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Below the Radar Transcript

Episode 191: Drug Policy — with Dr. Kora DeBeck, Erica McAdam, Kali Sedgemore, and Dean Wilson

Speakers: Sena Cleave, Am Johal, Erica McAdam, Dean Wilson, Dr. Kora DeBeck, Kali Sedgemore

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Sena Cleave 00:04
Hello listeners! I’m Sena Cleave with Below the Radar, a knowledge democracy podcast. Below the Radar is recorded on the territories of the Musqueam, Squamish, and Tsleil-Waututh peoples. On this episode of Below the Radar, our host Am Johal is joined by Dr. Kora DeBeck, Erica McAdam, Kali Sedgemore, and Dean Wilson to talk about drug policy in Vancouver. They discuss various models of drug decriminalization and safe supply, as well as what both academic research and community knowledge recommends for the future. Enjoy the episode!

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Am Johal  00:42
Hello, welcome to Below the Radar. Delighted that you could join us again this week. We're going to be talking about drug policy this week, regarding drug policy research with community members and academics that are working together on projects. We have a number of wonderful guests with us. Why don't we start with introductions. Erica, could you start?

Erica McAdam  01:00
Hi, thank you so much for having us on today. I'm really excited for our discussion. My name is Erica, I use she/her pronouns. I am currently a research assistant at the BC Centre on Substance Use and I'm a recent graduate from the Master of Public Policy Program at ¶¡ÏãÔ°AV. My thesis research at ¶¡ÏãÔ°AV focused on drug decriminalization and evaluated different models of decriminalization, and they all differed on how personal possession was defined. I'm also a white settler and I live and rest on the unceded and ancestral territories of the Coast Salish people. So the Musqueam, Squamish, and Tsleil-waututh. Yeah, thank you so much for having us.

Am Johal  01:33
Yeah. Thank you. Great to have you with us, Erica. Dean, did you want to go next? 

Dean Wilson  01:35
Yeah, I'm Dean Wilson. I'm the peer lead at the British Columbia Center for Substance Use. That's my main gig right now. I'm also a community liaison for the Portland Hotel Society. But my main gig is the BCCSU. And I'm the past president of VANDU, Vancouver Area Network of Drug Users. I started the British Columbia People on Maintenance nonprofit, won the Queen's Jubilee medal for my work in the neighborhood, and just a resident shit disturber in the Downtown Eastside. And I just don't think that because we use illicit drugs, supposedly, that we should be animals that should be jailed. And I will never stop saying that. So... 

Am Johal  02:14
Great to have you with us Dean. Kora.

Kora DeBeck  02:16
Hi, thanks so much. I'm so delighted to be on this podcast and have so much respect and regard for everybody on the call, or, on the cast. My name is Kora DeBeck. I'm a white settler from the traditional and unceded territories of the Squamish, Musqueam and Tsleil-Waututh First Nations. I'm an associate professor in the School of Public Policy at ¶¡ÏãÔ°AV. And I'm also a research scientist at the BC Center on Substance Use in Vancouver. And I lead a longitudinal cohort study of street involved youth who use drugs, and have been doing research on substance use and drug policy for about 15 years. And yeah, delighted to talk. Thanks for having me.

Am Johal  02:56
Right, Kali.

Kali Sedgemore  02:58
Hey, thank you for having me. I'm Kali and I'm a youth researcher with ARYS, At Risk Youth Study, and also someone with lived experience, or living experience. And I mainly work with a lot of youth that use drugs. And someone that fights for stimulant users, because they often get forgotten about in this crisis. So, that's me. 

Am Johal  03:15
Great. Thank you. Erica, why don't we start with you. And just in terms of setting up the study that you were involved with related to different models of decriminalization, where the project started from and kind of what the findings of your study was?

