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Addictions

Reckless: British Columbia’s “safe supply” fentanyl tablet experiment

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9 minute read

From the MacDonald Laurier Institute

By Adam Zivo

While safer supply sounds nice in theory, addiction experts have found that drug users are reselling (“diverting”) a significant portion of their free hydromorphone on the black market to purchase harder substances. This has fuelled new addictions while generating handsome profits for organized crime.

Adam Zivo reviews the latest drug protocols adopted by the BC government and reports on their alarming lack of evidence and accountability.

British Columbia’s new drug protocols allow doctors throughout the province to prescribe “safer supply” drugs in a reckless manner.

In a new report titled Reckless: British Columbia’s “safe supply” fentanyl tablet experiment, Adam Zivo reviews the newest drug protocols adopted by the BC government, documenting the evolution of “safe supply” opioid programs in Canada since 2020. Zivo reports on the concerning lack of evidence behind the protocols, how they undermine recovery, drive diversion to the black market, and ruin the lives of young Canadians.

The new protocols not only avoid any requirement for drug users to first try evidence-based recovery programs before receiving high-potency opioids, but also allow minors to receive them, with no reference to the rights and roles of parents or even a minimum age for safer supply clients.

Of deep concern is also the BC government’s approach of continually increasing access to “safe” opioids despite openly admitting that there is no evidence of proven benefits or safety. The protocols also require that clients be told that their access to free fentanyl and sufentanil will almost certainly be cut off if they are hospitalized, or if they attend withdrawal management or substance use treatment facilities.

Zivo explains: “The prospect of free fentanyl and sufentanil creates powerful incentives to sign away one’s rights to evidence based treatment, so the province is essentially exploiting clients’ addictions so that it can experiment on them without taking legal responsibility for potential harms.”

Zivo adds that “one can reasonably expect that a significant portion of the fentanyl tablets being distributed by the BC government will end up being traded or resold on the black market,” explaining how mass diversion is already a major issue for weaker “safer supply” opioids like hydromorphone.

While addiction experts have been overwhelmingly critical of unsupervised safer supply, Zivo notes that many believe that the solution is not to abolish but to reform the program so that drugs can be provided more responsibly. By receiving safer supply as a temporary intervention, addicted users can transition to recovery-oriented treatments such as opioid agonist therapy (OAT.)

“It would not take much to reshape BC’s safer supply fentanyl and sufentanil programs into something more responsible and genuinely safe,” concludes Zivo. “There is nothing preventing the province from redesigning safer supply as a recovery-oriented intervention.”

To learn more, read the full paper here:

PDF of paper

Executive Summary

This past August, British Columbia’s government quietly launched new protocols that allow doctors to prescribe “safer supply” fentanyl tablets and liquid sufentanil. Fentanyl is at least 10 times stronger than hydromorphone and sufentanil, which is derived from fentanyl, is a further 5 to 10 times more potent than its parent drug. While in theory these drugs could save lives if provisioned cautiously, the way the province has chosen to distribute these dangerous opioids is nothing short of reckless.

There is evidence to support the use of opioid agonist therapy (“OAT”) medications, such as methadone, buprenorphine, and slow release oral morphine in addiction treatment, but the government’s new protocols extrapolate OAT-related evidence to support “safer supply” fentanyl even though the two therapies have little in common. In fact, the government’s protocols stress that providing safer supply fentanyl or sufentanil is “not a treatment for opioid use disorder” and that “there is no evidence available supporting this intervention, safety data, or established best practices for when and how to provide it.” It is deeply concerning that the BC government has, over the past several years, significantly increased access to “safe” fentanyl and sufentanil despite openly admitting that there is no evidence showing that these interventions provide any benefits and can be implemented safely.

“Safer supply” programs claim to reduce overdoses and deaths by providing free pharmaceutical-grade drugs as alternatives to potentially tainted illicit substances. While safer supply sounds nice in theory, addiction experts have found that drug users are reselling (“diverting”) a significant portion of their free hydromorphone on the black market to purchase harder substances. This has fuelled new addictions while generating handsome profits for organized crime. Some patients have even been coerced into securing safer supply they didn’t need. Pimps and abusive partners pressure vulnerable women into securing as much hydromorphone as possible for black market resale. Other vulnerable patients, such as the geriatric and disabled, have been robbed of their safer supply outside of pharmacies.

There are other issues with the protocols, too. They require that clients be told that their access to free fentanyl and sufentanil will almost certainly be cut off if they are hospitalized, or if they attend withdrawal management or substance use treatment facilities. This creates powerful disincentives for drug users to seek life-saving health care. Further, none of the safer supply protocols by the British Columbia Centre on Substance Use (BCCSU) discuss the rights and roles of the parents of minors struggling with addiction. It appears that health care providers can give fentanyl and sufentanil to minors regardless of whether parents are aware of, or consent to, this intervention. The protocols do not specify a minimum age for safer supply clients.

