Agenda Index City of Vancouver

ADMINISTRATIVE REPORT

TO: Vancouver City Council

FROM: City Manager, in consultation with the General Manager of Community Services

SUBJECT: Drug Policy Coordinator

RECOMMENDATION

COUNCIL POLICY

Establishing of new positions needs Council approval.

PURPOSE

The purpose of this report is to seek Council's approval for a new position of Drug Policy Coordinator to support the development and implementation of a comprehensive substance misuse strategy for the City of Vancouver. The objective is to provide the leadership necessary over the next three years to ensure that drug policies and the implementation of new initiatives in the area of substance misuse are developed and coordinated with other government and community processes.

BACKGROUND

The serious health problems experienced by drug users including HIV/AIDS, hepatitis C, and other infectious diseases have had devastating effects on many Vancouver residents and their families. Between 1990 and the year 2000 more than twelve hundred people have died in Vancouver from drug overdoses. The rise in drug-related crime throughout the last 10 years has had a negative impact on the perception of safety in the Downtown Eastside area and in the rest of the city. Enforcement efforts alone have not been able to provide lasting solutions to illicit drug-related neighbourhood problems.

The significant growth of the drug problem in Vancouver has not been accompanied by a substantive increase in services to aid people with drug-related problems or addictions. Many would contend that had drug treatment programs, health services and other social supports targeting drug users kept pace and been responsive to the change in drug use patterns in Vancouver the serious health and public order issues that we now face may have been avoided.

i) A Changing Drug Market

In the late 1980's significant changes occurred in the illegal drug market that brought a new level of drug selling, drug consumption and the attendant negative impacts of the drug scene on individuals and communities in Vancouver. A number of social and environmental factors contributed to creating the conditions for a burgeoning drug market in the Downtown Eastside. Poverty, de-institutionalisation of the mentally ill without appropriate supports in the community, substandard housing, high unemployment, pressure from neighbourhoods surrounding the inner city to move sex trade workers and street drug dealers out of these neighbourhoods, have all contributed to the growth of the inner city drug market.

The introduction of large quantities of inexpensive cocaine and a steady supply of cheap and highly potent heroin has lead to a new level of open drug consumption in the city. The change in availability and cost of heroin and cocaine combined with the flight of legitimate businesses from the area created conditions for an entrenched street drug scene in the Downtown Eastside. The deterioration of the alcohol and drug service system in the 1980's ensured an inadequate response to the situation. The results had a negative impact on the entire city and the neighbourhood became a magnate for those outside of the Downtown Eastside who used illicit drugs.

The negative impacts of changes in the drug scene on Vancouver have been dramatic. The growth of a flourishing market for heroin and cocaine has brought international attention to the city. Residents of neighbourhoods throughout the region have grown fearful of drug dealers, drug users, drug paraphernalia and drug related crime.

ii) Analysis of the Problem

Throughout the 1990's there has been a growing analysis of the problem of substance misuse in the British Columbia. A substantial amount of research has been conducted and several reports have been produced that recommend a wide range of actions that could be taken to improve the ability of governments, service providers and communities to respond to the serious impacts of substance misuse. Recommendations have included the following: shifting the emphasis from treating substance misuse as a criminal matter to viewing it as a health issue, the reorganization of addiction services within the relevant Provincial Ministries, significant expansion of services for drug users, looking at new and innovative programs, and the coordination of efforts among the three levels of government toward developing a comprehensive substance misuse strategy for Vancouver.

There are many views on how to proceed to address the issue of substance misuse in the Downtown Eastside. While the goal of reducing the harm to individuals and communities by substance misuse is a common goal of most individuals and organizations, the measures to achieve this goal are often the subject of intense debate. The polarization of this debate has become one of the barriers to moving forward.

Chief Coroner's Report, 1994 - The Cain Report

In 1994 the Chief Coroner of British Columbia, Vince Cain, released a broad analysis of the extent of the substance misuse problem in the province. The study was a response to the severe increase in the number of British Columbians who suffered fatal drug overdoses during 1993. Fatal drug overdoses increased in Vancouver from 18 in 1988 to 200 in 1993. Between 1993 and 1999 there was an average of 145 drug overdose deaths per year in Vancouver.

