A New Approach to Managing Illegal Psychoactive Substances
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Transcript of A New Approach to Managing Illegal Psychoactive Substances
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A New Approach to Managing Illegal
Psychoactive SubstancesCPHA Conference
May 27 2014
Brian Emerson and Seema Nagpal Co-chairs
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- CPHA Resolutions- CPHA Alcohol and Tobacco Papers
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- Health Officers Council of BC- CPHA Illegal Psychoactive Substances
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Overview of PaperPurpose: –Review available information –Identify options–Provide recommendations and–Stimulate discussion Leading to a public health
approach to managing currently illegal substances.
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Overview of paper - continued
Foundational conceptsPublic health importance illegal
psychoactive substancesPolicy Approaches Criminalization and
prohibition; State Control; Commercialization; Prescription
Harms of prohibition & criminalization Public Health Approach – Framework
and examples
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Barriers and Facilitators to Public Health Shift
• Values and principles • Economics • Infrastructure • Canadian laws and international
conventions • Programs and projects• Leadership • Evaluation • Research
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Overview of paper - continued
Unintended Consequences of shifting paradigms – risk of commercialization
Vision for 2025Framework for Action and
RecommendationsGlossary
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Public Health Approach• Principles based - social justice,
equity, human rights, evidence-informed
• Addresses determinants of health • Organized, multi-level,
mulitsectoral, coherent, comprehensive, efficient, and sustainable
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Public Health Approach (continued)• Recognizes that people use
substances for anticipated and actual beneficial effects
• Attentive to the potential harms of the substances, as well as the unintended effects of associated policies
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• Directional Elements –Vision–Assumptions - explicit–Guiding principles/ethics –Goals and objectives
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Public health framework
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• Strategies – Universal and Targeted:–Health Promotion –Health Protection–Prevention –Harm-reduction–Health Assessment and
Surveillance –Services for people who are at risk
or develop problems with substances. 11
Public health framework
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Framework for Action and RecommendationsAwareness, Information, and Knowledge Analyze political parties positions Develop national research agenda Public awareness campaigns about a public
health approach Encourage research on therapeutic uses i.e.
stimulant substitution/maintenance treatment, psychedelic medicine
Monitor and disseminating information about the changes in other countries
Establish a national monitoring capacity
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Framework for Action and Recommendations
Collaboration on Strategies and Initiatives Collaborate on communications and advocacy Government of Canada should
Move “Anti-Drug Strategy” lead back to Health Canada
Re-instate harm reduction in federal policy Undertake consultations to prepare Canada’s
input to the 2016 UN General Assembly’s Special Session on Illicit Drugs.
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Framework for Action and Recommendations
Primary Prevention - Children and Youth Create a national dialogue about child and youth
health and prevention of problematic substance use
Empowerment, Harm Reduction and Treatment Broadly implement evidence-based harm
reduction measures Meaningfully involve people who use
substances and support development of peer run organizations
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Framework for Action and Recommendations
Stigmatization & DiscriminationImplement anti-stigma and discrimination
strategies
Evaluation Review the Controlled Drugs and
Substances Act
Legislative Change Support regulatory changes for managing
cannabis
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The Paradox of ProhibitionH
ealt
h a
nd
So
cial
Pro
ble
ms
Market Regulation
Illegal Market Gangsterism
Corporate Profit
HeroinCocaine
Tobacco
Alcohol
ProhibitionDefacto
Decriminalization
Decriminalization Prescription Legalize with
Many Restrictions
Legalize with Few
Restrictions
Public Health
CannabisMethamphetamine
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The Paradox of ProhibitionH
ealt
h a
nd
So
cial
Pro
ble
ms
Market Regulation
Public Health
Illegal Market Gangsterism
Corporate Profit
HeroinCocaine
ProhibitionDefacto
Depenalization
Decriminalization PrescriptionLegalize with
Many Restrictions
Legalize with Few
Restrictions
CannabisMethamphetamine
Medical Cannabis
Tobacco
Alcohol
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Key MessagesProhibition & criminalization not
working, creating much harm Public health approach holds
much promise Many lessons to be learned from
tobacco and alcohol experienceMuch to be learned from other
jurisdictions
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Key MessagesManagement of substances - alcohol,
tobacco, pharmaceuticals, and currently illegal substances - is a public health challenge.
Public health needs to step up to the plate to do what it canadvocate for the resources to do morecollaborate with the usual and
unusual partners to shift to a public health model.
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Acknowledgements• CPHA Board and CEO Ian Culbert• Working Group – especially Betsy MacKenzie• Reference Group• Society of Living Illicit Drug Users (SOLID)• Folks at Niva Inc., Anton Holland, for writing and
production• CPHA Staff – Initially Jim Chauvin, subsequently
Frank Welsh, and the dedicated, selfless interns Tasha Shields, Chandni Sondagar, Julia Neufeind, Dominique Morneau; and many others at CPHA.