The COVID-19 pandemic uncovered a long time of drug coverage failures

A syndeme occurs when multiple public health emergencies interact to make each other worse. Last year clearly fits the label: the global COVID-19 pandemic has undeniably exacerbated the existing drug overdose crisis in Canada.

COVID-19 has been reported continuously for over a year, while a number of other topics continue to be neglected as “topical”. For people who use drugs in particular, a public sentiment of the crisis has never fully caught on despite years of deaths and damage from overdosing in communities.

The pandemic has exacerbated the risk and harm to people who use drugs. However, it would be imprecise and short-sighted to assume that the surge in drug-related deaths last year was entirely or even primarily due to the pandemic.

Rather, the current realities should be understood as the result of decades of political decisions before the pandemic and the ensuing, firmly anchored political failures. From the lack of social and treatment services to the criminalization of drug use and the stigma it creates, it is longstanding political inaction and failed policies that have resulted in the deaths of thousands of people from overdoses and now from drug toxicity.

The pandemic has both exacerbated the problem and exposed the urgent and immediate need for a radical change in Canada’s drug policy.

Drug-related deaths during the COVID-19 pandemic

Earlier this month, BC entered its fifth year of a public health emergency related to overdose. And last year was the worst yet: Across the country, overdose deaths hit a record high, with 4,000 fatalities in 2020. The vast majority of these deaths are accidental.

However, these numbers do not include overdoses, which are non-fatal yet still cause harm, pain, and health consequences for users, loved ones, and communities. Research has only just begun to examine how drug use and the harm it causes has changed in the face of increased drug toxicity and social vulnerability.

There are a number of pandemic-related reasons for the reported increase in drug-related deaths. For one, drug supply chains have been disrupted by the closure of the Canada-United States border, which has led to increased drug toxicity. Users and advocates are now signaling a shift from an “overdose” to a “toxicity crisis”. Last year, more than a third of all deaths of people under the age of 44 were caused by drug poisoning in BC. Many other provinces are seeing a similar trend.


BC has been five years since it was declared a public health emergency due to toxic drug deaths.

In addition, public health actions to contain the spread of COVID-19 have had a number of unintended consequences that have seriously affected the well-being and survival of drug users.

Community-based organizations have identified the extent to which access to life-saving aids (such as overdose prevention services, food and housing) has been restricted by physical distancing and other public health guidelines.

However, as these organizations struggle to optimize their services in response to ever-changing COVID-19 conditions, their ability to provide direct support and interact with people who use drugs has become more difficult.

This has made people more likely to use drugs alone, increasing risk and limiting access to care and support that will help ensure safety and survival in an emergency.

This particular loophole in COVID-19 policy has highlighted the urgent need for access to safe consumer products (including naloxone) during the pandemic and beyond.

Crisis as an opportunity for radical political changes

It is important that we investigate and understand how the pandemic and the overdose crisis are related. It is all the more important, however, that we remember the decades of drug policy failures that created the perfect breeding ground for the devastation of the past year.

Heroin is distributed by the Drug User Liberation Front, which distributed a safe supply of illicit drugs in downtown Eastside to mark BC’s fifth anniversary of a public health emergency in the overdose crisis.
THE CANADIAN PRESS / Darryl Dyck

Crises like COVID-19 can be crucial moments in identifying issues that need resolution and clarifying our views on how society should function by pushing for real systemic change. As researchers investigating the nature and criminal and health responses to a so-called “meth crisis” in Manitoba, we believe it is essential to identify the relationship between current cascading and overlapping crisis points and to apply them in a broader political and social context understand .

We must consider radical cures for overdoses and deaths. First and foremost, the decriminalization of the possession of illegal drugs for personal use. Decriminalization promises the possibility of preventing accidental deaths and damage due to a toxic drug supply. It also helps reduce stigma and related barriers to accessing support.

Earlier this month, BC announced that the province “will seek an exemption from drug possession laws under Section 56 of the Controlled Drugs and Substances Act.” However, users and advocates are careful with the announcement and hold back their excitement until words turn into actions.

In the meantime, drug use people and activists will continue to advocate decriminalization and access to safe, regulated care. For the second year in a row, people have given clean heroin, cocaine, and methamphetamine to people over 18 who are already using illegal drugs in Vancouver’s downtown Eastside.

If COVID-19 hasn’t pushed our governments to take radical action, and if now is not the time to undo the damage caused by past drug policies, when will it be?

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