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Addictions

B.C. poll reveals clash between Indigenous views and drug policy

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9 minute read

By Alexandra Keeler

A supermajority of First Nations respondents disagree that criminalizing drug use is racist, challenging public health advocates’ assumptions

A new report shows a majority of British Columbians — and a plurality of all ethnic communities surveyed — disagree with the contention that drug criminalization policies are racist.

The findings challenge assertions made by prominent B.C. policymakers, who have advocated for drug decriminalization and harm-reduction initiatives on the grounds of anti-racism and reconciliation.

The report, published by the policy nonprofit Centre for Responsible Drug Policy and think tank Macdonald-Laurier Institute, draws from a poll of 6,300 B.C. adults that was commissioned by the centre and conducted by Mainstreet Research.

“Chinese and Indigenous leaders keep telling me that their communities are very anti-drug, but public health officials and harm-reduction activists keep saying that legalization is integral to anti-racism and reconciliation,” said Adam Zivo, a journalist and founder of the centre.

“Now we have data to show which side is more accurate.”

When asked whether criminalizing drug use is racist, just 22 per cent of all respondents agreed, while 60 per cent disagreed. Notably, 79 percent of the respondents identified as white.

Disagreement was strongest among First Nations respondents, with just nine per cent of the 172 Indigenous respondents agreeing that criminalization is racist and 67 per cent disagreeing.

Agreement was stronger among Asian communities, with East Asian and South Asian respondents being most likely to say criminalization policies are racist.

In the East Asian cohort, 42 per cent said they disagreed that criminalizing drug use is racist, while 36 per cent strongly agreed. Similarly, 46 per cent of South Asian respondents disagreed and 32 per cent agreed.

Self-determination

The poll challenges views articulated by some prominent B.C. policymakers and public health groups.

In July, B.C.’s provincial health officer, Dr. Bonnie Henry, released a report asserting that drug policies prohibiting the use of hard drugs are rooted in racism and colonialism.

“Prohibitionist drug policies are deeply rooted in colonialism, reflecting and perpetuating systemic racism that disproportionately impacts Indigenous peoples,” Henry’s report says.

“These policies were designed to control marginalized populations and have led to over-incarceration, intergenerational trauma, and significant health disparities within these communities.”

Henry’s report contends that decriminalization policies — such as those implemented by B.C. as part of a three-year trial project that began January 2023 — can help to rectify these injustices by prioritizing health and safety over law enforcement.

Henry’s report was released mere months after B.C. rolled back some of its decriminalization measures in response to growing public concerns over decriminalization’s effects on community safety and order. Henry’s report, which is published by the BC Ministry of Health, urges the province to move in the opposite direction.

“This report’s recommendation is to continue to refine and expand prescribed alternatives to unregulated drugs, and critically, to explore implementation of models that do not require prescription,” Henry writes, referring to harm-reduction initiatives such as safer supply that dispense prescription opioids to drug users.

The report presents decriminalization as a move supported by Indigenous communities, citing the Declaration on the Rights of Indigenous Peoples Act Action Plan. Action 4.12 aims to “address the disproportionate impacts of the overdose public health emergency on Indigenous Peoples by: applying to the Government of Canada to decriminalize simple possession of small amounts of illicit drugs for personal use.”

The Canadian Drug Policy Coalition, a policy advocacy group based out of Simon Fraser University, has similarly contended that drug criminalization is racist.

The coalition’s website says, “the demand by Black communities to decriminalize drugs and to immediately expunge records are a vital necessity for minimizing the racially disproportionate harms of drug criminalization, part of a broader struggle to end the war on Black communities.”

And in December 2023, the Harm Reduction Nurses Association, a national organization that advances harm-reduction nursing, obtained an injunction to prevent the B.C. government from imposing restrictions on public drug consumption.

The association alleged the government’s actions “would put people at greater risk of fatal overdose, make healthcare outreach more challenging, and drive racial discrimination, particularly against Indigenous people.”

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Minority polling challenges

Some Indigenous groups have expressed reservations about blanket decriminalization policies in other contexts.

In January 2024, the First Nations Health Authority, an agency that manages health services for Indigenous communities in B.C., issued a statement acknowledging decriminalization may not be the best approach for all communities.