It would not take much to reshape BC’s safer supply fentanyl and sufentanil programs into something more responsible and genuinely safe. There is nothing preventing the province from redesigning safer supply as a recovery-oriented intervention. Experts argue that safer supply could be helpful if used as a temporary intervention that helps severely-addicted users make the transition to recovery-oriented treatments, such as OAT.

There is also nothing stopping the province from fixing many of the issues with the safer supply program – including lax safeguards for youth. Any safer supply model must require supervised consumption. It is the absence of this supervision that has enabled the mass diversion of safer supply drugs onto the black market.

Governments have a duty to provide evidence-based treatment to vulnerable citizens and consider collateral harms to others. Rather than fulfil this duty, the BC government is committing to risky and highly experimental interventions that lack an appropriate evidence base.

Adam Zivo is a freelance writer and political analyst best known for his weekly columns in the National Post. He holds a Master of Public Policy from the Munk School of Global Affairs and Public Policy and recently founded the Centre for Responsible Drug Policy, a nonprofit advocacy organization.

Addictions

Activists Claim Dealers Can Fix Canada’s Drug Problem

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By Adam Zivo

We should learn from misguided experiments with activist-driven drug ideologies.

Some Canadian public-health researchers have argued that the nation’s drug dealers, far from being a public scourge, are central to the cause of “harm reduction,” and that drug criminalization makes it harder for them to provide this much-needed “mutual aid.” Incredibly, these ideas have gained traction among Canada’s policymakers, and some have even been put into practice.

Gillian Kolla, an influential harm-reduction activist and researcher, spearheaded the push to whitewash drug trafficking in Canada. Over the past decade, she has advocated for many of the country’s failed laissez-faire drug policies. In her 2020 doctoral dissertation, she described her hands-on research into Toronto’s “harm reduction satellite sites”—government-funded programs that paid drug users to provide services out of their homes.

The sites Kolla studied were operated by the nonprofit South Riverdale Community Health Centre (SRCHC) in Toronto. Addicts participating in the programs received $250 per month in exchange for distributing naloxone and clean paraphernalia (needles and crack pipes, for example), as well as for reversing overdoses and educating acquaintances on safer consumption practices. At the time of Kolla’s research (2016–2017), the SRCHC was operating nine satellite sites, which reportedly distributed about 1,500 needles and syringes per month.

Canada permits supervised consumption sites—facilities where people can use drugs under staff oversight—to operate so long as they receive an official exemption via the federal Controlled Drugs and Substances Act. As the sites Kolla observed did not receive exemptions, they were certainly illegal. Kolla herself acknowledged this in her dissertation, writing that she, with the approval of the University of Toronto, never recorded real names or locations in her field notes, in case law enforcement subpoenaed her research data.

Even so, the program seems to have enjoyed the blessing of Toronto’s public health officials and police. The satellite sites received local funding from 2010 onward, after a decade of operating on a volunteer basis, apparently with special protection from law enforcement. In her dissertation, Kolla described how SRCHC staff trained police officers to leave their sites alone, and how satellite-site workers received special ID badges and plaques to ward off arrest.

Kolla made it clear that many of these workers were not just addicts but dealers, too, and that tolerance of drug trafficking was a “key feature” of the satellite sites. She even described, in detail, how she observed one of the site workers packaging and selling heroin alongside crackpipes and needles.

In her dissertation, Kolla advocated expanding this permissive approach. She claimed that traffickers practice harm reduction by procuring high-quality drugs for their customers and avoiding selling doses that are too strong.

“Negative framings of drug selling as predatory and inherently lacking in care make it difficult to perceive the wide variety of acts of mutual aid and care that surround drug buying and selling as practices of care,” she wrote.

In truth, dealers routinely sell customers tainted or overly potent drugs. Anyone who works in the addiction field can testify that this is a major reason that overdose deaths are so common.

Ultimately, Kolla argued that “real harm reduction” should involve drug traffickers, and that criminalization creates “tremendous barriers” to this goal.

The same year she published her dissertation, Kolla cowrote a paper in the Harm Reduction Journal with her Ph.D. supervisor at the Dalla Lana School of Public Health. The article affirmed the view that drug traffickers are essential to the harm-reduction movement. Around this time, the SRCHC collaborated with the Toronto-based Parkdale Queen West Community Health Centre— the only other organization running such sites—to produce guidelines on how to replicate and scale up the experiment.

Thankfully, despite its local adoption, this idea did not catch on at the national level. It was among the few areas in the early 2020s where Canada did not fully descend into addiction-enabling madness. Yet, like-minded researchers still echo Kolla’s work.

