FDPS President and CEO Dr. Kevin A. Sabet in The National Post: The harm-reduction movement has lost sight of what truly matters

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Earlier this year, the federal government delayed an extension of medical assistance in dying (MAID) to include those suffering solely from mental illness, which could have included people with substance use disorder. At the same time, British Columbia’s provincial officer of health called for the province’s “safe supply” program to be expanded. Both policies should be rejected outright. Recovery from addiction is real, it works and it’s the only humane policy for people with a substance use disorder.

Canada has fully embraced extreme harm reduction, a primarily activist-driven approach to drug policy that aims to promote “safe” or “regulated” drug use, rather than discouraging it and encouraging people to seek treatment. The harm-reduction only strategy includes policies that fully decriminalize drugs like fentanyl and meth and provides potentially deadly prescription drugs to users.

Now, as the drug crisis has further spiralled out of control, some people want to double down on these policies, including decriminalization, expanding safe supply and allowing MAID for drug users. Harm-reduction advocates made inroads by arguing that individuals should be kept alive so that they can ultimately enter treatment and be given a second chance at life. Now, the movement has been hyper-extended to a grim point, where some seem to have given up on the prospect of a better tomorrow.

Harm reduction is not inherently bad. For those on the far end of the use spectrum — the hard to reach, hard to engage with population — it can be a way to bring them into services and get them into recovery. Meeting people where they are at can be valuable to get them the help they need. But it is only one of many tools, reserved for those who really need it.

Millions of people in recovery in North America are testament to the fact that treatment works, even if people take different paths to get there. Harm reduction should be just one part of a broader strategy to prevent drug use before it starts, treat substance use disorder, shut down open-air drug markets and increase international co-operation to reduce drug flows.

The harm-reduction movement has drifted from its founding values and disregarded the lives of drug users. It is extremely discouraging to hear Dr. Bonnie Henry, B.C.’s provincial health officer, state that, “Abstinence … just doesn’t work for people who have a dependency on opioids.” This statement is unprecedented, wrong, and without scientific merit.

Policymakers should learn from and celebrate the millions of individuals who have overcome their substance use disorders and achieved recovery. These individuals illustrate that recovery is possible and provide hope to those who are currently struggling with addiction.

To get people into recovery, of course, we need more and better treatment options. That places like Vancouver’s Downtown Eastside have little quality treatment available — but plenty of cheap drugs — shows how far we have to go. Treatment varies from traditional 12-step programs to medication-assisted treatment, such as methadone and buprenorphine for opioid use disorder. These programs share a common goal: to help individuals overcome their addictions and live better lives. Treatment and recovery, though difficult and often requiring multiple attempts, should not be controversial.

Canada should shift away from its embrace of decriminalization — which Oregon just did, after three years of painful experience — and embrace recovery as a solution to the drug crisis. Though policies like MAID may artificially lower the number of overdose deaths, it will not improve population-level health outcomes, like life expectancy, or allow individuals to achieve better outcomes in life.

Not surprisingly, a report from the Canadian Centre on Substance Use and Addiction stated that, “Recovery is positive, achievable and sustainable,” and that, “The vast majority of individuals in recovery describe a positive quality of life.”

Let’s not lose faith in this time-proven approach. It is inhumane to give up on treatment and the hope it offers. Individuals suffering from both addiction and mental illness need hope and help. They need supportive voices that are louder than their demons, which are telling them that recovery is not possible or life is not worth living. Yes, they need to be met “where they are at.” But we shouldn’t for one second think it’s OK to leave them there.

On May 30, those committed to fostering a culture of hope and vitality will gather in Vancouver for the PROSPER Symposium, an event focused on creating “a climate of prevention” and “a culture of recovery.” Speakers will address prevention, treatment and how extending a helping hand to those suffering from addiction and substance use disorders can promote thriving communities.

Policymakers should take note. Those facing addiction need to be reminded that recovery is a worthwhile and achievable goal. Instead of increasing access to drugs, despair and death, policymakers should increase access to prevention, treatment and, most of all, hope.

Kevin A. Sabet is the president and CEO of the Foundation for Drug Policy Solutions and an internationally recognized drug policy expert. He is based in Vancouver.