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Addictions

No, drug prohibition is not ‘white supremacy’

Published

9 months ago

14 minute read

From Break The Needle

British Columbia’s top doctor released a report arguing that the legalization of all drugs combats “racism” and “colonialism.” That’s historically illiterate.

The notion that drug prohibition is inherently racist has become exceedingly popular within the harm reduction world and, by extension, inside many public health institutions and graduate programs. Yet anyone with even a cursory knowledge of history can see that this is absurd. Societies from all across the world have long understood the dangers of addictive substances and supported efforts to criminalize them—so why is this being ignored?

Though the “prohibition is racist” movement usually flies under the public’s radar, it was thrust into the limelight earlier this month when B.C.’s top doctor, Bonnie Henry, released a report calling for the legalization of all drugs. Not only did Henry recommend that dangerous substances—including meth, cocaine and fentanyl—be sold in stores much like alcohol and cannabis, her team asserted that prohibitionist policies are “based on a history of racism, white supremacy, paternalism, colonialism, classism and human rights violations.”

One would hope such sweeping declarations would have been backed with fulsome arguments and historical references, but that didn’t happen here.

Instead, the report simply emphasized how Canada’s original drug laws, dating back to the late 19th and early 20th centuries, were motivated by racist animus against Chinese immigrants. As opium was popular among these immigrants, the drug was believed to pose a special moral threat to white society and was among the first substances to be harshly policed. This, in turn, gave the state a new legal tool to harass Chinese Canadians and, in some cases, deport them.

After briefly explaining this point, Henry’s report concluded that, “Over time, the moral panic associated with drug use expanded to target many more groups of people, including Indigenous people, Black people, women, people of colour, and people of lower socioeconomic status.” This extrapolation was presented as a self-evident fact, without any evidence or citations to explain or substantiate it.

Henry’s recommendations were immediately rejected by the provincial government and savagely ridiculed in the media. Yet the views articulated in her report, shocking as they may have been to many, were not actually exceptional. They only rehashed the dominant beliefs of the harm reduction world—beliefs have also, over the past decade or so, permeated deeply into Canada’s public health bureaucracies.

Henry’s report may be dead in the water, but the underlying ideas which animated it are still very much alive and will, in all likelihood, continue to influence Canadian policymakers within the cloistered hallways of the civil service. This is a shame, because it is difficult to overstate how strange these kinds of beliefs are.

To argue that drug prohibition is broadly based on a history of racism, mostly because it was misused for racist purposes a century ago, is kindergarten-level reasoning. There are ample examples of non-European societies, past and present, embracing criminalization. This is glaringly obvious and, in many cases, common knowledge.

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Non-Western drug prohibition throughout the ages

Perhaps one of the greatest examples of non-European drug prohibition is Sharia law, which has banned the consumption of mind-altering substances since the 7th century. One wonders how harm reduction activists can claim, with a straight face, that prohibition is rooted in “colonialism” and “white supremacy” when Islam’s religious and legal texts supported it centuries before global European empires emerged.

Since harm reduction scholars are so concerned about Chinese experiences, it would be instructive to look toward China itself, where prohibition is also popular.

In the late 18th century, the British began exporting large quantities of opium to the Qing Empire (China), which quickly fomented a wave of addiction and social disorder. Soon after, Qing officials embarked on a multi-decade campaign to criminalize the drug. “Opium is a poison, undermining our good customs and morality. Its use is prohibited by law,” wrote the Daoguang Emperor in an edict issued in 1810.

By the mid-19th century, the Qing worried that, without drastic action, China would be left bereft of money and productive men—so they banned all sales of opium and destroyed any supply of it they could find, including European wares. This angered the British, who profited handsomely off the opium trade, and led them to victoriously wage war against the Qing—not once, but twice—to forcibly stop prohibition.

Narcotics thus continued to flow through the veins of China’s body politic, wreaking havoc for generations. Since then, Chinese nationalists have bitterly remembered the Opium Wars as a colonial crime which marked the beginning of China’s “century of humiliation.”
The 98th Regiment of Foot at the attack on Chin-Kiang-Foo (Zhenjiang), 21 July 1842, resulting in the defeat of the Manchu government. Watercolour by military illustrator Richard Simkin (1840–1926).

