One of the most contentious issues in Canada, certainly in B.C., is the appropriate response to addictions and addicted individuals.
Harm reduction refers to techniques to provide safe consumption of drugs, including supervised injection sites and overdose prevention sites. Safer supply, launched in B.C. in 2021, provides pharmacygrade drugs by prescription to those with substance use disorder and sourced via the illicit street market.
Many advocates are emphatic supporters of both initiatives, while residents of cities plagued with high rates of drug use, and the crime and homelessness that accompany it, are often bitterly opposed.
The disorder playing out in the streets of B.C. cities, however, is but a symptom of a much larger problem. The November report of the Death Review Panel, convened by the B.C.含羞草研究社檚 chief coroner, estimated that 225,000 people are at risk of death or injury amidst the toxic drug crisis.
The panel noted that the death rate is twice what it was when B.C.含羞草研究社檚 health emergency was proclaimed in 2016. It doubled down on its previous call for increased safer supply to replace 含羞草研究社渢he unregulated toxic drug supply.含羞草研究社� The panel advised that this could most quickly be attained by creating a 含羞草研究社渘on-medical model含羞草研究社� of distribution.
B.C.含羞草研究社檚 minister of mental health and addictions promptly rejected 含羞草研究社渘on-prescription models含羞草研究社�, but said that the province含羞草研究社檚 chief health officer was working on expanding the prescription model.
Lisa Lapointe, the chief coroner, is a supporter of the report by the Death Review Panel. A separate report from Lapointe revealed 175 deaths were due to illicit drugs in September of 2023. That is a decrease of 10 per cent from September 2022, but the report advised it was not yet a meaningful trend.
The report states, 含羞草研究社淭here is no indication that prescribed safer supply is contributing to unregulated drug deaths.含羞草研究社�
That is a very low bar to set for safer supply, but even this limited claim is disputed. Seventeen medical and addiction practitioners from across Canada sent a letter to the federal Minister of Addiction and Mental Health.
含羞草研究社淸We] are deeply concerned about the continuing rise in opioid-related hospitalizations and deaths含羞草研究社� and Health Canada含羞草研究社檚 含羞草研究社渋nadequate response,含羞草研究社� the letter reads. 含羞草研究社淗ealth Canada含羞草研究社檚 support and funding of Safe Supply fails to recognize the negative public health impact of Safe Supply programs that we are seeing in our practices and communities.含羞草研究社�
These practitioners also say that the safer supply programs commonly prescribe 含羞草研究社渓arge doses含羞草研究社� of hydromorphone (often branded Dilaudid). These people, 含羞草研究社渁re at grave risk for harm, including addiction, injection-related infections, transitioning to fentanyl and overdose death.含羞草研究社�
They write that the federal government is ignoring opportunities to fund and support 含羞草研究社渁ccessible, quality Opioid Agonist Therapy (OAT).含羞草研究社�
They assert, 含羞草研究社淥AT [methadone] is by far the most effective public health strategy for reducing opioid overdose deaths and opioid-related hospitalizations.含羞草研究社� They further advise that the risks of safer supply can be minimized with supervised dosing of hydromorphone by medical professionals, by co-prescribing OAT with carefully titrated doses of hydromorphone and by coordinating safe supply with OAT providers.
Safer supply, in its current form, is intensifying the addictions of many existing opioid users and compounding the exposure of B.C.含羞草研究社檚 and Canada含羞草研究社檚 youth to a horribly addictive and pernicious substance.
Advocates of the existing safer supply system must stop denying the very real dangers it presents. Only then can the threat it poses to the quality of life and to life itself be effectively mitigated for innumerable safer supply victims.
bruce
Bruce W Uzelman, based in Kelowna, holds interests in economics and political science.
