Four years ago, I walked through Vancouver’s Downtown East Side to tour the collateral damage from the war on drugs.

Like San Francisco’s Tenderloin, the neighbourhood has become a safe haven for drug users and unhoused people. It has become a community like few others, where drug users cohabitate and the principles of harm reduction are really put to the test.

I went back to Hastings Street last week, on the eve of a massive shift in how that war on drugs is prosecuted. It’s easy to understand how those rival pictures came to be. In the middle of the day, it’s not unusual to see paramedics administering naloxone on the sidewalk, a teenager who should be in school slumped over a park bench, a gaggle of tents occupying a public park. A few blocks away, in a sea of well-kept semi-detached homes, an empty plot of land sells for $1.3 million.

The Downtown Eastside has become a symbol of failure: Of housing, of social services, of addiction counselling, of everything. Stare a little closer, though, and the DTES is a portrait of resistance and perseverance. An area that refused to be ‘cleaned up’ — a euphemistic way of describing how to displace, disperse, and isolate human beings. It has led a movement to reimagine how we deal with drug use and addiction. It’s a movement that has radically shaped politics in British Columbia, Canada, and across North America. Those policies, to which politicians had to be dragged into adopting, have saved an inestimable number of lives.

On January 30 31, Vancouver and British Columbia will join Oregon as the only jurisdictions on the continent that have fully decriminalized drug possession. It’s been a long time coming. (An earlier version of this newsletter said decriminalization begins on January 30. In fact, it began on January 31. I forgot how many days were in the month.)

While in Vancouver this week, I sat down with two people who were uniquely responsible for this culture shift.

Kennedy Stewart is a former member of Parliament and mayor of Vancouver. His four year term, which ended in his defeat last year, was marked by an aggressive housing plan and a push that ultimately cajoled to the federal and provincial governments to adopting decriminalization. That experience will be detailed in his upcoming book: Decrim. We met up for sushi at a busy lunch spot in downtown Vancouver.

Garth Mullins is a longtime drug user advocate, host of the (excellent) Crackdown podcast, and organizer for the Vancouver Area Network of Drug Users (VANDU). His work has helped give drug users and residents of the DTES political power and agency. I met him at the VANDU offices, where volunteers quickly armed me with some recently-fried bannock, which they had prepared for the memorial of longtime activist Flora Munroe.

This Bug-eyed and Shameless dispatch features excerpts of my conversations with Stewart and Mullins. My questions are italics. They have been liberally edited for length, legibility, and clarity — while still preserving the original intent of the comments.

In 2021, British Columbia hit a staggering milestone: For every 100,000 people in the province at the start of the year, 44 would be dead of an opioid overdose by the end. It was the deadliest year on record for the province’s drug crisis: 2,293 people lost their lives.

South of the border, only a half dozen states saw more severe mortality rates. More than 100,000 people die per year in the United States from drug overdoses, mostly due to opioid poisonings.

There had been considerable optimism last year that the tide was finally set to turn on the opioid crisis. People pointed to the proliferation of safe consumption sites, in some jurisdictions more than others; the wide availability of overdose-reversing drug naloxone; better support services; more visibility and awareness; and a stabilization of the drug supply as evidence that the worst could be behind us. Often unsaid was a belief that the drug user community had been so decimated that there was fewer people left to kill.

That hope was dashed as the year dragged on: From January to October of last year, 1,827 people had died of drug overdoses in B.C. — almost exactly the same number as the year before. Provisional CDC data shows hard-hit states are seeing more overdose deaths, not fewer.

Going back three decades, overdose deaths in North America have, generally, not been a function of the number of people using drugs but of the potency of the drugs they use. Normally, those changes were in the purity of heroin. With the advent of synthetic opioids, however, the math drastically changed. Oxycontin and, later, fentanyl are cheap, easy to transport, and incredibly strong. A tiny miscalculation or accidental contamination could mean death. More than an overdose crisis, it has become a poisoning epidemic.

What's the trend been like over the last three years? We know that everything kind of went haywire during the pandemic — supply chains backed up, there was floods of stuff, and there were shortages. We always talk about things just sort of flat terms, but that's not how it is, right?

