Vancouver Declaration on Responding to the Opioid Crisis

Whereas all people have the right to life, liberty, and security of the person, yet thousands of Canadians have lost their lives to illicit drug overdose;

Whereas the opioid crisis is a public health emergency; 

Whereas opioid use disorder is a chronic, relapsing condition affecting thousands of Canadians; 

Whereas the majority of people who are dying from illicit drug overdose are using alone and stigma is contributing to them doing so; 

Whereas Indigenous people and people released from custody have been disproportionately affected by fatal overdoses; 

Whereas drug use is a health and social issue, not a criminal issue; 

Whereas over a century of drug prohibition has failed to meet its objectives and it has instead created a lucrative underground market for illicit drugs with significant harm to individuals, families, communities, and nations; 

Whereas criminalizing people who use drugs has exacerbated the opioid crisis by punishing people for having substance use disorders, fuelling stigma, endangering their health and lives, isolating them from support, fostering other criminal and risky behaviours, increasing the risk of overdose death upon release from prison and for years later, and raising barriers to rehabilitation; 

Whereas drug laws and policies should be based on evidence and compassion for people who are using drugs—not ignorance, fear, ideology, and stereotypes; 

Therefore, we call on all levels of government, health authorities and medical practitioners, criminal justice and corrections professionals, and civil society to do everything within their power to: 

1. Make naloxone freely and widely available to individuals, and at public and private locations, and provide emergency first aid training in how to respond to an overdose; 

2. Immediately expand, and remove all legal barriers to, supervised consumption sites, overdose prevention sites, witnessed-use rooms, and “no-questions asked” drug testing services in all affected communities; 

3. Dramatically expand rapid access to evidence-based treatment as recommended in the new national guidelines for treating opioid use disorder, including Suboxone as a first-line treatment option; 

4. Provide legal, low-barrier, regulated access to opioids of known contents and potency (“safe supply”), under medical direction and supervision (e.g., diacetylmorphine, hydromorphone, and extended release medications) to people with opioid use disorder who would otherwise use contaminated street drugs and be at greater risk of a fatal overdose; 

5. Invest in research to develop new treatment options for opioid use disorder and a holistic response to responding to substance use disorders; 

6. Increase support to Indigenous communities, front-line and peer-based organizations, and families of people with opioid use disorder so that they can enhance their response to the opioid crisis; 

7. Stop criminalizing people who use drugs, including: 

     a. Expand Good Samaritan overdose laws to include immunity from prosecution for any non-violent offence and related breaches of conditions and warrants, as well as increase awareness of this legal protection; 

     b. Decriminalize simple possession of illicit drugs; 

     c. Cease imposing drug paraphernalia prohibitions, which prevent the possession of naloxone kits and harm reduction supplies like clean syringes; 

     d. Stop criminal law conditions that prohibit people from using illicit substances (“abstinence orders”); 

     e. End the imposition of geographic restrictions (“red zoning”) of people who use drugs; 

     f. Make substance use disorder a mitigating factor at sentencing

     g. Expunge criminal records for possession of illicit substances; 

     h. Provide people in prison with equal access to overdose prevention services, harm reduction supplies, and evidence-based treatment options; and 

      i. Prior to their release from custody, provide people with access to a medical practitioner who is trained in substance use disorders and who can provide them with the necessary information and medications to reduce their risk of suffering a fatal overdose. 

Note from author Benjamin Perrin: I wrote this Declaration as a way to summarize the book’s main legal and policy recommendations in a clear and concise format that could be helpful for those who want to advocate for a more compassionate, evidence-based drug policy. I named it the Vancouver Declaration on Responding to the Opioid Crisis not only because it’s the city that’s been hardest hit in Canada by the opioid crisis, but also because it’s the city that’s been at the forefront of courageous and innovative responses to it. It doesn’t include everything that could or should be done to address the crisis, but instead focuses on the most significant proposals that would have the greatest immediate to mid-term impact. 

Excerpt from Benjamin Perrin, Overdose: Heartbreak and Hope in Canada's Opioid Crisis (Viking Canada, 2020), pp. 235-8.