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Addictions

‘Harm Reduction’ is killing B.C.’s addicts. There’s got to be a better way

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7 minute read

From the Frontier Centre for Public Policy

By Susan Martinuk 

B.C. recently decriminalized the possession of small amounts of illicit drugs. The resulting explosion of addicts using drugs in public spaces, including parks and playgrounds, recently led the province’s NDP government to attempt to backtrack on this policy

Since 2016, more than 40,000 Canadians have died from opioid drug overdoses — almost as many as died during the Second World War.
Governments, health care professionals and addiction experts all acknowledge that widespread use of opioids has created a public health crisis in Canada. Yet they agree on virtually nothing else about this crisis, including its causes, possible remedies and whether addicts should be regarded as passive victims or accountable moral agents.

Fuelled by the deadly manufactured opioid fentanyl, Canada’s national drug overdose rate stood at 19.3 people per 100,000 in 2022, a shockingly high number when compared to the European Union’s rate of just 1.8. But national statistics hide considerable geographic variation. British Columbia and Alberta together account for only a quarter of Canada’s population yet nearly half of all opioid deaths. B.C.’s 2022 death rate of 45.2/100,000 is more than double the national average, with Alberta close behind at 33.3/100,00.

In response to the drug crisis, Canada’s two western-most provinces have taken markedly divergent approaches, and in doing so have created a natural experiment with national implications.

B.C. has emphasized harm reduction, which seeks to eliminate the damaging effects of illicit drugs without actually removing them from the equation. The strategy focuses on creating access to clean drugs and includes such measures as “safe” injection sites, needle exchange programs, crack-pipe giveaways and even drug-dispensing vending machines. The approach goes so far as to distribute drugs like heroin and cocaine free of charge in the hope addicts will no longer be tempted by potentially tainted street drugs and may eventually seek help.

But safe-supply policies create many unexpected consequences. A National Post investigation found, for example, that government-supplied hydromorphone pills handed out to addicts in Vancouver are often re-sold on the street to other addicts. The sellers then use the money to purchase a street drug that provides a better high — namely, fentanyl.

Doubling down on safe supply, B.C. recently decriminalized the possession of small amounts of illicit drugs. The resulting explosion of addicts using drugs in public spaces, including parks and playgrounds, recently led the province’s NDP government to attempt to backtrack on this policy — though for now that effort has been stymied by the courts.

According to Vancouver city councillor Brian Montague, “The stats tell us that harm reduction isn’t working.” In an interview, he calls decriminalization “a disaster” and proposes a policy shift that recognizes the connection between mental illness and addiction. The province, he says, needs “massive numbers of beds in treatment facilities that deal with both addictions and long-term mental health problems (plus) access to free counselling and housing.”

In fact, Montague’s wish is coming true — one province east, in Alberta. Since the United Conservative Party was elected in 2019, Alberta has been transforming its drug addiction policy away from harm reduction and towards publicly-funded treatment and recovery efforts.

Instead of offering safe-injection sites and free drugs, Alberta is building a network of 10 therapeutic communities across the province where patients can stay for up to a year, receiving therapy and medical treatment and developing skills that will enable them to build a life outside the drug culture. All for free. The province’s first two new recovery centres opened last year in Lethbridge and Red Deer. There are currently over 29,000 addiction treatment spaces in the province.

This treatment-based strategy is in large part the work of Marshall Smith, current chief of staff to Alberta’s premier and a former addict himself, whose life story is a testament to the importance of treatment and recovery.

The sharply contrasting policies of B.C. and Alberta allow a comparison of what works and what doesn’t. A first, tentative report card on this natural experiment was produced last year in a study from Stanford University’s network on addiction policy (SNAP). Noting “a lack of policy innovation in B.C.,” where harm reduction has become the dominant policy approach, the report argues that in fact “Alberta is currently experiencing a reduction in key addiction-related harms.” But it concludes that “Canada overall, and B.C. in particular, is not yet showing the progress that the public and those impacted by drug addiction deserve.”

The report is admittedly an early analysis of these two contrasting approaches. Most of Alberta’s recovery homes are still under construction, and B.C.’s decriminalization policy is only a year old. And since the report was published, opioid death rates have inched higher in both provinces.

