“Both Mexico and China are major source countries for fentanyl” U.S. Drug Enforcement Administration, “FAQs-Fentanyl and Fentanyl-Related Substance,” www.dea.gov/druginfo/fentanyl-faq.shtml.
It turns out that under our federal postal legislation Canada Post Corporation Act, R.S.C., 1985, c. C-10, s. 40(3). See R. v Perkins, 2018 BCSC 395. Some other judicial decisions have allowed controlled deliveries by the police without discussing the issue.
cocaine, heroin, guns, grenades, stun guns, and even a rocket launcher Canadian Association of Chiefs of Police, “Amendments to the Canada Post Corporation Act,” Resolution #8—2015.
They say that “micro-labs” could be in homes and apartments RCMP, “Fentanyl Drug Labs: Awareness for Landlords and Rental Services,” February 28, 2017, www.rcmp-grc.gc.ca/en/fentanyl-drug-labs-awareness-landlords-and-rental-services.
It identified three cases of varying levels of sophistication United Nations Office on Drugs and Crime, “Fentanyl and Its Analogues—50 Years On,” Global Smart Update Volume 17 at 7.
Since fentanyl is a synthetic drug that can be made in a number of ways Brian P. Mayer et al., “Chemical Attribution of Fentanyl Using Multivariate Statistical Analysis of Orthogonal Mass Spectral Data” (2016), 88 Analytical Chemistry, 4303–4310.
Chapter 7—Who’s Been Hardest Hit?
“Brandon had a smile that lit up a room” Brandon Janson Foundation, “Brandon’s Story,” https://brandonjansenfoundation.com/brandons-story.
“Brandon was an engaging young man who seemed motivated” Michael Egilson, Verdict at Coroners Inquest: Jansen, Brandon Juhani, File no. 2016:1027:0004 (January 25, 2017).
Egilson found that 18% of those who’d had a fatal illicit drug overdose Michael Egilson, BC Coroners Service Death Review Panel: A Review of Illicit Drug Overdoses (April 5, 2018) at 19.
a full 66% had been involved with BC Corrections Ibid.
The first two weeks after release are especially dangerous Elizabeth L.C. Merrall et al., “Meta-Analysis of Drug-Related Deaths Soon After Release from Prison” (2010), 105 Addiction, 1545–1554.
44% of those who fatally overdosed and had been in custody died Michael Egilson, BC Coroners Service Death Review Panel: A Review of Illicit Drug Overdoses (April 5, 2018) at 19.
It’s not surprising that there are so many overdoses among people who are homeless Ibid. at 14.
compared with only 0.3% of non-Indigenous children Statistics Canada, Aboriginal Peoples in Canada: First Nations People, Métis and Inuit, Catalogue no. 99-011-X2011001 (National Household Survey, 2011) at 5.
Data from the First Nations Health Authority First Nations Health Authority, Overdose Data and First Nations in BC: Preliminary Findings at 7.
Compared with non-Indigenous women Ibid.
Chapter 8—Can We Prosecute Our Way Out?
“It was a dark and stormy night” Bick’s account of the facts of this case was corroborated with the audio-recording of the trial in R. v. Bainbridge, British Columbia Supreme Court (New Westminster), Courtroom #413, April 20, 2015 (Chilliwack Indictment #57723-2).
an “exemplary sentence for an exemplary case” R. v. McCormick, [2017] B.C.J. No. 171, 2017 BCPC 22, para. 7.
“Mr. McCormick was the supplier to a mid-level drug trafficker” Ibid., para. 64.
“I recognize that a sentence above any established range” Ibid., para. 85.
“Recognizing a different and markedly higher sentencing range” R. v. Smith, [2017] B.C.J. No. 471, 2017 BCCA 112, para. 49.
