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Regulating heroin would improve public health and safety


Above photo: The Molson Overdose Prevention Site, where teams of trained staff provide people who use illegal drugs, like heroin or fentanyl, with a safe space to be monitored while they use, to help prevent and recover from overdoses.

By Dr Evan Wood and Dr Keith Ahamad

Op-ed published in the Vancouver Sun March 1, 2019

As a result of the emergence of fentanyl into the heroin market, record numbers of our fellow British Columbians continue to die needlessly of overdoses while addiction to opioids continues to spread in the province because of the marketing practices and profit motive of organized crime.

In a report released last week, the B.C. Centre on Substance Use is proposing a more effective approach to public health and safety for all British Columbians: Regulating and controlling the heroin market.

As recent investigations have revealed, the tremendous profits afforded to organized crime groups have resulted in the displacement of the traditional heroin market with fentanyl. Those massive profits contribute to the province's housing unaffordability, with hundreds of millions of dollars a year being laundered through real-estate schemes.

It is the opinion of the majority of scientists and experts in this area, including ourselves, that the strict regulation and control of the heroin market under a public health framework that limits access to those actively using heroin or fentanyl, would save lives and simultaneously wage economic war on organized crime, while having the potential to reduce rates of opioid addiction.

The report released last week proposes a model to undercut B.C.'s organized crime groups reaping billions off of the fentanyl trade, while improving health and social functioning for all British Columbians, including those with addiction to opioids by allowing limited heroin sales in a very safe and controlled way through the evaluation of a membership-based co-operative model.

A regulated heroin market is also well positioned to bridge the chasm that currently exists between public health and addiction treatment services when a person with fentanyl addiction's only point of connection is their drug dealer. Specifically, it is envisioned that the regulated and controlled sale of heroin be offed to eligible opioid-addicted persons alongside free addiction treatment and recovery services and supports.

We wish to stress that none of the individuals involved in developing this report fail to take the health and social concerns related to opioid addiction seriously. On the contrary, we bring this proposal forward specifically because we believe that the seriousness of the health and organized-crime challenges facing British Columbia warrant the evidence-based control and regulation of the heroin market.  

We also wish to stress that regulating and controlling the heroin market is not the solution to the province's untreated addiction problem. That will require establishing an effective continuum of addiction medicine and recovery services that does not yet exist in British Columbia and requires urgent focus and establishment.   

While we have an ongoing urgent focus on addressing the untreated addiction problem, what is being proposed by the B.C. Centre on Substance Use is the intervention needed to address the fentanyl poisoning problem while undercutting organized crime profits and — if done right — reduce the rate of new opioid addicted persons in British Columbia.

Historically, there have been entrenched special interests, an overwhelming stigma toward people with addiction and a reluctance on the part of policy-makers to be bold. We believe that era is over. The harms of prohibition are staring all British Columbians in the face and they want action. Reform led by all levels of government is desperately needed to reduce overdose deaths and organized-crime concerns in this province.

Dr. Evan Wood is executive director of the B.C. Centre on Substance Use. Dr. Keith Ahamad is medical director of the Vancouver Coastal Health Regional Addiction Program.

For general information about overdoses and services related to substance use visit

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