Still, the early returns do seem to favour Alberta’s approach. That should be regarded as good news. Society certainly has an obligation to try to help drug users. But that duty must involve more than offering addicts free drugs. Addicted people need treatment so they can kick their potentially deadly habit and go on to live healthy, meaningful lives. Dignity comes from a life of purpose and self-control, not a government-funded fix.

Susan Martinuk is a senior fellow at the Frontier Centre for Public Policy and author of the 2021 book Patients at Risk: Exposing Canada’s Health Care Crisis. A longer version of this article recently appeared at C2CJournal.ca.

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Addictions

London Police Chief warns parliament about “safer supply” diversion

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London Police Chief Thai Truong testifies to House of Commons Standing Committee on November 26, 2024.

By Adam Zivo

“Vulnerable individuals are being targeted by criminals who exchange these prescriptions for fentanyl, exacerbating addiction and community harm,” said London Police Chief Thai Truong.

Thai Truong, the police chief of London, Ontario, testified in parliament last week that “safer supply” opioids are “obviously” being widely diverted to the black market, leading to greater profits for organized crime. His insights further illustrate that the safer supply diversion crisis is not disinformation, as many harm reduction advocates have speciously claimed.

Truong’s testimony was given to the House of Commons Standing Committee on Health, which is in the midst of an extended study into the opioid crisis. While the committee has heard from dozens of witnesses, Truong’s participation was particularly notable, as safer supply was first piloted in London in 2016 and the city has, since then, been a hotbed for opioid diversion.

“While the program is well intentioned, we are seeing concerning outcomes related to the diversion of safe supply medications… these diverted drugs are being resold within our community, trafficked to other jurisdictions, and even used as currency to obtain fentanyl, perpetuating the illegal drug trade,” he said in his opening speech. “Vulnerable individuals are being targeted by criminals who exchange these prescriptions for fentanyl, exacerbating addiction and community harm.”

He later clarified to committee members that these vulnerable individuals include women who are being pressured to obtain safer supply opioids for black market resale.

Safer supply programs are supposed to provide pharmaceutical-grade addictive drugs – mostly 8-mg tablets of hydromorphone, an opioid as potent as heroin – as an alternative to riskier street substances. The programs generally supply these drugs at no cost to recipients, with almost no supervised consumption, and have a strong preference for Dilaudid, a brand of hydromorphone that is manufactured by Purdue Pharma.

Addiction experts and police leaders across Canada have reported that safer supply patients regularly divert their hydromorphone to the black market. A recent study by Dr. Brian Conway, director of Vancouver’s Infectious Disease Centre, for example, showed that a quarter of his safer supply patients diverted all of their hydromorphone, and that another large, but unknown, percentage diverted at least some of their pills.

Truong’s parliamentary testimony, which mostly rehashed information he shared in a press conference last July, further corroborated these concerns.

He noted that in 2019, the city’s police force seized 847 hydromorphone pills, of which only 75 were 8-mg Dilaudids. Seizures increased after access to safer supply expanded in 2020, and, by 2023, exploded to over 30,000 pills (a roughly 3,500 per cent increase), of which roughly half were 8-mg Dilaudids. During this period, the number of annual overdose deaths in the city also increased from 73 to 123 (a 68 per cent increase), he said.

Relatedly, Truong noted that the price of hydromorphone in London – $2-5 a pill – is now much lower than in other parts of the province.

As an increasing number of police departments across Canada have publicly acknowledged that they are seeing skyrocketing hydromorphone seizures, some safer supply advocates have claimed, without evidence, that these pills were mostly stolen from pharmacies, and not diverted by safer supply patients. Truong’s parliamentary testimony dispelled this myth: “These increases cannot be attributed to pharmacy thefts, as London has had only one pharmacy robbery since 2019.”

The police chief declined to answer repeated questions about the efficacy of safer supply, or to opine on whether the experimental program should be replaced with alternative interventions with stronger evidence bases. “I’m not here to criticize the safe supply program, but to address the serious challenges associated with its diversion,” he said, noting his own lack of medical expertise.

