editorial comment The Health Officers Council of British Columbia ? Must be a cover for a terrorist group! Where's Jack Bauer?

Whether we like it or not, we appear headed for what will certainly be a loud and rancorous debate over this country's drug policies. And framing the discussion will be the ever-growing view of health professionals that it's time to turn convention on its ear.

Almost certain to be cited in the national conversation that's ahead will be a study being released here today by the Health Officers Council of British Columbia entitled: A Public Health Approach to Drug Control in Canada. It may be the most comprehensive, progressive and controversial report yet to be published on the issue.

Certainly, by a group as qualified as this one.

The most contentious recommendation? Mind-altering drugs, including heroin and cocaine, be legalized and regulated. The thinking being that by gaining control over the pharmacological makeup (see purity) and delivery of drugs on the market, there would be fewer deaths from things like overdoses.

In other words, the emphasis in Canada should be on harm reduction rather than on the fruitless notion of eliminating drug use through jail sentences. An approach that is clearly not working.

"Prohibition is contributing to many of the problems stemming from substance abuse," said Gillian Maxwell, chair of a two-day conference on drug use where the paper will be presented.

"You throw people in jail and they pick up diseases like Hepatitis C or HIV and then when they return to society their lives are a mess. They are stigmatized and are often worse off than they were before. So they turn to crime and it begins a vicious cycle."

"We have experts from all over the world now saying that chronic dependence, regardless of the drug, cigarettes, alcohol, heroin, is a problem that should not be dealt with by the criminal justice system."

Fine. So how would it work?

Dr. Richard Mathias, a specialist in community medicine and a professor of public health at the University of British Columbia, said he envisions a regulatory framework that looks at drugs on an individual basis. Cannabis, for instance, would be legally sold and regulated because the "benefits out weigh the harms."

And heroin?

"Heroin is actually an exceedingly safe drug," said Dr. Mathias, one of the authors of the consensus report being released by the health officers. "It is not toxic. What's causing the major harm with heroin is the sharing of needles and impure product. We would propose and advise people use it other than through injection if they want to use it.

"If you choose to inject the drug it would be in a single dose syringe with pharmacological purity and with a known dose. If it's a single dose you don't share the needle."

Both dose and needle would be purchased at your local pharmacy.

Dr. Mathias agrees that part of the national debate will centre on the concern that by legalizing these drugs you will only encourage their use.

"We don't believe this will create more users," he said. "We sell cigarettes and we've cut down usage substantially over the years through education. We'd do the same here."

On his most optimistic days, Dr. Mathias sees a new national drug policy that resembles what the public health officers recommend in place some time during his lifetime.

In more pessimistic moments, he sees someone dying and a lawsuit being launched and the whole issue arriving on the door step of the Supreme Court, where it's decided drugs are a Charter issue.

"This has to be decided in the political sphere," he said.

"Let's forge ahead with this and if we're wrong we'll change it. But it's at least worth a try. We all know what we have now doesn't work."

gmason@globeandmail.ca

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