Zoë Dodd is a community researcher at the MAP Center for Urban Health Solutions and a co-organizer with the Toronto Overdose Prevention Society. Corey Ranger is president of the Harm Reduction Nurses Association and lead nurse for the Victoria SAFER initiative in British Columbia Eris Nyx is director of harm reduction with the SRO Collaborative and co-founder of the Drug User Liberation Front in British Columbia Mark Tyndall is physician and professor with the School of Population and Public Health at the University of British Columbia and founder of the MySafe Society, BC
In December, the Alberta government established a committee to examine the merits of providing access to a regulated supply of pharmaceutical-grade drugs, also known as safe supply, in response to the ongoing drug poisoning crisis.
This crisis has killed more than 27,000 Canadians since 2015, and there is no end in sight. The introduction of fentanyl, unpredictable drug combinations and other deadly contaminants into the drug supply has resulted in a prolonged slaughter of people who were already being left behind.
As a group, we declined the invitation to appear before the Alberta government committee. We believe this is a deeply flawed process and the conclusions have been predetermined. While we remain committed to saving lives by providing access to a safer drug supply, we refuse to give the process any credibility.
While governments across Canada have largely stayed on the sidelines as this crisis unfolds, the United Conservative Party of Alberta has taken an aggressive stance against people who use drugs by actively opposing harm reduction interventions, targeting both evidence-based supervised injection sites and injectable opioids. agonist treatment programs. Instead, the government promoted abstinence-based treatment programs and stricter law enforcement.
Moreover, its security supply committee clearly lacks impartiality: it is made up solely of UCP deputies. Opposition NDP MPs left the legislative committee. The party’s mental health and addictions spokeswoman Lori Sigurdson described it as a “rigged process” after reviewing the list of more than 20 “experts” who were asked to present.
The initial invitation list excluded anyone with personal experience of drug use, working on the front lines of harm reduction, experience delivering safe supply programs, or advocating for policy reform. on drugs. Instead, the list of presenters included people who had publicly spoken out against safe supply, those with direct ties to abstinence-based recovery programs, and even people who actively opposed the harm reduction.
As harm reduction experts, we can only conclude that this committee is a political theater to support the government’s anti-harm reduction agenda.
Canada’s drug poisoning epidemic is a public health crisis that can only be solved through a step change in current drug policies and a renewed look at how we view, support and engage people. who use drugs. There is a need to end punitive and futile law enforcement practices, scale up harm reduction programs that connect people to services, and reallocate the billions of dollars we currently use to maintain order and incarceration to housing and social programs. These are the pillars of a comprehensive response to drug use that community groups, people who use drugs and human rights advocates have been calling for for decades.
In response to the supply of toxic drugs, calls for access to safe supply have emerged as an additional pillar. In fact, the No. 1 recommendation released this week by the BC Coroners Service Death Review Committee was to urgently establish a provincial framework for safer supply and rapidly expand it in using medical and non-medical models.
It is unethical that we do not offer people life-saving pharmaceutical alternatives to the supply of toxic drugs when they are readily available. One of the narratives used to oppose safe supply is that the crisis was triggered by overprescribing by doctors. While easier access to prescription opioids may have helped, the current drug poisoning crisis is due to fentanyl and the unregulated drug supply, not overprescribing.
Despite mass deaths over the past six years, there has been no substantial change to our “war on drugs” playbook. We continue to target drug possession and trafficking through military-style policing and incarceration; promoting a rigid and over-medicalized drug treatment system; and supporting ineffective abstinence-based recovery programs. Ironically, these approaches led directly to the situation we find ourselves in today, where prohibition has predictably led to a more toxic drug supply, and drug addicts and their families feel they have no no alternative.
The vital benefits of a safe and regulated drug supply are obvious. People who use psychoactive drugs from a known source, with known potency, free of contaminants, will not overdose and die. We know this from our vast experience in the sale of alcohol. It’s not that alcohol is risk-free, but if you drink a bottle of beer in a restaurant you won’t drop dead at the table. Imagine if this happened over 27,000 times and nothing was done about it.
We recognize that providing people with a safe and regulated supply is a major shift in our approach to drug use and addiction. Like any public health intervention, there are risks and unknowns. Although there can never be a randomized, placebo-controlled trial to demonstrate the benefits of safe supply due to ethical considerations, pilot programs are currently being rigorously evaluated and refined. This includes evaluating different safe supply distribution models, such as programs where drugs are used under medical supervision, community compassion clubs, pharmacy distribution, and secure dispensing kiosks.
These are the kinds of operational issues that Alberta’s Safe Supply Committee should be tackling — not whether people should be able to access drugs that won’t kill them.
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