Erica McAdam  03:31
Yeah, thank you so much for that question. So, as I mentioned before, so my research was a multicriteria policy analysis that looked at a bunch of different decriminalization models, all which differed on how personal possession was defined. So some use threshold quantities to find to define personal possession, whereas others do not use threshold quantities. And this research really came out of some of the public response to the decriminalization submissions by the City of Vancouver in the province of BC, and also from the response from drug user advocacy organizations like VANDU, that really highlighted that the thresholds used in these submissions were inadequate from their perspective. And there was really like a lack of evidence and evaluation of different types of decriminalization models. And so my research really helped try to aim to fill that gap essentially. So I conducted—it was a mix of qualitative and quantitative methods—So I conducted 16 qualitative interviews with experts and key stakeholders, and then also analyzed police drug seizure data obtained through freedom of information requests, and also used data from the longitudinal cohorts of people who use drugs from the BC Centre on Substance Use, which was chorus research. So in this analysis, my research findings found that a model that uses 15 grams to define personal possession, so anything up to or equal to 15 grams, would be the model that would best advance the key objectives of decriminalization for the province.

Am Johal  04:49
And I imagine with the multiple stakeholders involved in attempting to come up with thresholds ends up being a kind of grand compromise, which probably includes law enforcement and others. Just having worked on the Vancouver agreement before, and I can remember some heated conversations back in the day around moving public policy, and the move towards harm reduction and health approaches outside of law enforcement, but they were certainly in the room. I'm wondering if you can sort of add to what Erica has shared, Kora, related to the study.

Kora DeBeck  05:19
Yeah. So Erica’s work around decrim, I would also even just, before she did some of that work, she did an analysis using our longitudinal cohort data, which was collected during the COVID pandemic. So when the COVID pandemic hit, we were able to, through telephone interviews or on Zoom, talk to over 700 people who use drugs to ask them about what the quality of the drug supply was like for them from their perspective since COVID hit. And that paper, which Dean and Kali are both co authors on, really highlighted what the community have been saying for a really long time, what people really know, which was that it was really the drug supply that was driving the overdose crisis. So we found that, you know, over 35% of people were reporting that the drug supply had reduced since COVID. And that the people who reported that were also more likely to experience an overdose. And so I think in the context of talking about decrim, and the different stakeholders and thresholds and various discussions, there was, I think, a lot of tension around what the purpose of decrim was and what we were trying to achieve. And I think I would love to hear from Dean and Kali, but, I think there was a lot of calls that we needed to respond to the overdose crisis. And decrim was put in for that, you know, supposedly. We know that it doesn't address the drug supply. But then in talking about what the, you know, what the thresholds might be, and, you know, different stakeholder’s perspectives. I think there's this real gap between what the scope of the problem that we're seeing, the amount of deaths, the harm, and then to, you know, what the decrim models have been put forward. So, yeah, I think in terms of different stakeholders and their different perspectives, I think when it came to discussions of threshold models, there was a lot of frustration about the scope of the problem, and where different actors wanted the threshold models to be.

Am Johal  07:02
Yeah, and definitely the pandemic situation exacerbated, accelerated issues that were happening on the ground, and Dean and I'm wondering if you can speak a little bit to that?

Dean Wilson  07:12
First of all, on the threshold, I think the number is irrelevant. I think getting the framework of decriminalization is the most important thing that has come out since the Insite case. You know, it's going to tell police to lay off, leave us alone, we're not criminals. And that's the important part. I love the fact that Erica’s research told us what the people think the number should be. And maybe we can get up to a half an ounce, 15 grams. I personally think the lowest level should be an eight ball, which is 3.5 grams for those that aren’t street. But that's about the lowest it should be. But I think, as I say, the numbers are irrelevant. Who cares what the number’s right now? We are going to put a framework in that says decriminalization is the proper way to go, we are on the right side of history. Now, as far as the COVID thing goes, I'm starting to wonder that COVID just speeded up the change of the toxicity of drugs. I think that the cartels, or whoever may be shipping this stuff, has realized that it's a lot better to have two chemists in the lab than 40 people growing opiate poppies in some field. This is the new wave. It was really hard to find heroin anywhere for the longest time. Now it's back at full force. But the thing is, the toxicity of the fentanyl structured drugs is just horrible. And of course the addition of valiums and all those other drugs, benzodiazepines added to it. It's just a horrible outcome. But that's where I think everything is at right now.

