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Leading addiction doctor warns of Canada’s ‘safer supply’ disaster

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A man considers using a prescription opioid. Credit: Dreamstime

By Liam Hunt

Addiction physician Dr. Sharon Koivu has seen the effects of safer supply programs in her clinical practice and personal life — and is sounding the alarm

Dr. Sharon Koivu, an addiction physician and parent, believes her son might not have survived to adulthood if Canada’s “safer supply” programs had been in effect during his adolescence.

Having worked on the front lines of Ontario’s opioid crisis, she views these programs as a catastrophic failure.

In an extended interview, Koivu explained the unintended consequences of these programs, which offer free tablets of hydromorphone — an opioid about as strong as heroin – to vulnerable patients with a history of addiction. While advocates of safer supply claim it mitigates the use of more dangerous illicit substances, there is evidence that most users divert — that is, sell or trade — their hydromorphone to acquire stronger substances.

Safer supply was first piloted in London, Ont., in 2016, before being widely expanded across Canada in 2020 with the help of generous federal grants. While the program looked good on paper, Koivu, who provides comprehensive addiction consultation services at a London-based hospital, saw a different reality: her patients were destabilizing, relapsing and fatally overdosing because of safer supply.

Koivu says that “one hundred percent” of her colleagues working in addiction medicine have noticed safer supply diversion. Some patients have told her they have been threatened with violence if they do not procure and divert these drugs. She estimates that, because of safer supply, tens of thousands of diverted hydromorphone pills — also known as “Dilaudid,” “dillies” or “D8s” — are flooding into Canadian streets every day.

For context, just two or three of these pills, if snorted, are enough to induce an overdose in a new user.

This influx has caused the drug’s street price to crash by as much as 95 per cent. While 8-milligram hydromorphone pills used to sell for $20 each several years ago, they can now be bought for as little as a dollar or two. These rock-bottom prices have ignited a new wave of addictions and relapses, and lured opioid-naive individuals into experimenting with what is essentially pharmaceutical heroin.

Koivu estimates that 80 per cent of her opioid-using patients now take diverted hydromorphone.

“The biggest harm is that we’ve turned on the tap and we’ve made everything cheap, which is leading to a large increase in the number of people becoming addicted and suffering,” she said.

“It is the most serious issue that I’ve seen in my lifetime.”

Safer supply programs seem to regularly overprescribe opioids without considering patients’ actual needs, Koivu says. Patients have come into her hospital with prescriptions that provide 40 eight-milligram hydromorphone pills a day, even though they can only tolerate 10 pills.

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‘That attraction is horrific’

Throughout the first few decades of Koivu’s career, almost “everyone” in her patient pool developed addictions due to childhood traumas or from mishandling opioids prescribed for chronic pain.

Since the advent of safer supply, the origins of new opioid addictions have shifted toward social or recreational exposure. Concerningly, this exposure often occurs in patients’ adolescent years.

“I’m seeing an increase in youth becoming addicted,” said Koivu, who has had patients as young as 15 tell her their addictions began through diverted hydromorphone.

“Almost everyone I see who’s started since 2018 started recreationally. It started as something that was at a party. It’s now a recreational drug at the youth level.”

Parents often seem completely unaware of the problem. Some have told Koivu they overheard their children discussing the availability of “D8s” at their highschools, only to later realize — when it was too late — they were referring to opioids.

“You can’t walk into your house with a six-pack of beer. If you’re smoking weed, people can smell it. But you can walk into your house with a lot of [tablets] in your pocket. So, it’s cheap, really easy to hide, and is even called ‘safe’ by the government. I think that attraction is horrific.”

“Our youth are dying at a higher rate … and we have a lot more hydromorphone found in [their bodies] at the time of death.”

While safer supply programs claim to make communities safer, Koivu’s lived experiences suggest the opposite. She used to reside in London’s Old East Village, where the city’s first safer supply program opened in 2016, but moved away after watching her neighbourhood deteriorate from widespread crime, overdoses and drug trafficking.

“I moved there to support a supervised injection site,” said Koivu. “Then I watched that community drastically change when safer supply was implemented. … I would go for walks and directly see diversion taking place. Homelessness is very complicated, but this has absolutely fueled it in ways that are unconscionable.”

Dr. Sharon Koivu

Koivu characterizes the evidentiary standards used by advocates of safer supply as “deeply problematic.” She says many of the studies supporting safer supply are qualitative — meaning they rely on interviews — and use anecdotal data from patients who have a vested interest in perpetuating the program.

While Koivu has been blowing the whistle on safer supply programs for years, her concerns largely went unnoticed until recently. She has faced years of harassment and denigration for her views.

“When I came to say I’m concerned about what I’m seeing: the infections, the suffering, the encampments … I was literally told that I was lying,” she said.

Last month, the London Police Service provided the National Post with data showing that annual hydromorphone seizures increased by 3,000 per cent after access to safer supply was significantly expanded in 2020. The newspaper has since raised questions about why this data was not released earlier and whether the police stonewalled attempts to investigate the issue.