The Cain Report outlined the vast amounts that were being spent on the drug problem within the criminal justice system with little or no effect on improving the situation. The report called for a significant shift in attitude among policy makers in the province. Cain articulated that the misuse of heroin, cocaine and other drugs was primarily a health issue and listed a series of 62 recommendations to address the serious damage to both society and addicts that the misuse of drugs was causing. Few of Cain's recommendations have been implemented to date.

Provincial Health Officer's Report, 1998 - "Pay Now or Pay Later"

In 1998 the Provincial Health Officer for British Columbia, Dr. John Millar released his report, "Pay Now or Pay Later" which outlined the causes of the current epidemic of injection drug use in British Columbia. The causes include the following:

· Failure to provide optimal environments for young children thus increasing the likelihood of developing substance abuse problems later in life.
· Inadequate provision of care for the chronically mentally ill.
· Availability of inexpensive heroin, often in unexpectedly high concentration, and cocaine for injection use.
· The illicit nature of drug use forcing users to criminal activity and jail.
· A persistent societal attitude that forces intravenous drug users to the margins of society where they are compelled to live without adequate housing, food, health care, and social supports.
· Inadequate provision of and capacity for addiction treatment for intravenous drug users.

Millar's report outlined a series of recommendations that focused on increasing coordination of service planning, increasing services to the mentally ill, increasing addiction services, improving access to services and developing new and innovative approaches such as tightly controlled medical prescription of heroin and a drug court pilot program. Millar argued that the increased expenditures would pay for themselves in the short term and lead to large cost savings in health care and the criminal justice system in the long term.

iii) Vancouver Richmond Health Board/Ministry of Health Response

By 1995-96 the epidemic of injection drug use and the epidemic of HIV among injection drug users in the Downtown Eastside had reached grave proportions. In the spring of 1997 the Provincial Ministry of Health responded with an allocation of three million dollars for the expansion of existing services for intravenous drug users in the Downtown Eastside based on a report by Dr. Penny Parry. The report "Something to eat, Somewhere to go, and Someone who gives a damn" outlined an urgent need for action and called for a range of expanded services in the Downtown Eastside, better coordination among Provincial Ministries and a significant increase in resources throughout the region to address the problem.

In October of 1997 the Vancouver Richmond Health Board (VRHB) announced a public health emergency in Vancouver of the transmission of HIV among injection drug users. An HIV action plan was developed that covered five strategic areas:

· Improve access to health services
· Enhance community response to the epidemic
· Strengthen community collaboration and accountability
· Address the basic determinants of health
· Advocate for inter-sectoral action for health

Building on the HIV action plan in 1999 the VRHB developed the "Integrated Health Approach to the Downtown Eastside" which outlines the immediate steps that must be taken in the areas of primary heath care, alcohol and drug services, communicable disease control and housing. The recent transfer of responsibility for adult alcohol and drug services to theVRHB from the Ministry of Children and Families has further enhanced the VRHB's ability to develop a local response to the current situation.

iv) The Vancouver Agreement

In February of 2000 City Council approved the Vancouver Agreement. The Agreement provides a framework for the Municipal, Provincial and Federal Governments to work together to address some of the serious issues within the Downtown Eastside of Vancouver. Three broad areas of work are outlined in the Agreement:

· Community Health and Safety
· Social and Economic Development
· Community Capacity Building

Within the area of Community Health and Safety, City staff are engaged in discussions with Provincial and Federal counterparts and the community toward developing a Comprehensive Substance Misuse Strategy for Vancouver.

DISCUSSION

The City has recognized the need at this time for a much higher degree of leadership and coordination of efforts in order to address the serious drug problems that Vancouver presently faces. The current inner city drug scene is a product of many years of uncoordinated initiatives and under funded addiction services. Many reports have been done, little action has been taken and new initiatives are in their formative stages. A dedicated staff resource is needed to enable the City to take the leadership necessary to facilitate the development of a comprehensive approach to substance misuse in Vancouver. A coordinated analysis and response to the open drug scene in the Downtown Eastside must be developed. In cities that have been successful in minimizing the harm to individuals and communities caused by the use and sale of illicit drugs coordination of municipal resources with enforcement efforts, health services and senior government initiatives has been crucial.

The new staff position with the title, Drug Policy Coordinator, will report directly to the General Manager of Community Services. Working at a senior level the Drug Policy Coordinator will advise Council, the City Manager and the General Manager of Community Services on developments in drug policy on a regional, national and international level. The position will play a lead role in the development of a coordinated substance misuse strategy among the City of Vancouver, Vancouver Richmond Health Board, Police, Vancouver School Board, Provincial and Federal partners and the community.