Am Johal  08:40
Great, thanks Dean. Kali.

Kali Sedgemore  08:43
As someone who works frontline and has worked at OPSs, but also runs a coalition for drug users, it's been horrific just with, especially with COVID. Because the drugs just got more toxic. And it was just bad because it's just like, people that were using stimulants, for instance, are dying a lot more now too because it's just getting worse out there. The decrim model is going to be interesting, but it's not going to really hit something to save anything, because it's not gonna save anybody lives like they think it is. Because it's not enough, like a lot of youth too buy a large amount. So like the 2.5 is gonna really put them at risk for more risk and stuff like that. So yeah the drug supply is just getting more and more toxic. And it's just going to be, I feel like it's just going to be getting worse because there's more things being added to drugs, like tranquilizers and stuff like that. So it's getting quite horrific and just we’re losing so many people too so it's not great. It's a step forward. But it's also not going to really save lives, I don't think.

Am Johal  09:30
Dean.

Dean Wilson  09:30
Yeah, I want to reiterate that the decriminalization of drugs will have no bearing on overdose, resulting in death. It has nothing to do with that. You know, the government seems to get the strangest answers to the questions we ask. But the decriminalization is a great, great thing. But it will have no effect on the overdose at all, the only way we're going to affect change there is to offer the people that need it, the drugs that they're asking for. That's it. I hate using the word safe supply, because safe supply means so many things to so many different people. It's just being trampled on. I don't even know what it means nowadays. But I think that the only thing that will change the overdose is to actually make sure that people are able to access the drugs that they wish to access, period.

Am Johal  10:16
That's a really great point, Dean, in looking at the period. And sometimes it's great to look at historical examples. Because when Insite as the supervised injection site opened, you have to remember, the demands in the community were around heroin prescription and getting access to a safe supply of drugs. But at the time, the government was unwilling to move on it because they felt like the academic studies hadn't been done and that type of thing. And so the opening of Insite, the supervised injection site where people brought in street drugs, was a compromise to have something open while those studies were being done. And as NAOMI and then later SALOME open, was to create the kind of policy framework and over 20 years have gone by without that policy framework having been implemented in a proper way. Although it seems like there's going to be some movement on some kind of safe supply, although not fully defined, as of yet. And still, a lot of challenges around the medical professions and the distribution around questions of ethics related to that, which haven't fully been worked out. And I'm wondering if any of you would like to speak a little bit to… You know, the context that we're in right now is very different than the 90s, where the push for harm reduction came from to reorient this from a criminal justice issue to a health and human rights issue. But we're having triple to quadruple the number of deaths in BC that's been driven by the fentanyl contamination of this street drug supply, exacerbated by the pandemic. And I'm wondering if you can speak to this broader context of perhaps forms of legalization or safe supply that could be a further intervention. And kind of how can we put some lines around defining what that might look like, from a policy point of view that lands down on the ground that could change those indicators as quickly as possible.