“FNHA acknowledges and supports the self-determination of each First Nations community when considering implementing this exemption,” the statement reads, referring to the three-year exemption B.C. obtained from federal laws prohibiting the use of hard drugs.

First Nations Health Authority has emphasized the need for culturally informed approaches that prioritize community health and safety and advocated for nuanced strategies tailored to each community’s specific needs.

The Mainstreet Research poll reveals challenges in accurately representing the views of B.C.’s smaller ethnic communities.

While non-white Canadians make up 40 per cent of B.C.’s population, they accounted for only 16 per cent of the poll’s 6,300 respondents.

Responses by Black, Middle Eastern and Southeast Asian respondents were excluded from the current analysis because sample sizes were too small, numbering below 100. The English-only and automated telephone polling format may also increase uncertainty.

As the poll focused primarily on B.C. and broad drug policy questions, its findings underscore the need for a deeper understanding of community beliefs to inform drug policies.

The Centre for Responsible Drug Policy is releasing the polling data and its report on a “preliminary” basis so it can inform drug policy discussions ahead of provincial elections, which are taking place this October in B.C., Saskatchewan and New Brunswick.

But Mainstreet Research is continuing to gather data, aiming for a final survey size of more than 12,000 respondents. Once completed, the survey will be one of the largest polls on harm reduction ever conducted in Canada.

“The final report, set to be released later this year, will include larger samples from B.C.’s diverse ethnic communities, providing further clarity on their beliefs,” Zivo said.


This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.

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Addictions

Addiction experts demand witnessed dosing guidelines after pharmacy scam exposed

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By Alexandra Keeler 

The move follows explosive revelations that more than 60 B.C. pharmacies were allegedly participating in a scheme to overbill the government under its safer supply program. The scheme involved pharmacies incentivizing clients to fill prescriptions they did not require by offering them cash or rewards. Some of those clients then sold the drugs on the black market.

An addiction medicine advocacy group is urging B.C. to promptly issue new guidelines for witnessed dosing of drugs dispensed under the province’s controversial safer supply program.

In a March 24 letter to B.C.’s health minister, Addiction Medicine Canada criticized the BC Centre on Substance Use for dragging its feet on delivering the guidelines and downplaying the harms of prescription opioids.

The centre, a government-funded research hub, was tasked by the B.C. government with developing the guidelines after B.C. pledged in February to return to witnessed dosing. The government’s promise followed revelations that many B.C. pharmacies were exploiting rules permitting patients to take safer supply opioids home with them, leading to abuse of the program.

“I think this is just a delay,” said Dr. Jenny Melamed, a Surrey-based family physician and addiction specialist who signed the Addiction Medicine Canada letter. But she urged the centre to act promptly to release new guidelines.

“We’re doing harm and we cannot just leave people where they are.”

Addiction Medicine Canada’s letter also includes recommendations for moving clients off addictive opioids altogether.

“We should go back to evidence-based medicine, where we have medications that work for people in addiction,” said Melamed.

‘Best for patients’

On Feb. 19, the B.C. government said it would return to a witnessed dosing model. This model — which had been in place prior to the pandemic — will require safer supply participants to take prescribed opioids under the supervision of health-care professionals.

The move follows explosive revelations that more than 60 B.C. pharmacies were allegedly participating in a scheme to overbill the government under its safer supply program. The scheme involved pharmacies incentivizing clients to fill prescriptions they did not require by offering them cash or rewards. Some of those clients then sold the drugs on the black market.

In its Feb. 19 announcement, the province said new participants in the safer supply program would immediately be subject to the witnessed dosing requirement. For existing clients of the program, new guidelines would be forthcoming.

“The Ministry will work with the BC Centre on Substance Use to rapidly develop clinical guidelines to support prescribers that also takes into account what’s best for patients and their safety,” Kendra Wong, a spokesperson for B.C.’s health ministry, told Canadian Affairs in an emailed statement on Feb. 27.

More than a month later, addiction specialists are still waiting.

 

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According to Addiction Medicine Canada’s letter, the BC Centre on Substance Use posed “fundamental questions” to the B.C. government, potentially causing the delay.

