Promoting Healthy Living Can't Stop at Cigarettes | Opinion

Canada's government recently announced new regulations that require individual cigarettes to have health warnings printed on them, in the hopes of reducing tobacco usage rates among Canadians to less than 5 percent by 2035. Experts have said a total prohibition of sales could be the next step.

It leaves one wondering: what about drugs like methamphetamine, fentanyl, and even marijuana, which all have a far greater connection to negative mental health impacts, crime, community harm, and decreased well-being than nicotine?

Rather than try to reduce demand for those drugs, the Canadian government decriminalizes them and provides "safe" injecting rooms and a "safe supply" of pills to substitute for injection drugs. Recovery from addiction to dangerous psychoactive drugs barely gets a passing mention in most government messages.

The results of these policies have been disastrous, and should spur action.

For one, Canadian cities like Vancouver now have an overdose rate 50 percent higher than the United States. Canada saw an average of 20 opioid overdose deaths every day in 2022, double the rate three years prior. About half of the opioid overdose deaths also involved a stimulant, such as meth. Even the government admits there is no "safe supply" for that drug—so these statistics don't represent the full picture of the current policy's devastating consequences.

In 2022, there were more than 5,000 opioid-related hospitalizations in Canada, averaging 14 per day—90 percent of them occurred in Ontario, British Columbia, and Alberta. By comparison, there were 12 per day in 2019. Beyond that, there were almost 36,000 EMS responses to opioid-related overdoses, compared to about 21,000 in 2019.

Canada also has one of the highest rates of youth marijuana use in the world. Not surprisingly, legalization—that is, the normalization and commercialization of marijuana—has resulted in increases in many youth categories since 2018. That's significant because the rational part of a person's brain isn't fully developed until about age 25. Marijuana use is also associated with cognitive impairment, worsened academic performance, and reduced educational attainment. Car crashes, ER mentions, and mental illness incidents are all up along with marijuana use.

If the government's new cigarette regulations were about addressing public health concerns, then they've only taken on part of the battle. You can't promote healthy living while ignoring the harms of drugs like opioids, meth, and cannabis.

The government in British Columbia has officially decriminalized all drugs—though that's been an unofficial policy since harm reduction was added as a "fourth pillar" to the drug strategy two decades ago. Interventions (like Narcan distribution or syringe services programs) designed to reduce immediate harm to people who use drugs certainly have their role. But policymakers seem to have completely forgotten the other three pillars—prevention, treatment, and enforcement. This one-sided, extreme harm reduction policy has led to deaths rising almost every year since it was implemented, supported by an array of nonprofits and even researchers who financially benefit from this failure.

What those suffering from addiction really need is a health ministry and public policy that discourages drug use and connects individuals to treatment, so that they can achieve recovery. This does not mean we should be criminalizing users; it means we should offer treatment on demand and nudge people to get help who may be otherwise reluctant.

To deter future use, especially among minors, officials should scale up mass-media and prevention programs. Though some may be uncomfortable with this idea, the government should also work to reduce the supply of illicit drugs and arrest those who sell them. Enabling drug use indefinitely has failed to reduce usage rates and deaths in many parts of the country. With drug overdoses in British Columbia surpassing 1,000 people just five months into the year, there really is no choice but to try something new.

It may sound radical, but we need interventions that will help more people live healthy, drug-free lives. That goes far beyond cigarettes.

If the government wants to improve people's health by making them more aware of the dangers associated with using tobacco, then it should expand these new public health regulations to include all drugs, not just those currently out of fashion.

Kevin Sabet, Ph.D. is a former three-time White House drug policy advisor and the President of Smart Approaches to Marijuana (SAM), the nation's leading alliance of organizations and individuals dedicated to a health-first approach to marijuana policy.

The views expressed in this article are the writer's own.