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Responding to Crisis: A human rights and public health approach to legal regulation of currently prohibited substances

There is a growing body of evidence that traditional “war on drugs” law enforcement-based approaches to the control of illegal drugs have had a significant negative impact on individuals, communities and states in terms of public health, human rights, economics, rule of law, and the environment. Globally and within Canada, criminalization of production, distribution, and possession of controlled substances has led to a vast unregulated market for drugs controlled by organized criminal actors (Auditor General of Canada 2001; UNODC 2005).

In North America, we are now experiencing the after-effects of such a market in the opioid overdose epidemic, which is largely attributed to supply of street drugs tainted with adulterants such as fentanyl. It is estimated that there were over 4,000 opioid-related deaths in Canada in 2017, of which 72% are attributable to clandestinely-produced fentanyl (Government of Canada 2018). British Columbia has declared a public health emergency resulting from the opioid crisis.

Jurisdictions across the globe are increasingly experimenting with alternative legal and policy frameworks that aim to reduce the harmful effects of prohibition, including the legal regulation of recreational, religious and medical cannabis, legalization of the coca leaf for subsistence and traditional use, decriminalization of drug possession, and expansion of harm reduction services such as supervised consumption and injectable opioid agonist treatment.

While superior to absolute prohibition, each of these legal and policy shifts offers only a partial solution to the unregulated market that flourishes in every part of the world. The ongoing opioid crisis has made bolder and more comprehensive policy and legal shifts away from prohibition an urgent and life-saving endeavour (Godley, F. & Hurley, R. 2016). The importance of learning from the experience of alcohol and tobacco by “using alternatives to ‘prohibition’-based policy and legislation” was noted at a recent Canadian Institutes of Health Research “Best Brains” knowledge exchange meeting. (Canadian Institutes of Health Research 2017).


The goals of the proposed Roundtable are:

  1. to develop a strategic road map – with concrete steps – for Canada to progress away from the policies of prohibition towards policies that promote public health, human rights, and social inclusion based on the legal regulation of currently illegal substances;
  2. to outline areas of further research to inform this strategy and identify appropriate regulatory models for the Canadian context;
  3. to outline a knowledge translation strategy aimed at raising awareness and support for policy change;
  4. to identify opportunities for international collaborations that will support further action.


The goals of the Roundtable will be achieved through the exploration of three themes:

  1. the legal regulation of opioids as a response to the overdose crisis;
  2. the impact of criminal justice policies on people who use drugs; and
  3. c) intersections of drug policy and the social determinants of health, including poverty, housing, stigma, income, access to health care.


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