Dean Wilson  12:00
You know, back in those 90s, late 90s, and early 2000s, we were fighting a whole different thing. We were looking for a needle exchange, because we were all dying of HIV/AIDS. And so it was a whole different thing. People were— let's remember 93’ and 97’, we did have many overdose crises. But I'd say most of the things that we worked on back there were anti HIV sort of stuff. And so that's what we wanted. We wanted a safe place for people to shoot so they could get their clean gear and that was part of the Insite thing. But, you know, nowadays, it's the actual drugs that we're using are toxic. It's a whole different thing. It's like 100% different. It's not the same as back then. It's a whole different thing. The drugs are now toxic, they're poisonous. People that are addicted to opiates have no recourse, they have to use something to keep that monkey off their back. And you know, you said something that's really interesting how we went from a criminal to a medical model. I wish we had skipped the medical model and just gone to the social model. Look at, some of these doctors are as bad as any cop I've ever met, let me be honest with you. They think that they should be in charge of the drug control and everything else. The bottom line is the drugs are toxic, the only way we're going to prevent any more overdoses is to give people what they need. And if that's true, like a compassion club type of thing. Dr. Sutherland, Christy Sutherland, who works for the Portland Hotel Society, is doing some marvelous things. But she doesn't want to be prescribing drugs for people who want to use them for enjoyment or for coping stuff like that. She wants to be a doctor. And so she wants to sort of hand off these programs to more like a club where people could join, they don't have to have substance use disorder, but they're able to buy what they need, such as fentanyl or heroin or whatever. So I think compassion clubs would be a starting out point, Am. But as I say, right now is so much different. I don't think that comparison is even needed anymore. It's just totally different. We've arrested HIV in our neighborhood, we did a really, really good job as a community health program. And now that we're looking at something completely different.

Am Johal  14:04
Thanks Dean. Anyone else like to jump in there?

Kali Sedgemore  14:06
I could. I think the other big thing about that is that, like, stimulant users are being left out of the conversation when it comes to this because it's just, they don't see it as stimulant users having the same effect as someone that uses opiates. But it's not true. For a long time stimulant users, and especially IV stimulant users, that could by accident go through a different withdrawal than people that just maybe like smoke it and stuff like that. But it's also a lot of stimulant users that are using drugs and the drug supply is so toxic now that it's leaked into the stimulants now. That it's like meth is contaminated with fentanyl or benzos. And same with cocaine and crack. And it's becoming more and more of an issue that a lot of people don't seem to want to talk about or bring up. Because it’s an opiate crisis. And it's not true. It's a toxic drug supply crisis and a big one.

Kora DeBeck  14:47
I really want to echo from our research perspective and looking at the data and coroner's records and information, it's certainly not an opiate crisis. You know, stimulant users are increasingly impacted and affected. And so in thinking about safe supply, some of our preliminary work is showing that people who use drugs often don't know that it's available, or if they do know it's available, they're not given the kinds of drugs that they need, or that they want. I don't know, Kali, you could probably speak to that experience as well, from your observations. And also a real discrepancy in access based on where people are. So the current systems right now, you know, maybe if you're living in the Downtown Eastside, you could find somebody like Christy Sutherland, but you know, you get a few kilometers outside, and it's absolutely nothing. So access type, there's so many more innovations that are needed around the safe supply to have an impact. And I completely agree with Dean how important decriminalization is, and it's a huge step. But I also think it's really important to emphasize that, as Kali was saying, it's not going to have an impact on overdose deaths. And I think if the public has that perception that this is a response to the overdose crisis, they're going to be potentially disappointed or having unfounded evaluations of how decrim goes over time. So I think it's really important to keep the perspective of what decrim can and can't do in this context.

Dean Wilson  16:09
You know Am, I think Kali is so right. I'm an opiate addict and I don't even think about meth and amphetamines. So like in all of my 22 years, I'm mostly speaking from an opiate standpoint. I know that some of my stance covers that. But stimulants have even a worse name amongst people. And in fact, on this extended access program that Dr. Sutherland is running, we've got fentanyl. I was the first person to buy powdered fentanyl to take home and use as I wish. It looks like heroin maybe in September, but the government just doesn't want to move on methamphetamine. They just don't want to touch it. So even now, Kali is so right on. He is way behind the rock. Opiate addicts have sort of pushed a little rock a little bit up it, but Kali and his buddies are there under the rock, period.

Am Johal  16:54
Kora, Erica, I'm wondering if you can just speak to, you know, since this study has been done, there's so many other research questions that come to the surface in the way that Dean and Kali raise. And I'm wondering if you could just speak to the kinds of things that come up for you as researchers doing work with community members, in terms of what are the areas and the questions in the future and which research can help inform the movement of public policy?