Garth Mullins: The drug war never stands still. For my whole life. It's been getting stronger and more unpredictable. When it became illegal in 1908, people were just smoking opium. I survived the overdose crisis in the 90s when heroin suddenly got super strong — they called it China White. So It's like always been on this march to stronger and more unpredictable. The police go crack down on heroin, right? That opens up this vacuum and fentanyl comes in. Then come the border disruptions with the pandemic. And that lets these benzo-like substances come in. So the next thing is xylazine, which is a tranquilizer — it’s used for tranquilizing horses and cows and shit like that. And it causes just fucking brutal overdoses with seizures and these crazy necrotizing wounds. It's just starting to arrive here. Every day, every year that we don't stop the war on drugs, it gets worse. People learn how to find a little bit of equilibrium, or a little bit of safety, then it changes, and you lose that.

What’s the state of the drug supply right now?

GM: Most of the dope in Vancouver right now is garbage. I wouldn't touch it. Most of it’s full of fentanyl analogs or opioid analogs and benzodiazepine-like substances — between a third and half of it tests regularly for these benzodiazepine-like substances. But heroin is very rare. So it's hard to find here.

Benzos are a different type of drug than opioids. Together they have a synergistic effect. You're not intending to knock yourself unconscious, or even into an overdose, but that's what can happen frequently. So it makes the overdose more complicated. And Naloxone doesn't work on the benzo part of that overdose. You give the person Narcan [naloxone] anyway. And they come back, but not all the way. So they start breathing again, but they're unconscious and you just have to monitor their breathing. Sometimes, for hours.

Throughout the war on drugs, users in Vancouver were the insurgency. It was in the 1990s that organizations like VANDU began to exercise political power. They began setting up places where people could use in common company, and get help if they needed it (safe consumption sites); they scored alternatives to help each other move off more unpredictable street drugs (opioid agonist therapy); and they sourced a dedicated supply of street drugs that they could, where possible, test and vouch for the potency of (safe supply). The war on drugs met each of these tactics with more police raids and more criminalization.

It took decades, and scores of deaths, but three tactics have slowly become official public health policy in British Columbia and, to a more limited extent, the Government of Canada. Those strategies have saved thousands of lives. But a continued belief that drugs must be an inherently criminal domain, coupled with political cowardice, has kept progress moving at a glacial pace.

The federal government loves talking about safe supply programs. Right? If you push them on the opioid crisis, their immediate response is: ‘Well we've been doing all this safe supply stuff, opioid agonist therapy.’ How effective has have the pilot projects been?

Garth Mullins: Well, I gotta say, the availability of hydromorphone is good. I'm glad that's out there. I'm glad that people can get it cuz some people are able to separate themselves from the street supply with that. Hydromorphone is not perfect, but it’s not a bad substitute for heroin, for fentanyl. It's like trying to say to someone: ‘Instead of drinking a pint glass of tequila, have a Coors Light.’ It just ain't up to it. So it's hard. And that's mainly the thing that's called ‘safe supply’ by the state. This word was invented by us, the drug user movement, and we mean: If you're wired to heroin, here's prescription heroin. If you're wired to fentanyl, here's prescription fentanyl. And you can use it just in the same way you would have the other stuff. You don't have to go and be observed. You don't have to do appointments. The point is just to substitute the deadly thing for the known thing.

The feds says they have sourced heroin.

GM: For 100 people at Crosstown. It’s been that way for 15 years.

Since the 90s, drug users have kept a constant line: None of these strategies can truly be effect while criminalization continues.

In 2020, drug users in Oregon scored a huge victory: Voters approved a ballot measure to decriminalize hard drugs. Two years on, deaths are continuing to mount and there are fears that the system has been overwhelmed by those seeking help, but there are reasons to be optimistic.

In 2021, Vancouver followed suit. Mayor Kennedy Stewart put in an application to the federal government to exempt itself from criminal law on drug possession.

Apart from Oregon and Portugal, this has never really done before. So this feels like a rare time where the government is going: We've been doing this thing that hasn't been working for a long time, let’s stop doing that, and hope it gets better.

