A new approach to managing illegal psychoactive substances in Canada

Psychoactive substances have been used throughout human history in spiritual and religious rituals, for medicinal purposes, and by significant proportions of populations for individual reasons and as part of social interactions. Human interaction with these substances ranges from abstinence to a spectrum of use from beneficial to non-problematic, potentially harmful use, and the development of substance use disorders.

Societies manage the health, social, and economic consequences of these substances in a variety of ways with varying degrees of success. The effects of these approaches on the health of populations, however, are often overshadowed by attention to the direct effects of substance use on individuals. Currently, western societies manage illegal psychoactive substances largely through prohibition and criminalization. The laws and systems to control these substances often reflect the times and prevalent issues when they were developed, early in the 20th century, and do not coincide with current scientific knowledge and measurable experience concerning harm to individuals, families, or communities.

There is growing evidence, awareness, and acceptance that prohibition and criminalization are not achieving their intended objectives of reducing drug use and associated harms. Furthermore, it is becoming clear that prohibition has engendered an environment that fuels the growth of illegal markets, organized crime, violent injuries, and the deaths of users, dealers, and police. It also has adverse public health consequences such as accelerating the spread of HIV and hepatitis C, and increasing overdose deaths from concentrated and contaminated products.

The purpose of this paper is to review the available information concerning the use, management, and harms of currently illegal psychoactive substances, and to provide recommendations for a future direction.

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