David Eby on public drug use, being an activist and what won’t solve the overdose crisis

Written By Fran Yanor

“There is a perspective among some … that people [should be] allowed to use anywhere they want in community with no standards, accountability or oversight – I just disagree with that point of view.”

–David Eby

In our final 2023 interview with BC Premier David Eby, Northern Beat stuck to two topics: what Nanaimo mayor Leonard Krog called “the social issue of our times” – the confluence of addictions, homelessness, brain injury, mental illness, crime, and drug use in our inner cities – and the challenges of being a life-long activist now governing for the whole province.

Q: Many former premiers had activist tendencies, but you really are an activist. It’s probably the first time that perspective is in the Premier’s office. How does that inform your decisions and drive your agenda?

A: I think the best example of my view of the role of government and the law is probably on the housing issue. I believe that government and law is there to serve people. And that if it’s not serving people, it needs to fix things.

There are some very conservative views out there that are promoted by [other] parties that the role of government is basically to stay out of the way. I just think, what’s the point of having government, paying taxes, if government is not going to take on these issues in an aggressive way, especially ones that make such a difference in people’s lives? 

I make no apologies for that perspective. That’s a difference between me and some of the other parties. And it’s one that I think, so far, British Columbians have appreciated. But they’re going to want to see progress on these issues and results. So my goal from swearing-in to election day is to have examples in communities across the province that people can look, see, touch, experience, that show them where we’re going on these incredibly hard issues. 

“What’s the point of having government, paying taxes, if government is not going to take on these issues in an aggressive way?”

[Whether] it’s housing, or mental health and addiction issues, or cost-of-living issues. These are big, big challenges that aren’t unique to British Columbia. They do require a government that’s willing to roll up their sleeves and do some work, in my opinion.

[Prior to his election in 2013 as the MLA for Vancouver-Point Grey, Eby, a lawyer, led anti-poverty organizations, including Pivot Legal Society and the BC Civil Liberties Association, and represented residents of Vancouver’s Downtown Eastside.]

Q: There have been a few pieces that you brought forward that your government has had to modify – public drug use and encampment legislation to name a couple. Do you think the consultation in the beginning wasn’t wide enough? Maybe because of your experience and perspective it didn’t include the wider community in a way that maybe it should have?

A: There’s a difference between local government officials that may agree or disagree with a particular initiative and the broader community. I don’t think you’re going to find a lot of British Columbians that are on the fence about whether or not government needs to take action on housing or ensure that our parks are free from people that are actively using hard drugs. Or that business owners should be able to get in the doorways of their businesses without having to step over people that are using injection drugs. Or wait at the bus stop without having to share it with somebody who’s using crystal meth.

These are the basics, and I think they’re widely shared values in British Columbia that don’t require a huge amount of engagement or consultation for me to know that, at least they’re my values, and I think they’re values that are shared by British Columbians.

Q: But initially, for instance if you take decrim and public drug use, there were no rules. It was only after a lot of backlash and public activism on the part of the municipal councils and local citizens that the government put rules in that seemed kind of obvious afterwards.

A: Well, I don’t think there was anybody … [that disagreed] with the decriminalization of drugs to recognize that people are addicted to whatever the substances are not criminals for being addicted, they shouldn’t be dragged into jail and to court and put through a show trial. 

I [had]… a very brief stint as a drug prosecutor where I prosecuted  an Indigenous woman for possession of a small amount of crack cocaine at huge public expense. She was found guilty and released at the end with no sentence. This is not a productive use of public resources. And it certainly didn’t help her.

And so saying that that’s not the way forward, I think is something that everybody at least understood … and why we think that health approaches are better. But I don’t think there were many people who [mistook] that approach to be ‘Okay, well, now you can use hard drugs anywhere’ [or that] there shouldn’t be any tools for police to say ‘No, this is not an appropriate space, please go to the safe consumption site.’ 

“I don’t think there were many people who [mistook] that approach to be ‘Okay, well, now you can use hard drugs anywhere.’”

Unfortunately, that is what happened, despite what we understood were police tools around public intoxication to be able to use those kinds of mechanisms to say, ‘No, this isn’t the right place.’ Police were clear with us that they weren’t able to use those tools that we were expecting they would be able to. 

And as soon as I heard from mayors that this was a serious issue that [they were] concerned about, I committed in the legislature that we would put in place the rules to address this. It took some time, working with police back and forth, to get to the right place around a set of laws that would recognize the human rights of people struggling with addiction, but also ensure that our public spaces were safe for everybody. I think we’ve arrived there. 

There is a court challenge underway, which we expected. Once we have that [decision], we’ll be able to move forward with regulations and implementation.

[Several days after this interview, a British Columbia Supreme Court decision granted the Harm Reduction Nurses Association, represented by Eby's former employer, Pivot Legal, a three-month injunction against B.C.'s law restricting public drug use.]

Q: The rules that you brought in placated the mayors that I spoke to, even the ones who are forging ahead doing their own thing, but what I’m hearing is, why weren’t they brought in in the beginning? Like, if there was proper consultation before decrim was brought in, then those rules would have been there in the first place. 