“Addiction motivated nearly all the individuals who were engaging in street-level trafficking” Haley Hrymak, “A Bad Deal: British Columbia’s Emphasis on Deterrence and Increasing Prison Sentences for Street-Level Fentanyl Traffickers” (2018) 41:3 Manitoba Law Journal 149–179 at 158.
“Research shows that the threat of an increased jail term does not dissolve an addiction” Haley Hrymak, “Calling for Harm Reduction: The Opioid Crisis and What the Courts Can Do,” 2018 UBC Interdisciplinary Legal Studies Graduate Conference (Vancouver, BC: May 11, 2018). See also Caitlin Elizabeth Hughes & Alex Stevens, “What Can We Learn from the Portuguese Decriminalization of Illicit Drugs?” (2010) 50 British Journal of Criminology 999.
“The VPD will not distinguish between the two” Vancouver Police Department, Vancouver Police Department Drug Policy (adopted September 2006).
Between 2015 and 2017, the VPD filed a total of 899 illicit drug trafficking charges Vancouver Police Department—Organized Crime Section, “Trafficking/PPT Statistics & Heroin/Fentanyl Pricing” (May 3, 2018) (on file with author).
Only 31 out of 899 (3.4%) of drug trafficking charges in Vancouver Ibid.
“Prison has been characterized by some as a finishing school for criminals” R. v. Proulx, [2000] 1 S.C.R. 61, para. 16.
Jordan was arrested in December 2008 R. v. Jordan, 2016 SCC 27, [2016] 1 S.C.R. 631, para. 9.
“It ‘rewards the wrong behaviour, frustrates the well-intentioned’ ” Ibid., para. 40 (citations omitted).
An alleged fentanyl dealer in Ontario recently had his charges stayed R. v. McCready, [2017] O.J. No. 621, 2017 ONCJ 15.
“More severe punishments do not ‘chasten’ individuals” U.S. National Institute of Justice, “National Institute of Justice Five Things About Deterrence” (May 2016), www.ncjrs.gov/pdffiles1/nij/247350.pdf; see also, e.g., Heather Mann et al., “What Deters Crime? Comparing the Effectiveness of Legal, Social, and Internal Sanctions Across Countries” (2016) 7:85 Frontiers in Psychology 1–13 at 2; Daniel S. Nagin, “Deterrence in the Twenty-First Century,” in M. Tonry, ed., Crime and Justice in America: 1975–2025 (Chicago: University of Chicago Press, 2013) 199–264.
legal sanctions also have less of a deterrent effect on serious offences Heather Mann et al., “What Deters Crime? Comparing the Effectiveness of Legal, Social, and Internal Sanctions Across Countries” (2016) 7:85 Frontiers in Psychology 1–13 at 2.
President Donald Trump has gone so far as to propose that fentanyl traffickers be subject to the death penalty U.S. National Institute of Justice, “National Institute of Justice Five Things About Deterrence” (May 2016), www.ncjrs.gov/pdffiles1/nij/247350.pdf.
“Specifically, annual street-level data suggest the price of heroin, cocaine, crack cocaine” BC Centre for Excellence in HIV/AIDS, “Drug Situation in Vancouver” (October 2009) at 9.
Chapter 9—What Is Naloxone and Is It the Solution?
“They call me ‘Little Doug’ on the street” Toward the Heart, “In Memorial: Douglas Nickerson (‘Little Doug’),” https://vimeo.com/244131663.
studies have shown naloxone to be 94% effective when administered by laypeople Michael A. Irvine et al., “Distribution of Take-Home Opioid Antagonist Kits During a Synthetic Opioid Epidemic in British Columbia, Canada: A Modelling Study” (2018) The Lancet Public Health, http://dx.doi.org/10.1016/S2468-2667(18)30044-6 at 2.
