Addictions
B.C. officials push back against safe supply critics and their ‘polarizing rhetoric’
Provincial health officer Dr. Bonnie Henry looks on as chief coroner Lisa Lapointe discusses details about the province’s application for decriminalization in the next step to reduce toxic drug deaths during a news conference in the press gallery at the legislature in Victoria, Monday, Nov. 1, 2021. THE CANADIAN PRESS/Chad Hipolito
Victoria
British Columbia officials have sought to rebut claims that drugs prescribed through the province’s safe supply program aimed at curbing overdoses are being re-sold to young people, helping fuel the deadly drug toxicity crisis.
B.C.’s representative for children and youth, Jennifer Charlesworth, said her office reviews injury and death reports involving young people and she hasn’t seen any sign that youth are either using drugs “diverted” from the safe supply program, or that they are suffering overdoses from such drugs.
Instead, she said “polarizing rhetoric” on the issue was causing harm.
“Safe supply is an alternative to the poison that is available on the street, and I’ll repeat, for emphasis, what I said earlier: there’s no indication from our data that diverted safe supply is causing overdoses for children and youth,” she said.
“Is it possible that diversion will be an issue in the future? Anything is possible within this highly complex and fast-evolving crisis we are all in.”
Her remarks came after Opposition Leader Pierre Poilievre recently told the House of Commons that federal and B.C. government policies are worsening the overdose crisis because prescription hydromorphone “gets sold to kids” by those taking part in the program, with the profits used to buy stronger substances, such as fentanyl.
B.C.’s chief coroner, Lisa Lapointe — who joined Charlesworth and provincial health officer Dr. Bonnie Henry at a news conference on Monday — said toxicology tests show hydromorphone hasn’t been present in any significant number of deaths.
Officials are “closely monitoring, continually, for any and all trends that may impact public safety” as a result of the safe supply program, she said.
Henry said monitoring has not detected an increase in opioid overdoses involving children, or new diagnoses of opioid use disorder.
She said the amount of hydromorphone being prescribed through the safe supply program is very small, and the drug has been available in large quantities through other routes for a long time.
Even if all of the hydromorphone prescribed as safe supply made its way to the street, “it would be a very, very tiny percentage of what is out there,” she said.
Asked to comment, a spokesman for Poilievre shared links to recent media stories, saying they “directly challenge” the “allegations” made by the B.C. officials.
The three officials expressed concern over the “polarization” of safe supply and other harm-reduction measures.
Charlesworth told the news conference they were “standing together, saying fear-based, polarizing rhetoric that is not evidence-informed is causing harm.”
Lapointe said it was not a response to any one person or media report, but they’ve been concerned about “increasingly polarized rhetoric that is not informed by evidence.”
She said recent “divisive” language and rhetoric surrounding people who use drugs drives them further underground, and that includes children and youth.
“If they’re using drugs, they will not come forward, or your relatives or your neighbours, and that is the most harmful thing we can do,” she said.
Asked about safeguards to ensure prescribed drugs are not being resold, Lapointe said drug trafficking remains a crime.
Officials are “dealing with a lot of anecdotal information and allegations,” she said.
Henry said officials can’t change policies based on “individual stories or anecdotes.”
“We need to have the data behind it.”
Still, Henry said she wanted the public to know that officials take concerning reports from clinicians, media and others seriously, and they investigate accordingly.
“We are not just doing this without having robust monitoring and evaluation.”
Henry said it may be time to re-evaluate the safe supply program to ensure it’s meeting people’s needs as the province emerges from the COVID-19 pandemic, which has contributed to increases in drug toxicity and overdose deaths.
She said she’s heard from some clinicians that hydromorphone isn’t always meeting patients’ needs, and may be used to acquire other substances.
“What we’re also hearing from people who use drugs is that sometimes they use (hydromorphone) as a commodity for friends, for others, who don’t have access.”
