While the US argues whether or not they have an opioid crisis at emergency levels (yes, no, depends what mood the president is in) Vancouver has spent time being the front line of one.
Much has been made about Metro Vancouver's hyperinflated housing market, but if you want a microcosm of income inequity: not only is Vancouver home to the most expensive postal code in Canada, it's also home to the poorest. The Downtown Eastside (DTES) is mere blocks away from the high-priced hotels where you might find yourself sharing the lobby with the Hollywood Star d'jour, but it might as well be another world. The triad of extreme poverty, drug use and mental illness defines the DTES, and when most people first became aware of Fentynal as the drug that killed Michael Jackson, in the DTES, people were more than familiar with its effects. With a state of emergency that Federal politicians seemed determined to ignore, people close to the problem recognised that something had to be done, Drug War be damned. And so the "Four Pillars" approach was adopted.
And then came this:
As the story points out, these policies weren't adopted as any kind of progressive, high-minded ideal, but out of desperation. People were dying at alarming rates and the approaches being used clearly weren't working. (I won't dig too deep into the complicating issues like the racism that helped delay TPTB and the general public backing these initiatives, but they were, nonetheless, a factor). There were some dicey moments too, such as the long battle with Harper's Conservative government who wanted nothing more than to make Insite a footnote of history. And (as the BBC article points out) the solution may not scale or work as well in a city where people dealing with the above triad aren't as concentrated in a single community, but lives have been saved.
It's not perfect, it might not even be "good" but as someone who grew up under "Just Say No" and a doctrine that "any is evil" it's interesting what happens when you change the view from looking at the addicts' morality and start looking at society's (who are we, if we're willing to just let people die?). It is, I think, at least worthy of discussion.