Kora DeBeck  17:18
I think a huge interest and piece for us right now is looking decrim, although, I think it's very clear, it's not going to have a notable impact on the overdose crisis. I think it is really important to be able to monitor and evaluate the extent to which it's at least meeting its objectives around reducing contact with police, and improving people's experiences on a day to day basis when they're in their community and in the streets. So that's something that is a research priority for us. And an aspect of that is also looking at the impact for young people. There's been age restrictions around decrim and so seeing the exclusion of younger people, what the potential impact is for that. And another big area for us and how we've designed designed our Research, and Dean and Kali have both contributed a lot of ways into our structure of our research questions and various things is looking at safe supply and how its access, and what the reception is, like for people who use drugs and how far reaching it is within our cohort studies are based in Vancouver. So we're, we don't have a rural aspect to it, but even just within people in Vancouver, what the reach is like for people. So those are two areas that we're sort of focusing on right now.

Erica McAdam  18:27
Yeah, I would echo everything that Kora said. I think something else in addition to the fact that there's an age limit, so decriminalization excludes youth who use drugs. I think another important point is also just that decriminalization in BC excludes a multitude of other substances. So it's really just focused on opioids, cocaine, methamphetamine, and MDMA. So that also leaves out diverted pharmaceuticals and psychedelics as well. And I would also add just that decriminalization in BC obviously excludes other jurisdictions across Canada. So there's not much equity there for people who use drugs across Canada.

Am Johal  18:58
Kali and Dean, from your perspective, what do you see as research that would be helpful in terms of what's happening on the ground that could move the dial on public policy?

Kali Sedgemore  19:08
Well, we have like, for instance, I helped write a paper around youth, call to action on harm reduction and stuff like that. And that's one big thing now, we're hoping that will help change and influence people to understand that youth use drugs and just it’s a big thing, like this decrim model's really left out youth and it's like a lot of youth buy large amounts so it doesn’t get suspicious whatever with their parents and whatever. But it's just, it's really frustrating now. It's been— youths have been left out again, because youths use drugs and just harm reduction really needs to bring focus to youth that use drugs. And by providing education, it's safe to do that, but and even just like how the quote unquote safe supply model works, it just leaves the youth too, like you don't have access to a lot of the same things that a lot of us can access when it comes to a safe supply or whatever. Yeah, to change the dial, I think it really means to listen to the call to action we made with their paper that we wrote in youth harm reduction and stuff.

Am Johal  19:55
Dean?

Dean Wilson  19:56
Well, I would really like to see some real research on how badly the police affect our lives through the prohibition. And because of the prohibition they're just reactions to the prohibition their own personal vendetta against us. You know, it's funny, you know, people say, oh, you know, we're more likely, you know, we've got to take handguns. I'm more likely to be shot by a police officer in the Downtown Eastside than any gun slinging gangster. And I know there's been talk about this for a long time, you know, prohibition. I would like to see some real research that says their effect is causing this, their effect is causing that. And for once to be able to say, see, it's not just us, this is real, all this research that's ever been around there, has always sort of been fluffy around the edges, and it doesn't really want to stab at the real problem. And I'll tell you, anybody who's a drug user, especially if they're on the street or around the street, knows what I'm talking about. And it's the prohibition obviously, is the killer. But the way the police enact that law is just horrible. And I've seen it in so many cities, it's not just Vancouver, it's in every lower income neighborhood in North America.

Am Johal  21:07
Thanks, Dean. Is there anything that any of you would like to add?

