Note: This interview has been edited for clarity, readability, and concision.
Scott Douglas Jacobsen: How did you get an interest in Canadian drug policy?
Stephanie Lake: I became interested in Canadian drug policy while I was studying health sciences at the University of Ottawa. I remember writing a paper on supervised injection sites for a sociology of health course, and throughout my literature review, I found myself getting increasingly frustrated at the state of our prohibitive and punitive drug policies which all seemed to be based on ideology rather than evidence. This frustration left me feeling determined to contribute to change in drug policy through health research and advocacy.
Jacobsen: What is your position in the chapter and responsibilities?
Lake: I am currently working with a small group of students to revive CSSDP’s Vancouver chapter. I fell into this role when I came across the CSSDP Vancouver facebook group, and noticed a post from a former CSSDP board member asking if anyone wanted to try and get the chapter going again. I decided to give it a try, and I’m really happy that I did. Right now, since we are a relatively small core group of students (3-4), we all share the responsibility of chairing meetings, organizing events, and growing the chapter. Our chapter is organizing its first event (naloxone training for students and youth in Vancouver). I have also recently joined the national board, where I will be focusing on student outreach and conference planning.
Jacobsen: What is your perspective on the more punitive approaches to drug policy and the harm reduction approaches?
Lake: I think most people know by now that the war on drugs is a failure. Punitive approaches to drug policy just don’t work, and they don’t protect the health and human rights of people who use drugs. Substance use has been around as long as humans have walked the earth, so it is unrealistic to think that we can just abolish such a deeply rooted human behaviour through punitive measures. Instead, we should be supporting the health of people who use drugs through minimizing the potential harms associated with drug use. When we do this, we reduce stigma that is so often linked to drug use, connect people who use drugs to health and social resources, and ultimately protect the health of the entire population.
Jacobsen: What are the consequences on individuals with drug misuse if the punitive issues are employed?
Lake: Since the war on drugs began in the 1970’s the number of individuals in the US who have been incarcerated for drug law violations has gone up more than 10-fold. In other parts of the world, including the Philippines and Vietnam, drug-related offences can even result in the death penalty. These harsh responses to drug use mean that people who use drugs are often pushed underground, where they become disconnected with potentially life-saving health and social supports. Incarceration has been linked to HIV infection (people do use drugs in jails, but they don’t have access to clean needles/pipes because this would require admitting that drugs get into jails), poor HIV treatment access and sub-optimal treatment outcomes, inadequate access to evidence-based addiction treatment (e.g., opioid substitution treatment), etc. Also, once someone goes to jail for drugs, it becomes hard to break the cycle. Many individuals will struggle to find steady employment or decent housing, and risk returning to drug dealing or related illicit activities to support themselves or their families.
Jacobsen: How does this cascade into larger society?
Lake: It is incredibly expensive to incarcerate individuals for drug use, and at the rate we’re going, it also isn’t sustainable. I think the biggest way punitive approaches to drug use can cascade into larger society is through divesting funds from other approaches that could have a positive effect on society. For example, roughly 73% of the previous Canadian federal government’s drug strategy expenditures were dedicated to enforcement, while research, prevention, treatment, and harm reduction were left to share the remaining 27% of funds. When we put so much time and energy into reactionary measures, we are unlikely to address the root causes of the “problem”.
Jacobsen: Who are some researchers in the harm reduction movement who are reliable sources of information?
Lake: When I first became interested in drug policy and harm reduction, I was inspired by the team of investigators at the BC Centre for Excellence in HIV/AIDS who were heavily involved in the evaluation of Insite (Vancouver’s supervised injection site). This includes Dr. Thomas Kerr, Dr. Evan Wood, Dr. Mark Tyndall, Dr. Brandon Marshall, Dr. M-J Milloy, and Dr. Julio Montaner, and many others. I have also spent a lot of time reading Dr. Don Des Jarlais’ research – he was one of the harm reduction pioneers in response to the HIV crisis in New York City in the 90’s. My PhD supervisor, Dr. Jane Buxton, does some amazing work coordinating BC’s harm reduction programming as head of harm reduction at the BC Centre for Disease Control. Tim Rhodes has also done an amazing job conceptualizing a health framework (the Risk Environment) for drug-related health outcomes among people who use drugs. Instead of focusing on individual behaviours, this framework sees drug-related harm as a result of interacting social, physical, policy, and economic states on macro- and micro-levels.
Jacobsen: What about organizations?
Lake: Vancouver has many user-led community organizations (e.g., Vancouver Area Network of Drug Users; Western Aboriginal Harm Reduction Society; BC Association for People on Methadone) who offer a great resource about on-the-ground experience with drug policy and harm reduction in Vancouver. In terms of larger national organizations, I often check out what’s going on with the Canadian Drug Policy Coalition, the Canadian Harm Reduction Network, and the Canadian HIV/AIDS Legal Network.
Jacobsen: Since you’re newer, you have a fresh perspective on the operations of CSSDP. Any areas for improvement for CSSDP? Any areas where things are going well? Also, where do you hope the organization goes into the future for students?
Lake: I have only been involved with CSSDP for a few months, so it is a bit early to say for sure. I am hoping to see communication between what’s going on nationally and what’s going on with individual chapters. It would be great to be part of a movement with all other chapters across the country. I am happy that the organization is supportive of engagement in both higher-level policy issues as well as individual-level interventions. For example, here in Vancouver we are facing an immediate crisis of fentanyl-related overdoses. Although this crisis warrants many higher-level policy discussions about the harms of prohibition and the benefits of harm reduction, the most immediate steps we can take to respond to this crisis is through making sure that students and youth have access to naloxone and know how to use it. I’m glad that naloxone training is within the scope of activities mandated by the CSSDP.
Jacobsen: Any new thoughts or feelings in conclusion?
Lake: I’m very happy that I took the chance to be involved with CSSDP, and I’m really excited to see where this work takes me. My own research focuses on the health implications of cannabis legalization for people who use drugs, particularly in the context of the current opioid crisis. It is a really exciting time to be involved in drug policy in Canada!
Jacobsen: Thank you for your time, Steph.
Member-at-largeScott Douglas Jacobsen researches and presents independent panels, papers, and posters, and with varied research labs and groups, and part-time in landscaping (lifting, mowing, and raking) and gardening (digging, planting, and weeding). He founded In-Sight: Independent Interview-Based Journal and In-Sight Publishing. He is a Tobis Fellow (2016) at the University of California, Irvine’s (UCI) Interdisciplinary Center for the Scientific Study of Ethics and Morality (Ethics Center). He researches in the Learning Analytics Research Group, works as the Gordon Neighbourhood House Community Journalist/