This raises an important question: how exactly can anyone square this history with the ideological framework of the harm reduction movement? Were the Qing embodying some mystical form of white supremacy? Perhaps we should be grateful that the British sent their anti-racist warships to decolonize China’s drug laws.

Even today, the legacy of the Opium Wars continues to inform Chinese attitudes towards drugs—both within China itself (where strict prohibitionism is the norm) and in the diaspora.

In San Francisco, America’s petri dish for drug liberalization, it is Chinese-Americans who are leading a public backlash against progressive policies and calling for greater prohibition. Similarly, Chinese-Canadians were instrumental to Vancouver’s political pivot during the 2022 municipal elections, wherein the centrist ABC party swept the city council and the mayor’s office. Just this spring, Chinese-Canadian protestors in Richmond, the most ethnically Chinese city in North America , thwarted the launch of a new supervised consumption site, only to have a white progressive woman shout “Go back to Hong Kong” at them. No doubt another anti-racist activist.

When I interviewed almost a dozen Chinese-Canadian small business owners and workers in Vancouver’s historical Chinatown last summer, their support for prohibition was clear—and the legacy of the Opium Wars was invoked several times. Many other ethnic groups are processing similar historical traumas, and facing similar erasure. Do harm reduction activists forget, for example, that early European colonists devastated North American Indigenous communities by plying them with alcohol?

Indigenous leaders did not respond to that crisis by calling for more booze. On the contrary, they pushed for prohibition. Illustratively, when Treaties No. 6 and 7 were negotiated during the 1870s, Indigenous representatives asked for the “exclusion of fire water” from Saskatchewan, and that “no intoxicating liquor be allowed to be introduced or sold” on reserves. Even today, dozens of “dry” Indigenous reserves throughout Canada continue to ban alcohol and drugs to whatever extent they can.

When I interviewed over a dozen Indigenous elders and community members in Calgary last summer, their opposition to drug liberalization was clear—some went so far as to condemn decriminalization and “safer supply” programs as “pharmaceutical colonialism.” Ronnie Chickite, chief of the We Wai Kai Nation in British Columbia, told me this spring that his entire band council was “entirely against” decriminalization and that provincial officials had allegedly ignored them.

Building upon these interviews, two senior contacts in the Ontario government confirmed to me earlier this year that Indigenous leaders across the province seem to commonly hold prohibitionist beliefs. Who would have thought that Indigenous people could be such raging white supremacists?

Surveying the world today, it is clear that drug prohibition is actually strongest in non-European states—particularly East Asian and Middle Eastern ones—while liberalization is actually more popular in the West. It is telling that the harm reduction movement seems intent on ignoring this, or, alternatively, positioning non-white prohibitionism as a symptom of corrupting European influences. Both responses are, ironically, more than a little racist—how else can one describe the systematic erasure of non-European voices?

How is it that harm reduction advocates, who make such a theatre of their own “anti-racism,” cannot grasp that non-white communities have intellectual and cultural agency and do not simply let white people dictate their beliefs? In their obsessive disdain for European civilization, these advocates close their eyes to the rest of the world and inadvertently reproduce the same cultural narcissism that they ostensibly condemn—their calls for racial justice conceal a Eurocentric mindset sopping  with paternalism.

How is this possible? How has this happened? A glimpse of an answer can be found in the “Acknowledgements” section of Henry’s report this month, where brief biographies of the report’s contributors were provided. Each contributor fixated on their ethnicity and, in many cases, proclaimed themselves as “third generation settlers” or “occupiers.” Unsurprisingly, almost everyone on the team was white. Though there were some Indigenous voices (who were seemingly relegated to working on exclusively Indigenous-related tasks, of course), not a single Asian, black or Middle-Eastern voice could be found.