A: There was a huge amount of engagement. It was endorsed by all the police association chiefs. Everybody was looking at it and saying ‘Yeah, this is the right direction.’ This was something that evolved afterwards, and we moved to address it.

I understand the critique, you should have moved faster. Okay. Fair enough. There’s always opportunity for us to move faster, I think, especially in government. But the idea that the people were saying this was going to be a serious issue in the early days is not correct. It’s something that arose later.

Q: The public drug use rules satisfied most at the community level, but you had a backlash in the activism ranks who saw it as a walk back. The pushback you get when you modify policy to deal with wider community concerns … how do you deal with that? Because activists come down hard on you. I listened to some of their speeches after the Drug Users Liberation Front got defunded, and they blame [BC United critic Elenore] Sturko, they don’t like [BC United Leader Kevin] Falcon, they’re mad at [BC Addictions Minister Jennifer] Whiteside, but boy, you betrayed them.

A: There is a perspective in the community among some people that the way forward to deal with this crisis is to distribute hard drugs with no physician or nurse practitioner intermediary, that people [should be] allowed to use anywhere they want in community with no standards, accountability or oversight. 

I just disagree with that point of view. It’s never been my point of view. 

It’s a very unusual libertarian perspective that some folks have, but frankly, I think is grossly mistaken. That people think that that is going to somehow resolve in toxic drug crisis that we face. I do understand that people hold these perspectives legitimately, that they have them in good faith, I don’t question that. I just disagree with them. I think a lot of angst comes from the sheer volume of death and grief that people have to deal with when they lose loved ones. And they’re searching for a way forward. 

“Recovery really is the only way to guarantee that someone is going to be less likely to overdose and die – if they are not using these drugs.”

This fentanyl crisis is profoundly challenging. When people use drugs that they had bought. They don’t know what’s in them, they’re at a party. And they get fentanyl and they were expecting something else. And they die. This is one of the most challenging prevention initiatives that government faces. There’s no easy way forward here.

From my perspective, our government, our approach, we are investing in things like the seamless treatment at St. Paul’s in the model of care that we’re looking to expand across the province, where you attend an emergency room with an overdose and you go directly into treatment. You don’t have to go somewhere else or call a number, or go on a waitlist. Already 94 people have been through that program with great success. 

A billion dollars in the budget around expanding additional mental health and addiction treatment beds, because recovery really is the only way to guarantee that someone is going to be less likely to overdose and die – if they are not using these drugs. Even prescribed supply is highly toxic and potentially fatal. So it’s important to recognize that as well.

Q: When we first talked in April 2022, you said that some people have to be compelled into treatment, that they won’t do it voluntarily. Going back to [Nanaimo mayor] Krog and [Penticton mayor Julius] Bloomfield, a number of high-profile mayors say that we are not going to be able to actually deal with the crux of the issues – that small number of most-troubled people in inner cities – unless we have mandatory treatment. That it’s just necessary in terms of the brain injuries and all that. And this idea that we can’t have mandatory treatment until we have voluntary systems set up, that you can never have that all set up. This is what I’ve heard.

A: I think two things could be true. One is that there is a significant group of people that could benefit from increased interventions in the form of holding them until they’re sufficiently sober to be able to make a reasonable decision about how to move forward. And that people can be so intoxicated on drugs, or as a result of drugs and a brain injury, that their ability to make decisions about their own health are so compromised that physicians should hold them. 

But I think that decision should be made by physicians and not by politicians. 

We have expanded the group of people that are able to make that decision to include nurse practitioners. So that in hospitals, doctors and nurse practitioners now can make those decisions. And we’re not tying up emergency physicians with the volume of these kinds of evaluations that need to be made. 

There is a significant group of people that could benefit from increased interventions in the form of holding them until they’re sufficiently sober.”

We’re expanding the number of beds in hospitals around mental health and addiction for that kind of care across the province. We’ve got five hospitals under construction right now that include significant psychiatric support wings. We also have the expansion of the Redfish Centre.

Anytime we’re talking about healthcare expansions, there are two big challenges. One is the capital, the space, the physical area where people are going to be supported with their medical challenges. The other is the staffing. And just like every other area of care in our healthcare system, we’re really challenged around the people to deliver that care. Everything from the social workers to the psychiatric nurses, to the physicians that are expert in this area. It’s part of our health, human resources strategy, it’s part of the work that we’re doing. 

I agree with the fundamental argument that these mayors are making that this group of people need this kind of care, and also recognize some of the reasons why it’s taking us some time to roll that out. But we are doing that work. 

“I agree with the fundamental argument that these mayors are making that this group of people need this kind of [mandatory] care.”

Where it’s particularly controversial is around youth. 

It’s one of the areas where I think there’s still an opportunity for us to do more work with, in particular, First Nations, because First Nations youth are disproportionately represented in this group. And to date, there hasn’t been a great deal of enthusiasm around that approach from the community in terms of its own youth. 

But if we’re able to show the First Nations treatment options that are available, and we’re working with the First Nations Health Authority on that, on expanding those very beds, I think we may be able to make the case that indigenous decisions around Indigenous kids and their care at Indigenous-run facilities may be the best path forward there.

Editor’s note: The Premier’s responses have been lightly edited for clarity; the writer’s questions, for brevity and intelligibility.