Kora DeBeck  21:11
I think one thing I was thinking of, recently in the news with discussion around charging pharmaceutical companies around opiate prescribing and those types of things. Just emphasizing what, I think, a distraction that is from the overdose crisis. And in different settings that may have been more of a driver, but we have looked into it within Vancouver, and within the people who use drugs within our cohort studies. And we haven't found big connections between people entering substance dependence through physician prescribing. And the kinds of harms that happen when subscriptions are taken back and rolled back is really just devastating. Just connected to these conversations, and you know, Dean, please jump in, because…

Dean Wilson  21:55
Hey, you're so right, Kora, a 14 year old kid doesn't get his dope off a pharmacist, he gets it off a 15 year old kid. You're right. That's how people start drugs. The thing is, if the kid is looking for something, that drug dealer might have two or three other things. And so the kid gets introduced to other drugs. And that's how they say the so-called gateway. It's the prohibition that starts it. But you're right. I know some people who were too easily given oxycontin back in the day because they had a hockey injury or something like that. They got caught up with it. But it wasn't because the doctor didn't do everything in his possibility to get those pills off after two weeks and everything else. They just fell in love with the drug and they carried on. I think you're really right, Kora, the doctors are being punished way too much over this whole thing, and now they're scared to prescribe properly. They're scared to give opiates to some people who are in horrible pain, but I like the fact that they're getting stringent about not giving it for very long periods of time to anybody who's in supreme pain. And so I think you're right on Kora.

Am Johal  22:58
Erica, anything you'd like to add?

Erica McAdam  23:00
I would just echo those comments, I think. It takes up a lot of new space, I think. Especially since there's been recent settlements. But yeah, I think that conversation really needs to be refocused on the fact that the crisis is still ongoing. And how can we implement real policy change?

Am Johal  23:15
Kali?

Kali Sedgemore  23:16
Yeah, I think the media is really washing out with this and saying that like it's going to be helping the overdose crisis, when it's not. That's not the reason why that is going on, it's because we have a toxic drug supply and toxic drug supply needs to be addressed more than what's going on with doctors and stuff like that. It’s not the doctors that are making these drugs toxic.

Am Johal  23:33
I’m wondering now, what's next then. Since the study has come out, how has it been received? And have you engaged with policymakers around it?

Erica McAdam  23:42
Yeah. So we've done a couple of presentations to different levels of government on the research findings. So my research was completed after the federal government approved decriminalization, which was the threshold of 2.5 grams. So I think at this stage, our focus kind of turns to evaluation like Kora was saying, and looking at, you know, do the thresholds need to be lower or higher based on the evidence that we see coming out of our research after decriminalization is implemented? I don't know if you have anything to add there, Kora.

Kora DeBeck  24:10
Yeah, I think the opportunity that we have to share our work with people in government, policymakers. And I also put a lot of emphasis too in terms of the public, because I think the public, the more that they're putting pressure on their elected representatives and saying that they support things like safe supply, decrim, progressive drug policy. I think the more progress we will have. It's certainly incredibly frustrating when, you know, we've had the kind of evidence around the harms of prohibition and criminalization. You know, sometimes it's frustrating in terms of do we really need more studies around this? What more is another study going to do that hasn't already been said? But, you know, then again, it does seem that there are sometimes these policy windows where, you know, research evidence does come to play and can push things forward. And knowing that research evidence was so critical with the supervised injection site court case, and you know, you just sort of never know where it is going to make a difference or change some minds or, you know, open some other perspective. So I think, you know, what people who use drugs, and you know, what Dean and Kali are doing, and the kind of advocacy and engagement that they're doing, you know, they have more power than the research. But I think hopefully all of it together, bringing it forward, wherever we can, will move things forward. So that's what we're hoping.

Dean Wilson  25:29
You know, just the last little bit of research seems to have caught the public's fancy. I'm asked by the media, when anything has to do with drugs, the media contacts me for, whether I get published or not, it doesn't matter. But on this one I was quite surprised at how widespread the media was looking at this latest research and other research that's come out in the last, say, five months. So I think right now that people are actually realizing that made in Canada research is pushing the overall movement, and that's what saved our lives and Insite. So we've got to keep this up. Just keep going the way we're going. We've got to keep proving that this stuff, what we're saying is right, you know, I wish Kali and his folks would have a lot more research on the youth because youth dope and adult dope are two different dopes. It's not the same, they are in way more stressful situations than the average adult. So that's really got to get looked into. And I really, seriously, if they want to start effecting change in the youth of this country, start looking at the youth for crying out loud. Anyways, I could go on a rant forever.

