The province of British Columbia has been granted a temporary exemption by the federal government to decriminalize all “hard” drugs. The request for the exemption was only made nearly six years after the opioid crisis was first declared a public health emergency by the province. In those six years, some 9,400 people died due to illicit drug toxicity in British Columbia. Handling the crisis of opioid-related deaths is not a simple matter, but this measure on its own, while a step forward, will ultimately prove insufficient.
Decriminalization, even if temporary (the exemption will last for three years beginning on January 31, 2023), is at least a concrete action. Decriminalization, by removing law enforcement, allows addiction and drug use to be addressed as a health and social issue—something that advocacy groups have demanded for decades.
However, it’s not a demand that governments have been open to. As recently as 2019, three years into the opioid health crisis, the NDP government put out a policy paper on what to do about mental health and drug abuse. The paper made no mention of decriminalization. In fact, the entire document lacked any concrete means or goals, and there was a total lack of explanation as to why the crisis is even occurring. Poverty was mentioned twice, once in relation to child poverty and second in a long list of various possible reasons people become addicts, lumping it in with genetics, stress and others. The policy paper was utter fluff: lots of talk about “wellness promotion”, and an entire page dedicated to a thought cloud! This, while thousands of British Columbians had so far died from fentanyl poisoning.
Then as now, the government has no clear understanding of why the drug crisis—or, for that matter, the mental health crisis—is even happening. They don’t even seem to understand why people end up on opioids in the first place. Sadly, their thought cloud lacks the words “capitalism”, “alienation”, “poverty”, or “profits”.
The problem of drug addiction saw a long escalation before reaching the point of being officially declared a public health emergency in 2016. Drug use in B.C. has been on the rise for decades. Between 2005 and 2013, the number of British Columbians who had used prescription opioids rose from 473,000 to 503,000. And over that same period, the actual amount of opioids being prescribed went up 31 per cent.
First Nations were also disproportionately affected. While only representing 3.3 per cent of the population in 2019, they were nearly 10 per cent of all overdose deaths. And the trend has been getting worse. In 2019 they were 3.4 times more likely to die than other B.C. residents, but in 2020 that number rose to 5.6 times.
Not only has the crisis not stabilized, it’s trending in the wrong direction with more overdoses and more deaths. From 2012 to 2022, the B.C. Coroners Office reports the drug crisis getting worse every year except for a temporary dip in 2019. And while they seem hopeful that 2022 will see a leveling off of the deaths in B.C., a “mere” 2,200 dead this year is nothing to hope for.
The opioid deaths are only the tip of the iceberg. Many thousands more are being put on painkillers because of injuries and as a substitute for more expensive healthcare. We have approximately 221,000 construction workers in British Columbia, and construction is the industry most likely to have opioid and cocaine users. While the government is putting out thought clouds trying to understand where this crisis is coming from, this part is not difficult to understand. Workers can’t afford to be off work for too long, and taking some painkillers means getting back to work sooner. One StatsCan study from 2021 determined one fifth (20.4 per cent) of people who died from an overdose were employed for every year of the five years before their death. Opioids are simply a cheap alternative to costly or time-consuming health care alternatives. The fentanyl crisis is a workers’ problem, and it’s the working class that needs to step in to deal with this crisis.
There’s also the issue of homelessness. It’s no surprise that homelessness and drug use are connected. Evictions have been shown to be a risk factor for drug relapse and overdose deaths, and yet B.C. is the eviction capital of Canada. But again, the government remains firmly obtuse in identifying high rents as a real cause of these deaths. They will put all the pieces together but refuse any direct indictment of the status quo. This is because the government even under the NDP can’t give a coherent explanation, because to do so would require a critique of capitalism and the market.
The opioid crisis is an emergency, and in an emergency immediate action needs to be put forward. We need to begin with the most immediate situation. The decriminalization of hard drugs is a step in that direction. We support decriminalization, but again it must be paired with a safe supply. Otherwise, even more people will die. Without a safe supply, this measure will only be decriminalizing poison. Also, we can’t simply support a “self-serve” system for buying these drugs. Programs to treat addiction administered on prescription under the compassionate medical supervision of properly trained and qualified medical personnel need to be put in place to transition people away from these drugs. We need to stop people from dying, not introduce semi-legal markets for hard drug use. We need full and proper workers’ compensation so that no one is pressured into becoming addicted to painkillers just to keep their job.