The multi jurisdictional nature of solutions to the drug problem requires strong working relationships with other levels of government, regional health boards, surroundingmunicipalities, police and the community be developed and maintained in order to build a regional approach to the issue of substance misuse over the next three years. By providing the leadership to coordinate efforts in Vancouver we send a strong message to surrounding municipalities that they too must begin to deal with substance misuse in their cities.

Vancouver bears the major burden of the regional drug problem and therefore must fully participate in strategies to reduce the consumption of drugs in the city and reduce the numbers of individuals coming into Vancouver to participate in the drug scene. The notion that cities must take the leadership to address their drug problems is common in Europe and gaining currency in Canada and the United States. Cities need to develop strategies that fit the specifics of their local environments. The Drug Policy Coordinator will work closely with individuals, organizations and businesses in the community, police and government to develop local strategies.

The past 10 years have seen many resources put into enforcement actions in and around the Downtown Eastside with minimal impact on the drug scene. The open drug scene in the Downtown Eastside is extremely unhealthy for individuals involved in it and for the community. A coordinated strategy to close it must be developed. Inner city neighbourhoods have been inundated with problems associated with the sale and use of drugs and have strongly demanded a comprehensive approach to the problem that moves beyond mere displacement of drug-related activities to other neighbourhoods.

It is clear that a continuum of health services for drug users must be developed in the region and supported by coordinated enforcement efforts. The Drug Policy Coordinator will work closely with the Vancouver Richmond Health Board, the Vancouver Police and the community in developing new initiatives. New health services for drug users must be sensitively placed within a larger city context and balance the need for contact with drug users in the inner city and the desire to decentralize services to increase access to those outside of the Downtown Eastside. Enforcement efforts should complement new public health and social service initiatives and increase the sense of security to surrounding neighbourhoods as well as to those who will use the services.

This new position will ensure that there is coordination of public consultation processes for new facilities and programs targeting substance misuse in the city. Primary health initiatives targeting drug users such as harm reduction programs and drug treatment facilities are often contentious and public consultation and education on locating these kinds of services will be particularly important in the next few months and years.

The City of Vancouver is working on a range of plans in the Downtown Eastside toward creating a healthy and vibrant neighbourhood with a variety of housing options, services and a diverse economic base. Critical to the success of this work is the extent to which we achieve the goal of developing and implementing a comprehensive strategy to deal withsubstance misuse in the Downtown Eastside and in the rest of Vancouver. To help create this strategy the Drug Policy Coordinator will develop an information base that will inform policy development and planning in the area of substance misuse, enforcement and health. Currently little information is collected and/or shared among agencies that are involved in the analysis of patterns of drug dealing, drug use, addiction and its relation to disorder and crime in Vancouver. The City is in an excellent position to facilitate the creation of this information base.

The Drug Policy Coordinator will work closely with the Lower Mainland Municipal Association members in their effort to develop a crime prevention and drug strategy for municipalities surrounding Vancouver. The position will also link with the Federation of Canadian Municipalities recent initiative to develop municipal drug strategies.

There is a high degree of support across the city for developing a comprehensive strategy to deal with the negative impacts of drug use on individuals and neighbourhoods. Neighbourhood organizations, community crime prevention groups, and school-based organizations are demonstrating a desire to learn more about the impacts of drug use in the city and strategies that may work to improve the situation. People are looking for ways to support the effort to find solutions to the growth in the use of illicit substances. They fear that the youth of the city are more vulnerable to the harmful effects of drug use than ever before.

CONCLUSION

There has been a great deal of focus on the issue of substance misuse in Vancouver over the past several years and we are now poised to develop a comprehensive and coordinated approach to the very complex drug-related problems that are before us. This report recommends the establishment of a new exempt position of Drug Policy Coordinator to coordinate policy development, planning and implementation of new initiatives to address the negative impacts of the sale and use of illicit drugs in Vancouver. The position will enable the City to build on the research to date and take the leadership necessary to develop and implement a comprehensive substance misuse strategy for Vancouver.

* * * * *

ag000404.htm

Comments or questions? You can send us email.
[City Homepage] [Get In Touch]

(c) 1998 City of Vancouver