Good morning. Thanks for the opportunity to speak here today. You'll hear a bit of overlap. I guess that won't surprise you.
You all know that this is a stimulant. What you might not appreciate is that, chemically, it's almost indistinguishable from the prescription drug Adderall. I assure you that you all know someone who has that medicine, those capsules, in their cabinet at home.
People use this drug for a variety of reasons. Some use it intermittently, socially, to disinhibit or facilitate interactions with others or to increase sexual drive, especially in the community of men who have sex with men. Some people use it to be functional—long-haul truckers and construction workers—and some people use it because they're dependent on it and will do whatever is needed to procure it. As you've heard already, it's incredibly cheap and its effects are incredibly long lasting.
As I think you heard the mayor say, it particularly effects the homeless population. They use it to keep moving, to stay awake and protect their meagre belongings, and sometimes, to change the mental state that accompanies exposure to and discomfort from the elements.
We see the harms of the acute use of meth in a variety of different ways. It can cause anxiety and frank psychosis, and this is a common reason for coming to hospital. First responders see this all the time. It's one of the main ways that meth can cause people to die. They engage in high-risk sexual activity. They can have seizures, strokes and heart attacks in their twenties. With chronic use, they can have heart problems, dental problems, skin problems and neuropsychiatric problems including depression. Even for those who do manage to stop, the depression can be long lasting and crushing.
People can die from this stuff through a whole host of mechanisms, including the suicidality that comes with the effects of this drug on the brain over the long term, and of course the mixing of it with other drugs. Sometimes that's not within the person's control.
What could be done to make this better? Right now, when patients are brought to hospital after meth use, there's a lot of tinkering and turfing, and then they're sent back out. I think we could be a lot more proactive and less reactive with how we handle people with meth addiction.
Unlike with opioids, we don't have a lot of good drug options. With opioids we have two very effective drugs for people who stick to them, drugs that are shown to reduce death. We don't have that same sort of chemical treatment with meth addiction. What I think we'd have to do—and you've already heard this—is engage people who use meth in treatment and improve access to supports, including qualified addiction care. Many people who use meth don't know about or have access to the path to treatment.
We could better treat their underlying psychiatric disorders and untreated mental health problems that often help these patients find meth in the first place. I think that would go a long way towards reducing the burden on law enforcement and the criminal justice system for patients who use meth.
We could improve access to their associated health problems, whether it's HIV from sharing needles, hepatitis C or the PTSD that so many of them have in the first place.
We could actually help them get better access to low-income housing, or shelters that don't require them to arrive late and leave early in the morning. I think that alone would go a long way to decreasing the demand for meth in a particularly reliable customer base.
To the extent that there is domestic production—there is some—we could make the main ingredient in Sudafed, pseudoephedrine, a prescription-only drug. It's not going to solve the problem, but you'll have fewer lab explosions if you do that.
I want to spend the last few moments of my time talking about something that I know is not popular. It's the issue of decriminalizing drug use. I know many of you will have views on this, and perhaps they're immutable. I'm not talking, of course, about the property crime or the physical or sexual assaults that accompany drug use. Those require punishment, as do the people who deal the drugs. I'm talking about the simple possession and use of drugs.
The mayor made a comment about reducing stigma. Part of the stigma comes from the fact that this is an illegal behaviour. Drugs have been around for a very long time, and people have used drugs for as long as there have been drugs, so drug use is here to stay. If you have had a few drinks on occasion, maybe one or two more than you intended to have, you are a person who has used drugs. You just happen to use a socially acceptable drug that's legal to use.
I think that in political circles as well as in social ones, there's a tendency to oversimplify the decriminalization discussion and sort of assume that people who don't forbid drug use therefore must condone it. That's simply not true. Whatever your view is on this issue, I think we should be able to agree that it would be better if fewer people had drug-related problems, and it would be better if fewer people died.
It's worth asking what criminalizing the simple use of drugs accomplishes. The threat of going to jail or of a criminal record causes people to hide their drug use. This is why so many people, especially with opiates but also with methamphetamine, die alone at home, in alleys, or in Tim Hortons' washrooms. It promotes stigma, as I mentioned earlier, as does the word “addict”, and I would discourage the use of that word. These are often people who've endured hardships that maybe you and I have been lucky to avoid. Maybe they have an untreated mental illness. Maybe they've had exposure to drugs or alcohol in the womb, and maybe, as children, they endured physical, emotional or sexual abuse. Maybe we can't expect them to be quite as resilient as those of us who grew up without those forces in our lives.
When someone who uses drugs and is a criminal as a result of using it is discovered, they're arrested and jailed. In jail it's often easy to get drugs. Sometimes it's easier than it is in the community. It is easy to share needles and transmit disease. People will sometimes die in prison or shortly after release. Even after the arrest, they have a permanent criminal record and all that goes with it. They have all the things that exacerbate drug problems: unemployment, social exclusion, trauma and family separation. Those things get worse after jail, not better.
I think the main argument, if I understand it correctly, for criminalizing drug use is that it deters the use of drugs, and there's very little evidence that claim is true. According to the Global Commission on Drug Policy, it does not do what you might think it does. In truth, we have very little to show for the vast societal resources consumed by our current policies aside from overburdened police departments, courts and prisons. I'd ask you to consider that tough drug laws don't result in fewer drug-related problems and deaths. They do the exact opposite.
There's a medical maxim. It's sort of simple on its face. If what you're doing is not working, stop doing it. As MPs, you might want to reflect on that in the context of drug criminalization. Portugal, as you know, did this in 2001. They were faced with a huge threat from heroin. In 2001 they decided to approach this as a health problem as opposed to a criminal one. They decriminalized the possession of small amounts of drugs for personal use. Today in Portugal, if you're found with drugs, you're offered help; you're not put in jail. Today in Portugal, you can tell someone you use drugs without fearing going to jail or a criminal record.
In the wake of that change, drug deaths fell, maybe not exclusively due to the change, but they fell nevertheless. New cases of HIV plummeted, and drug use didn't increase. In fact, it even fell in some segments of the population. In Portugal—and here's a statistic I hope stays with you—six people per million died from drug overdoses last year. In Canada, that number is in the order of 110. It's one of the highest drug-related death rates in the world.
I think it's time to acknowledge that our approach to drug use isn't working. It's really been a failure. As I said before, drug use is a health issue, and when we treat it as a criminal one, we promote fear, isolation and harm. We don't arrest people for drinking alcohol or smoking cigarettes. When people come to me with a problem with those drugs, we offer them help to the extent that we have it. We help them moderate their use or help them quit. When it comes to other drugs, we expend untold resources on measures that are plainly ineffective and even counterproductive, like imprisonment and interdiction.
I realize that the idea of decriminalizing drug use will be unpopular in some circles, particularly in political ones, but the alternative is staying a course that has quite clearly failed. One day in the future, Canada will eventually change its laws regarding drug use. I don't know when that will be. It might be decades hence. I think that, not long thereafter, we'll look back and ask what took us so long to start approaching this as a health problem. How many people died because for so many years we used the wrong approach?
I'll end my comments there.