The B.C. provincial health officer report’s contributors section:

So it seems that a bunch of white progressive bureaucrats produced a document that fixated on “colonialism” and “racism” while ignoring the actual beliefs of many, if not most, non-white communities. Nothing could encapsulate the harm reduction zeitgeist more perfectly: the privileging of empty gestures over real consultation, the self-indulgent self-flagellation of the white bourgeoisie, the patronizing assumption that minority communities have homogenous political beliefs that happen to align with progressive causes.

All of this would be comedic if lives weren’t at stake.

It should be clarified that there are many valid ways to criticize drug laws from a racial justice lens. Laws are just tools which we use to order society, and, like any tool, they can be abused—so it is fair to explore how some laws, in some contexts, have racist intentions or outcomes.

This is best illustrated by the wealth of scholarship criticizing American cannabis laws—in this case, critics have been able to concretely show that specific laws, in specific contexts, are being enforced unfairly and exacerbating inequities without producing justificatory social benefits.

Yet this mode of analysis, which focuses heavily on outcomes and concrete data, is an entirely different beast from the essentialist arguments recklessly flung around by the harm reduction movement. It makes sense to test measurable hypotheses about specific laws and their implementations. But to argue that drug prohibition is intrinsically “racist” is to succumb to ideological hallucination.

This essay originally appeared in The Hub and has been syndicated to Break The Needle through a co-publishing agreement.

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Addictions

Four new studies show link between heavy cannabis use, serious health risks

Published on April 28, 2025

By

Cannabis products purchased in Ontario and B.C., including gummies, pre-rolled joints, chocolates and dried flower; April 11, 2025. [Photo credit: Alexandra Keeler]

By Alexandra Keeler

New Canadian research shows a connection between heavy cannabis use and dementia, heart attacks, schizophrenia and even death

Six months ago, doctors in Boston began noticing a concerning trend: young patients were showing up in emergency rooms with atypical symptoms and being diagnosed with heart attacks.

“The link between them was that they were heavy cannabis users,” Dr. Ahmed Mahmoud, a cardiovascular researcher and physician in Boston, told Canadian Affairs in an interview.

These frontline observations mirror emerging evidence by Canadian researchers showing heavy cannabis use is associated with significant adverse health impacts, including heart attacks, schizophrenia and dementia.

Sources warn public health measures are not keeping pace with rapid changes to cannabis products as the market is commercialized.

“The irony of this moment is that society’s risk perception of cannabis is at an all-time low, at the exact moment that the substance is probably having increasingly negative health impacts,” said Dr. Daniel Myran, a physician and Canada Research Chair at the University of Ottawa. Myran was lead researcher on three new Canadian studies on cannabis’ negative health impacts.

Legalization

Canada was the first G7 country to create a commercial cannabis market when it legalized the production and sale of cannabis in 2018.

The drug is now widely used in Canada.

In the 2024 Canadian Cannabis Survey, an annual government survey of cannabis trends, 26 per cent of respondents said they used cannabis for non-medical purposes in the past year, up from 22 per cent in 2018. Among youth, that number was 41 per cent.

Health Canada’s website warns that cannabis use can lower blood pressure and raise heart rates, which can increase the risk of a heart attack. But the warnings on cannabis product labels vary. Some mention risks of anxiety or effects on memory and concentration, but make no mention of cardiovascular risks.

The annual cannabis survey also shows a significant percentage of Canadians remain unaware of cannabis’ health risks.

In the survey, only 70 per cent of respondents said they had enough reliable information to make informed decisions about cannabis use. And 50 per cent of respondents said they had not seen any education campaigns or public health messages about cannabis.

At the same time, researchers are finding mounting evidence that cannabis use is associated with health risks.

A 2023 study by researchers at the University of Calgary, the University of Alberta and Alberta Health Services found that adults with cannabis use disorder faced a 60 per cent higher risk of experiencing adverse cardiovascular events — including heart attacks. Cannabis use disorder is marked by the inability to stop using cannabis despite negative consequences, such as work, social, legal or health issues.

