Addictions
Safe supply opioids based more on ideology than evidence?
From the Frontier Centre for Public Policy
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Instead, the report found that health authorities are overly reliant on incomplete and out-of-date fact sheets about the program’s performance.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 London, Ottawa 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.
Addictions
Harm Reduction is a Lie: Red Deer South MLA Jason Stephan
News release from Red Deer South MLA Jason Stephan
Truth is wonderful. We can trust in truth. Truth leads to better choices and more happiness. Yet, there are many lies around us. A failure to comprehend things as they were, as they really are, as they will be, results in bad choices and unhappiness.
Sometimes lies are cloaked in words which distort their true outcomes. One such lie is so called “harm
reduction”. One government program under the heading of harm reduction is “safe supply”. Safe supply is a lie. It is not “safe”.
Another government program under the heading of harm reduction is an “overdose prevention site”. That is a lie also – these sites do not prevent overdoses.
Consider this, if your neighbor was drowning in filthy waters, would you row a boat out, and do nothing,
watching your neighbor flail and choke beside you in filthy waters, and just before he was about to go under, grab his hair as he was about to drown? And then, gasping for air, would you let him go, so that he resumes flailing and choking in filthy waters? What if you kept doing that bizarre thing?
What would be the normal thing to do? Get them out of filthy waters and onto shore, of course. Begin with the end in mind – for men and women drowning in filthy waters of addiction, that means recovery, not drug sites that keep them in those filthy waters.
Supervised consumption / overdose prevention sites are in fact drug sites – where illegal drugs are consumed accompanied with many other bad things.
Albertans did not ask for drug sites in their communities. Government imposed them on Albertans.
As a private citizen, prior to serving as an MLA, I attended packed town hall meetings at Red Deer City
Hall. The vast majority of townhall participants did not want the NDP to impose a drug site in Red Deer. They did anyways.
The drug site in Red Deer has now been in our community for too many years and its impacts are
evident for all to see. Let’s speak plainly and honesty. Drug sites in Alberta are an attraction for individuals seeking to live in drug addictions. Because of drug sites, there are more, not less, individuals living in addictions in communities with drug sites.
There is an exodus of businesses from areas containing drug sites. I have seen it. There is too much stealing, too much vandalizing, too much uncertainty for local businesses, their employees, their customers.
Regardless of good intentions, the truth is that drug sites facilitate a growing lawlessness, including embedding and emboldening criminal elements, which either abuse drug sites or prey on those living in addictions, some of whom support addiction lifestyles through stealing or robbing businesses and families in our communities.
The truth is that “harm reduction” drug sites result in “harm production” to businesses and individuals in our communities seeking to peaceably live their lives, working, and raising their families.
Communities that do not want drug sites should not be forced to have them.
Red Deer City Council, listening to its citizens and businesses, passed a motion to get the drug site out of Red Deer. The Alberta government listened, announcing that the drug site will be removed out of Red Deer. That is good for Red Deer!
Other Alberta municipalities that have suffered with drug sites will follow Red Deer and will seek to get drug sites out of their communities also.
It is good to confront and reject harm reduction lies, get drug consumption sites out of Alberta, and support recovery for those suffering under addiction, blessing themselves, their families, and our communities.
Alberta is the best province in a nation in trouble. Our lives belong to ourselves, not government. The machine is not greater than the creator.
Alberta is a land of freedom and prosperity. We must be vigilant to keep it that way.
Addictions
B.C. mayors voice discontent over province’s response to drug crisis
The street outside the Harbour Supervised Consumption Service in Victoria, B.C., on Sept. 6, 2024. (Photo credit: Alexandra Keeler)
By Alexandra Keeler
A number of B.C. mayors say the province’s drug decriminalization project has been a failure — and they are not confident involuntary care will address the problem
Many B.C. mayors are unhappy with the province’s handling of the drug crisis, saying it is failing their communities.
“I don’t think [the province’s] approach was very well thought out,” said Mayor Brad West of Port Coquitlam, a city of 61,000 that is a half-hour’s drive east of Vancouver.
“They announced, seemingly pretty quickly, that the province was going to pursue decriminalization, and there didn’t seem to be a lot of public discourse or consultation in the lead up to it,” he said.
“It was just kind of like, ‘Bam! Here it is.’”
West’s comments were echoed by other municipal leaders, who also say the province’s harm-reduction and treatment services are under-resourced, leaving them ill-equipped to help community members who are struggling.
‘Can’t do anything’
West says he and Port Coquitlam’s constituents observed an immediate increase in public drug use after the province launched a three-year, trial decriminalization project in January 2023.