“We’re stuck in a place where the government publicly has said it’s told BCCSU to make guidance, and BCCSU has said it’s waiting for government to tell them what to do,” Melamed told Canadian Affairs.

This lag has frustrated addiction specialists, who argue the lack of clear guidance is impeding the transition to witnessed dosing and jeopardizing patient care. They warn that permitting take-home drugs leads to more diversion onto the streets, putting individuals at greater risk.

“Diversion of prescribed alternatives expands the number of people using opioids, and dying from hydromorphone and fentanyl use,” reads the letter, which was also co-signed by Dr. Robert Cooper and Dr. Michael Lester. The doctors are founding board members of Addiction Medicine Canada, a nonprofit that advises on addiction medicine and advocates for research-based treatment options.

“We have had people come in [to our clinic] and say they’ve accessed hydromorphone on the street and now they would like us to continue [prescribing] it,” Melamed told Canadian Affairs.

A spokesperson for the BC Centre on Substance Use declined to comment, referring Canadian Affairs to the Ministry of Health. The ministry was unable to provide comment by the publication deadline.

Big challenges

Under the witnessed dosing model, doctors, nurses and pharmacists will oversee consumption of opioids such as hydromorphone, methadone and morphine in clinics or pharmacies.

The shift back to witnessed dosing will place significant demands on pharmacists and patients. In April 2024, an estimated 4,400 people participated in B.C.’s safer supply program.

Chris Chiew, vice president of pharmacy and health-care innovation at the pharmacy chain London Drugs, told Canadian Affairs that the chain’s pharmacists will supervise consumption in semi-private booths.

Nathan Wong, a B.C.-based pharmacist who left the profession in 2024, fears witnessed dosing will overwhelm already overburdened pharmacists, creating new barriers to care.

“One of the biggest challenges of the retail pharmacy model is that there is a tension between making commercial profit, and being able to spend the necessary time with the patient to do a good and thorough job,” he said.

“Pharmacists often feel rushed to check prescriptions, and may not have the time to perform detailed patient counselling.”

Others say the return to witnessed dosing could create serious challenges for individuals who do not live close to health-care providers.

Shelley Singer, a resident of Cowichan Bay, B.C., on Vancouver Island, says it was difficult to make multiple, daily visits to a pharmacy each day when her daughter was placed on witnessed dosing years ago.

“It was ridiculous,” said Singer, whose local pharmacy is a 15-minute drive from her home. As a retiree, she was able to drive her daughter to the pharmacy twice a day for her doses. But she worries about patients who do not have that kind of support.

“I don’t believe witnessed supply is the way to go,” said Singer, who credits safer supply with saving her daughter’s life.

Melamed notes that not all safer supply medications require witnessed dosing.

“Methadone is under witness dosing because you start low and go slow, and then it’s based on a contingency management program,” she said. “When the urine shows evidence of no other drug, when the person is stable, [they can] take it at home.”

She also noted that Suboxone, a daily medication that prevents opioid highs, reduces cravings and alleviates withdrawal, does not require strict supervision.

Kendra Wong, of the B.C. health ministry, told Canadian Affairs that long-acting medications such as methadone and buprenorphine could be reintroduced to help reduce the strain on health-care professionals and patients.

“There are medications available through the [safer supply] program that have to be taken less often than others — some as far apart as every two to three days,” said Wong.

“Clinicians may choose to transition patients to those medications so that they have to come in less regularly.”

Such an approach would align with Addiction Medicine Canada’s recommendations to the ministry.

The group says it supports supervised dosing of hydromorphone as a short-term solution to prevent diversion. But Melamed said the long-term goal of any addiction treatment program should be to reduce users’ reliance on opioids.

The group recommends combining safer supply hydromorphone with opioid agonist therapies. These therapies use controlled medications to reduce withdrawal symptoms, cravings and some of the risks associated with addiction.

They also recommend limiting unsupervised hydromorphone to a maximum of five 8 mg tablets a day — down from the 30 tablets currently permitted with take-home supplies. And they recommend that doses be tapered over time.

“This protocol is being used with success by clinicians in B.C. and elsewhere,” the letter says.

“Please ensure that the administrative delay of the implementation of your new policy is not used to continue to harm the public.”


This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.


