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Instead, the report found that health authorities are overly reliant on incomplete and out-of-date fact sheets about the program’s performance.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

Why can’t we just say no?

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From the Frontier Centre for Public Policy

By Susan Martinuk

Drug use and violence have become common place in hospitals. Drug-addicted patients openly smoke meth and fentanyl, and inject heroin. Dealers traffic illicit drugs.  Nurses are harassed, forced to work amidst the toxic fumes from drugs and can’t confiscate weapons. In short, according to one nurse, “We’ve absolutely lost control.”

“Defining deviancy down” is a cultural philosophy that emerged in the United States during the 1990s.

It refers to society’s tendency to adjust its standards of deviancy “down,” so that behaviours which were once unacceptable become acceptable.  Over time, this newly- acceptable behaviour can even become society’s norm.

Of course, the converse must also be true — society looks down on those who label social behaviours “wrong,” deeming them moralistic, judgemental or simply out of touch with the realities of modern life.

Thirty years later, this philosophy is entrenched in British Columbia politics and policies. The province has become a society that cannot say “no” to harmful or wrong behaviours related to drug use. It doesn’t matter if you view drug use as a medical issue, a law-and-order issue, or both – we have lost the ability to simply say “no” to harmful or wrong behaviour.

That much has become abundantly clear over the past two weeks as evidence mounts that BC’s experiment with decriminalization and safe supply of hard drugs is only making things worse.

recently-leaked memo from BC’s Northern Health Authority shows the deleterious impact these measures have had on BC’s hospitals.

The memo instructs staff at the region’s hospitals to tolerate and not intervene with illegal drug use by patients.  Apparently, staff should not be taking away any drugs or personal items like a knife or other weapons under four inches long.  Staff cannot restrict visitors even if they are openly bringing illicit drugs into the hospital and conducting their drug transactions in the hallways.

The public was quite rightly outraged at the news and BC’s Health Minister Adrian Dix quickly attempted to contain the mess by saying that the memo was outdated and poorly worded.

But his facile excuses were quickly exposed by publication of the very clearly worded memo and by nurses from across the province who came forward to tell their stories of what is really happening in our hospitals.

The President of the BC Nurses Union, Adriane Gear, said the issue was “widespread” and “of significant magnitude.” She commented that the problems in hospitals spiked once the province decriminalized drugs. In a telling quote, she said, “Before there would be behaviours that just wouldn’t be tolerated, whereas now, because of decriminalization, it is being tolerated.”

Other nurses said the problem wasn’t limited to the Northern Health Authority. They came forward (both anonymously and openly) to say that drug use and violence have become common place in hospitals. Drug-addicted patients openly smoke meth and fentanyl, and inject heroin. Dealers traffic illicit drugs.  Nurses are harassed, forced to work amidst the toxic fumes from drugs and can’t confiscate weapons. In short, according to one nurse, “We’ve absolutely lost control.”

People think that drug policies have no impact on those outside of drug circles – but what about those who have to share a room with a drug-smoking patient?

No wonder healthcare workers are demoralized and leaving in droves. Maybe it isn’t just related to the chaos of Covid.

The shibboleth of decriminalization faced further damage when Fiona Wilson, the deputy chief of Vancouver’s Police Department, testified before a federal Parliamentary committee to say that the policy has been a failure. There have been more negative impacts than positive, and no decreases in overdose deaths or the overdose rate. (If such data emerged from any other healthcare experiment, it would immediately be shut down).

Wison also confirmed that safe supply drugs are being re-directed to illegal markets and now account for 50% of safe supply drugs that are seized. Her words echoed those of BC’s nurses when she told the committee that the police, “have absolutely no authority to address the problem of drug use.”

Once Premier David Eby and Health Minister Adrian Dix stopped denying that drug use was occurring in hospitals, they continued their laissez-faire approach to illegal drugs with a plan to create “safe consumption sites” at hospitals. When that lacked public appeal, Mr. Dix said the province would establish a task force to study the issue.

What exactly needs to be studied?

The NDP government appears to be uninformed, at best, and dishonest, at worst. It has backed itself into a corner and is now taking frantic and even ludicrous steps to legitimize its experimental policy of decriminalization. The realities that show it is not working and is creating harm towards others and toward institutions that should be a haven for healing.

How quickly we have become a society that lacks the moral will – and the moral credibility – to just to say “no.”

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

British Columbia should allow addicts to possess even more drugs, federal report suggests

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From LifeSiteNews

By Clare Marie Merkowsky

Despite the drug crisis only getting worse in British Columbia after decriminalization, a federal report by the Canadian Institutes of Health Research advocates for further relaxing its policy so addicts can possess even more drugs.

Despite the drug crisis only worsening since decriminalization, federal researchers are now advocating for British Columbia to allow the possession of even larger quantities of cocaine, claiming that current possession limits don’t allow addicts to buy enough.

According to a federal report published April 23 by Blacklock’s Reporter, the current decriminalization program in British Columbia approved by Prime Minister Justin Trudeau’s government has set cocaine possession limits “too low.”

“People who use drugs are less concerned about being arrested and feel more comfortable carrying substances they need,” said the report by the Canadian Institutes of Health Research. “The threshold of 2.5 grams is too low and is unreflective of users’ substance use and purchasing patterns.” 

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 – including cocaine, opioids, ecstasy and methamphetamine – 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.   

However, now researchers are claiming that the new policy is insufficient for drug users.   

“People who use drugs indicated the 2.5 gram threshold is too low and unreflective of their substance use patterns,” the report stated. “Although some people indicated the policy wouldn’t impact their purchasing patterns because they are unable to purchase large amounts at a time, others suggested it may force them to seek out substances more frequently which could increase their risk of harms.”  

“Buying in bulk may be more economical particularly for people who use drugs,” it continued, adding that it was “common practice to purchase in bulk and split or share among peers.”  

The recommendation comes as deaths from drug overdoses in Canada have gone through the roof in recent years, particularly in British Columbia.  

Gunn says he documents the “general societal chaos and explosion of drug use in every major Canadian city.”   

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

Similarly, even Liberals have begun to condemn Trudeau’s “safe supply” program, linking them to “chaos” in cities.  

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.    

Last week, Liberal MP Dr. Marcus Powlowski revealed 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.”  

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