Am Johal  26:36
Kali, anything you'd like to add to that?

Kali Sedgemore  26:39
Yeah, well, like there's ARYS brings on a lot of research for youth and stuff like that. The politicians love research and stuff. But it's really frustrating that they're not wanting to acknowledge it or see it and just like trying to do things like involuntary treatment, for instance, is a terrible idea and not the right way to do it. It's just, we need harm reduction services and education for youth to understand that youth, they're gonna use drugs and stuff, but it's just, they just, a lot of the higher ups or whatever, don't want to really read that research or see that research not acknowledging it or acknowledging people’s lived experience for instance, around it. And so it's really frustrating that people don't really want to address it, and a lot of people are just wanting to go thinking that treatment will be the right push for them when it's like, that's not going to work all the time. 

Am Johal  27:18
Yeah, I had a question just around— are there other policy jurisdictions and other countries that are more progressive than the Canadian context in terms of decriminalization or other drug policy that we can look to that could help inform our context here, if any of you have anything to share related to that research.

Dean Wilson  27:37
The City of Vancouver has the best drug outcomes, period, in the world as far as I'm concerned. You know, you've had Portugal do their thing, but they're still embracing the whole medical model without looking at the social model at all. Look at the City of Portland, they're like Vancouver. And I think a lot of these ways of using the law, it doesn't have to be national sometimes. It can be made in the areas and it's been really effective but you know. There's always a place to learn from other places.

Kora DeBeck  28:06
What I would add is I think the model that Vancouver, that BC put forward had two really important features in it. One being that there's no administrative penalties for possession under the threshold. So in many other places you get what would be sort of like a ticket, or some kind of fine. Which can be absolutely devastating for somebody really in terms of we know when those sorts of tickets add up, and then they turn into arrests, and they turn into incarcerations. And they're just crippling. And then another important, very important feature is that there's no seizures under the threshold. And so not having people worried that their drugs are going to be taken away is really, I think, one of the key benefits and wins of the decrim model, because from research, too, we know that when people have their drugs taken away, they're more likely to be in absolute desperation. They'll be more likely to go to a dealer that they don't know as well, use a supply that's not as well known, or also they have to go and do some sort of criminal activity to get more money to get drugs again. So those are two aspects of the decriminalization model that are very important. And I don't think any other setting has those two features together. So in that sense, I say, let's not look at other places, let's look at BC, let's evaluate it and monitor it. And I think it's very, very progressive and important.

Dean Wilson  29:24
You gotta save that clip, Am. That was perfect, Kora. I wish we could just bottle that up for a minute. And if you want to use advertising for your podcast, that was beautiful. Exactly. Those two things change it all, they can't do anything. And that's why I'm really adamant about this, please stop right now. That's the real line, we've got to somehow find. And if they can't take anything away from us, and they can't give us anything like a ticket. Bye officer, see you later. And you're on your way. This is wonderful stuff. This is as big as Insite easily.

Kora DeBeck  29:57
Kali, you could also probably speak to that. That won't be the case for younger people. 

Kali Sedgemore  30:02
Yeah, no, that won't be the case for younger people and that's what's really frustrating. For instance, a lot of youth buy a large amount, because it's just a safety thing. People don't get suspicious when they're leaving the house 20 times to go and do that. And also, they brought large amounts to share with their friends to maybe sell with a friend or whatever. And it's really frustrating because I've dealt with two cases now where youth have been arrested because they have drugs on them. And it brings a criminal case to it. And it just brings this element of them being arrested, them being traumatized by that. And then it's a whole thing of just them needing more drugs to cope with that traumatization. It's like whatever happened to not locking up kids, but it's becoming more and more of an issue now and especially with the decrim stuff. A lot of youths, they're probably going to face criminal charges due to the fact of having drugs in them. The model does not have youth attached to it. I'm hoping we don't see more arrests with youth, but we never know, because it seems like cops are gonna want to arrest someone. So it'd be tricky, I think.