Between February and April of this year, three other Canadian studies linked frequent cannabis use to elevated risks of developing schizophrenia, dementia and mortality. These studies were primarily conducted by researchers at the Ottawa Hospital Research Institute and ICES uOttawa (formerly the Institute for Clinical Evaluative Sciences).

“These results suggest that individuals who require hospital-based care for a [cannabis use disorder] may be at increased risk of premature death,” said the study linking cannabis-related hospital visits with increased mortality rates.

The three 2024 studies all examined the impacts of severe cannabis use, suggesting more moderate users may face lower risks. The researchers also cautioned that their research shows a correlation between heavy cannabis use and adverse health effects, but does not establish causality.

 

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Budtenders

Health experts say they are troubled by the widespread perception that cannabis is entirely benign.

“It has some benefits, it has some side effects,” said Mahmoud, the Boston cardiovascular researcher. “We need to raise awareness about the side effects as well as the benefits.”

Some also expressed concern that the commercialization of cannabis products in Canada has created a race to produce products with elevated levels of THC, the main psychoactive compound that produces a “high.”

THC levels have more than doubled since legalization, yet even products with high THC levels are marketed as harmless.

“The products that are on the market are evolving in ways that are concerning,” Myran said. “Higher THC products are associated with considerably more risk.”

Myran views cannabis decriminalization as a public health success, because it keeps young people out of the criminal justice system and reduces inequities faced by Indigenous and racialized groups.

“[But] I do not think that you need to create a commercial cannabis market or industry in order to achieve those public health benefits,” he said.

Since decriminalization, the provinces have taken different approaches to regulating cannabis. But even in provinces where governments control cannabis distribution, such as New Brunswick and Nova Scotia, products with high THC levels dominate retail shelves and online storefronts.

In Myran’s view, federal and provincial governments should instead be focused on curbing harmful use patterns, rather than promoting cannabis sales.

Ian Culbert, executive director of the Canadian Public Health Association, thinks governments’ financial interest in the cannabis industry creates a conflict of interest.

“[As with] all regulated substances, governments are addicted to the revenue they create,” he said. “But they also have a responsibility to safeguard the well-being of citizens.”

Culbert believes cannabis retailers should be required to educate customers about health risks — just as bartenders are required to undergo Smart Serve training and lottery corporations are required to mitigate risks of gambling addiction.

“Give ‘budtenders’ the training around potential health risks,” he said.

“While cannabis may not be the cause of some of these negative health events … it is the intersection at which an intervention can take place through the transaction of sales. So is there something we can do there that can change the trajectory of a person’s life?”

This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.

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2025 Federal Election

Study links B.C.’s drug policies to more overdoses, but researchers urge caution

Published on April 24, 2025

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By Alexandra Keeler

A study links B.C.’s safer supply and decriminalization to more opioid hospitalizations, but experts note its limitations

A new study says B.C.’s safer supply and decriminalization policies may have failed to reduce overdoses. Furthermore, the very policies designed to help drug users may have actually increased hospitalizations.

“Neither the safer opioid supply policy nor the decriminalization of drug possession appeared to mitigate the opioid crisis, and both were associated with an increase in opioid overdose hospitalizations,” the study says.

The study has sparked debate, with some pointing to it as proof that B.C.’s drug policies failed. Others have questioned the study’s methodology and conclusions.

“The question we want to know the answer to [but cannot] is how many opioid hospitalizations would have occurred had the policy not have been implemented,” said Michael Wallace, a biostatistician and associate professor at the University of Waterloo.

“We can never come up with truly definitive conclusions in cases such as this, no matter what data we have, short of being able to magically duplicate B.C.”

Jumping to conclusions

B.C.’s controversial safer supply policies provide drug users with prescription opioids as an alternative to toxic street drugs. Its decriminalization policy permitted drug users to possess otherwise illegal substances for personal use.

The peer-reviewed study was led by health economist Hai Nguyen and conducted by researchers from Memorial University in Newfoundland, the University of Manitoba and Weill Cornell Medicine, a medical school in New York City. It was published in the medical journal JAMA Health Forum on March 21.