Kennedy Stewart: I see it unfolding in a different way, mainly because the prime minister said twice right to my face that he was never going to do it. It was political maneuvering that got that to happen. I think it was all a bluff from every side. The Prime Minister was very clear: No. The province kind of pushed for it, but said: ‘Well, we need the feds to do it.’ So they didn't have any authority to do it, but it was great cover for them, as overdose deaths spiked. The police said: ‘Well, we already kind of decriminalize, because we don't arrest as many people as we used to.’ And so what it took was for the City of Vancouver to actually submit an application to decriminalized and then Health Canada accepted it. Then, somebody had to make a decision.

I'm telling you, the minute we submitted, the bluff was called. Then, things started to change. Once the minister had it in front of them, they had to say: ‘No,’ or ‘Yes.’ And this caused all kinds of consternation everywhere. And I said: ‘Well, just imagine what your letter to me is going to look like, declining this application.’ Then the federal government started talking to the province saying: ‘Well, we like Vancouver's application.’ And then the province panicked and put together their own application.

I have no authority, right? I don’t control healthcare, I don’t control the police. But it's poked a hole in the dam.

Listen to Kennedy Stewart talk about the road to decriminalization. (Apologies for the poor audio quality.)

Even as drug user advocates have made gains, a backlash is brewing. Critics of safe supply and decriminalization have pointed to the continuing death toll as evidence that this experiment has failed. They have also weaponized misinformation to denigrate harm reduction as the religion of the woke and soft-on-crime.

Police have, intentionally or not, spread the entirely baseless idea that they are at risk of overdose by merely touching drug users and their drugs. Fox & Friends have argued that it’s cannabis legalization that has driven the tainted drug crisis. Failed Successful senate candidate J.D. Vance has touted the idea that fentanyl is being deliberately let into the United States in order to kill Trump voters, an even-more deranged take on the white supremacist great replacement theory.

There’s a big problem with the right-wing, tough-on-crime, close-the-borders rhetoric: Fentanyl is being made at home.

The abolitionist camp always puts forward the idea that we can solve this if we interdict supply — like, oh, god, we didn’t we think of that, right? — but did you get a sense of where it’s coming from?

Kennedy Stewart: It's just being domestically produced, now. It was coming in from China, originally. [And still is.] Someone once told me you can get 50,000 doses in an envelope. And the factories there are so unregulated. Jane Jacobs has this theory called import replacement theory — you import stuff, it's expensive, and you start to produce it domestically, then export it, and then that builds your local economy. Well, that's what's happened. So that's when you actually might find stabilization in deaths, eventually, if you can find a way to stabilize the supply and make it consistent.

Few politicians have taken on the issue with more intensity than Conservative Party of Canada leader Pierre Poilievre.

For Poilievre, the opioid crisis is proof positive that “Canada is broken.” In a wildly-seen video, Poilievre sits on a Vancouver beach, right in front of a huddle of tents. "Another tent city," he says.

Pierre Poilievre @PierrePoilievre

Everything feels broken. But we can fix it.

2:08 PM ∙ Nov 20, 2022

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14,696Likes3,774Retweets

He points to Los Angeles, Portland, Seattle, San Francisco, all of which tried this safe supply strategy, “always with the same results.”

Poilievre’s plan is, essentially, prohibitionist. Put users in treatment, and arrest dealers. “We must protect the lives of users, but also provide them with a path to a drug-free life,” he wrote in the National Post. It’s an argument that was recently laid out by Marshall Smith, chief of staff to the premier of Alberta, which has taken a treatment-first approach, at the expense of other harm reduction measures.

The Line

Q&A, Part 1: 'It’s the furtherance of a highly liberalized drug legalization agenda.'

Read more

2 months ago · 73 likes · Line Editor

He makes the argument that Alberta has ramped up capacity in its treatment system whereas British Columbia, largely, has not.

Kennedy Stewart: The weird thing is: Either or? What? Why either, or? Of course, treatment beds. But what if only 10% of the people that you're serving are going to ever stabilize to a point where they're not using, or using as much? There are simply people that are not going to actually just stop using drugs, right? Look at ‘dry January.’ For people, with a legalized drug, it’s like: ‘Oh, man, can I do it? I can’t do it.’ Imagine if you're using an illicit substance that's highly, highly, highly addictive.

