In a bid to combat the escalating crisis of toxic drug overdoses, British Columbia health authorities spent four years attempting to establish a heroin compassion club that would allow members to purchase a regulated form of the drug without the need for a prescription. However, this initiative faced significant political hurdles and was ultimately halted. Cheyenne Johnson, executive director of the BC Centre on Substance Use (BCCSU), shared insights into this challenging journey during her testimony at the Supreme Court of British Columbia on Monday. Her evidence was part of an ongoing constitutional challenge against Canada’s drug laws, put forth by Jeremy Kalicum and Eris Nyx, who are currently appealing their convictions for operating an unregulated drug compassion club.
The Road to Establishment
Johnson’s testimony revealed the extensive legal and regulatory complexities involved in trying to launch the compassion club. This initiative stemmed from a 2019 white paper co-authored by Johnson, which advocated for the controlled retail sale of pharmaceutical-grade heroin as a means of protecting vulnerable users from the dangers of contaminated street drugs. Over the following four years, a committee from the BCCSU collaborated with various health organisations at regional, provincial, and federal levels to transform this concept into a viable operational model.
At the federal level, Eric Costen, assistant deputy minister at Health Canada, expressed interest in the white paper and offered guidance on navigating the myriad logistical issues associated with establishing a heroin compassion club. This included navigating importation regulations and adhering to strict guidelines concerning the drug’s storage and transportation.
By 2021, various sub-working groups had been convened, with Vancouver Coastal Health and Fraser Health identified as operational partners for the programme. The ambition was to cater to up to 100 members each from these health authorities, with an estimated operational cost of £13 million annually, while potentially generating £4.6 million in revenue. This funding would be crucial, particularly through Health Canada’s Substance Use and Addictions Programme, to ensure sustainability.
Financial and Regulatory Hurdles
The proposed model required members to pay an annual fee of £50, in addition to between £7 and £10 per dose, aiming to discourage the redistribution of drugs among users. However, Johnson noted that various factors contributed to the eventual standstill of the project. Attempts to secure a reliable supply of the drug—initially from a Swiss manufacturer and later from local sources—ran into a series of regulatory obstacles. Furthermore, concerns grew regarding the sustainability of the programme’s funding, especially given the uncertainty that federal support would last beyond five years.
“It was quite difficult for our health authority partners to justify the ongoing costs of an £8 million programme serving just 100 participants,” Johnson explained. The situation was further complicated by a political climate that increasingly framed drug use as a primary concern linked to crime and public disorder. As discussions intensified within the provincial government in late 2022 and early 2023, Conservative Leader Pierre Poilievre harshly criticized the province’s existing drug policies, linking them directly to rising overdose fatalities.
Political Backlash and Its Impact
During the court proceedings, Kalicum and Nyx’s lawyer, Tim Dickson, presented a widely circulated campaign video from Poilievre, which depicted scenes of drug use and poverty in Vancouver. In the video, Poilievre asserted, “Stop using tax dollars to fund dangerous drugs under the so-called and ironically named idea of safe supply. There is no safe supply of these drugs. They are deadly, they are lethal and they are relentlessly addictive.”
Johnson acknowledged the impact of such political rhetoric on the provincial government’s willingness to support innovative approaches to drug supply. She observed a noticeable increase in the politicisation surrounding pharmaceutical alternatives to illicit substances, coinciding with a decline in political enthusiasm for pursuing innovative solutions to drug addiction.
“There was a lot more politicization around this issue, which I think played a crucial role in our inability to obtain the necessary letter of support from the province,” she stated.
Why it Matters
The challenges faced by the proposed heroin compassion club in British Columbia underscore the broader difficulties in addressing the opioid crisis through innovative healthcare solutions. As political discourse continues to shape public perception of drug policies, the potential for effective harm reduction strategies becomes increasingly jeopardised. The stalled compassion club initiative highlights the urgent need for a balanced approach to drug use—one that prioritises public health and safety over punitive measures—if we are to make meaningful progress in reducing overdose deaths and supporting those struggling with addiction.