Officials will review early evidence from the program to consider any adjustments over the coming weeks and months, Henry said.
More than 12,400 people have died from overdoses since the B.C. government declared a health emergency in 2016.
Lapointe said it’s estimated that more than 100,000 people in B.C. have an opioid use disorder, a number that does not include people who use illicit opioids occasionally, or those who regularly or irregularly use stimulants.
“All of those tens of thousands of people are currently at risk of death or serious harm. A substantial, co-ordinated, comprehensive response is required.”
— By Brenna Owen in Vancouver
This report by The Canadian Press was first published June 5, 2023.
Addictions
‘Our Liberal Government Is Acting Like A Drug Lord’: A Mother’s Testimony
By Adam Zivo
“As soon as [my son] was put on safe supply, he started diverting his safe supply” Mom tells Parliament safer supply isn’t working
“The whole purpose of the safer supply program was to divert addicts from using harmful street drugs, but that’s not happening,” testified Masha Krupp, an Ottawa-based mother, at the House of Commons Health Committee last week. Exhausted and blunt, she described how her son has, in the past, diverted his “safer supply” drugs to the black market and how she has personally witnessed widespread diversion, by other patients, outside the clinic her son attends.
Safer supply programs distribute free addictive drugs – typically hydromorphone, a heroin-strength opioid – under the belief that this stabilizes addicts and dissuades them from consuming riskier street substances. Addiction experts and police leaders across Canada, however, say that recipients regularly divert these taxpayer-funded drugs to the black market, fueling new addictions and gang profits.
The Liberals and NDP have denied that widespread safer supply diversion is occurring, despite ample evidence to the contrary – but Krupp’s lived experiences underline the folly of their willful blindness.
“As soon as he was put on safe supply, he started diverting his safe supply,” she testified. “You’ve got drug dealers – I know this for a fact through my son; I’ve seen it – they will come to your home, 24/7, you can call two in the morning. They take your hydromorphone pills.”
According to Krupp, her son’s addiction issues have not improved despite him being enrolled in a safer supply program for more than two years. He still uses fentanyl and crack cocaine, which led to yet another overdose just last month, she said, adding that diversion and a lack of recovery-oriented services contribute to his instability.
“The Dilaudid (brand name hydromorphone) is a means of currency for my son to continue using crack cocaine – so it’s not safe, because he’s still using unsafe street drugs,” she said in parliament.
Krupp further explained that, on multiple occasions, she witnessed and photographed patients selling their safer supply in front of the clinic where her son has been a patient since June 2021. The transactions were not subtle: she could see them counting and exchanging white pills.
Over time, Krupp corroborated these observations by acquainting herself with some of these patients, who would admit to selling their safer supply: “I get to know all these people that are diverting and using right in front of the clinic, in front of all the tourists, parents walking by with kids.”
She believes that safer supply could have a role in addiction care if it were better regulated, but feels that the current model, where supervised consumption of these drugs is rarely required, is only “flooding the market, using taxpayers’ dollars, with lethal opiates…”
“It’s unsafe supply, in my view, as a mother with lived experience,” said Krupp. “Our Liberal government, right now, is acting like a drug lord.”
Her testimony was consistent with what was described in a CBC investigative report published last February, wherein Ottawa’s police officers confirmed that safer supply diversion is rampant.
One constable quoted in the story, Paul Stam, said that virtually anytime police would pull up to Rideau and Nelson street, where the clinic Krupp’s son attends is located, “they would observe people openly trafficking in diverted hydromorphone.” The officer further told the CBC that the “street is flooded with this pharmaceutical grade hydromorphone” and that there has been a dramatic, province-wide reduction in the drug’s blackmarket price – from $8-9 per 8-mg pill to just $1-2 today.
Although Krupp gave her parliamentary testimony last week, I interviewed her in July and kept her story private at her request – at the time, she worried that going public could interfere with her son’s attempts at recovery.
