Canada continues to be burdened with fighting the war on drugs. Substance abuse is quickly becoming a major problem to the country contributing to the large amount of health dollars being spent on drugs, which is approximately 15.7% of the health spending.1 Instead of enforcing laws to incarcerate individuals using and abusing illegal substances, policies can be used to regulate access to these drugs and decriminalize substance users. By doing this, Canada can control the distribution and purity of illegal drugs, prevent the spread of HIV/AIDS and hepatitis C, and decrease the stigma on substance abuse.
It is known that many illegal drugs sold on the street are laced with various fillers to keep the expenses low and make the drug more potent.2 One of the most popular fillers is fentanyl. This is typically mixed in with opioids, like heroin, to produce the desired effect using less amounts, as fentanyl is significantly stronger and more potent opioid.2 Drugs sold on the street are not regulated nor trustworthy because the measurements of each ingredient may not be accurate and the environment that they are made in may not be sterile. By having the government control the production of drug, users can be reassured that the drugs they are taking are safe and clean. Apart from handling production, the distribution of the drugs can also be managed at the pharmacy level. By doing this, the number of pills given per patient in a certain amount of time can be limited and overdose can be better prevented.
Canada has already made progress toward hindering the transmission of HIV/AIDS or hepatitis C in substance users by implementing safe injection sites and discouraging users from sharing needles. With controlled distribution of these drugs, their administration can be monitored at a more efficient manner. Pharmacists can reinforce the importance of using new needles to prevent contracting immunocompromising diseases and infections from fellow users.3 Medication for hepatitis C is one of the top three drug classes in terms of public drug program spending.4 By advocating for safe drug administration instead of enforcing a complete elimination of illegal drug use, our allocation of resources can shift from covering expensive medication for hepatitis C and towards education and safety of the population. Needless to say, the government can also benefit from this financially, as they can monopolize certain substances and offer them at an affordable price. Overall, they will be providing the public with safe access to these drugs, while depriving illegal businesses of customers.5
Decriminalizing substance use is not equivalent to legalizing them. It has to be emphasized that the use of these psychoactive drugs is not recommended in any way. Also, the decriminalization of these drugs does not come without any policies of regulation. People who use these substances should not be incarcerated, but should be entered into a mandatory treatment program, where the goal is to manage their addiction or dependence under the supervision of a health care professional.6 Refining the laws can protect these individuals from being seen as criminals and remove the stigma behind drug use. This can ultimately create a better community and support group for people who are suffering from substance use.
There is actual evidence that implementing the decriminalization of drugs can have a positive impact. This can be observed with Portugal. Portugal decriminalized all drugs in 2011 and since then, they have experienced significant decline in drug overdose and HIV cases caused by injections.7 Possessing these drugs for any use is still prohibited, but it is not a criminal offense. Instead, they are considered administrative violations. Because the distribution of prohibited drugs is controlled and monitored, individuals are not allowed to have more than 10-day supply of the drug and needle-sharing is avoided. This has been shown to decrease substance abuse and unsafe injection practices.8
How can pharmacists help in this regard? Pharmacists have the knowledge and skills to determine if a drug is safe to be consumed by the individual, therefore, they can be responsible for drug distribution. Pharmacists can also help with drug administration via injection or daily dosing as well as assist in preventative education by informing the patients of behavioural therapy and addiction management. Overall, decriminalizing drugs will work in favour of Canada’s war on drugs with the help of healthcare professionals, such as pharmacists.