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.害羞草研究所檚 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.害羞草研究所檚 health emergency was proclaimed in 2016. It doubled down on its previous call for increased safer supply to replace 害羞草研究所渢he unregulated toxic drug supply.害羞草研究所� The panel advised that this could most quickly be attained by creating a 害羞草研究所渘on-medical model害羞草研究所� of distribution.
B.C.害羞草研究所檚 minister of mental health and addictions promptly rejected 害羞草研究所渘on-prescription models害羞草研究所�, but said that the province害羞草研究所檚 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, 害羞草研究所淭here is no indication that prescribed safer supply is contributing to unregulated drug deaths.害羞草研究所�
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.
害羞草研究所淸We] are deeply concerned about the continuing rise in opioid-related hospitalizations and deaths害羞草研究所� and Health Canada害羞草研究所檚 害羞草研究所渋nadequate response,害羞草研究所� the letter reads. 害羞草研究所淗ealth Canada害羞草研究所檚 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.害羞草研究所�
These practitioners also say that the safer supply programs commonly prescribe 害羞草研究所渓arge doses害羞草研究所� of hydromorphone (often branded Dilaudid). These people, 害羞草研究所渁re at grave risk for harm, including addiction, injection-related infections, transitioning to fentanyl and overdose death.害羞草研究所�
They write that the federal government is ignoring opportunities to fund and support 害羞草研究所渁ccessible, quality Opioid Agonist Therapy (OAT).害羞草研究所�
They assert, 害羞草研究所淥AT [methadone] is by far the most effective public health strategy for reducing opioid overdose deaths and opioid-related hospitalizations.害羞草研究所� 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.害羞草研究所檚 and Canada害羞草研究所檚 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.