In 2024, for example, a group of American harm-reduction advocates published a paper in Drug and Alcohol Dependence Reports that concluded, based on just six interviews with drug traffickers in Indianapolis, that dealers are “uniquely positioned” to provide harm-reduction services, partly because they are motivated by “the moral imperative to provide mutual aid.” Among other things, the authors argued that drug criminalization is harmful because it removes dealers from their social networks and prevents them from enacting “community-based practices of ethics and care.”

It’s instructive to review what ultimately happened with the originators of this movement—Kolla and the SRCHC. Having failed to whitewash drug trafficking, Kolla moved on to advocating for “safer supply”—an experimental strategy that provides addicts with free recreational drugs to dissuade use of riskier street substances. The Canadian government funded and expanded safer supply, thanks in large part to Kolla’s academic work. It abandoned the experiment after news broke that addicts resell their safer supply on the black market to buy illicit fentanyl, flooding communities with diverted opioids and fueling addiction.

The SRCHC was similarly discredited after a young mother, Karolina Huebner-Makurat, was shot and killed near the organization’s supervised consumption site in 2023. Subsequent media reports revealed that the organization had effectively ignored community complaints about public safety, and that staff had welcomed, and even supported, drug traffickers. One of the SRCHC’s harm-reduction workers was eventually convicted of helping Huebner-Makurat’s shooter evade capture by hiding him from the police in an Airbnb apartment and lying to the police.

There is no need for policymakers to repeat these mistakes, or to embrace its dysfunctional, activist-driven drug ideologies. Let this be another case study of why harm-reduction policies should be treated with extreme skepticism.

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Addictions

Canadian gov’t not stopping drug injection sites from being set up near schools, daycares

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From LifeSiteNews

By Anthony Murdoch

Canada’s health department told MPs there is not a minimum distance requirement between safe consumption sites and schools, daycares or playgrounds.

So-called “safe” drug injection sites do not require a minimum distance from schools, daycares, or even playgrounds, Health Canada has stated, and that has puzzled some MPs. 

Canadian Health Minister Marjorie Michel recently told MPs that it was not up to the federal government to make rules around where drug use sites could be located.

“Health Canada does not set a minimum distance requirement between safe consumption sites and nearby locations such as schools, daycares or playgrounds,” the health department wrote in a submission to the House of Commons health committee.

“Nor does the department collect or maintain a comprehensive list of addresses for these facilities in Canada.”

Records show that there are 31 such “safe” injection sites allowed under the Controlled Drugs And Substances Act in six Canadian provinces. There are 13 are in Ontario, five each in Alberta, Quebec, and British Columbia, and two in Saskatchewan and one in Nova Scotia.

The department noted, as per Blacklock’s Reporter, that it considers the location of each site before approving it, including “expressions of community support or opposition.”

Michel had earlier told the committee that it was not her job to decide where such sites are located, saying, “This does not fall directly under my responsibility.”

Conservative MP Dan Mazier had asked for limits on where such “safe” injection drug sites would be placed, asking Michel in a recent committee meeting, “Do you personally review the applications before they’re approved?”

Michel said that “(a)pplications are reviewed by the department.”

Michel said, “Supervised consumption sites were created to prevent overdose deaths.”

Mazier continued to press Michel, asking her how many “supervised consumption sites approved by your department are next to daycares.”

“I couldn’t tell you exactly how many,” Michel replied.

Mazier was mum on whether or not her department would commit to not approving such sites near schools, playgrounds, or daycares.

An injection site in Montreal, which opened in 2024, is located close to a kindergarten playground.

Conservative Party leader Pierre Poilievre has called such sites “drug dens” and has blasted them as not being “safe” and “disasters.”

Records show that the Liberal government has spent approximately $820 million from 2017 to 2022 on its Canadian Drugs and Substances Strategy. However, even Canada’s own Department of Health admitted in a 2023 report that the Liberals’ drug program only had “minimal” results.

Recently, LifeSiteNews reported that the British Columbia government decided to stop a so-called “safe supply” free drug program in light of a report revealing many of the hard drugs distributed via pharmacies were resold on the black market.

British Columbia Premier David Eby recently admitted that allowing the decriminalization of hard drugs in British Columbia via a federal pilot program was a mistake.

Former Prime Minister Justin Trudeau’s loose drug initiatives were deemed such a disaster in British Columbia that Eby’s government asked Trudeau to re-criminalize narcotic use in public spaces, a request that was granted.

Official figures show that overdoses went up during the decriminalization trial, with 3,313 deaths over 15 months, compared with 2,843 in the same time frame before drugs were temporarily legalized.

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