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Canada’s Public Health/Public Safety response to the Fentanyl Overdose Crisis

The fentanyl overdose epidemic is a front in the escalating war between the State and the poor in western Canada. As the population of the visibly poor increases, so do overdose deaths, and so do Canada’s parallel interventions of public health and criminalization. The death toll from last year alone speaks volumes – there were 4,000 overdose deaths in Canada in 2017 – 1,420 in British Columbia. In B.C., the first and most heavily impacted area in Canada, the initial policy responses of Provincial and Municipal governments to the overdose crisis have been focused publicly on health care at the visible point of crisis – increasing overdose death prevention infrastructure in public places. The huge efforts of volunteers and new frontline staff, as well as the anti-drug user controversies surrounding these overdose prevention sites, have given the impression that public health now defines the State’s response to the overdose crisis.

But Canada’s prohibition-based war on drugs has never gone away. Now, under the veil of public health, Canada has renewed its “tough on crime” strategy: cracking down on poor, small-time drug user/dealers. This strategy is a singular focus on drug dealers who sell or “traffick” mostly to support their own use, rather than actually doing anything to get fentanyl out of drugs and communities. The war on drugs and public health strategies are connected, parallel strategies dealt by two arms of the same State that create a false division between “victims” of overdose and “criminal” drug dealers, even though these are often the very same people. Last year, Canada evaded responsibility for the thousands of deaths its anti-poor policies caused; this year the goal is to incarcerate all those who did not die.

“Public Safety,” Public Spending, and Rising Drug Charges

Money dedicated to addressing the opioid crisis continues to follow a tried-and-failed strategy of targeting supply and criminalizing those seen by business and property owners as a threat to “public safety.” In September 2017, when Premier John Horgan announced $322 million in funding for the opioid crisis in B.C., the largest spending category ($31.3 million) was for law enforcement efforts and drug investigations targeting supply and protecting public safety. In comparison, $20 million was dedicated to rural Indigenous communities and urban Indigenous organizations to combat a crisis that sees overdose rates at 5 times that of non-Indigenous people; 180 applicants competed to share the first of 3 years of funding (2.4 million).

But while resources for public health are scarce and limited to managing the point of death, policing resources for “public safety” are practically unlimited and are integrated into every part of life and society. In October, B.C.’s new NDP Solicitor General Mike Farnworth said, “We strongly believe that if you’re dealing fentanyl, you’re dealing death, and you should be facing much more severe penalties such as manslaughter charges.” Fentanyl is in 90% of the street drugs, meaning there are a lot of potential dealers to lock up. As charges increase, so does the severity of the sentences. The cops’ focus is on finding fentanyl on known street dealers/users to put them away for longer.

Discussions of decriminalization of opiates focus on possession, maintaining the false division of victim-user and criminal-dealer. People are not dying from marijuana overdoses, but the Trudeau government has solely committed to cannabis legalization over all other drugs. In her report for the Vancouver Area Network of Drug Users (VANDU), Susan Boyd writes that from 2015 to 2016, drug related arrests have gone down 5.5%. Looking closer at the numbers, while possession arrests for cannabis have gone down, arrests for all other drugs (heroin, meth, and “other drugs” including fentanyl) have gone up. For instance, in B.C., heroin trafficking arrests increased by 23%.

Canada’s legal reforms to address the overdose epidemic fail to protect those who are most harmed and killed. They focus on over-policing rather than access to resources proven to help with dangerous drug use, such as stable housing, community life, money for a proper diet, and treatment.

Possession vs Trafficking: the racist and anti-poor logic of locking up drug dealers

The difference between whether a drug user receives treatment in the name of the public health framework or arrested under public safety depends on their racial, colonial, and class position – not on their vulnerability to overdose death. Public safety possession and trafficking arrests are rising for heroin, meth, and fentanyl amidst increased resources to target “the supply.”