There’s absolutely truth to the idea that better mental health support could reduce drug dependancy. PTSD, in particular, is a huge driver to opioids — Mullins counts himself in that camp. A decade ago, he got a unionized job with mental health benefits, which was a game changer. Not everyone is that lucky. But that doesn’t mean you can pathologize all addiction on the same way. And many are happy to create a horrific depiction of users as immoral zombies.

Garth Mullins: People, including the new premier Dave Eby, are much more like: ‘Re-open Riverview!’ which is the old asylum. This narrative has sunk its roots really deep. It's all up and down the West Coast. You know, Michael Shellenberger’s book, San Fran-sicko, it says: ‘The reason all these cities are dying is because progressive policy has coddled criminals, drug users, and homeless people, who just want to do drugs in the street, blah, blah, blah, blah.’ All that shit, right? But that narrative is so wrong because just like in Vancouver, there are little pilot projects, little things that don't even dent the main problem, but they allow the right to take them as units of propaganda in order to say: ‘Look at all this look at all this coddling!’

Poilievre’s whole line is: ‘Canada is broken.’ Shellenberger does the same thing.

GM: Ironically, he's right! Things are broken! So the Liberal and, to some extent, the NDP narrative here is: ‘No, no, everything's fine,’ or: ‘There's a few things in work. Don't worry. We're tweaking the knobs.’ It just doesn't resonate with people. People in the center, they'll be in the center of whatever it is. So if you have two poles — ‘total fucking apocalypse’ and ‘crisis’ — liberals will be like: ‘We're happy with somewhere between the two.’

What does a modern treatment facility look like?

GM: The abstinence-first facilities do say that substance use disorder, addiction, is a chronic relapsing disease. You have it for your whole life, but you relapse. So it's a symptom of the disease to relapse, to use again, but if you express that symptom of the disease, they will kick you out. So the first thing you have to do, before you get into one of these places, is to detox. That's very hard to do. There's only one place in Vancouver that will take you if you have benzos on your system — and everybody does now. Even then, you have to go on a waiting list for three to six weeks. There's too many hoops, right? Even if you could go right away, treatment right now is kind of like this wild west. It's mostly imagination. It’s something for the voters. The imagination stops with ‘a bed.’ Like: ‘We can get them from pooping on our front lawn to having a cup of cocoa and going to bed.’

People have been writing books for a hundred years, probably more, asking: ‘What is addiction? What's the cause? How you fix it?’ Fuck me, I don't know. But the thing that's happening right now is not a problem of people being addicted or using drugs, it’s a problem of people dying. So triage says you have to stop the dying before you even think about the next thing.

Garth Mullins explains the tricky matter of addiction counselling

It seems increasingly obvious that the biggest threat to these strategies will be a rise in crime. That’s what happened in San Francisco, where district attorney Chase Beaudin was ousted amid sicko-style backlash. In Oregon, Republicans have mounted the case that decriminalization has made cities fundamentally unsafe. Some preliminary data from that state, however, blows a hole in that idea. There was no rise in 911 calls after decriminalization, researchers found.

But the Downtown Eastside is forever held up as a problem that needs fixing. People don’t like the actual solutions, however. But the city, writ large, is growing increasingly expensive. More and more people are winding up in that neighborhood with nowhere else to go — and that’s putting pressure on the whole city, particularly neighboring Chinatown. That, in turn, ramps up the political pressure to do something. But in a city where huge pockets of home-owning NIMBYs don’t want density, ‘something’ usually means more cops, not more homes.

Vancouver obviously has a particular, unique experience, when it comes to Downtown Eastside, right? It gets held up as the example, apart from San Francisco — what happens when you let drugs run amok, and the city has no law, yada, yada, yada. But people that are not necessarily wrong. The Downtown East Side is...

Kennedy Stewart: It’s what happens when you commit genocide. 40% of the folks living on the street, are Indigenous. They don't respond well to police or traditional institutions. Why would they? But we just kind of leave that racialized part out of it. Until you understand your clients, you're never going to help them get to a better place. There's also a split in cities. People drive down Hastings Street and some think: How do I help that person? Other think: How do I clean this street up? That is very real. I fear in Vancouver, we've moved from a place of experiments to a cruel place. And I think a lot of cities are swinging that way.

