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Safe supply opioids based more on ideology than evidence?

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7 minute read

From the Frontier Centre for Public Policy

By Susan Martinuk

Those who advocate for them always claim the moral high ground because of ‘evidence-based studies.’ But such studies appear to be in short supply.

That’s probably why 72 BC doctors recently signed a letter that argues against safer supply, saying the evidence underlying the philosophy is “weak or inadequate.”

Almost three years into the experimental opiate “safer supply” program in British Columbia and no one, including those handing out the pills, seems to know if it is working or making the problem worse. There are no shortage of opinions arguing on either side of the debate, but recent reports suggest that the facts remain in short supply.

Safe supply initiatives fall under the broad category of harm reduction programs. For opiate addiction, the program typically involves the prescription and distribution of pills like hydromorphone, a medical-grade opioid that is as potent as heroin, to addicts. The underlying hope is that addicts will then forgo possibly-tainted, illicit street drugs in favour of the ‘safer’ government-provided pills.

More than 40,000 Canadians have lost their lives to opioid overdoses since 2016 and British Columbia is one of the world’s first jurisdictions to take the ‘safer supply’ route in an effort to quell opioid overdoses.

But BC’s Auditor General just released a report on the trial program and, so far, it remains unclear as to whether the program has made any progress. Opioid deaths are still increasing and, while the report doesn’t criticize the underlying philosophy of ‘safer supply,’ it does note “deficiencies in key areas.”

According to the report, the government is conducting the program in a rather haphazard way. BC health authorities failed to maintain basic standards for administering an experimental trial and neglected their obligation to publish data on how the program is doing. The data was supposed to be publicly available by September 2022, more than 18 months ago.

Instead, the report found that health authorities are overly reliant on incomplete and out-of-date fact sheets about the program’s performance. It also cited authorities for major failings in the management and delivery of the program.

The bureaucrats in charge claim that they have the data to support their claims about the success of the program, yet one has to wonder why — three years in — no data is available to support those claims.

A similar dearth of data has been noted in Ottawa where the House of Commons Health Committee has been exploring the opioid epidemic and toxic drug crisis. One doctor who leads a safer supply program in London, Ontario, appeared to be a strong advocate for safer supply programs, claiming that safe supply clinicians “rely on good research and published evidence.”

But Dr. Marcus Powlowski, a Liberal MP and medical doctor who also has a master’s degree in health law and policy from Harvard, had apparently looked at the papers that she proclaimed as evidence, and soundly renounced the studies as “basically a bunch of anecdotes.”

So where is this rigorous scientific evidence for safer supply programs?

Those who advocate for them always claim the moral high ground because of ‘evidence-based studies.’ But such studies appear to be in short supply.

That’s probably why 72 BC doctors recently signed a letter that argues against safer supply, saying the evidence underlying the philosophy is “weak or inadequate.” They called for all safer supply programs to be “tightly controlled, rigorously monitored, and meticulously documented.”

A lack of medical evidence is likely related to another major issue outlined in the Auditor General’s report – “prescriber hesitancy.” That is, there are only a limited number of doctors who are willing to write prescriptions for the potent opioids used in safer supply.

However, there is plenty of evidence for one disturbing aspect of this program – diversion. This is a practice whereby safer supply pills (primarily hydromorphone) given to addicts are subsequently sold (or diverted) to drug traffickers and/or organized crime groups to obtain more potent and illicit drugs like fentanyl.

In early March, the RCMP in Northern BC revealed that thousands of safe supply opiate pills had been seized as part of organized crime busts in Prince George and Campbell River. It was considered to be solid evidence that diversion of safer supply drugs was occurring. According to the RCMP spokesperson, “Organized crime groups are actively involved in the redistribution of safe supply and prescription drugs,” and “what has been deemed safe is not being kept safe.”

It is simply not realistic to expect that such practices are not occurring in our major cities. The National Post, the CBC and an independent filmmaker have all previously published evidence of diversion occurring in LondonOttawa and Vancouver, respectively.

Drug policies such as safe supply have long bypassed appropriate scientific scrutiny because they supposedly save lives.  But the question still remains – do they? And at what cost to addicts and the rest of society?

Susan Martinuk is a Senior Fellow with the Frontier Centre for Public Policy and author of Patients at Risk: Exposing Canada’s Health-care Crisis.

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Addictions

Claims about ‘safer supply’ diversion aren’t disinformation

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News release from Break The Needle

This month, police in London, Ont., admitted to what critics have said all along: safer supply diversion is happening at alarming levels

Last spring, Canada’s minister of mental health and addictions claimed critics’ concerns about “safer supply” diversion — the illegal selling and trading of taxpayer-funded addictive drugs — were based on lies.