Between January and October 2016, 298 deaths were averted BC Centre for Disease Control, “Study: Wide Distribution of Naloxone Can Slash Overdose Deaths During Epidemics” (April 18, 2018), www.bccdc.ca/about/news-stories/news-releases/2017/take-home-naloxone; see Michael A. Irvine et al., “Distribution of Take-Home Opioid Antagonist Kits During a Synthetic Opioid Epidemic in British Columbia, Canada: A Modelling Study” (2018) The Lancet Public Health, http://dx.doi.org/10.1016/S2468-2667(18)30044-6.
“Naloxone should be readily available to all Canadians at no cost” Canadian Pharmacists Association, “Environmental Scan: Access to Naloxone Across Canada” (November 2017) at 3, www.pharmacists.ca/cpha-ca/assets/File/cpha-on-the-issues/Environmental%20Scan%20-%20Access%20to%20Naloxone%20Across%20Canada_Final.pdf.
A recent death review panel by the BC Coroners Service Michael Egilson, BC Coroners Service Death Review Panel: A Review of Illicit Drug Overdoses (April 5, 2018) at 4.
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A program in the United Kingdom that gives prisoners these kits European Monitoring Centre for Drugs and Drug Addiction, European Drug Report 2017: Trends and Developments (EMCDAA: Belgium, 2017) at 79.
The coroner’s inquest jury recommended that all substance use treatment centres Michael Egilson, Verdict at Coroners Inquest: Jansen, Brandon Juhani, File no. 2016:1027:0004 (January 25, 2017).
“Naloxone does not truly save lives, it merely extends them” Kevin Miller, “LePage Vetoes Bill Aimed at Increasing Access to Overdose Antidote,” Press Herald, April 20, 2016.
delaying the rapid distribution of take-home naloxone costs lives Michael A. Irvine et al., “Distribution of Take-Home Opioid Antagonist Kits During a Synthetic Opioid Epidemic in British Columbia, Canada: A Modelling Study” (2018) The Lancet Public Health, http://dx.doi.org/10.1016/S2468-2667(18)30044-6.
intravenous drug users who were educated and trained in how to respond to an overdose Karen H. Seal et al., “Naloxone Distribution and Cardiopulmonary Resuscitation Training for Injection Drug Users to Prevent Heroin Overdose Death: A Pilot Intervention Study” (2005) 82:2 Journal of Urban Health: Bulletin of the New York Academy of Medicine 303–311; see also Alexander R. Bazazi et al., “Preventing Opiate Overdose Deaths: Examining Objections to Take-Home Naloxone” (2010) 21(4) Journal of Health Care for the Poor and Underserved 1108–1113.
“opioid overdose education may reduce incremental risky behaviors” Todd Kerensky & Alexander Y. Walley, “Opioid Overdose Prevention and Naloxone Rescue Kits: What We Know and What We Don’t Know” (2017) 12:4 Addiction Science & Clinical Practice 1–7 at 3.
“Be Prepared. Get Naloxone. Save a Life.” U.S. Surgeon General, “Surgeon General’s Advisory on Naloxone and Opioid Overdose,” www.surgeongeneral.gov/priorities/opioid-overdose-prevention/naloxone-advisory.html.
“Addiction doesn’t need to be a death sentence.” PHS Community Service Society, “Insite Supervised Injection Facility,” www.phs.ca/project/insite-supervised-injection-facility.
Studies have found that bystanders often don’t call 911 See Kathryn Hawk & Gail D’Onofrio, “Reducing Fatal Opioid Overdose: Prevention, Treatment and Harm Reduction Strategies” (2015) 88 Yale Journal of Biology and Medicine 235–245 at 241–242.
Research has shown that drug overdose Good Samaritan laws Ibid.
BC’s Take Home Naloxone program estimates Toward the Heart, “THN in BC Infograph” (updated May 15, 2018), http://towardtheheart.com/thn-in-bc-infograph.
Chapter 10—Don’t Supervised Injection Sites Enable Drug Use?
And there have been zero deaths Overdose Prevention Society, 2017 Year End Report at 2, 4.
Blyth shared a couple of the comments she’s received from clients and peers Ibid. at 7–11.
