The Alberta government has appointed a panel to study supervised drug-consumption sites. Panel members have been told to not consider the merits of the facilities, only how they affect neighbouring residents and businesses.
The logic, presumably, is that the merits of the sites are well established: They prevent overdoses, calls for emergency medical services, emergency-department visits and transmission of diseases such as HIV and hepatitis C. All of this is well catalogued in a report by the Alberta Community Council on HIV.
A skeptic might think that the fix is in, that this political exercise isn’t so much about providing “balance” in the analysis of the pros and cons of supervised consumption as it is about vilifying one type of drug user.
And that’s understandable. Because the reality is there are already a lot of supervised consumption sites in Alberta and every province and territory – places where clients can be served their poison of choice unadulterated, in relatively safe quantities and not be judged or jailed.
We call these places bars.
What they really are are supervised alcohol-consumption sites: a place people can consume a safe supply of a drug in social surroundings and where if they overdose (i.e. get too drunk), there are friends and bar staff around to help.
Drinkers can be rambunctious and obnoxious. So, in and around supervised alcohol-consumption sites, there are fights, sexual harassment, screaming and other disruptive noise-making, detritus such as broken glass and vomit, occasional vandalism and even more serious offences such as drunk driving, sexual assault, stabbings and shootings.
In other words, there is sometimes crime and social disorder around supervised alcohol-consumption sites. The neighbours – both commercial and residential – are not always thrilled.
Yet, there are 1,226 bars, lounges and taprooms in Alberta alone.
So why is the panel focusing only on seven supervised drug-consumption sites in the province where opioids rather than alcohol are used?
Sure, there are “social impacts” around supervised drug-consumption sites. But are they really much worse than around supervised alcohol-consumption sites?
Hold on, some will say: Opioids are illegal and alcohol is legal, so these different types of supervised consumption sites can’t be compared.
But the classification of drugs as legal or illegal is quite arbitrary. Any drug can be used recreationally or to numb one’s pain, physical or psychological. Any drug can be used responsibly. The assumptions we have that injected drugs are dangerous and bad, while liquid drugs ingested in clean glasses are innocuous and safe, are false.
The best way to minimize the harm caused by drugs is to legalize them, to ensure the supply is safe.
Imagine for a moment if, like opioids, alcohol was vilified and there were only seven places where you could take a drink.
They would be pretty busy places, frequented by desperate people with an acute substance-use disorder. They would go to supervised consumption spots to drink because the potency and safety of other alcohol would be unknown and unpredictable, as they would be far more likely to get ethanol than Jim Beam.
Bars are well-established and effective means of harm reduction, but they’re not perfect, of course. A lot of people still die of alcohol-related conditions – about 5,000 a year in Canada, with roughly 600 of those being in Alberta.
By contrast, about 4,000 people died of overdoses in Canada last year, roughly 800 of them in Alberta. Proportionally, Alberta is one of the provinces hit hardest by the opioid crisis.
That’s why the province needs more, not fewer, supervised consumption sites.
People don’t drink themselves to death in supervised alcohol-consumption sites. They do that alone.
The same is true of other drugs. There has never been a death in an Alberta supervised consumption facility, despite 4,305 overdoses.
But outside of the facilities, there are two deaths a day in Alberta, almost all people using alone.
Critics of supervised consumption sites want them to promote rehab more aggressively. You can refer people to help, but you can’t coerce someone out of a substance-use disorder.
And if we’re going to be consistent, when are we going to force people who go to bars to go into rehab?
People go to supervised alcohol-consumption sites because they want a safe, clean supportive environment in which to consume. That’s what people who go to supervised drug consumption sites want, too.
The alternative is not no drug use, nor is it pristine, crime-free neighbourhoods.
The alternative is more death in the streets.
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André Picard