In the Vancouver Sun on March 28th, 2012, there was an announcement that Dr. Perry Kendall, B.C.'s Provincial Health Officer, has joined other provincial, national and international experts arguing for the decriminalization of marijuana (http://tinyurl.com/6rromxw). This is good news. The harms of drug use are exacerbated by current drug policy, which focuses on the criminalization of people who use illegal drugs. In particular, current drug policy impacts those who are experiencing structural disadvantages such as poverty.
Dr. Kendall and others are calling for a public health approach to prevent the harms of substance use. Such an approach is evidence based and will promote health equity. As a registered nurse, I support harm reduction because it is consistent with ethical and professional standards of nursing practice. Our standards call for nurses to base their practice on the best evidence available and to advocate for change to policies that promote health equity. For people experiencing some of the greatest harms of substance use, harm reduction strategies can open the door to much needed health and social services. However, harm reduction is not enough. We need drug policy reform. In the work myself and other colleagues have done on harm reduction, we have highlighted the importance of decriminalization of currently illegal drugs, including marijuana, as well as a regulated market for drugs as a way to reduce harms of substance use.
For further information, see http://www.canadianharmreduction.com/sites/default/files/HR%20Ethics,%20Laws,%20Social%20-%20Cdn%20Nse%20Assn%20-%202007.pdf. Also, check out the Canadian Nurses Association Discussion Paper on Currently Illegal Drugs and Nursing http://www2.cna-aiic.ca/CNA/documents/pdf/publications/Harm_Reduction_2011_e.pdf
As nurses we have a great deal of knowledge to contribute to drug policy reform as the documents above attest. Keeping informed and being involved in drug policy debates is highly relevant to nurses, as is the prevention of harms of substance use and promotion of health equity.
Editor's Note: Please see also a Letter to the Editor on this subject printed in the Vancouver Sun on March 31, 2012 by Drs. Paddy Rodney and Sally Thorne, members of the ARNBC Board of Directors.
Dr. Bernie Pauly is an Associate Professor in the School of Nursing, a Scientist with the Centre for Addictions Research of BC and member of the BC Core Public Health Functions Research Initiative. The focus of her research is promotion of health equity in policy and reducing health inequities associated with substance use, poverty and homelessness. Her current research includes explicating values that shape public discourses about harm reduction and drug policy, promotion of culturally safe care for people who use drugs and the development of an equity lens for public health policy and programs as part of public health renewal in BC. She has co-authored two policy papers on harm reduction and drug policy regionally and nationally. In 2011, she was recognized as an Honorary Citizen of Victoria and was a recipient of a University of Victoria Community Leadership Award.
Dead on! Nice to see nurses wading in on this from a policy/public health approach. Well done ARNBC. Really appreciate the thoughtful and thought-provoking posts in your blog, as well as the comments and observations. Keep it up.
Our society’s continued criminalization of drugs has not only paradoxically fuelled the illicit drug trade and all of its ill effects, but also created an impossible situation for so many of our chronically ill and dying patients for whom the very substances that might provide comfort are withheld or obtained with difficulty. The role of nursing is to assist on both the individual level of care and to look at what are the causes and effects to human misery and ill health in our communities and society. As a group of health professionals, we in nursing try to figure out how to address these dilemmas. While we know that there were good intentions underlying the US’s “War on Drugs,” nursing’s front-line position allows us to see how misguided and damaging that kind of idealistic and simplistic policy perspective can be when it is put into action. This policy has failed miserably and to have our federal government fall into the same mindset would only continue down this road of failure. With good controls, regulation, teaching and public input we can create safe and workable policies for these substances. Rebuilding a nursing voice and perceptive through the Association in BC is creating a means for the intelligence that comes from expert nursing knowledge to be applied to these complex and critically important public policy issues for both our provincial and federal governments.
Have you seen the article in the Province newspaper today?
I am not so sure about the legalization of marijuana anymore...I don't want to see increased future populations of people coming in to the hospital with lung cancer!