“For Pierre Poilievre to state untrue information about safer supply, and try to create barriers to accessing harm reduction services that are saving lives amid this ongoing crisis, is incredibly irresponsible and dehumanizing to people who use drugs,” read a statement by then-minister Carolyn Bennett’s office.

Fast forward a year, and it’s clear which side was telling the truth.

This month, police in London, Ont., admitted to what critics said all along: diversion of pharmaceutically supplied opioids to the streets is happening at alarming levels. London is home to Canada’s longest-running safer supply program, which dates back to 2016 and was significantly expanded in 2020.

The London Police Service released data that shows a staggering 3,000 per cent increase in the seizure of hydromorphone tablets — the opioid predominantly given out by safer supply programs — over the last five years. In 2019, London police seized just under 1,000 tablets. By 2020, that number had tripled. In 2023, they seized 30,000 hydromorphone tablets.

For context, hydromorphone is as potent as heroin and just two or three of these pills, if snorted, can cause an overdose in an inexperienced opioid user.

Earlier this month, the city’s deputy police chief, Paul Bastien, told CBC’s London Morning, “We recognize the value that safe supply plays as part of that harm reduction piece, but diversion is an important issue that is affecting community safety. I won’t say that everyone’s doing it, but some of the tablets from safe supply are being diverted for that purpose.”

“Criminal groups are fairly adept at exploiting policy changes that are well intended. But unforeseen consequences sometimes arise and this appears to be, at least in part, one of them,” he continued.

A reasonable person may assume that, given this alarming new evidence, proponents of safer supply would change their tune about widespread diversion being “fake news.” Unfortunately, they haven’t.

Some activists are now claiming on social media that London’s spike in hydromorphone seizures was not caused by safer supply, but rather by a high-profile theft of 245,000 hydromorphone tablets from an Ontario pharmacy. Yet the spike in seizures began years before this theft and, according to multiple addiction physicians, the street price of hydromorphone collapsed in the city well before 2023, suggesting an earlier influx of diverted supply.

However, these mental contortions aren’t surprising. As more and more evidence of widespread diversion emerged over the past year, accusations of disinformation and misinformation haven’t stopped –– they have simply evolved. The narrative changed from “Diversion doesn’t exist” to “Fine, it exists, but only on a small scale” to, now, “Fine, diversion exists at scale, but imagine the alternative?”

This is the angle already emerging in British Columbia, where the province’s top doctor, Bonnie Henry, authored a damning report that acknowledges the regularity and harms of safer supply diversion, yet still concludes safer supply is “ethically defensible” and advocates for its expansion.

Like many safer supply activists, Henry often argues diversion isn’t a significant concern because most opioid deaths are caused by fentanyl.

While it’s true that most opioid deaths are attributable to fentanyl, hydromorphone is still incredibly dangerous. When diverted into the black market, it creates new addictions, often among young people, which culminate in fentanyl use.

Moreover, data indicate hydromorphone is implicated in an increasing share of drug-related deaths in young people in B.C. In 2019, there were no reported deaths involving hydromorphone. By 2022, that number jumped to 22 per cent. Similarly, a recent report by the Centre for Addiction and Mental Health in Ontario found the number of youth in the province who self-reported using prescription opioids for “non-medical” reasons jumped 71 per cent between 2021 and 2023.

Still, safer supply activists continue to insist, despite overwhelming evidence to the contrary, that widespread diversion isn’t happening.

In 2017, Collins Dictionary declared “fake news” the word of the year. Since then, the term –– along with sister terms “misinformation” and “disinformation” –– have taken on a disturbing new life.

While fake news, misinformation and disinformation are very real democratic threats, some politicians and activists realized they could delegitimize opponents’ arguments and unflattering media stories by simply proclaiming them fake. Now, we’re in the dizzyingly ironic position of real news, and real facts, being dismissed as misinfo and disinfo by self-declared guardians of the truth.

This is the exact problem journalists and concerned medical professionals continue to face when raising the alarm on so-called “safer supply.” Despite the abundance of solid reporting, emerging data, whistleblower warnings and first-hand accounts of widespread diversion, harm reduction activists and their allies in government don’t just recklessly dismiss the problem, they weaponize the language of fake news to discredit a reality they don’t like.

Communities across Canada, and addicts themselves, deserve better.

A guest post by
Sabrina Maddeaux
Bold opinions and analysis of the political and economic issues that matter.
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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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