There has yet to be a single documented fatal overdose Chloé Potier, Vincent Laprévote, Françoise Dubois-Arber, Olivier Cottencin, & Benjamin Rolland, “Supervised Injection Services: What Has Been Demonstrated? A Systematic Literature Review” (2014) 145 Drug & Alcohol Dependence 48–68 at 62; Harm Reduction Coalition, Alternatives to Public Injecting (2016) at 15, http://harmreduction.org/wp-content/uploads/2016/05/Alternatives-to-Public-Injection-report.pdf.
Not a single person died Vancouver Coastal Health, “Insite User Statistics,” www.vch.ca/public-health/harm-reduction/supervised-consumption-sites/insite-user-statistics.
In 2017, that had risen to six overdoses every day Ibid.
Vancouver’s overdose prevention sites reversed 1225 overdoses Vancouver Coastal Health, “Overdose statistics—November 2017” (December 20, 2017), www.vch.ca/about-us/news/overdose-statistics-november-2017.
in Vancouver one person died from an illicit drug overdose every day in 2017 BC Coroners Service, “Illicit Drug Overdose Deaths in BC (January 1, 2018–March 31, 2018),” www2.gov.bc.ca/assets/gov/public-safety-and-emergency-services/death-investigation/statistical/illicit-drug.pdf.
“There has been no discernible negative impact on the public safety” Canada (Attorney General) v. PHS Community Services Society, [2011] 3 SCR 134, para. 133.
These studies found no evidence of negative impacts See Urban Research Initiative of the British Columbia Centre for Excellence in HIV/AIDS, Finding from the Evaluation of Vancouver’s Pilot Medically Supervised Safer Injecting Facility—Insite (June 2009); E. Wood, M.W. Tyndall, J.S. Montaner, & T. Kerr, “Summary of Findings from the Evaluation of a Pilot Medically Supervised Safer Injecting Facility” (2006) 175(11) Canadian Medical Association Journal 1399–1404.
A study in The Lancet found that after intravenous drug users started using Insite T. Kerr, M.K. Tyndall, K. Li, J. Montaner, & E. Wood, “Safer Injection Facility Use and Syringe Sharing in Injection Drug Users” (2005) 366(9482) Lancet 316–318.
In 2017, Insite provided 3708 such clinical treatments Vancouver Coastal Health, “Insite User Statistics,” www.vch.ca/public-health/harm-reduction/supervised-consumption-sites/insite-user-statistics.
433 clients went to Onsite and had an average stay of 11 days Ibid.
“supervised injection facilities are unlikely to result in reduced use of addiction-treatment services” E. Wood, M.W. Tyndall, R. Zhang, J. Stoltz, C. Lai, J.S.G. Montaner, & T. Kerr, “Attendance at Supervised Injecting Facilities and Use of Detoxification Services” (2006) 354(23) New England Journal of Medicine 2512–2514 at 2513.
Researchers found “significant reductions in public injection drug use” E. Wood, T. Kerr, W. Small, K. Li, D. Marsh, J.S. Montaner, & M.W. Tyndall, “Changes in Public Order After the Opening of a Medically Supervised Safer Injecting Facility for Illicit Injection Drug Users” (2004) 171(7) Canadian Medical Association Journal 731–734 at 733.
But there was a drop in vehicle thefts and break-ins E. Wood, M.W. Tyndall, C. Lai, J.S.G. Montaner, & T. Kerr, “Impact of a Medically Supervised Safer Injecting Facility on Drug Dealing and Other Drug-Related Crime” (2006) 1(1) Substance Abuse Treatment, Prevention, and Policy 13.
Researchers saw this as doubly beneficial K. DeBeck, E. Wood, R. Zhang, M. Tyndall, J. Montaner, & T. Kerr, “Police and Public Health Partnerships: Evidence from the Evaluation of Vancouver’s Supervised Injection Facility” (2008) 3(1) Substance Abuse Treatment, Prevention, and Policy 11.
