MIDDLE PATH IS THE RIGHT APPROACH TO REGULATING DRUGS

The Supreme Court of Canada recently instructed Ottawa to issue a
federal exemption to Insite, North America's first, recognized
supervised injection site. The Court highlighted evidence of Insite's
achievements in saving lives, reducing the spread of infections and
improving the health of people who inject drugs. This important
decision will open the door to a more humane, pragmatic and
evidence-based approach to drug problems in our communities. Too
often, important public policy decisions about drugs are made with
little regard for the evidence and over reliance on ideology,
political expedience and/or opportunism. The need to change this
practice is critical as each day of delay costs lives and results in
human suffering.

This year, many of Canada's leading experts in drug policy formed the
Canadian Drug Policy Coalition (CDPC) a national civil society
organization to advance changes in Canadian policy. CDPC is comprised
of researchers, public health officials, front-line harm reduction and
treatment providers, people who use drugs, HIV/AIDS ser-vice
organizations, youth organizations, parents, and community members,
all concerned with the health and safety outcomes of our drug strategies.

Based at Simon Fraser University's Centre for Applied Research in
Mental Health and Addiction, the Coalition's key goals include:
shining the light of evidence on all drug problems, fostering informed
discussion on drug policy and supporting leader-ship to develop
effective responses to problems stemming from substance use and
related policies.

Today, the Canadian Drug Policy Coalition launches a national program
of public discussion, education and advocacy for reform of Canada's
drug policies and legislation in partner-ship with the Health Officers
Council of B.C. (HOC). In their discussion paper: Public Health
Perspectives for Regulating Psychoactive Substances HOC articulates a
vision of how public policy on all psychoactive substances, whether
legal or illegal, should be developed if health, safety and social
development outcomes are a priority.

The negative health and social effects of the use of, and polices
related to, alcohol, tobacco, prescription drugs, and illegal
substances are substantial and largely preventable. Human and health
care costs are huge. The use of non-prescription substances is
estimated to account for 21 per cent of all deaths in Canada and costs
$40 billion a year. Of this, tobacco contributes 43 per cent, alcohol
36 per cent and other substances 21 per cent. These numbers are shocking.

Evidence shows that both prohibition of psychoactive substances at one
extreme and unregulated, free-market access, at the other, increase
the harms from use. Somewhere between these two extremes lie models of
regulated access guided by public health principles that balance costs
and benefits for individuals and society.

This does not necessarily mean legalization of currently illegal
substances, nor does it reject that possibility. A public health
approach uses the best evidence and focuses on promoting health and
preventing illness, injury, premature death and disability.

HOC has three recommendations. First, governments should use our
public health framework to evaluate and update laws on all
psychoactive substances so they encompass a public health approach to
regulation including taxation. Second, governments should lead by
including all those groups with interests in the production,
dissemination, or use of these substances to develop solutions, which
respect economic and public health principles. Finally, we call for a
national inquiry to recommend exactly how to proceed using the growing
body of evidence of what works (and what doesn't) for reducing the
harm, and increasing the benefits associated with psychoactive substances.

Donald MacPherson is the director of the Canadian Drug Policy
Coalition, and author of Vancouver's Four Pillars Drug Strategy. Dr.
John Carsley is a public health and preventive medicine specialist and
a member of the Health Officers Council of B.C.