Pubdate: Mon, 02 Oct 2017
Source: Globe and Mail (Canada)
Copyright: 2017 The Globe and Mail Company
Author: Andrea Woo
Page: A3


The Global Commission on Drug Policy has issued recommendations on
tackling North America's opioid crisis, calling for the immediate
expansion of harm reduction services, the decriminalization and
regulation of currently illicit drugs and an initiative to allow
interested cities to de facto decriminalize as federal debates over
drug policy continue.

The position paper, to be released on Monday, comes in advance of the
final report of the White House opioid commission, led by New Jersey
Governor Chris Christie, due out in November.

An interim report of the White House commission released in late July
cited as its top recommendation the declaration of a national
emergency as the number of overdoses continues to rise.

Michel Kazatchkine - a physician, professor of medicine, former
executive director of the Global Fund to Fight AIDS, Tuberculosis and
Malaria and a member of the Global Commission - said he was favourably
impressed with the White House commission's interim report.

"It is going in the right direction - but these steps will fall short
in the next few months," said Dr. Kazatchkine in a telephone interview
from Geneva, Switzerland.

The Global Commission has called for drug decriminalization and
regulation since its creation in 2011. Faced with the mounting death
toll in North America's opioid crisis, it is now recommending a
"sanctuary city" initiative under which cities that wish to do so can
de facto decriminalize petty drug use and possession.

The Global Commission is chaired by former United Nations
secretary-general Kofi Annan. Its members include Richard Branson,
former U.S. secretary of state George Schultz, former chairman of the
U.S. Federal Reserve Paul Volcker and 10 former heads of state.

"Repression is harmful," Dr. Kazatchkine said. "Wherever repressive
policies are in place, people will not be in the best condition to
access services. There is no way decriminalization will happen at the
federal level soon in the U.S., but states or cities can sometimes
make decisions for which they do not need federal approval, or for
which they will enter into a battle with the federal process, but they
still can continue to do things."

He cited as examples the legalization of marijuana in some U.S. states
and Seattle's Law Enforcement Assisted Diversion (LEAD) program, which
sees police officers redirecting those involved in lower-level drug or
sex-work offences to community-based services rather than jail.

In Canada, health officials including British Columbia's provincial
health officer and the head of the BC Centre for Disease Control have
called for decriminalization. Jag meet Singh, elected head of the
federal NDP on Sunday, has also pledged to decriminalize petty drug
use. The reigning Liberal government, which has pledged to legalize
recreational marijuana by Canada Day, 2018, says there are no plans to
decriminalize or legalize any other drugs.

Both commissions agree on the need to expand access to substitution
therapies such as methadone and bu pren or phi ne na lox one( Sub ox
one ); they are offered in only about 10 per cent of conventional
drug-treatment facilities in the United States. However, the Global
Commission also notes the efficacy of treatments with
pharmaceutical-grade heroin and hydro morph one-both currently offered
in Canada, but to only a few hundred people. It has also called for
supervised-consumption sites.

Canada has approved a total of 18 federally sanctioned sites, a dozen
of which are in operation. B.C. is home to several other provincially
sanctioned "overdose prevention sites" and activists have set up
various other unsanctioned sites.

The United States has not approved a single site, although various
cities have expressed interest and a "secret" site is said to have
monitored some 2,500 injections over three years with no fatal overdoses.

Clean needles also need to be available to prevent the spread of
blood-borne illnesses, the Global Commission says.

"The U.S. has a very ambiguous position on needle and syringe
exchange," Dr. Kazatchkine said. "It is forbidden, for example, at the
federal level in any foreign programs that the U.S. funds, including
harm reduction abroad."

Other recommendations from the White House commission include the
development of fentanyl-detection sensors - but only for use of
law-enforcement agencies to stanch the flow of the illicit opioid into
the country.

The Global Commission would like to see drug checking be available to
drug users - something that also has been available on a small scale
in B.C.

Approximately 64,000 people died from drug overdoses in the United
States last year. In Canada, there were at least 2,816 opioid-related
deaths, with preliminary data suggesting another 3,000 dead by the end
of 2017.
- ---
MAP posted-by: Matt