The project initially enabled residents to use otherwise illicit drugs — such as fentanyl, heroin and cocaine — in most parts of the province, although it prohibited drug use on school premises or near child-care facilities.
Yet, West says drug use in parks and playgrounds was a major issue in his community.
“What [decriminalization] meant in a place like Port Coquitlam is that when you did have an incident that required a police response, none was forthcoming anymore,” he said. “[Police] would tell you, ‘Well, we can’t do anything. We’re not allowed to.’”
In June 2023, Port Coquitlam responded by passing a bylaw, introduced by West, that banned drug use in public spaces. Other B.C. municipalities — including Nelson, Kamloops and Campbell River — soon followed suit.
In December, B.C. tried to pass a law enabling police to remove people from public spaces if they were using drugs. But a B.C. court temporarily blocked it, citing risks to drug users.
The province then sought approval from Ottawa to re-criminalize public drug use, which it obtained this spring. Now, hard drug use is only permitted in private residences, legal shelters or harm-reduction clinics.
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Wait times
West says he has also been frustrated with the province’s harm-reduction facilities, which he describes as “poorly staffed” and “under-resourced.” These facilities often fail to connect individuals to necessary resources or recovery programs, he says.
West has witnessed some of these problems up close. His stepbrother battled addiction and homelessness before finding recovery.
“The biggest barrier that I think he encountered — and most people encounter in terms of recovery — is the wait times,” he said.
The wait time to get into B.C.’s private addiction rehab centres is about three to seven days. But the cost — ranging from $10,000 to $30,000 a month — is out of reach for many.
By contrast, the wait time to get into government-funded programs is about three to six months.
In addition to advocating for more accessible recovery services, West emphasizes the need for stronger enforcement at docks, ports and borders to combat drug trafficking.
“Our ports of entry, our border, the port itself, are completely porous,” he said. “We have no dedicated port police — one of the few jurisdictions that doesn’t. And as a result, Metro Vancouver has become an epicentre for drug trafficking.”
In May 2023, he was the sole Canadian mayor invited by US Secretary of State Antony Blinken to discuss the issue with other mayors. “We have weak [drug] laws … This is why I think we’ve become a global hub for [drug trafficking],” he said.
Brain damage
The BC NDP and BC Conservatives have both recently pledged to introduce involuntary care, which would enable the province to admit people with addiction challenges, brain injuries and mental-health issues into treatment facilities without their consent.
Mayor Leonard Krog of Nanaimo, a coastal city of about 100,000 on the east side of Vancouver Island, has long advocated for involuntary care.
Nanaimo Mayor Leonard Krog sits in his office at Nanaimo City Hall on Sept. 4, 2024. (Photo credit: Alexandra Keeler)
Krog notes that a significant segment of the homeless population has suffered brain damage, which can exacerbate efforts to help them. A 2020 report by Brain Injury Canada says about 50 per cent of people experiencing homelessness have some form of brain injury.
Krog does not believe people with brain injuries and addiction issues are likely to seek treatment on their own. “Those folks should be in secure, involuntary care,” he said.
But he is not optimistic that NDP’s involuntary care proposal will address the full scope of the issue.
“[I]n terms of numbers, my strong view is that it will not address the significant population who are currently in the streets.”
Stay alive
Victoria Mayor Marianne Alto believes in providing support to keep people alive until they seek recovery.
“My view of harm reduction is … I’ll give you anything you need to stay alive until you have that epiphany moment,” she said.
But she is concerned that the province has not adopted a comprehensive approach to tackling the drug crisis. The recent proposals to introduce involuntary care have not eased her concerns.
“Involuntary care can be a necessary tool in a complex system,” she said. “But its effectiveness hinges on clear standards. We must ensure that individuals receive not just initial intervention but also ongoing support to prevent their return to the circumstances that led them there.”
“The devil is in the details,” she said.
Victoria Mayor Marianne Alto leans against a railing in downtown Victoria, B.C. , in May 2022. (Marianne Alto’s Facebook)
The B.C. capital has been pursuing additional strategies to tackle the city’s homelessness, addiction and mental health challenges.
For example, a local nonprofit has been working with individuals living in parks to connect them with housing and support. “It’s also very slow, because to be very successful, you have to do it one person at a time, one-on-one. But it’s working,” she said.
But other efforts have met resistance.
City council rejected a motion introduced by Alto that had proposed rewarding churches and cultural centres that offered overnight parking to vehicle-dwelling homeless people. Five council members opposed it, Alto says, citing fears about crime and concerns that the program overstepped their duties.
“There is a genuine fatigue in the public, which is being reflected in municipal councils, saying, ‘How much further, how much longer, how much more?’”
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
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