Improving community health and safety in Canada through evidence-based policies on illegal drugs

Evan Wood, Moira McKinnon, Robert Strang & Perry R. Kendall
Open Medicine Vol 6, No 1 (2012)
March 2012

publicationThe use of illegal drugs remains a serious threat to community health. However, despite the substantial social costs attributable to illegal drugs, a well-described discordance between scientific evidence and policy exists in this area, such that most resources go to drug law enforcement activities that have not been well evaluated. When the Office of the Auditor General of Canada last reviewed the country’s drug strategy, in 2001, it estimated that of the $454 million spent annually on efforts to control illicit drugs, $426 million (93.8%) was devoted to law enforcement.

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The report further concluded, “Of particular concern is the almost complete absence of basic management information on spending of resources, on expectations, and on results of an activity that accounts for almost $500 million each year.” Despite the long-standing emphasis on drug law enforcement, the federal government has recently further prioritized this approach by developing legislation requiring mandatory minimum prison sentences for minor drug law offences. This article reviews the impact of conventional drug policies employed internationally and describes evidence-based steps to reduce the health and social costs attributable to drug policies in Canada.

A call for action

In 2005, as part of the renewal of Canada’s National Drug Strategy, an exhaustive national consultative process led by Health Canada and the Canadian Centre on Substance Abuse culminated in a “national framework for action” to reduce the harms associated with drugs in Canada. This inclusive process, which involved all stakeholder groups, aimed to remove the rhetoric and emotion that have traditionally guided Canada’s response to illicit drugs and instead sought to incorporate the best available scientific evidence into the country’s drug policy. The central aim of the strategy was “to ensure that Canadians can live in a society increasingly free of the harms associated with problematic substance use,” and it differed from the US approach in emphasizing harm reduction.

In 2007, however, the federal government abandoned this framework in favour of a new anti-drug strategy, which removed support for the evidence-based harm reduction programs recommended by the World Health Organization. The new strategy has also supported various drug-use prevention measures that have proven ineffective and potentially harmful elsewhere. Lastly, as described above, more recent plans to enact costly mandatory minimum sentences for drug law violations highlight a complete departure from evidence-based policy-making.

Publications in medical journals often attract transient media attention, but their impact can be short-lived without meaningful debate on the part of policy-makers. We urge that such an informed debate take place without delay to increase the relevance of scientific evidence in drug policy decision-making.