BC's "safe supply": Myths & misinformation
WTH challenges five assumptions about BC's risk mitigation flub
BC’s “safe supply” is facing public and political scrutiny, as Conservatives push to end the program, citing “harms to children” as a main concern.
We agree that (government-funded) safe supply — which allows physicians to prescribe drugs like Dilaudid/hydromorphone and M-Eslon as alternatives to toxic street drugs — isn’t working. At best, safe supply is a half-measure; a limited version of the real thing. But that doesn’t mean a revised safe supply program can’t work.
“Safe supply refers to a legal and regulated supply of drugs with mind/body altering properties that traditionally have been accessible only through the illicit drug market.” — Canadian Association of People Who Use Drugs (CAPUD)
Because our mandate is to clarify misinformation about drugs and people who use drugs (PWUD), here are five beliefs about safe(r) supply — debunked:
1. Safe supply is contributing to additional overdose-related deaths: There is no evidence suggesting the (current) safe supply program is responsible for drug-related deaths. When compared with the toxic street drug supply — found to include high potency fentanyl analogues, illicit benzodiazepines and/or dangerous tranquilizers — safe supply drugs are unlikely culprits. So, please don’t lose sleep over them.
“We know for a fact that people are not dying (from safer supply), including children. The rates of death amongst those under 19 have not increased at all since safer supply was introduced.” — Lisa Lapointe, Chief Coroner, BC
2. Safe supply drugs are widely available/accessible to PWUD across BC: False. In fact, very few people have had access to safe supply prescribing, making it much harder for critics to claim that safe supply has accelerated the toxic drug crisis. How could a limited set of medications, with such a paltry reach, have any real influence on the provincial death toll? Similarly, how could a set of drugs — not overly known for their pleasure-enhancing/euphoria-enducing properties — possibly compete with the juggernaut that has become our street drug supply?
“The limited access to these safer supply services is just so tiny.” — Guy Felicella on Global News.
3. Harm reduction initiatives — like safe supply — have failed to reduce overdose deaths in BC: How do we know that harm reduction is to blame? Harm reduction, at its most basic, seeks “to save lives and protect the health of both people who use drugs and their communities.” Like wearing a seatbelt, brushing our teeth, or (attempting to) replace black-market drugs with safer/known alternatives1, harm reduction interventions are designed to reduce risk of illness, injury and death; it makes no promise to prevent or stop them (because that would be impossible).
And what about BC’s abstinence-based treatment system? Why not blame the unregulated recovery industry for failing to prevent or stop overdose deaths? It’s no secret that residential treatment programs routinely fail to produce successfully abstinent alumni. Instead, most graduates relapse, returning to familiar patterns and behaviours, sometimes returning to those same treatment programs again and again (provided they actually stay long enough to finish the program).
4. Safe supply drugs can help folks eventually get into a rehabilitative treatment program: At WTH, we agree that stabilization is a logical step in the quest for health and wellness. In the case of drug use, folks who are not overwhelmed each day by the tiring — often frustrating — quest to find and afford street drugs, should have additional time and resources to enjoy a renewed sense of safety, stability and love.
But prescribed safer supply meds tend to be a barrier to entering recovery programs in BC. In fact, some programs won’t even accept clients who are on methadone (a common and recommended treatment for those wanting to cease or curb their opiate use). And policies that prohibit folks from taking their medications can be dangerous, inappropriate and stigmatizing.
5. Diverting safe supply medications is a serious concern: No. When it comes to drug use, we must fix our attention on the problem of drug toxicity-related suffering and pre-mature death. Diversion is a red herring, so don’t be fooled. At best, diverting prescription drugs means that someone somewhere is (hopefully) benefitting from a pharmaceutical alternative with known ingredients. At its worst, the diverted medication fails to disrupt a reliance on the toxic street supply.
Rest assured — diverted medications are not “spurring a new opioid crisis.” We are already facing the worst leg of a seven-plus-year-long drug poisoning epidemic. And rather than strategize a coordinated response, our political leaders are wasting time debating the alleged evils of diverted medications. Shame on them.
At WTH, we aim for honesty and transparency in our reporting and writing. We are, therefore, compelled to tell our readers how we feel about safe supply. In theory, the substitution intervention — according to its original design — feels somewhat like a fantasy. Think about street drugs, and their toxicity; think about the cut and the buff — even the bugs. How can we possibly substitute poison? Of course, we believe safe supply can — and will — do better. But a near-perfect substitution, with safe/known ingredients, is unlikely to produce the same effect. Maybe it’ll feel better. We hope it won’t feel worse. And we encourage PWUD to maintain a critical stance. Protect each other from hype, and shattered glass.