Early in July, Canadians with substance use problems received support from an unexpected group: Canada’s police chiefs. This is taken from the statement of Chief Constable Adam Palmer, the President of the Canadian Association of Chiefs of Police, on July 9, 2020:

“The CACP proposes increased access to healthcare, treatment and social services to divert people struggling with substance use or addiction away from the criminal justice system. This would apply to individuals in possession of small or predetermined amounts of illicit drugs for personal consumption.

These healthcare and social supports need to exist on a local, provincial and national level. The CACP asserts that diversion opportunities would improve the health and safety outcomes for individuals who use drugs, while also reducing property crime and repeat offences and the demand for drugs in communities.”

For people like me, who work with youth affected by substance use, decriminalization of the possession of small amounts of illegal drugs would be a welcome development. The words of law enforcement leaders recognizing that drug use is a health problem allows a dialogue about how to help victims of substance use to heal.

One country that has done what the police chiefs are recommending is Portugal and their experience confirms that this strategy is effective. In 2001, Portugal decriminalized the possession of all illegal drugs for personal use. A person can still be fined or given community service for possession of drugs, but they cannot be arrested and charged. The penalties are handed out by the Commissions for the Disuasion of Drug Addiction and are typically focussed on harm reduction strategies and not punishment. While there are several important outcomes related to Portugal’s change from a law enforcement approach to a health approach, the most important is a reduction in drug-related sequelae and improved health outcomes.

For those who support an approach the decriminalization approach, it’s important to remember that the Portuguese didn’t only decriminalize the personal possession of drugs, they also developed an approach to drug use based on social and health guidelines. This change necessitated a reorientation of many services and not just law enforcement. In other words, if Canada undertook to make the changes to the criminal code necessary to do as the Chiefs of Police in Canada are asking, they would also have to support the resources necessary to make the social and health system changes that the Portuguese implemented. This would be more complicated in Canada than Portugal because, in our model of government, health and social programs are delivered by the provinces. Because of this, the entire process would take much longer to implement. It would also take a lot of good will between the federal, provincial and territorial governments. The Chiefs’ recommendation did recognize the need for both health and social supports, which indicates how carefully they have considered this recommendation.

The need for an evidence-based healthcare approach to substance use disorders, that provides law enforcement, healthcare professionals and social service agencies with the resources they need to help Canadians suffering from these conditions has grown during COVID-19. The stress of social isolation, the financial stresses related to job loss and the lack of access to the usual resources available to substance users in our communities have exacerbated the difficulties these individuals face. Everyone working in mental health recognizes the need to address these health problems as we move forward. The Canadian  Psychiatric Association stresses the need for a comprehensive approach to treatment in this document outlining an overview of clinical practice and general recommendations.

The statement from Canada’s Chiefs of Police starts a dialogue that is overdue and medical organizations and social services agencies should seize the opportunity for change.

(Art therapy can provide important insights in treatment. This is a very good article about art therapy and addiction treatment.)

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