In the July interview, Krupp explained that, not only had her son told her that safer supply diversion is ubiquitous, she had also heard this from two acquaintances of his, who were also on the program: “The information that I’ve received is that the drug dealers have operations set up 24/7 across the city, buying legal dillies (the slang term for hydromorphone).”
She explained that she had been able to witness and document safer supply diversion because, on most Friday mornings, she would take her son to his clinic appointments and wait for him outside in her car. As she was often parked just two or three metres away from where many drug deals occurred, she had a line of sight into what was going on: clearly-identifiable dillies being handed over for other drugs.
She estimated that, by that point, she had cumulatively witnessed at least 25 safer supply patients engage in diversion.
“[Safer supply patients] would trade their dillies for fentanyl and/or crack cocaine and smoke or inject it right in front of me. They would just huddle in a corner. It’s all done very openly,” she said. “What I witness, to me, is a human tragedy on the sidewalks of the nation’s capital, with Parliament Hill eight or nine blocks away, and all the politicians sitting there singing praises to safer supply.”
She pushed back on the narrative, popular among Liberal and NDP politicians, that criticism of safer supply is conservative fear mongering and said that she had voted NDP in the past, and had even voted for Trudeau in 2015. Her disgust with safer supply was simply her “speaking from the heart as a mother.”
While harm reduction activists claim that safer supply is a form of compassionate care, Krupp vehemently disagreed: “How is it compassionate to fuel somebody’s addiction? How is it humane to keep a perpetual cycle of drug abuse and dependence?”
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Addictions
A conversation with Premier Smith’s outgoing chief of staff, architect of Alberta’s recovery-focused drug policies
Marshall Smith, Alberta’s Chief of Staff, sits in his office at the Alberta Legislature in Edmonton
Marshall Smith, on what he has learned as an addict and policy leader and what’s next for him
Alberta Premier Danielle Smith’s chief of staff, Marshall Smith, is leaving his post at the end of October.
Since taking office in 2022, he has been instrumental in shaping Alberta’s drug policies and developing the Alberta Model — a recovery-focused addiction treatment policy that has gained international recognition for enhancing access to mental health and addiction services.
Under his guidance, Alberta has prioritized building recovery communities over harm-reduction programs. Government data show a 53 per cent decrease in opioid-related overdose deaths in June 2024 from the prior year, which may suggest Smith’s initiatives are having an impact.
In a statement on social media, the Premier shared that Smith informed her of his decision to retire earlier this year, after dedicating 32 years to public service. His departure comes just ahead of the United Conservative Party’s leadership review on Nov. 2.
Smith met with reporter Alexandra Keeler on Sept. 10 to discuss his personal journey from addiction to recovery and how it has shaped Alberta’s drug policies. On Oct. 10, they spoke by phone to discuss his recent decision to step down and what lies ahead for him.
AK: What emotional and psychological impact did your addiction have on your sense of self?
MS: It makes you feel powerless. Addiction is an illness of isolation, despair, loneliness and powerlessness. One of the hallmarks of addiction is continuing to use a substance despite a complete lack of control over your using, and over the circumstances that you’re in.
AK: Do you think that sense of powerlessness impacts an individual’s ability to provide informed consent for involuntary treatment?
MS: I think that, over time, if addiction is left unchecked or untreated, or is allowed to progress to its very latter stages, you absolutely lose agency over your ability to make decisions.
I used to get the question a lot: ‘Is it a disease? Is it a choice?’ And I say it’s both. It’s actually a disease of choices, which is to say that it’s a disease or an illness that affects my brain’s ability to make good choices.
AK: Were you the driving force behind Alberta’s shift away from harm reduction towards a recovery-focused approach, or was there a broader change in attitudes within the community?
MS: Certainly I’m not solely responsible. I’m a member of a broad community of people in recovery who have been advocating for these policies for two decades. I think that I have a background [and] certain skills that have found me in positions like this, where I can be most effective helping my community advance these ideas and concepts and actually get them implemented into policy and action.
