Toronto doctors call for legal drugs

Needles and trash located near Toronto Public Health's safe injection site at Dundas and Victoria Sts. (Dave Abel, Toronto Sun)

Originally published in the Toronto Sun July 18, 2018

Toronto’s Board of Health voted Monday to ask the federal government to decriminalize possession of all drugs for personal use, and to convene a task force to explore options to fully legalize and regulate all drug use in Canada.

Calling on government to change drug laws is politics, of course, not medicine. But, politics is what Toronto’s Medical Officers of Health historically do. If only their politics had broad public support.

Who benefits from this proposal?

Well, first and foremost: the people who make a living off the misery of drug addicts. Drug addicts may also benefit, of course. I believe it makes sense to treat drug addiction as a medical issue … but, only if governments are going to fund treatment for it.

Without those treatment options, this proposal by the Board of Health is just political puffery that won’t help a single addict.

Why would the Board of Health recommend this?

The board is composed largely of politicians and wannabe-politicians — only two its 11 members are health professionals. They adopted a recommendation made by Toronto’s Medical Officer of Health Dr. Eileen de Villa in a report stating, “the evidence on the health and social harms of our current criminalization approach to illegal drugs … strongly supports the need to shift to a public health approach.”

That public health approach being: to make all drugs legal to use and possess in small quantities.

According to Dr. de Villa, “Torontonians agree the current approach is not working, and we should treat drug use as a public health and social issue, not a criminal issue.”

There you go. This was your idea! To prove it, she points to a four-part “Community Dialogue” process that showed strong public support for decriminalization.

Or, did it?

The dialogue included community sessions where 60 people participated – mostly drug users, friends and family of drug users and professional drug-huggers.

Almost 350 people completed an online survey — people who self-selected to participate because they were aware of it and had a personal interest in the subject.

A third group of 20 people with “lived experience” — in other words, drug users — were interviewed.

Finally, 503 people selected to represent the demographic make-up of the city were surveyed by Ipsos Public Affairs.

Only the last group, the representative sample designed by a credible research firm to represent a typical cross-section of Toronto residents, generated statistically valid data. All the other groups were, by design, biased.

Not surprisingly, the representative sample yielded different results from the biased groups. They were less supportive of legalization, although you wouldn’t know that to read the Medical Officer’s report. You have to dig into the data to find the facts.

When asked whether Canada’s current approach to drugs is working, two-thirds of the representative sample agreed it was working well or somewhat well. Less than a third felt it was not working.

This contrasts with 78% of the self-selected groups of people involved in the “drug sector” who felt the current approach is not working. The Medical Officer of Health glossed over this difference in her report, summarizing the results by saying Torontonians told her “Canada’s current approach drugs is broken.”

Hardly supported by the data.

Even though the representative sample appears to be statistically valid, the survey questions seem to have been designed to prompt support for legalization.

“As far as you know, what are the negative health and social effects of the Canadian laws that make it a crime to possess certain drugs for personal use?”

“Research has identified a range of harms caused by our drug laws…”

These preambles suggest current laws have negative effects.

After another leading preamble, the final question asked: “Some people feel Canada should take a public health approach to drugs … To what degree would you support a public health approach to drugs that are illegal now?”

Sixty-one per cent of the representative group agreed. That’s 32% more than even thought there was a problem in the first question.

Just goes to show how easily it is to shape a desire outcome by asking the right questions. But, it doesn’t convince me that’s “strong support for a public health approach to drugs,” as claimed by the Medical Officer of Health in her report.

Dr. de Villa may be right. But her report is far from convincing.

Then again, public health is about politics, not medicine.

And, politics is about perception, not facts.