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Safe supply opioids based more on ideology than evidence?

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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Instead, the report found that health authorities are overly reliant on incomplete and out-of-date fact sheets about the program’s performance.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

Liberal MP blasts Trudeau-backed ‘safe supply’ drug programs, linking them to ‘chaos’ in cities

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First responders in Ottawa dealing with a crisis                                           Fridayman 0102 / YouTube
From LifeSiteNews

By Clare Marie Merkowsky

‘There is certainly the perception by a lot of Canadians that a lot of downtown cores are basically out of control,’ Liberal MP Dr. Marcus Powlowski said, before pointing specifically to ‘safe supply’ drugs and injection sites.

A Liberal MP has seemingly taken issue with “safe supply” drug policies for increasing public disorder in Canada, policies his own party, under the leadership of Prime Minister Justin Trudeau, has endorsed.

During an April 15 health committee meeting in the House of Commons, Liberal MP Dr. Marcus Powlowski, while pressing the Royal Canadian Mounted Police (RCMP), stated that “safe supply” drug policies have caused Canadians to feel unsafe in downtown Ottawa and in other major cities across the country.

“There is certainly the perception by a lot of Canadians that a lot of downtown cores are basically out of control,” Powlowski said.  

“Certainly there is also the perception that around places like safe supply, safe injection sites, that things are worse, that there are people openly stoned in the street,” he continued.   

“People are getting cardio-pulmonary resuscitation performed on them in the street. There are needles around on the street. There is excrement on the street,” Powlowski added.  

Safe supply“ is the term used to refer to government-prescribed drugs that are 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 where implemented.

Powlowski, who has worked as an emergency room physician, also stated that violence from drug users has become a problem in Ottawa, especially in areas near so-called “safe supply” drug sites which operate within blocks of Parliament Hill.   

“A few months ago I was downtown in a bar here in Ottawa, not that I do that very often, but a couple of colleagues I met up with, one was assaulted as he was going to the bar, another one was threatened,” said Powlowski. 

“Within a month of that I was returning down Wellington Street from downtown, the Rideau Centre, and my son who is 15 was coming after me,” he continued. “It was nighttime and there was someone out in the middle of the street, yelling and screaming, accosting cars.” 

Liberal MP Dr. Brendan Hanley, the Yukon’s former chief medical officer, testified in support of Powlowski, saying, “My colleague Dr. Powlowski described what it’s like to walk around downtown Ottawa here, and certainly when I walk home every day, I encounter similar circumstances.” 

“Do you agree this is a problem?” Powlowski pressed RCMP deputy commissioner Dwayne McDonald. “Do you agree for a lot of Canadians who are not involved with drugs, that they are increasingly unhappy with society in downtown cores which are this way? Do you want to do more about this, and if you do want to do more about this, what do you need?”  

McDonald acknowledged the issue but failed to offer a solution, responding, “One of the success factors required for decriminalization is public support.” 

“I think when you are faced with situations where, as we have experienced in our communities and we hear from our communities, where public consumption in some places may lead to other members of the public feeling at risk or threatened or vulnerable to street level crime, it does present a challenge,” he continued.   

Deaths from drug overdoses in Canada have gone through the roof in recent years, particularly in British Columbia after Trudeau’s federal government effectively decriminalized hard drugs in the province.

Under the policy, which launched in early 2023, the federal government began allowing people within the province to possess up to 2.5 grams of hard drugs without criminal penalty, but selling drugs remained a crime.  

The policy has been widely criticized, especially after it was found that the province broke three different drug-related overdose records in the first month the new law was in effect.  

The effects of decriminalizing hard drugs in various parts of Canada has been exposed in Aaron Gunn’s recent 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 says he documents the “general societal chaos and explosion of drug use in every major Canadian city.”  

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Addictions

Ontario and Saskatchewan join Alberta’s approach to opioid recovery

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The governments of Alberta, Ontario and Saskatchewan are establishing a partnership to build systems of care focused on recovery.

On April 3 and 4, 2024, the eighth annual Recovery Capital Conference of Canada in Calgary welcomed nearly 2,000 delegates from Alberta, across Canada and around the world. A major focus of the conference was the Alberta Recovery Model—the system of care that Alberta’s government is building to provide treatment and recovery support for people living with mental health and addiction challenges.

Ministers responsible for mental health and addiction in Alberta, Ontario and Saskatchewan have agreed to collaborate on building systems of care that focus on recovery. This highlights the importance of breaking down barriers and increasing access to recovery-oriented care, sharing best practices, advancing partnerships with Indigenous communities, and advocating to the federal government for investment and policies that support recovery.

“We are eager to share the Alberta Recovery Model because we believe it is the most dignified, comprehensive and compassionate approach in any jurisdiction across Canada to help people overcome their mental health challenges and recover from the deadly disease of addiction. I look forward to seeing what this partnership brings as we work together with other provinces on building a system of care that focuses on recovery.”

Dan Williams, Minister of Mental Health and Addiction

“Saskatchewan is focused on helping people overcome addictions and live healthy, safe lives in recovery. Under our Action Plan for Mental Health and Addictions, we are doubling capacity to make addictions treatment more available and accessible, and transitioning to a Recovery-Oriented System of Care to better care for patients. By helping people overcome addictions, we can save lives, heal families and strengthen our communities.”

Tim McLeod, Minister of Mental Health and Addictions, Seniors and Rural and Remote Health, Saskatchewan

“Through our Roadmap to Wellness, Ontario is making unprecedented investments to ensure that those in our province struggling with mental health or addictions challenges get the care they need, when and where they need it. I look forward to working in closer collaboration with my colleagues from Alberta and Saskatchewan to build systems of care that prioritize recovery and help more people break free from addiction.”

Michael Tibollo, Associate Minister of Mental Health and Addictions, Ontario

This partnership is a step forward in working with and learning from other provinces on policies that bring meaningful and lasting change to those suffering from the deadly disease of addiction, or who are facing mental health challenges.

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