Those being targeted are also those most at risk of deaths in the public health emergency. Public health initiatives are increasing access to drugs to treat opioid addiction (e.g., injectable hydromorphone, methadone, suboxone, and even heroin) in efforts to provide an untainted drug supply. But in the face of increased criminalization of “street drugs” the message becomes clear: get your supply from the State or face the consequences. A person’s ability to get access to these legal drugs depends on their ability to be seen as deserving of treatment.

The hyperincarceration of drug dealers is rooted in the contradictory notion that racialized and low-income people are at once “sick and helpless” as well as “criminal and predatory.” Public health initiatives focused on overdose prevention and treatment, alongside huge increases in funding for fentanyl-finding through “boots on the ground” special operations to target known drug dealers in the community, have created a false distinction between drug users who deserve sympathy and drug dealers who do not. Vann R. Newkirk II, a journalist covering U.S. President Trump’s emergent law-and-order focused response to the overdose crisis, argues that the focus on drug dealers as predatory and drug users as helpless has little to do with the reality of the situation. In reality, what anti-drug dealer rhetoric is doing is: “creating state protection and sympathy for one group of people, while wielding the full resources of the most advanced carceral state in history against another.”

As the fentanyl crisis reaches into a white middle-class demographic, the U.S. President, along with Canadian politicians and police agencies, are creating a folk-devil to preserve white innocence. Newkirk mentions that in the U.S., “white users have increasingly become the face of the opioid epidemic, while Black victims in particular are largely discounted from public consideration.” Similarly, in western Canada, Black, Indigenous, and Chinese people involved in drug user communities are simultaneously erased as victims and overrepresented as predatory drug dealers who should be charged with manslaughter as well as trafficking offenses when caught with drugs. This mythology becomes real through the legal crack down on drug trafficking.

While police-reported stats on arrests in Canada do not include race and ethnicity demographics, we know that Indigenous and Black people are overrepresented in Provincial and Federal prison systems for drug related offenses. For instance, Susan Boyd reports that Black people make up 2.9% of the Canadian population but 8.6% of federal prisoners, and of that, 54% of Black women sentenced to federal prison are serving time for a drug offence. Only 5% of people in Federal prisons are women; in 2015, 27% of female prisoners were serving time for a drug-related offence (compared to 16.7% of men) and these were disproportionately Indigenous and Black women.

Communities Against Criminalization: resisting hyper-criminalization through militant community self-defense

Victoria, Lkwungen and W̱SÁNEĆ territories is one of the highest per capita policed cities in Canada. Policing now consumes 23% of the City of Victoria’s operating budget, far more than any other spending category. With crime rates decreasing across the country, including Victoria, the Victoria Police Department (VicPD) seeks to expand their power and budgets by carving out a role for themselves in traditionally public health arenas. Increasingly, police are receiving funding for anti-poverty, mental health, and overdose emergency initiatives, conflating support with enforcement. This has the effect of reshaping health initiatives, combining police powers of surveillance and coercion with them.

VicPD asserts that they are necessary partners for mental health and social workers to effectively deal with mostly poor, mostly racialized people who use drugs in public or in ways that disrupt the public order. Increasingly, mental and overdose prevention health care for poor and racialized people is being criminalized through the reliance on the cops to control these populations. The VicPD is centring the two arms, public health and public safety, of Canada’s overdose management strategy in the body of policing.

In Victoria, a group of activists and low-income drug users who are affected by this public health / public safety war on drugs are getting organized to fight back. Their campaign, Communities Against Criminalization (CAC), is challenging the criminalization of people, health, and social issues. Campaign members come from different experiences and backgrounds, and have been involved in community self-defense of homeless run spaces (like Victoria’s Super InTent City) as well as prison abolition movements. CAC collectively learns and fights together, pushing back on paternalistic and criminalizing anti-homeless, anti-drug dealer, and racialized discourse and decision-making. Overdose deaths will not stop when support for one group comes at the expense of those who are most harmed by the newest War on Drugs.

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