By Jen St Denis, published on Metro Vancouver
Canadian Drug Policy Needs 'Total Rethink': Four Pillars Author
In 2001, Donald MacPherson developed the City of Vancouver’s Four Pillars drug strategy, a policy that emphasized concepts like harm reduction (such as safe injection sites) as well as addictions prevention, treatment and drug trafficking enforcement.
The deadly overdose crisis shows no sign of stopping — earlier this week, Vancouver reported that at 232 deaths in 2017, the city has already surpassed 2016's entire total. MacPherson is now turning his attention to a "total rethink" of Canadian drug strategy and is calling for what he calls “the legal regulation” of all drugs.
Metro spoke to MacPherson about political risk and what it takes to move controversial policies to the mainstream. MacPherson was recently awarded the Nora and Ted Sterling Prize in Support of Controversy from Simon Fraser University. He'll deliver a lecture on drug policy after receiving the award on Oct. 10.
Metro: What holds us back when it comes to acceptance of legalizing or decriminalizing drugs?
MacPherson: People are very risk averse when it comes to drugs. They tend to lapse to the same old, same old thinking, which isn’t moving us forward. In fact, it’s killing people and making things worse at the moment.
We really need to break this logjam in thinking if we are to make progress on issues like fentanyl. And fentanyl’s a product of drug prohibition. Drug prohibition favours highly concentrated substances because they’re easier to smuggle.
Metro: In the past when you worked on the Four Pillars strategy, you had a breakthrough — you got political buy-in and it became a model for other cities. How did you make that breakthrough?
MacPherson: It was kind of a perfect storm in a positive sense. You had a crisis, you needed a response of some sort… you had a mayor (Philip Owen) who was willing to go out on a political limb, you had a community that was very organized and were calling for change, which you have now too. And you had leadership at all levels of the community, from the people on the street to people at city hall to people in the provincial bureaucracies to federal bureaucrats in Ottawa, who were pushing for a new approach.
Metro: Today we have a spike in opioid overdoses, because of the addition of fentanyl to most street drugs. What was the crisis in the late 1990s?
MacPherson: The crisis then was very similar. It was an overdose epidemic across British Columbia. It was an HIV epidemic among intravenous drug users, and it was a toxic drug supply in the sense that the heroin that was being used at that time was way stronger than people were used to.
Metro: With the overdose crisis, we have seen more people speaking out in support of legalizing or decriminalizing drugs, like Dr. Perry Kendall, B.C.’s provincial health officer, and Dr. Patricia Daly, chief medical officer for Vancouver Coastal Health, and the City of Vancouver as well. How important are those groups and who else needs to join?
MacPherson: We need people in positions of power within the health field, but not just the health field. It would be great if police would speak out and say we need to try a new approach. The premier, the minister of health, the minister of mental health and addictions, they need to embrace this way of thinking to.
Metro: How do you respond to those who fear legalizing or decriminalizing all drugs will lead to a free for all and rampant drug use?
MacPherson: Right now is the free for all. It’s a totally unregulated, unsupervised, uncontrolled market that we know exists in a big way around the world. We’re talking about the opposite: a highly regulated situation where people have access to drugs at known dosage and in many cases supervised use.