AK: Obviously your lived experience with addiction brings a valuable perspective to the table. But what data sources are the province using to inform its addiction and recovery policies?
MS: We have a very broad literature base that we use to inform a lot of our policy decisions … Alberta [also] has the most comprehensive data collection and data analytics system in North America, bar none.
A practical example of how that’s useful is … [if] the data shows us that a very high number of people who were in custody — whether that’s corrections or police custody — went on to fatally overdose in a period after their release, that tells us that we need to focus on correctional programs, and we need to focus on policing programs.
And we’ve done that. We have amazing new correctional treatment programs that are second to none. I don’t know of anybody in Canada that’s doing this — we’ve taken [jail units where inmates sleep and live] and turned them into treatment centres, and connected them with our new treatment centres outside of jails. We partnered with police, because police have probably the most amount of contact with people who are using substances, and we gave them the ability to help people get on to opioid-substitution medications.
We’re going to go even further. Minister [of Mental Health and Addiction Dan] Williams has just announced the creation of the Centre of Recovery Excellence (CoRE), which is a first of its kind in Canada. It’s a Crown corporation not beholden to pharmaceutical money, which is a big change for us, and we were very deliberate about that.
[CoRE] will give us the ability to pull in data from across systems in government and have that data analyzed … So we’re entering into a very exciting time in terms of data and analytics around this issue.
AK: Without CoRE fully operational yet, what made you confident the recovery-focused approach would succeed?
MS: I see hundreds of thousands of Canadians every day entering recovery and maintaining their recovery … What I see in the alternative is a lot of drug use, homelessness, despair, disease [and] crime.
We spend a lot of time talking about data and evidence and science, and all of those things are good and necessary … but it’s not the only component of the decision-making process. … The policies that we’re making and the pathways that we take also have to be informed by the values of the community that we serve. … For far too long in Canada, that hasn’t been a consideration.
I think that we are at a place in Canada where the country is saying to us it’s time to revisit the direction that we’ve been going. I think that they’re saying to us, as policymakers, that we gave this a chance. We had become convinced by experts and the media … to give [pro-drug, harm-reduction policies like safer supply] a try …
[A]fter 20 years of that, I think that Canadians are ready to throw in the towel and to say, ‘We’re done with this. We’ve given you enough time to prove out your thesis. It’s not worked, and now we’re looking for fresh ideas.’
So Alberta is here leading that conversation of fresh and different ideas, and we’re happy to have that role.
The remainder of this interview took place on Oct. 10.
AK: Premier Smith announced your retirement at the end of October. What prompted your decision to step down?
MS: My time in Alberta has been a lengthy and intense role of system transformation over two premiers and standing up government twice.
While there’s still a lot of work to be done here, we have a tremendous team in Alberta that is leading that work under Minister Williams. I just felt that it’s time for me to step out of the role and continue to serve in other capacities.
AK: Looking ahead, what aspects of the Alberta Model will you carry with you into your future endeavours?
MS: I would say all aspects of the model need to be expanded across Canada, for jurisdictions that are interested.
Where I can be of the most assistance to other governments is talking to them about how to effectively organize themselves to be successful in this area. I think that governments across the country are struggling to figure out how to do that.
AK: What new opportunities do you hope to pursue that you haven’t been able to explore during your time in this role? Will your focus continue to be in addiction and drug policy?
MS: The majority of my focus will be on addiction and drug policy, but I have other areas of interest.
I’m passionate about the work that we’re doing with Indigenous people … I’m also very passionate about emerging technology and how we’re going to use that to uncover some of the answers that we’re looking for on these models.
I’m looking forward to having a little bit more freedom and focus.
This interview has been edited and condensed for clarity.
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.
Subscribe to Break The Needle. Our content is always free – but if you want to help us commission more high-quality journalism, consider getting a voluntary paid subscription.
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