Are politicians too disconnected from the reality of drug abuse to solve the opioid crisis?

At an event on Indigenous child welfare in B.C. on Monday, Premier Christy Clark was asked what she thought about the unsanctioned supervised injection tents that have popped up on Vancouver's Downtown Eastside.

While Clark said she supported a national strategy on opioids and detailed her government's efforts to make naloxone kits readily available, she also referred to pop-up injection sites as: "a Band-Aid solutions to a much bigger problem. My focus is saying first of all, you shouldn't do drugs."

Those comments have drawn criticism from drug users, activists and health officials who say they harken back to a time when politicians had a misguided view of illicit drugs.

The former approach to battling drug abuse was to criminalize addicts. That model has since shifted to an understanding of addiction as a health issue that can be mitigated with harm reduction.

In 2007, Stephen Harper was asked about Vancouver's safe injection facility InSite. In response he said: "If you remain a drug addict, I don't care how much harm you reduce, you're going to have a short and miserable life."

Drug advocates say comments like Clark's show that some politicians are still missing the point.

Despite efforts by multiple levels of government to manage the crisis, drug-related deaths have remain consistently high. Six hundred and twenty-two people have died as of November 1st and the year isn't over yet.

'When you're pouring blood out of your system, you need a Band-Aid'

Experts say, during a public emergency, the focus shouldn't be on criticizing people for taking drugs.

Donald MacPherson began working as a drug policy advocate on the Downtown Eastside in the 1980s.

He praised the Clark government for its efforts to distribute 15,000 naloxone kits that have saved lives but called her off-the-cuff comment damaging.

"It's a totally inappropriate comment and it shows how out of touch she is with the disaster that's happening in our province," said MacPherson, who serves as the executive director of the Canadian Drug Policy Coalition.

Activists like MacPherson say the model of "just say no to drugs" was the prevailing mindset in the 1980s but not anymore.

"That's the type of rhetoric we heard out of the Harper regime. And it really did take us backwards," said MacPherson.

MacPherson said if government officials understood just how dire the situation is they'd be putting up pop-up injection sites themselves.

"The pop-up tents are a band-aid, but when you're pouring blood out of your system, you need a  Band-Aid ... what are you supposed to do? Wait in a back alley watching people die waiting for a policy to change?"

Subtle optimism

Hugh Lampkin is a board member with the Vancouver Area Network of Drug Users. He said even off-the-cuff remarks by politicians like Clark can have long-term effects.

"You're demonizing people for putting a substance into their body," said Lampkin.

But Lampkin said he is encouraged by discussions that have been happening at the federal level.

Last week, leaders and health officials from across the country met in Ottawa to discuss the opioid crisis.

Lampkin said he was surprised to hear candid discussions about the benefits of harm reduction.

"For me, what I heard probably the most often was talk of scrapping the old Bill C-2 which makes it virtually impossible to have places like Insite," said Lampkin.

Federal Health Minister Jane Philpott has hinted that changes are coming to Bill C-2 (The Respect for Communities Act) which acts as a barrier to opening up new safe injection sites — but there's no timeline.

MacPherson said while positive changes to drug policy were discussed, some were misguided.

He also attended the summit and said the focus was more on prescription opioid abuse rather than illicit drug abuse.

"I experienced it in Ottawa as well. There was no sense of urgency and that's what the [pop-up supervised injection] tents are about," said MacPherson.

Getting down to the street

The supervised injection facility Insite opened its doors in 2003 on the basis of the city's Four Pillars Strategy to combat drug addiction: prevention, treatment and rehabilitation, enforcement and harm reduction.

Those pillars were designed by former Vancouver mayor Philip Owen.

Thirteen years later, Owen said he's stunned by what's happening on the Downtown Eastside.

"I could have never envisioned it being this bad," said Owen.

The former NPA mayor said all three levels of government are unsure of who should assume what responsibility.

He also blamed politics.

"There's a political concern on all three levels of government. They're terrified of getting their fingers stained in any way," said Owen.

Owen said politicians need to get out of their comfort zone to understand drug abuse.

That means getting back to the streets.

"You've really just got to go down there and start chatting with people ... get your ear to the sidewalk and find out what's really happening" said Owen.