Addictions
The new drug agency tasked with improving Canada’s medication practices
By Alexandra Keeler
A recent report calls on the newly-created Canada’s Drug Agency to implement a strategy to improve prescription medication practices
As Canada moves toward establishing a national drug agency, a new report has outlined recommendations for a prescription medications strategy that the agency should be tasked with implementing.
The report, released July 26 by the Canadian Drug Agency Transition Office, calls on the newly established Canada’s Drug Agency to implement a nation-wide strategy for the appropriate use of prescription medications. The transition office is a temporary government initiative responsible for developing the drug agency’s mandate and plan.
“Part of the opioid crisis has been linked to prescribing particular medications, and the dependency that people can develop with respect to certain medications,” said Stephen Samis, chair of the Appropriate Use Advisory Committee, which helped guide the development of the medications strategy outlined in the report.
“If there’s a way to help get people off of those medications in a safe and effective way, and by the use of alternatives to the medication, that’s really important,” said Samis, who formerly served as deputy health minister in the Yukon.
Canada’s Drug Agency, which was first announced by Health Minister Mark Holland in December 2023, is tasked with managing and coordinating Canada’s pharmaceutical system across the provinces and territories. It has begun establishing advisory bodies, building partnerships and conducting research.
Under Canada’s proposed pharmacare legislation, the drug agency will also be responsible for identifying the essential prescription drugs to which Canadians should have access under pharmacare.
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Primary care crisis
The report proposes six guiding principles for improving Canada’s prescription and medication use practices. These include providing more personalized primary care to patients, ensuring careful oversight of prescription medications and improving coordination between health-care providers.
Currently, more than one in five Canadian adults — about 6.5 million people — lack access to primary care, according to a May 2024 study in the Canadian Medical Association Journal. Primary care refers to health care that is regular and ongoing, such as doctor check-ups or management of chronic conditions.
“The crisis in primary care right now is really one of those potential barriers to people receiving appropriate medication with a provider that they have a relationship with,” said Samis.
The lack of access to primary care can lead to problems such as inconsistent prescribing, inadequate follow-up and insufficient patient education on prescription medications, the report says.
About 1.9 million Canadian seniors use at least one prescription medication inappropriately. This costs them and the health-care system an estimated $1.4 billion in direct and indirect costs, the report says.
“Benzodiazepines, sleeping pills … even things like medications that control heartburn. If people are on them for too long, [it] can have other kinds of side effects,” said Samis.
“Same thing with opioid related medications. It’s really important that people have medications they need so that they don’t develop dependencies.”
The report also notes that fragmented information systems and poor coordination between service providers complicate medication management — resulting in duplicate prescriptions, contradictory treatment plans and gaps in care.
“What happens often is that somebody is in primary care, and their data is over here,” said Samis. “They go into long-term care, and that information doesn’t follow them. They get prescribed new things in long-term care, they go into the hospital, then the long-term care information system might not be speaking to the hospital information system.”
‘Neutral space’
Samis says he is optimistic that Canada’s Drug Agency will be able to address some of the problematic medication practices identified in the report.
Samis will co-chair a new committee responsible for assisting with the implementation of the report’s recommendations.
“We have a diverse and knowledgeable group joining our newly established Appropriate Use Advisory Committee, with the inaugural meeting to take place on September 13,” a media relations spokesperson for Canada’s Drug Agency’s told Canadian Affairs in a written statement.
Samis envisions the agency as a “neutral space” to address health-care issues and resolve conflicts between governments and health-care providers.
“This approach avoids the conflicts that often arise between jurisdictions, levels of government, or between government and [health-care] providers,” he said.
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.
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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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