The researchers used a statistical method to create a “synthetic” comparison group, since there is no ideal control group. The researchers then compared B.C. to other provinces to assess the impact of certain drug policies.

Examining data from 2016 to 2023, the study links B.C.’s safer supply policies to a 33 per cent rise in opioid hospitalizations.

The study says the province’s decriminalization policies further drove up hospitalizations by 58 per cent.

“Neither the safer supply policy nor the subsequent decriminalization of drug possession appeared to alleviate the opioid crisis,” the study concludes. “Instead, both were associated with an increase in opioid overdose hospitalizations.”

The B.C. government rolled back decriminalization in April 2024 in response to widespread concerns over public drug use. This February, the province also officially acknowledged that diversion of safer supply drugs does occur.

The study did not conclusively determine whether the increase in hospital visits was due to diverted safer supply opioids, the toxic illicit supply, or other factors.

“There was insufficient evidence to conclusively attribute an increase in opioid overdose deaths to these policy changes,” the study says.

Nguyen’s team had published an earlier, 2024 study in JAMA Internal Medicine that also linked safer supply to increased hospitalizations. However, it failed to control for key confounders such as employment rates and naloxone access. Their 2025 study better accounts for these variables using the synthetic comparison group method.

The study’s authors did not respond to Canadian Affairs’ requests for comment.

 

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Correlation vs. causation

Chris Perlman, a health data and addiction expert at the University of Waterloo, says more studies are needed.

He believes the findings are weak, as they show correlation but not causation.

“The study provides a small signal that the rates of hospitalization have changed, but I wouldn’t conclude that it can be solely attributed to the safer supply and decrim[inalization] policy decisions,” said Perlman.

He also noted the rise in hospitalizations doesn’t necessarily mean more overdoses. Rather, more people may be reaching hospitals in time for treatment.

“Given that the [overdose] rate may have gone down, I wonder if we’re simply seeing an effect where more persons survive an overdose and actually receive treatment in hospital where they would have died in the pre-policy time period,” he said.

The Nguyen study acknowledges this possibility.

“The observed increase in opioid hospitalizations, without a corresponding increase in opioid deaths, may reflect greater willingness to seek medical assistance because decriminalization could reduce the stigma associated with drug use,” it says.

“However, it is also possible that reduced stigma and removal of criminal penalties facilitated the diversion of safer opioids, contributing to increased hospitalizations.”

Karen Urbanoski, an associate professor in the Public Health and Social Policy department at the University of Victoria, is more critical.

“The [study’s] findings do not warrant the conclusion that these policies are causally associated with increased hospitalization or overdose,” said Urbanoski, who also holds the Canada Research Chair in Substance Use, Addictions and Health Services.

Her team published a study in November 2023 that measured safer supply’s impact on mortality and acute care visits. It found safer supply opioids did reduce overdose deaths.

Critics, however, raised concerns that her study misrepresented its underlying data and showed no statistically significant reduction in deaths after accounting for confounding factors.

The Nguyen study differs from Urbanoski’s. While Urbanoski’s team focused on individual-level outcomes, the Nguyen study analyzed broader, population-level effects, including diversion.

Wallace, the biostatistician, agrees more individual-level data could strengthen analysis, but does not believe it undermines the study’s conclusions. Wallace thinks the researchers did their best with the available data they had.

“We do not have a ‘copy’ of B.C. where the policies weren’t implemented to compare with,” said Wallace.

B.C.’s overdose rate of 775 per 100,000 is well above the national average of 533.

Elenore Sturko, a Conservative MLA for Surrey-Cloverdale, has been a vocal critic of B.C.’s decriminalization and safer supply policies.

“If the government doesn’t want to believe this study, well then I invite them to do a similar study,” she told reporters on March 27.

“Show us the evidence that they have failed to show us since 2020,” she added, referring to the year B.C. implemented safer supply.

This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.

Our content is always free – but if you want to help us commission more high-quality journalism,

consider getting a voluntary paid subscription.

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