada for decades. The New Democratic Party government, facing an election that is expected to focus on issues of law and order, has made a rare retreat from a key measure. To restore its credibility, the province needs to show how it plans to meet its promised commitments – starting with a recruitment plan so that it can ramp up much-needed addictions treatment.