B.C. health authorities tried for four years to create a heroin compassion club whose members could purchase a regulated version of the drug without a prescription, an effort to reduce toxic-drug deaths that was ultimately derailed by political blowback.
Cheyenne Johnson, executive director of the BC Centre on Substance Use (BCCSU), testified to the efforts in British Columbia’s Supreme Court on Monday as part of a continuing constitutional challenge to Canada’s drug laws by Jeremy Kalicum and Eris Nyx.
The two were found guilty in November of trafficking for having operated an unsanctioned illicit drug compassion club from August, 2022, to October, 2023; their convictions are on hold pending the outcome of the challenge.
Lawyers for the pair called Ms. Johnson as one of several witnesses to speak to the extensive legal and regulatory challenges of trying to establish such a program through official channels.
Ms. Johnson was co-author of a 2019 BCCSU white paper that recommended regulated retail sale of pharmaceutical-grade heroin as a way to separate drug users at high risk of overdose from toxic street drugs. She told the court Monday that a BCCSU committee spent the next four years meeting regularly with regional, provincial and federal health bodies discussing how to turn the concept into an operational model.
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At Health Canada, assistant deputy minister Eric Costen in the Controlled Substances and Cannabis Branch expressed interest in the white paper, Ms. Johnson said. He provided guidance on navigating the unique logistical and operational issues of a heroin compassion club, including importation regulations and strict storage and transportation requirements, she added.
Then-deputy provincial health officer Brian Emerson co-ordinated across B.C.’s Ministry of Health, Ministry of Mental Health and Addictions, and Overdose Emergency Response Centre in assisting the committee in its application to Health Canada for the exemption from the Controlled Drugs and Substances Act required to operate the compassion club. Leadership at the BC Centre for Disease Control also advised.
By 2021, various sub-working groups were meeting weekly.
Vancouver Coastal Health and Fraser Health would serve as operational partners, with each health authority operating a program serving up to 100 members each.
The program was estimated to cost about $13-million a year, and generate $4.6-million in revenue, making federal funding through Health Canada’s Substance Use and Addictions Program critical.
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Members would pay a $50 annual fee, and between $7 and $10 a dose, with the idea that requiring members to pay would reduce the likelihood they would sell or give their substances away to unintended recipients, the court heard.
Ms. Johnson said she believed the project ultimately stalled for several reasons. Trying to obtain the drug – first from a Swiss manufacturer, then locally – ran up against several regulatory hurdles. Costs were also becoming untenable; the health authorities worried that the federal funding, if it was approved, would sunset in five years.
“It was quite difficult, in our conversations with our health authority partners, for them to justify continuing the costs of an $8-million program that serves 100 participants,” Ms. Johnson said.
The application was also finalized amid a political environment in which drug use, crime and public disorder were at the forefront. In late 2022 and early 2023, as the committee ramped up briefings with the provincial government, Conservative Leader Pierre Poilievre blasted the province’s drug policies, depicting them as the cause of overdose deaths.
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Tim Dickson, a lawyer for Mr. Kalicum and Ms. Nyx, played a widely circulated November, 2022, campaign video from Mr. Poilievre that featured images of drug use and poverty in Vancouver.
“Stop using tax dollars to fund dangerous drugs under the so-called and ironically named idea of safe supply,” Mr. Poilievre said in the video.
“There is no safe supply of these drugs. They are deadly, they are lethal and they are relentlessly addictive. Giving people more of these drugs will not free them from their addiction, it will only lead to their ultimate deaths.”
Mr. Dickson asked Ms. Johnson whether she saw a relationship between the political discourse and the impact on provincial support for the heroin compassion club model.
She replied in the affirmative, saying there was “a lot more politicization” around pharmaceutical alternatives to illicit drugs, which coincided with “a lack of political interest in pursuing innovation around safe supply.”
“I could see the mounting pressure on the province, in terms of us bringing a proposal to them at that time, when all that discourse was very, very heated,” she said, “which, I think, was ultimately one factor in them not providing us with a letter of support.”