The chief emphasized that, while more needs to be done to stop safer supply diversion, the addiction crisis is a “complex issue” that cannot be tackled solely through law enforcement. He advocated for a “holistic” approach that integrates prevention, harm reduction and treatment, and acknowledged the importance of London’s community health and social service partners.

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In response to Truong’s testimony, NDP MP Gord Johns, an avid safer supply advocate, downplayed the importance of the diversion crisis by arguing that “people aren’t dying from a safer supply of drugs; they’re dying from fentanyl.”

While it is true that 81 per cent of overdose deaths in 2024 involved fentanyl, addiction physicians across Canada have repeatedly debunked Johns’ argument as misleading. The dangers of diverted hydromorphone is not that it directly kills users, but rather that it easily hooks individuals into addiction, leading many of them to graduate to deadly fentanyl use.

Johns previously faced criticism when, in a September health committee meeting, he seemingly used parliamentary maneuvers to reduce the speaking time of a grieving father, Greg Sword, whose daughter, Kamilah, died of drug-related causes after she and her friends got hooked on diverted hydromorphone.

There is currently no credible evidence that safer supply works. Most supporting studies simply interview safer supply patients and present their opinions as objective fact, despite significant issues with bias and reliability. Data presented in a 2024 study published in the British Medical Journal, which followed over 5,000 drug users in B.C., showed that safer supply led to no statistically significant mortality reductions once confounding factors were fully filtered out.

An impending update to Canada’s National Opioid Use Disorder Guideline, which was recently presented at a conference  organized by the Canadian Society of Addiction Medicine, determined that the evidence base for safer supply is “essentially low-level.” Similarly, B.C’s top doctor acknowledged earlier this year that safer supply is “not fully evidence-based.”


This article was syndicated in The Bureau, an online media publication that investigates foreign interference, organized crime, and the drug trade.

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Addictions

Parliament votes for proposal recommending hard drug decriminalization

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From LifeSiteNews

By Clare Marie Merkowsky

Canadian MPs have voted 210 to 117 in favor of a proposal to decriminalize simple possession of heroin, cocaine and all other illegal drugs across Canada despite the disastrous effects of lax drug policies already observed.

Canada may be one step closer to decriminalizing hard drugs as the majority of MPs voted in favor of a proposal recommending the move.

According to information published November 25 by Blacklock’s Reporter, MPs voted 210 to 117 in favor of a proposal recommending the decriminalizing of the simple possession of heroin, cocaine and all other illegal drugs across Canada. While the proposal is non-binding, it could point to how MPs would vote on a future bill seeking to augment the law.

“Why has it come to this?” Conservative MP Jacques Gourde, who opposes such a move, questioned. “We have reached the end of the road and nothing better lies ahead if we continue down this path.”  

The recommendation, which received a House majority with only Conservative MPs voting against it, suggested “that the Government of Canada decriminalize simple possess of all illicit drugs.”  

Prime Minister Justin Trudeau’s cabinet was noncommittal in their response to the suggestion, saying, “The government recognizes there are increasing calls from a wide range of stakeholders to decriminalize the simple possession of drugs as another tool to reduce stigma that can lead many to hide their drug use and avoid seeking supports including treatment.” 

“The government is exploring policy approaches and a broader framework that would ease the impact of criminal prohibitions in certain circumstances,” the Cabinet continued. 

The Trudeau government’s consideration of nationwide decriminalization comes despite drug-related deaths skyrocketing in the province of British Columbia after decriminalization was implemented there by the Trudeau government in 2023. In fact, the policy was considered so damaging by the left-wing controlled province that it had to ask to have certain aspects of the policy, such as the public use of drugs, rescinded earlier this year.

Other soft-on-drug policies have already been implemented by the Trudeau government, including the much-maligned “safer supply” program.

Safe supply” is the term used to refer to government-prescribed drugs 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 when implemented.    

Gunn, who has since become a Conservative Party candidate, previously noted that his film shows clearly the “general societal chaos and explosion of drug use in every major Canadian city” since lax policies were implemented.  

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

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