Koivu considers herself a lifelong progressive and has historically supported the New Democratic Party. But she is concerned many left-leaning politicians have ignored criticism of safer supply. Many seemingly believe that opposition to it is inherently conservative.

“I went to a hearing in Ottawa of a standing committee to talk about addiction,” she said. “We had five minutes to give a talk, and then two hours to answer questions, [but] I didn’t receive any questions from the NDP or the Liberals.”

Although Koivu believes safe supply can play a role in the continuum of care for opioid addiction, she says it must be executed in a meticulous manner that prevents diversion and emphasizes pathways to recovery.

“It needs to be part of a comprehensive strategy to help people get their lives back. And right now, it’s not.”

Above all, it is Koivu’s experience as a mother that drives her to criticize safer supply. One of her sons struggled with opioid addiction as a young adult. Although he eventually recovered, the experience could have killed him.

“Had this program been around … my family could have been another statistic from an opioid death. That drives me. Because it’s very real, and it’s very personal.”

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Addictions

‘Drug dens’: Poilievre calls out Trudeau’s misleadingly named ‘safe’ injection sites

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From LifeSiteNews

By Clare Marie Merkowsky

Pierre Poilievre haș again sounded off on the Trudeau government’s ‘safe’ injection sites and other drug measures, policies which have been followed by an uptick in drug overdoses wherever implemented.

Conservative Party leader Pierre Poilievre has condemned Prime Minister Justin Trudeau’s Liberal government and the mainstream media for concealing the failure of federally-subsidized “safe” injection sites for hard drug use.

During a July 12 press conference in Montreal, Quebec, Poilievre slammed politicians and mainstream media alike for masking the failure of the Trudeau government-led “supervised injection sites,” pointing out the misleading nature of the term “safe” often used when discussing these facilities, which allow addicts to abuse themselves by injecting deadly narcotics such as heroin.

“I know wacko politicians in the Liberals and the NDP [New Democratic Party] and their supporters in the media want to make it sound like there’s a constitutional obligation that we allow these drug dens anywhere they want to go up,” said Poilievre. “That is not true. That is the opposite of true.” 

Poilievre’s remarks were delivered in a kindergarten playground near Montreal’s first federally-subsidized injection site that opened on April 15.  

Poilievre promised that “there will not be a single taxpayer dollar from a Poilievre government going to drug dens.”  

“Every single penny will go to treatment and recovery services to bring our loved ones home drug-free,” he added. 

Poilievre further called out mainstream media reporters for repeating Trudeau’s claim that the drug sites are “safe” or “supervised.” 

“What will you do around safe injection sites across the country?” Globe & Mail reporter Eric Andrew-Gee questioned. 

“You guys repeat the same language you get from the radical Liberal-NDP activists and bureaucracy,” said Poilievre. “You call them safe. How can they be safe? Do you think it’s safe when a bullet comes flying out of one these sites to kill a mother in Toronto? Do you think that’s safe? Do you think it’s safe to have people using crack and heroin and cocaine next to a playground like this? Do you think that is safe? It’s not safe.”  

Poilievre’s mention of the Toronto mother is a reference to the 2023 shooting death of Karolina Huebner-Makurat, a 44-year-old mother of two. Police allege Huebner-Makurat was killed by a stray bullet fired by a man in a drug-related dispute with another man outside of an injection site in the city’s Leslieville neighborhood.

In addition to injection sites, the Trudeau government has also been involved in the distribution of drugs to addicts. In fact, Health Canada recently noted that the Trudeau government has budgeted over $27 million in funding for “safe supply” drug programs that have been linked to increased violence and overdose deaths across Canada. 

Safe supply” is the term used to refer to government-prescribed drugs given to addicts under the assumption that a more controlled batch of narcotics reduces the risk of overdose. Critics of the policy argue that giving addicts drugs only enables their behavior, puts the public at risk, disincentivizes recovery from addiction and has not reduced – and sometimes even increased – overdose deaths when implemented. 

The best example of the Trudeau government’s drug policy failures come from the province of British Columbia. Starting in 2023, the Trudeau government decriminalized the possession of up to 2.5 grams of hard drugs without criminal penalty.

Shortly thereafter, record numbers of overdose deaths and similar incidents occurred, leading to the province itself requesting that the Trudeau government recriminalize drugs in public spaces.

Nearly two weeks later, the Trudeau government announced it would “immediately” end the allowance of hard drug use in public, which critics see as tacit admission the policy was a disaster.

The effects of decriminalizing hard drugs have been the source of contention throughout the country, as evidenced in Aaron Gunn’s documentary, Canada is Dying, and in U.K. Telegraph journalist Steven Edginton’s mini-documentary,  Canada’s Woke Nightmare: A Warning to the West. 

Gunn, who has since become a Conservative Party candidate, previously noted that his film shows clearly the “general societal chaos and explosion of drug use in every major Canadian city” since lax policies were implemented.

“Overdose deaths are up 1,000 percent in the last 10 years,” he said in his film, adding that “every day in Vancouver four people are randomly attacked.”