Am Johal  30:53
Yeah. So my last question to each of you. Let's say you're walking down the street, and you just happen to run into the Premier and the Prime Minister. And you're going to tell them what provincial and federal government policy should be doing that would advance the interests of drug users, that will make their day to day life easier, better, away from harm… What would you suggest to them? Why don't we start with Dean.

Dean Wilson  31:18
Well, boy, oh, boy, tough question. I think Horgan’s been one of the worst premiers ever, for anything harm reduction. He's just horrible. I think I’d tell Trudeau about a story about when I met his dad, just after the Le Dain commission came out in 1972. When the other Prime Minister Trudeau said, we should just legalize all drugs. And of course, the American push back was so heavy in '72. That even no matter what the Le Dain Commission said, it was over. That's what I would remind him that his father said that all drugs should be legalized in 1972, 50 years ago this year. And what I should say to the Premier is I wish the NDP would do a lot more for the drug user. They've done absolutely nothing. So there you go. That's what I'd say, Am. 

Am Johal  32:06
Great. Thanks, Erica.

Erica McAdam  32:08
I mean, I would definitely echo Dean's feelings there. And I think a regulated safe supply in the form and quantity that people who use drugs need. Over 22,000 people have died during the current overdose crisis. And I think it's time that we implement true policy change that's actually going to stop people from dying. And then I think the other part is ending the barbaric system that we have of prohibition, and decriminalization across the country for personal possession. And that those are the two policy changes that I would really like to see.

Am Johal  32:34
Ok. Thanks, Kali?

Kali Sedgemore  32:35
I probably have a hard time, same feelings. It's just so much anger and just frustration because it's just see, yeah, Premiere has not done anything. I believe that he wouldn't hear us, whatever and all the same. It's just like having a regulated supply and stuff like that would be great. But it's just, they're not listening. And that's what's really frustrating. They need to listen, That's all I can really say to that without getting mean.

Am Johal  32:55
Thank you. Kora.

Kora DeBeck  32:56
Yes. Very much what everyone else is saying. A regulated supply. So not decriminalization, decriminalization doesn't address the supply of drugs, but a regulated supply of drugs or legalizing drugs, makes it so that, you know, just as people who are getting alcohol are able to know what the purity, what the concentration, what the content of what they're drinking is. That's what we need for drugs, and also, from my perspective—but I think we would need very close monitoring and evaluation—when something is regulated, we have a lot more tools to help control the use and, you know, we've had very successful public health interventions and measures around things like tobacco consumption. And so you know, always a balance between being overly stringent but I think with a regulated model, there's a lot more tools in terms of reducing the harms of substance use and recognizing the the benefits of substance use as well. So that is what I would advocate for nationally.

Am Johal  33:55
Great, thank you all so much for joining us on Below the Radar. Dean, Erica, Kora, Kali, so wonderful to speak with you. And thank you for the great work that you're doing. And hopefully we're going to see some changes sooner rather than later. This has been a long time happening and we've been in the middle of a public health crisis for a very long time. And a crisis that was declared in something like 2016 again, and still seeing worrying trends in terms of the numbers of people dying, and the situation on the ground. So thank you so much for joining us on Below the Radar.

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Sena Cleave  34:33
Below the Radar is a knowledge democracy podcast created by ¶¡ÏãÔ°AV’s Vancity Office of Community Engagement. Thanks for listening to our conversation with Dr. Kora DeBeck, Erica McAdam, Kali Sedgemore, and Dean Wilson. Head to the show notes to check out resources mentioned in the show as well as more research around drug policies in Vancouver. We release episodes every Tuesday, so subscribe to Below the Radar on your podcasting app of choice to make sure you never miss an episode. Thanks again for tuning in!