Medical research has also found that supervised consumption sites T. Kerr, M.W. Tyndall, C. Lai, J.S.G. Montaner, & E. Wood, “Drug-Related Overdoses within a Medically Supervised Safer Injection Facility”(2006) 17(5) International Journal of Drug Policy 436–441.
“I’m dead against that.” The Canadian Press, “Doug Ford Says He’s ‘Dead Against’ Supervised Injection Sites,” CBC News, April 20, 2018, www.cbc.ca/news/canada/windsor/doug-ford-says-he-s-dead-against-supervised-injection-sites-1.4628547.
“helping addicts inject poison into their bodies is not a solution” Tim Kalinowski, “Kenney Opposes Consumption Sites,” Lethbridge Herald, March 1, 2018, http://lethbridgeherald.com/news/lethbridge-news/2018/03/01/kenney-opposes-consumption-sites.
“Why isn’t the federal government massively increasing resources for the Canada Border Services Agency” Jason Kenney (@jkenney verified account), Twitter, March 2, 2018, at 11:19 a.m.
“SIFs [safe injection facilities] are counterproductive and dangerous” U.S. Attorney’s Office for the District of Vermont, “Statement of the U.S. Attorney’s Office Concerning Proposed Injection Sites,” Press Release, December 13, 2017, www.justice.gov/usao-vt/pr/statement-us-attorney-s-office-concerning-proposed-injection-sites.
A study in the American Journal of Public Health found that “the average Insite user had been injecting for 16 years” Urban Research Initiative of the British Columbia Centre for Excellence in HIV/AIDS, Finding from the Evaluation of Vancouver’s Pilot Medically Supervised Safer Injecting Facility—Insite (June 2009); see T. Kerr, M. Tyndall, R. Zhang, C. Lai, J. Montaner, & E. Wood, “Circumstances
of First Injection Among Illicit Drug Users Accessing a Medically Supervised Safer Injection Facility” (2007) 97(7) American Journal of Public Health 1228–1230.
police-reported crime has declined significantly since the early 1970s Kathryn Keighley, “Police-Reported Crime Statistics in Canada, 2016” (Statistics Canada: July 24, 2017), www150.statcan.gc.ca/n1/en/pub/85-002-x/2017001/article/54842-eng.pdf?st=UOEV3Typ.
Preliminary data from Insite suggests that while regular opioid users don’t tend to dispose of drugs BC Centre on Substance Use, Drug Checking as a Harm Reduction Intervention: Evidence Review Report (December 2017) at 21.
A review of published research by the BC Centre on Substance Use Ibid. at 22.
Chapter 11—Is Providing “Safe Drugs” Giving Up On People?
The results of the NAOMI study were published in the New England Journal of Medicine in August 2009 Eugenia Oviedo-Joekes et al., “Diacetylmorphine versus Methadone for the Treatment of Opioid Addiction” (2009) 361 New England Journal of Medicine 777–786. All statistics provided about the NAOMI study are from this article.
The findings from the SALOME study were published in the Journal of the American Medical Association Psychiatry Eugenia Oviedo-Joekes et al., “Hydromorphone Compared with Diacetylmorphine for Long-Term Opioid Dependence: A Randomized Clinical Trial” (2016) 73(5) JAMA Psychiatry 447–455.
“Our policy is to take heroin out of the hands of addicts, not to put it into their arms” Providence Health Care Society v. Canada (Attorney General), 2014 BCSC 936, para. 21; see also Laura Eggertson, “Health Minister Ends Special Access to Prescription Heroin,” CMAJ, November 19, 2013 185 (17) E773–E774.
“I was shocked to learn today that Health Canada approved applications to give heroin to addicts” Peter O’Neil, “Ottawa Overrules Health Officials on Vancouver Heroin Replacement Study,” Vancouver Sun, October 4, 2013.
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