Kingston, Frontenac, Lennox and Addington (KFL&A) survey respondents agree strongly that a stronger drug strategy is needed to deal with the drug poisoning crisis — but there is some debate on whether decriminalization is the answer.
At the KFL&A Board of Health (BOH)’s first meeting of the year on Wednesday, Jan. 24, 2024, Dr. Piotr Oglaza, Medical Officer of Health (MOH) and Chief Executive Officer (CEO) of KFL&A Public Health, was joined by health promoter Nico Selibio to present the findings of their recent community consultation on decriminalizing drug possession for personal use.
Oglaza began by explaining that Public Health is legislated to work on harm reduction, saying, “The work that’s done on decriminalization, and specifically the survey, fits within our harm reduction pillar, [which is] one of the four elements that we look at when addressing the opioid crisis: prevention, treatment, community safety, and harm reduction.”
Another specific example is the distribution of naloxone kits to organizations and the community, he said, but more generally, “The work on decriminalization has been part of the focus of our Community Drug Strategy Advisory Committee, which is a group of community agencies chaired by Public Health.”
Oglaza then provided a timeline of the Committee’s work so far. In September of 2016, the KFL&A Board of Health advocated for the establishment of a national advisory committee to contemplate drug policy reform. Then, in April 2021, the Board endorsed the KFL&A Community Drug Strategy Advisory Committee (CDSAC)’s statement on decriminalizing people who use substances. The BOH reiterated in April 2022 its support for decriminalizing drug possession for personal use and access to uncontaminated drug supply. Finally, in April 2023, the CDSAC formed the Alternative to Criminalization subcommittee to conduct a community consultation on decriminalization. The online portion of the community survey was open until May 15, 2023.
Oglaza explained that the BOH had been “apprised of these steps along the way, and today we’re going to provide you with the summary of what that survey revealed.”
The survey, he began, sought to understand four things:
- The readiness of the community to consider a policy change related to substance use.
- The perceived risks and benefits of decriminalization.
- What decriminalization might look like in the KFL&A region.
- Whether there is support for decriminalization.
Selibio then took the floor to describe the methods used in collecting the data. First was an online survey, he said, “which garnered 1,775 responses.” Second, there were 10 focus group sessions with a total of 100 participants.
He acknowledged, “Before we discuss the findings from our community consultation, it is essential to acknowledge that these results are based on personal opinions of the participants, and while they provide valuable insights into community sentiments… they may not always align with the facts and evidence.”
First, Selibio described the findings about the community’s readiness for a policy change, saying the survey “revealed that 86 per cent of respondents expressed concern about the drug poisoning crisis. Seventy per cent supported the idea of changing drug possession laws so that people who use substances can access services without the risk of being charged.”
Selibio did note that, “while respondents are familiar with the term ‘decriminalization,’ some responses show that there is some confusion about how it differs from legalization.”
According to the Canadian Centre on Substance Use and Addiction, decriminalization means “non-criminal responses, such as fines and warnings, are available for designated activities, such as possession of small quantities of a controlled substance.” Legalization means “criminal sanctions are removed,” although “regulatory controls can still apply, as with alcohol and tobacco.”
Data from both the survey and focus groups revealed skepticism towards the current criminal approaches used, explained Selibio, and two-thirds of those surveyed disagree with criminalizing individuals for personal drug possession.
Focus groups, he said, provided deeper insights into the “cascading effects” of this approach, with one participant summarizing the severe consequences by saying, “Well, you get arrested, you go to jail, you lose your place to live, you lose your job, you lose everything you own, you lose your clothes, you lose everything, you gotta start over, and what do you do? You got nothing.”
People’s views were “cautiously optimistic,” Selibio noted, when it came to recognizing the risks and benefits of decriminalization.
He pointed out that many respondents raised concerns about decriminalizing unregulated substances: “It is important to investigate this further to see if they are real concerns, and if so, to find ways to address and reduce this risk.”
When considering what people thought could go wrong, about one-third of survey respondents expected negative outcomes for the community and raised questions about decriminalization. Selibio shared some of these concerns: “Could it make the drug poisoning crisis worse? Would community safety be compromised? Would it result in increased drug use with it becoming more accepted?”
Regarding the positive outcomes, the online survey revealed that 55 per cent of respondents believe decriminalization would benefit the community. Two-thirds of the survey responses viewed legalization as a way to promote safer drug use practices. And survey respondents generally expected that decriminalization would make it easier for people who use drugs to access the help and the support they need.
In both the survey and focus groups, 60 per cent of respondents believe that decriminalization could reduce the social stigma associated with drug use.
“This shift in societal perception is seen as key in encouraging people to seek help. One survey respondent noted, ‘[Decriminalization] would reduce stigma for people who use drugs, and reducing stigma may aid in patients’ recovery [and] improve their ability to access medical services for the treatment of addiction, mental health issues, and other underlying medical problems.’”
What could decriminalization look like in the KFL&A region?
Participants emphasized that decriminalization should be integrated within a comprehensive Public Health strategy, according to Selibio. This strategy should involve experts and people who have lived experiences of substance dependence. There should be an expansion of health and support services for those affected by substance use.
Selibio said that survey respondents supported the potential implementation of a decriminalization policy in the KFL&A region. However, they emphasized the importance of ensuring that the policy maintains community safety and well-being. Additionally, there was a clear desire for better mental health and addiction services.
Lastly, he pointed out, “Interestingly, despite the different views on decriminalization, qualitative data revealed a common thread: the emphasis on a Public Health approach was universal.”
Supporters of decriminalization underlined the importance of having strong health-care services for it to work well. For instance, one online survey respondent wrote, “Decriminalization of drugs should be coupled with the scale-up of health and social services (including harm reduction initiatives) that are patient-centred.”
On the other hand, those opposed argued for a focus on health care improvements rather than policy changes. “Decriminalization is not the answer,” wrote one respondent. “More addiction-related supports, as well as education to reduce the stigma of addiction, are needed to help those affected and to prevent the numbers from climbing even higher.”
So, despite the divergence of opinion, Selibio noted, there was consensus on the need for comprehensive mental health and addiction services, treating drug use as a Public Health issue rather than a criminal problem.
Oglaza concluded, “When we look at the findings, the community consultation revealed that there’s cautious optimism towards decriminalization. It was made very clear that there’s a need for a careful and well-thought-out revision to current drug policy and a look at the potential impact of it locally.”
It has been highlighted that any policy changes must strike a balance between the welfare of those individuals affected by substance use as well as the overall safety and well-being of the community, and this process opens up a door to a compassionate effective strategy in addressing substance use within KFL&A, Oglaza stated.
Oglaza went on to say that the next steps, as confirmed by the survey, would be for Public Health to engage in in-depth discussion with key sectors including health care, support services, police, and correctional services to understand how decriminalization would impact them.They would also need to assess the readiness capacity among service providers and identify areas needing improvement. The MOH also pointed to a need to communicate with other regions for best practices they have already implemented.
Oglaza told the board members that the full report on these findings would be released publicly in the very near future “to advance this discussion in the community.”