Addictions
Safe supply opioids based more on ideology than evidence?
From the Frontier Centre for Public Policy
Those who advocate for them always claim the moral high ground because of ‘evidence-based studies.’ But such studies appear to be in short supply.
That’s probably why 72 BC doctors recently signed a letter that argues against safer supply, saying the evidence underlying the philosophy is “weak or inadequate.”
Almost three years into the experimental opiate “safer supply” program in British Columbia and no one, including those handing out the pills, seems to know if it is working or making the problem worse. There are no shortage of opinions arguing on either side of the debate, but recent reports suggest that the facts remain in short supply.
Safe supply initiatives fall under the broad category of harm reduction programs. For opiate addiction, the program typically involves the prescription and distribution of pills like hydromorphone, a medical-grade opioid that is as potent as heroin, to addicts. The underlying hope is that addicts will then forgo possibly-tainted, illicit street drugs in favour of the ‘safer’ government-provided pills.
More than 40,000 Canadians have lost their lives to opioid overdoses since 2016 and British Columbia is one of the world’s first jurisdictions to take the ‘safer supply’ route in an effort to quell opioid overdoses.
But BC’s Auditor General just released a report on the trial program and, so far, it remains unclear as to whether the program has made any progress. Opioid deaths are still increasing and, while the report doesn’t criticize the underlying philosophy of ‘safer supply,’ it does note “deficiencies in key areas.”
According to the report, the government is conducting the program in a rather haphazard way. BC health authorities failed to maintain basic standards for administering an experimental trial and neglected their obligation to publish data on how the program is doing. The data was supposed to be publicly available by September 2022, more than 18 months ago.
Instead, the report found that health authorities are overly reliant on incomplete and out-of-date fact sheets about the program’s performance. It also cited authorities for major failings in the management and delivery of the program.
The bureaucrats in charge claim that they have the data to support their claims about the success of the program, yet one has to wonder why — three years in — no data is available to support those claims.
A similar dearth of data has been noted in Ottawa where the House of Commons Health Committee has been exploring the opioid epidemic and toxic drug crisis. One doctor who leads a safer supply program in London, Ontario, appeared to be a strong advocate for safer supply programs, claiming that safe supply clinicians “rely on good research and published evidence.”
But Dr. Marcus Powlowski, a Liberal MP and medical doctor who also has a master’s degree in health law and policy from Harvard, had apparently looked at the papers that she proclaimed as evidence, and soundly renounced the studies as “basically a bunch of anecdotes.”
So where is this rigorous scientific evidence for safer supply programs?
Those who advocate for them always claim the moral high ground because of ‘evidence-based studies.’ But such studies appear to be in short supply.
That’s probably why 72 BC doctors recently signed a letter that argues against safer supply, saying the evidence underlying the philosophy is “weak or inadequate.” They called for all safer supply programs to be “tightly controlled, rigorously monitored, and meticulously documented.”
A lack of medical evidence is likely related to another major issue outlined in the Auditor General’s report – “prescriber hesitancy.” That is, there are only a limited number of doctors who are willing to write prescriptions for the potent opioids used in safer supply.
However, there is plenty of evidence for one disturbing aspect of this program – diversion. This is a practice whereby safer supply pills (primarily hydromorphone) given to addicts are subsequently sold (or diverted) to drug traffickers and/or organized crime groups to obtain more potent and illicit drugs like fentanyl.
In early March, the RCMP in Northern BC revealed that thousands of safe supply opiate pills had been seized as part of organized crime busts in Prince George and Campbell River. It was considered to be solid evidence that diversion of safer supply drugs was occurring. According to the RCMP spokesperson, “Organized crime groups are actively involved in the redistribution of safe supply and prescription drugs,” and “what has been deemed safe is not being kept safe.”
It is simply not realistic to expect that such practices are not occurring in our major cities. The National Post, the CBC and an independent filmmaker have all previously published evidence of diversion occurring in London, Ottawa and Vancouver, respectively.
Drug policies such as safe supply have long bypassed appropriate scientific scrutiny because they supposedly save lives. But the question still remains – do they? And at what cost to addicts and the rest of society?
Susan Martinuk is a Senior Fellow with the Frontier Centre for Public Policy and author of Patients at Risk: Exposing Canada’s Health-care Crisis.
Addictions
London Police Chief warns parliament about “safer supply” diversion
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.
Addictions
Parliament votes for proposal recommending hard drug decriminalization
From LifeSiteNews
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.
The effects of decriminalizing hard drugs have been the source of contention throughout the country, as evidenced in Aaron Gunn’s documentary, Canada is Dying, and in U.K. Telegraph journalist Steven Edginton’s mini-documentary, Canada’s Woke Nightmare: A Warning to the West.
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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