Pubdate: Sat, 24 Dec 2016
Source: Globe and Mail (Canada)
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Authors: Bernie Pauly, Meaghan Thumath, and Marilou Gagnon
Page: S3

CHANGING DRUG POLICY WILL TAKE TIME TO TRANSLATE INTO ACTION

The federal changes to withdraw the National Anti-Drug Strategy are
significant for Canada's nurses and their ability to deliver ethical
and evidence-based care. Harm reduction will again be a pillar of
Canadian drug strategy. Evidence, not ideology, will be privileged.
And the Minister of Health, not the Minister of Justice, will be in
charge.

However, proposed changes will take time to translate into action.
Nowhere is this more evident than in British Columbia, where on one
December night 13 people died of overdoses. Our hearts are with
everyone who is experiencing these losses and with those who are
working hard to save lives daily.

The recent policy changes undo regressive drug policies, for which we
are thankful, but they do not go far enough to address the root causes
of this epidemic. Canada's current approach to the control of drugs is
killing people. Life-saving interventions such as supervised
consumption and heroin prescription require federal exemptions to
operate. In line with the United Nations, we are calling for the
decriminalization of drug use and for a public health approach that
moves people toward services rather than the criminal-justice system.

As nurses, we routinely witness the effects of Canada's failed drug
policy. People in desperate need of care do not access health services
for fear of judgment. Time and again, researchers have demonstrated
that social stigma acts as a barrier to health care. This is causing
harm. It is costing lives.

As a result of criminalization, people often use drugs alone -
contrary to good public-health overdose measures, which advise people
to use with others. We see housing policies that prohibit guests or
restrict people in resident rooms. Even when shelters and housing
programs distribute harm-reduction supplies, many have policies that
prohibit and sanction use on site, pushing people into bathrooms,
alleys and alcoves.

These policies must be rescinded immediately. In British Columbia,
overdose-prevention sites are critical emergency interventions to
ensure people are not alone and have access to lifesaving
harm-reduction measures. We still need to expand supervised-consumption
services, which provide the full scope of primary nursing care, peer
education and support, counselling, treatment referrals and housing.
Nursing research has consistently demonstrated that trust and
culturally safe care are central to the delivery and effectiveness of
such services to counter criminalization.

As nurses, we have an ethical obligation to implement the best
evidence available, treat people with respect and promote fairness and
justice. While some nurses are being stretched beyond capacity, others
have found their ability to respond quickly restricted by drug
policies and organizational barriers that limit the provision of the
anti-overdose drug naloxone and supervised injection - despite the
evidence and the fact that harm reduction is B.C. provincial policy,
national nursing policy and now federal policy. We have witnessed the
decimation of street nurse programs that would have been able to
respond quickly in crisis situations.

So, as we approach 2017, we need to dramatically scale up
comprehensive harm-reduction services as part of the treatment
continuum. We need to work with people who use drugs and ensure that
interventions are culturally appropriate and coupled with strong links
to housing, income and other supports. Registered nurses need to be
used to their full scope to provide these services. We need to get to
the real work of changing the Controlled Drugs and Substances Act and
stop criminalizing drug use. Decriminalization, along with increased
harm reduction and treatment, has been successful in countries such as
Portugal in reducing drug-related deaths, drug use, crime and societal
costs. If we want to get fully upstream, we need to move from
criminalization to regulation. We need a radical shift in thinking to
challenge long-held ideas about abstinence as the only path to
recovery. Harm reduction saves lives and is a path to recovery.

Bernie Pauly is a professor of nursing at the University of Victoria; 
Meaghan Thumath is the Trudeau Scholar at the department of social 
policy and intervention at the University of Oxford; and Marilou Gagnon 
is the founder of the Coalition of Nurses and Nursing Students for 
Supervised Injection Services.
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MAP posted-by: Matt