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2025 Federal Election

Poilievre to invest in recovery, cut off federal funding for opioids and defund drug dens

Published on

From Conservative Party Communications

Poilievre will Make Recovery a Reality for 50,000 Canadians

Conservative Leader Pierre Poilievre pledged he will bring the hope that our vulnerable Canadians need by expanding drug recovery programs, creating 50,000 new opportunities for Canadians seeking freedom from addiction. At the same time, he will stop federal funding for opioids, defund federal drug dens, and ensure that any remaining sites do not operate within 500 meters of schools, daycares, playgrounds, parks and seniors’ homes, and comply with strict new oversight rules that focus on pathways to treatment.

More than 50,000 people have lost their lives to fentanyl since 2015—more Canadians than died in the Second World War. Poilievre pledged to open a path to recovery while cracking down on the radical Liberal experiment with free access to illegal drugs that has made the crisis worse and brought disorder to local communities.

Specifically, Poilievre will:

  1. Fund treatment for 50,000 Canadians. A new Conservative government will fund treatment for 50,000 Canadians in treatment centres with a proven record of success at getting people off drugs. This includes successful models like the Bruce Oake Recovery Centre, which helps people recover and reunite with their families, communities, and culture. To ensure the best outcomes, funding will follow results. Where spaces in good treatment programs exist, we will use them, and where they need to expand, these funds will allow that.
  2. Ban drug dens from being located within 500 metres of schools, daycares, playgrounds, parks, and seniors’ homes and impose strict new oversight rules. Poilievre also pledged to crack down on the Liberals’ reckless experiments with free access to illegal drugs that allow provinces to operate drug sites with no oversight, while pausing any new federal exemptions until evidence justifies they support recovery. Existing federal sites will be required to operate away from residential communities and places where families and children frequent and will now also have to focus on connecting users with treatment, meet stricter regulatory standards or be shut down. He will also end the exemption for fly-by-night provincially-regulated sites.

“After the Lost Liberal Decade, Canada’s addiction crisis has spiralled out of control,” said Poilievre. “Families have been torn apart while children have to witness open drug use and walk through dangerous encampments to get to school. Canadians deserve better than the endless Liberal cycle of crime, despair, and death.”

Since the Liberals were first elected in 2015, our once-safe communities have become sordid and disordered, while more and more Canadians have been lost to the dangerous drugs the Liberals have flooded into our streets. In British Columbia, where the Liberals decriminalized dangerous drugs like fentanyl and meth, drug overdose deaths increased by 200 percent.

The Liberals also pursued a radical experiment of taxpayer-funded hard drugs, which are often diverted and resold to children and other vulnerable Canadians. The Vancouver Police Department has said that roughly half of all hydromorphone seizures were diverted from this hard drugs program, while the Waterloo Regional Police Service and Niagara Regional Police Service said that hydromorphone seizures had exploded by 1,090% and 1,577%, respectively.

Despite the death and despair that is now common on our streets, bizarrely Mark Carney told a room of Liberal supporters that 50,000 fentanyl deaths in Canada is not “a crisis.” He also hand-picked a Liberal candidate who said the Liberals “would be smart to lean into drug decriminalization” and another who said “legalizing all drugs would be good for Canada.”

Carney’s star candidate Gregor Robertson, an early advocate of decriminalization and so-called safe supply, wanted drug dens imposed on communities without any consultation or public safety considerations. During his disastrous tenure as Vancouver Mayor, overdoses increased by 600%.

Alberta has pioneered an approach that offers real hope by adopting a recovery-focused model of care, leading to a nearly 40 percent reduction in drug-poisoning deaths since 2023—three times the decrease seen in British Columbia. However, we must also end the Liberal drug policies that have worsened the crisis and harmed countless lives and families.

To fund this policy, a Conservative government will stop federal funding for opioids, defund federal drug dens, and sue the opioid manufacturers and consulting companies who created this crisis in the first place.

“Canadians deserve better than the Liberal cycle of crime, despair, and death,” said Poilievre. “We will treat addiction with compassion and accountability—not with more taxpayer-funded poison. We will turn hurt into hope by shutting down drug dens, restoring order in our communities, funding real recovery, and bringing our loved ones home drug-free.”

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