Stewart ran on an ambitious — some say, impractical — plan of building 20,000 new housing units a year. That sort of policy, without a doubt, would alleviate pressure on the DTES, far more than cracking down on drugs. Ken Sim, the man who defeated Stewart and is now mayor of Vancouver, has been less ambitious in housing construction goals. He’s also been relatively mum on decriminalization, although his party recently went out of their way to yank a city grant to VANDU.

While decriminalization feels like a massive step, it can’t be the final one.

There's a feeling of like criminalization at the level that we're being decriminalized without the sort of wraparound supports — I mean that both in terms of treatment beds but also the safe supply question. Without this being a national project, one that figures out supply, it's sort of only half the solution.

Kennedy Stewart: It can't make it any worse. One drug user advocate was talking to me, he painted this picture for me: Lots of his lots of friends are in and out of Vancouver jail. He said, he can't wait until February 1, when one of his friends goes to jail for shoplifting or whatever, with heroin in his pocket. They release him the next day, and they have to give him his heroin back. So the big thing about this is that the seizures will stop. And that is not discussed. The police still seize a ton of drugs. And so if you're a sex worker, you're out on the stroll, doing something, and police stop you, they seize your drugs. So if you have to score, you're pushed into a very risky behavior.

So even if it doesn't increase a safe supply, it decreases the interdiction of existing supply.

KS: And it gets the police out of the lives of drug users. There's maybe 10,000 regular hard drug users in the city, they're all going have to get supply. And then there's a partiers on the weekend. So you're a dealer, you've got a large quantity, but you have no idea what's in it. You can take your two and a half grams and go down to a testing site, and you can find out what your larger batch has. You can say: ‘Holy shit, it’s three quarters fentanyl.’ You can at least tell your buyers what what you're getting.

The next steps, if decriminalization is ever really to work, need to account for that safe supply question. There needs to be a way for users to get drugs that aren’t supplied by biker gangs, international drug traffickers, unreliable domestic producers, and street dealers. Buyers’ cooperatives were instrumental in reducing overdose deaths in the 1990s, and they could be instrumental in helping users avoid overdose today.

Is there hope that it's going to encourage more buyers cooperatives?

Garth Mullins: Buyers cooperatives are still illegal under this decriminalization scheme. So if I was to go out and get two points for you and me to use — it’s a very small amount, a tenth of a gram — well under if I gave it to you, I would instantly be voiding the decriminalization. I would be dealing or sharing. As an organizer, I have my eye on what we need and how to get there. So I'm constantly going to put the pressure on. Kennedy Stewart probably feels like people like me are ingrates, or even like angry children stamping their feet because we didn't get our way. But that's not it. You have to say: ‘Yes, this was good.’ But you also have to know the state will seize any unit of your acknowledgement and use it for its own purposes.

Kennedy Stewart — and this is not dig at him — but he has the luxury, now, of going back to teaching. He gets to go: ‘I took a step forward. People on both sides hate me but, you know, I did my job.’

GM: I don't hate Kennedy. Stewart. I understand, structurally, what position he was in. My job is to light a fire and constantly be putting gasoline on it, under the mayor’s chair. I voted for him. Because there was no alternative. He was the one guy offering to do something about decriminalization, and backing safe supply. The rest of them were just like: ‘Hire more cops to solve this.’ Kennedy Stewart said: ‘We ought to freeze the police budget, and hiring more cops isn’t going to solve this problem.’ For a mayor of this city to get offside with the cops is fucking unheard of and goddamn courageous. So I salute him for that.

Walking down Hastings Street, it’s hard not to feel uncomfortable. Many people are in despair. There are teens there, who should be enjoying the best years of their lives. You feel helpless.

But there’s also a tremendous feeling of community. People are helping each other, looking out for each other. They're fighting for each other. Addiction is a hell of a thing, and fentanyl is a hell of a drug. There’s no policy out there that will magically cure addiction, or make fentanyl disappear. There’s no humane solution that will ‘clean up’ or ‘take back’ this street. We’ve tried, for more than a century, threatening and cajoling people into stopping their addiction. It hasn’t worked. It’s time to try something else.

On the way to meet Mullins, I spotted a hand-painted sign above a huddle of tents:

“Safe supply, or we die.”