The Workers’ Compensation Board was originally gutted by the B.C. Liberals in 2002. The fight to fix the WCB has been going on for 20 years. WCB is broken, and the government knows this. Their own report from 2019 says the WCB behaves more like a private insurance company instead of an instrument for defending workers’ rights. However, the B.C. NDP has sat on that report for two years. Even though their own reports say change is needed, the B.C. NDP has yet to truly repair the damage done to it. Some small improvements to funding have been made, but it’s nowhere near where it needs to be as a tool to keep workers safe—nevermind in the fight against the opioid crisis.
The good news is the B.C. Federation of Labour (BCFED) is taking up this fight to improve workers’ compensation in the face of NDP inertia. Their demands are simple: implement the recommendations of the province’s own study. But it has to be said that simply asking the government for what we want doesn’t work. If the B.C. NDP isn’t stirred to act by all the horror stories of lost limbs and brain damage cataloged by the BCFED, we need to do something they can’t help but listen to. The BCFED needs to demand, backed up by a militant plan of action, full workers’ compensation based entirely on medical assessments and not on insurance company calculations. These demands will have to be backed up by the strength of the B.C. labour movement up to and including a real threat of job action if the BCFED’s demands aren’t met. The government will listen to nothing less. And if the BCFED insists that such action would only sour the relationship between them and the B.C. NDP, it also has to be said that they won’t be maintaining a cordial relationship with the NDP but will, in fact, only be discrediting the value of organized labour for hundreds of thousands of B.C. workers.
Long before the current crisis, activist and advocacy groups had spent decades lobbying both the federal and provincial governments for changes in drug policy. Experience shows the government simply will not do these things on its own, and certainly not within the timeframe we need. It took six years and thousands of dead just to get a temporary exemption for small amounts of hard drugs. With this decriminalization, the B.C. NDP has effectively washed their hands of responsibility. If it works and deaths go down, then they “fixed it”. And, if the crisis continues and people keep dying, well, “we did everything we could”. If we leave this crisis to the government, thousands of British Columbians dying each year from opioid poisoning will become just another fact of life, like low wages, rising inflation, increasing unemployment, high rents, etc. We need to look elsewhere.
It’s workers who are dying, and it’s the working class through its organizations that need to take the lead. We need to be fighting for concrete demands to deal with this crisis within our unions and the B.C. Federation of Labour. The advocacy groups are relatively powerless in the face of capitalism, but with a united effort between them and working class organizations, we have the real material power to end this crisis and save thousands of lives.
Ultimately, the roots of the opioid crisis go far deeper than any policy on drugs can reach. They include the profits of both pharmaceutical companies and of bosses working their employees to the point of injury; capitalist governments off-loading the burden of capitalist crisis onto the workers by cutting back on health care and housing; and the profound sense of alienation and hopelessness that capitalism engenders. As long as we continue to live in a capitalist society that prioritizes profit over people, that values commodities and their production more than the workers who make them, drug addiction and deaths related to drug abuse will continue. With capitalist society in deep crisis and our social institutions crumbling all around us, it is inevitable that many people will succumb to the profound sense of alienation and hopelessness gripping society at all levels. We must fight to protect and expand health and social services; fight for decent wages, jobs, and affordable housing, and the nationalization of the pharmaceutical industries and the other big corporations whose greed is destroying the very fabric of society. The struggle against the opioid crisis is the struggle against the alienation and hopelessness that are the ultimate drivers of drug addiction. This struggle against capitalist exploitation then becomes a key component in the struggle for another world, a world where people and their well-being are prioritized over profits, a world where worker safety is prioritized over the bottom line of insurance companies and workers’ compensation boards, a world with good jobs, good wages and decent housing for all—a socialist world.