Vancouver is the third largest city in Canada with a population of over 600,000 residents. While the stable economy is a testament to the city's success, the lives of many individuals, particularly in the Downtown Eastside (DTES), are negatively impacted by a high concentration of poverty, gentrification, and substance use. Drug enforcement in this area has done little to deter consumption. Given the high numbers of overdose cases, many have called for a shift from punitive measures to increased harm reduction practices. The Drug User Liberation Front (DULF) is an activist organization that advocates for harm reduction in the city's DTES. Such organizations have provided a humane way of supplying drugs and cultivating compassionate care for drug users. Vancouver’s approach illustrates that building a resilient city with an urban future––one marked by evolving growth and innovations––requires flexible, community-driven interventions. 

 

History of Drug Control in BC

Over the past few decades, British Columbia has become a testing ground for Canada's ambitious harm reduction strategies. In 1989, Vancouver became the site of BC's first needle exchange program, delivered through a partnership between the nonprofit organization DTES Youth Activities Society and the North Health Unit of Vancouver Coastal Health, the regional public health authority. Since 1989, Vancouver has funded BC's first needle exchange program, delivered by the DTES Youth Activities Society and the North Health Unit. By 1998, drug users had constructed the Vancouver Area Network of Drug Users (VANDU), a peer-led force "dedicated to improving the lives" of the drug user community. By the early 2000s, Vancouver had created North America's first supervised injection site, offering not only sterile supplies and overdose intervention but a space to counteract stigmatization. These services expanded over time––naloxone distribution began in 2012, and, by 2017, legal protections were in place. Specifically, the Good Samaritan Drug Overdose Act ensured that people who dialed 911 for overdose support would not be penalized for simple drug possession. 

However, the crisis evolves in spite of these efforts. In 2024 alone, a reported 2253 British Columbians died from overdoses, which is double the yearly average five years earlier, in 2019. The deaths are not attributed to a low quantity of services, but limited long-term treatment. A 2021 report by the Chief Provincial Health Officer found that just 32% of addicts remained in methadone care after one year. One criticism of this system is that support agencies are dominated by abstinence therapies or underfunded primary care providers who do not specialize in addiction. The future of a resilient city now relies on the construction of compassionate care for those who need it most and incentivizing addicts to accept long-term treatment.

 

Case study: DULF and its Actions in Vancouver

DULF has tested and packaged doses of cocaine and raw opium to respond to the escalating lethality of the drug supply. To legitimize its actions, DULF aimed to establish a legally sanctioned “Compassion Club and Fulfillment Centre” while facilitating crowd-sourced donor campaigns to pressurize governments to address the drug crisis. As a result, 64.3% of members claimed they reduced their overall drug use, while 90% perceived a reduced risk of overdose. These results indicate the benefits of safer supply programs, often leading to reduction of health issues involving drugs and reducing interactions with illicit markets. 

Applied globally, DULF serves as a model for city policies that humanize drug users while advocating that medical care is the most effective solution. Upon introducing more harm reduction practices, governments, health departments, and police agencies will improve the city's outlook. That may include providing clean drug supply or establishing compassion clubs. Compassionate, accessible care can replace punitive systems with humanizing frameworks that measurably reduces overdose deaths and upholds the dignity of drug users. While governments cannot fully eradicate drug use, harm reduction methods are critical to provide underlying support for those who need it most. The humanitarian support relies not merely on legalization, but on the long-term regulations and decriminalization efforts that stem from it.

 

The Theoretical Result of Harm Reduction Models

Harm reduction refers to a set of practical strategies aimed at reducing negative consequences associated with drug use. On top of incentivizing greater oversight in the drug markets, harm reduction is a fundamental step to decriminalize drug usage and develop rehabilitative measures. Decriminalization refers to a change in the criminal status of a specific behavior or action. For drug control, decriminalization would indicate a shift in policy away from the criminal justice system to focus on a healthcare framework. While the carceral system was built on discipline and deterrence, legalization of drugs would incentivize authorities to address underlying causes to overdoses––trauma, anxiety, unsafe supply, or financial instability. It would change the current isolation and stigmatization of drug users and prioritize rehabilitation and care over punishment. This requires a redirection of funding from law enforcement agencies towards accessible services, whether it be addiction centers or general mental health care. Addressing drug use as a public health concern rather than a threat would promote an effective and humane approach. 

 

Beyond increasing structural support, building resilient cities means affirming the dignity of all individuals. Besides structural advancements like regulatory policies or services, legalization would encourage social support for decriminalization after legalization, specifically through harm reduction frameworks. This includes educating policymakers, law enforcement, and pharmacies to supply sterile equipment for users' drug practices. This also includes expanding the accessibility of decriminalization efforts, such as Substance Use Disorder (SUD) treatments and addiction services.  

 

Given the history of the government's difficulties handling drug crises, harm reduction organizations like DULF put pressure on governments to regulate the process of local Canadian drug production and distribution. Just as pharmaceuticals are rigorously developed and tested, DULF continued to push safe supplies through citywide, crowd-sourced donor campaigns while hoping for a grant from Health Canada Substance Use and Addictions Program. The organization’s application was ultimately rejected due to the government's worries about public health risks. Regardless, it maintained widespread harm reduction pressures for government oversight of the composition of these substances through launching new programs for episodic compassion clubs. In an unregulated market, users are more frequently exposed to "dirty drugs" cut with unsafe additives, leading to greater harms of SUD. As well, regulation reduces consumers' reliance on illicit drug markets, puts dangerous drugs on tightly controlled schedules (like pharmaceutical grade opiates), and provides tax revenue from drugs that are deemed recreational (like marijuana). This weakens illegal street drug economies and ideally leads to less violent crime associated with drug trade and consumption.

 

While harm reduction strategies have been criticized by some, legalization allows for legislative bodies to employ preventative measures to destigmatize drug users. As drugs come under rigorous oversight, people may perceive drug users as less of a threat, knowing that their consumption is regulated and safe. As drug users become more integrated into society, they are more likely to feel comfortable accessing support for their substance use. Through fully acknowledging drug users as they combat drug intake inconsistencies, society can normatively destigmatize the actions of drug users. Following the government's legal actions, society can reciprocate with sincere attempts to socially support users through their medical struggles.