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Opioids: The 110 Year War

On March 26, Health Canada announced it had corrected a disconnect between federal drug regulations and the ability of doctors to prescribe synthetic heroin for long term users who have not benefited from other harm reduction, and medication, programs thereby removing undue barriers to treatment.

Preliminary death data by Public Health suggests more people died in Niagara of suspected opioid overdoses in a six-month period of 2017 than all of 2016. Make no mistake: this will save lives.

Pre-criminalization: From war to taxation

Once upon a time, all granny had to do was walk down to her local apothecary and order herself up some cocaine or prescription heroin; soldiers, left addicted to morphine after being wounded, could order up opium by mail until 1908. One hundred and ten years : that’s how long it’s taken Canada’s government to criminalize, to stigmatize, and finally, to take some real action on opioid addiction.
Like alcohol, opium was considered a commodity, a revenue stream for the Crown; ever wonder how Hong Kong became a British subject? Opium. For real. Hong Kong island was ceded in the treaty ending The First Opium War. A decade later, in 1856, Britain again went to war with China, this time joined by France, in an attempt to further open China to foreign merchants, and legalize the opium trade, in what is commonly called the Second Opium War.

Even Canada imposed a tax on opium factories in 1871; because consumption of opium and cocaine were viewed in terms of medical uses, opiates were not only perfectly legal, they were completely unregulated. Medicines didn’t list their ingredients until the early-twentieth century and most users of opioids and cocaine, or some combination thereof, had no idea they were even taking these compounds, they just knew they felt better.

While therapeutic usage was not the only value to opium, recreational use is as old as the Mesopotamians, addiction for most was accidental (insert deja-vu reference).

With the synthesis of morphine, then heroin, and the advent of the hypodermic needle, opium use gained popularity throughout the nineteenth century. The medical profession was beginning to explore psychiatry and even Freud spoke of morphine addiction in his 1884 On Coca (still controversial, Freud, himself a regular intravenous cocaine user, advocated the use of cocaine as a cure for morphine addiction).

Yet wasn’t until 1908 with the passage of the Opium Act of 1908 and the Proprietary and Patent Medicine Act 1908, that regulations around opiates and cocaine were introduced.

So what changed in the years between 1871 and 1908? Why did Canada move away from taxation to classify substance use as criminal and vilify those we deem to reject proper societal rules?

Moral Propagandists

Tell me if any of this sounds familiar. The world is in chaos as Imperial powers fight for control of key trade routes and resources. Mass waves of immigrants and refugees flee political turmoil and famine. Colonial institutions are failing as national protectionists are blaming the loss of jobs on reciprocity agreements, or lack thereof.

Don’t forget cheap labour, provided by new arrivals to the country!

(If the men don’t have work, the men drink, and when the men drink, they beat their wives)

Even worse, women are marching. For rights. Equal rights of personhood! (feign moral indignation – if women drink or smoke opium, that leads to prostitution and other moral atrocities like unplanned pregnancy, venereal disease, and, worst of all… she might engage in sodomy collective gasp) as the Church loses it’s congregation to new morals and a new society not entirely made of the Old World.

No, I am not dishing the salacious details of Trump’s as-yet-unnamed manifesto. Surprisingly, or not?, the more things have changed in the last century, the more they have stayed the same. So it was, with the first true waves of globalization, little more than a century ago, so-called proper society rejected mind and mood altering substances in favour of advocating temperance and sexual repression.

Racism, Fear, and Moral Agendas

Where once the government saw revenue, by the early-twentieth century, labour disputes and strikes brought with them rising racial tensions and newly created drug laws.

Some will argue that drug laws were entirely morally based but that simply isn’t true; the Opium Act of 1908 was initiated by then Deputy Minister of Labour MacKensie King after helping negotiate the end of two major labour strikes in 1907, both directly related to cheap Asian labour. While we might like to judge history less harshly, or turn a blind eye to the chronology of events, Canadian archives show that, by 1922, nearly three quarters of those imprisoned for opium offences were Asian Canadians.

The disproportionate number of Chinese charged under the Opium Act, and subsequent narcotics legislation, led to the general population, European Canadians, to believe the laws didn’t apply to them.

And they didn’t; while opiates were restricted, there was nothing in the original legislation to prevent doctors from writing themselves scripts. That’s right. While granny could no longer walk over to the apothecary, Doc Magoo could… and so could granny after doc wrote her a script.

How many people do you think sought a doctor before Tommy Douglas gave us universal health care? Don’t hurt yourself, it was a rhetorical question.

If you still question whether race plays a factor in the application of drug laws, let’s look at current data. According to a 2013 report by the Office of Correctional Investigator, one in four people incarcerated in Canada are Indigenous, despite representing 3% of the general population; Black Ontarian’s are three times more likely to be charged for drug possession or trafficking and despite Black males representing 2.9% of the general population, they represent 9.8% of Canada’s incarcerated population; visible minority offenders increased 40% in the five years covered by the report.

And still, people use drugs; the threat of death by overdose and/or incarceration simply do not work as a deterrent; while we are busy locking people up, people are dying. Not just on the streets but in detention centres – there were 5 OD’s at the Niagara Detention Centre on March 24 (thankfully, all are expected to recover).

As our prisons grew to overcapacity, people found new ways to get high, and disputes over social moors continue. We’ve bumbled along, incarcerating and marginalizing; we’ve synthesised new, deadlier opioids; we’ve created a third Opium War.

Peeling Back The Shame of the Twentieth Century

Alcohol use by humans predates the written word while archeological evidence points to opium being discovered around 5,500 years ago and chewing coca leaves around 5,000 years ago; addiction has been around as long as humans have sought to alter our perception through the use of chemical compounds. Colloquially known as the village drunk, it is only with societal disacceptance, and the advent of modern psychiatry, that we have tried to conceptualize drug and alcohol (ab)use.

One hundred and ten years after first passing regulations on opioid use, there is hope for drug users and those who suffer from addiction. We are peeling back the stigma we created to see the human beneath and acting on scientific data not moral superiority. We are easing access to medical treatments that have proved successful in managing addiction while providing users a modicum of respect and humanity… for that’s what harm reduction is: seeing the human being inside the addiction.

Once upon a time, all granny had to do was walk down to her local apothecary and order herself up some cocaine, morphine, or even prescription heroin; soldiers, left addicted to morphine after being wounded, could order up opium by mail.

After one hundred and ten years of stigmatization and criminalization, anyone who seeks to reduce the harm of their addiction to opioids through the use of medical heroin will again have access outside of a hospital setting. Those who seek to manage their opioid addiction through methadone, will have easier access and doctors who wish to prescribe methadone will no longer need to seek an exemption from drug laws.

For hundreds of years, Colonizing powers have fought for Afghan poppyfields; Britain, Russia, the US, have all sought control of, and benefitted financially, from Afghanistan’s main harvest: the poppy. There is a direct correlation between the ongoing war in the middle east and the inability of world powers to stabilize the region, an addiction older than our love of fossil fuels, opium.

According to the United Nations Office of Drugs and Crime (UNODC), Afghan opium production was up 87% in 2017 — over 2016 — to 9000 metric tonnes. To put that in perspective, in 2001 opium production was at an all time low of 180 metric tonnes while in 2002, after the US invasion, it jumped to 3000 metric tonnes. If we are to understand how the twenty-first century has led to soaring opioid death rates, we need first examine the economic benefits. But alas, that is a topic best covered in depth; til next time, Niagara. Stay safe.

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