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Addictions

Opioid seizures exploded by 3,000% in Ontario city after “safer supply” experiment

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A London police drug seizure in April included 9,298 Dilaudid eight milligram tablets.

By Matthew Hannick

Doctors and journalists wondering why local police failed to disclose concerning statistic to public sooner

Nigel Stuckey saved more lives during the last five years of his policing career than the previous three decades combined. “Every time you go back to the street, it has a different flavour,” said Stuckey, a former sergeant with the London Police Service (LPS) who retired in 2022. “As a frontline police officer, you are constantly going to overdoses in the city. I’ve administered Narcan to multiple people, and this is just something that never existed before.”

Stuckey first noticed a dramatic increase in overdoses and drug-related crimes occurring throughout his city – London, Ontario – in 2019. While the reasons behind this increase were initially unclear, recent data released by the LPS suggest that “safer supply” programs may be contributing to the problem.

Safer supply programs aim to save lives by providing drug users with pharmaceutical-grade alternatives to the untested street supply. That typically means distributing hydromorphone, a heroin-strength opioid, as an alternative to illicit fentanyl. However, addiction experts say the program is having the opposite effect, as many people who are enrolled in safer supply programs are illegally selling or trading their prescribed hydromorphone on the black market, a practice known as “diversion.”

Harm reduction advocates claim that safer supply diversion is not a significant issue, but according to an investigation into London Police Services (LPS) seizure data by journalist Adam Zivo, the number of hydromorphone tablets seized in London increased by 3,000 per cent after access to safer supply was greatly expanded in 2020.

In 2019, the LPS seized fewer than 1,000 hydromorphone tablets. This number jumped significantly in 2020 and continued to rise afterwards, reaching 30,000 tablet seizures last year – an unprecedented amount. The London police estimate that last year’s record will be met or exceeded by the end of 2024.

Doctors have said that this is only representative of a small fraction of what is actually out there, and that just 3-4 of these pills, if snorted, are enough to induce an overdose in a new user.

Some people are wondering why this data wasn’t released months, if not years, earlier.

Dr. Sharon Koivu, a London-based addiction physician, was among the first to recognize the harms of safer supply and has been warning the public about widespread diversion for years. Based on her clinical experiences, she believes that diverted safer supply hydromorphone is causing new addictions and falling into the hands of youth.

When Koivu tried to speak out against safer supply and call attention to diversion and an overall lack of program transparency, she was bullied and told that the suffering she was witnessing didn’t exist. This harassment was so severe that her mental health deteriorated and she worried about whether her career had been irreversibly damaged – yet the London police had quietly possessed data showing that she was right all along.

“It’s become an ideological thing,” she said. “People seem to have doubled down on the information they have. They don’t want to hear from someone who has information and concerns that don’t align with their, I’m going to say, ideology – because it’s not science.”

News of skyrocketing hydromorphone seizures might have remained hidden from the public had it not been for a major bust earlier this year.

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On April 12, the London police announced a drug seizure which included 9,298 hydromorphone eight-milligram tablets. When Zivo inquired into this seizure, he received no answers to his questions for almost two months. He says that he was “stonewalled” and that the police seemed unwilling to release key data until it became impossible for them not to.

Zivo found it particularly concerning that the 2019-2023 hydromorphone seizure data was not released earlier. “Journalists and addiction physicians have been trying to raise the alarm about this issue for years,” he said, “but have been called liars, grifters and fearmongers, despite the fact that data validating their concerns existed and was held by the London Police Service.”

Stuckey, who now works as a documentary filmmaker covering London’s homelessness, addiction and mental health crisis, had a similar experience when he queried the LPS about the 9,290 hydromorphone pills seized this April.

Despite multiple requests for information about a possible connection to safer supply, the police service did not get back to him. He expressed frustration at the police’s unresponsiveness and worried that a lack of government transparency is endangering both the general public and law enforcement officers.

“Members of the London Police Service are being put in harm’s way dealing with organized crime and firearms to take drugs off the street, which were provided by the federal government. It’s absolute lunacy that we are paying one branch of government to rid a problem that was created by another branch of government,” said Stuckey.

It would be deeply concerning if the LPS knowingly withheld data pertaining to safer supply diversion. Not only has the failure to publish such data hindered informed public debate and policy development, it has also compromised the safety of the very communities which police are tasked with protecting.

According to Zivo, safer supply programs have benefitted from the silence of powerful institutions like the LPS. He said that, as there seems to be significant institutional resistance to acknowledging the community harms of safer supply, then more attention and trust should be given to local grassroots-level addiction medicine practitioners “who are bravely testifying to what they are seeing in their clinics.”

However, Dr. Koivu thinks that “the tide is turning” and that more people are beginning to understand the harms of safer supply

“I think it’s unfortunate that this data wasn’t made available sooner, when it was relevant to the funding of these programs and the changes we’re seeing in the city. The police need to be accountable for that. I really don’t understand their rationale for not addressing this” she said. “They hung me out to dry while knowing that what I was saying was accurate. If the police are afraid to come forward, no wonder physicians are afraid to come forward, too.”

A guest post by
Matthew
Matthew Hanick is a journalist living in Toronto.
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