Canadian front-line workers opioid crisis Even amid renewed political debate on the issue, approaches to harm reduction such as a safe supply for substance users are clear.
The debate about secure supplies recently flared up after the leader of the Conservative Party Pierre Poilievre posted a video on his Twitter account saying that offering safe consumption sites and a safe supply of drugs to people in the grip of addiction “will only lead to their eventual death.”
Global News spoke with experts working on the front lines of the opioid crisis to hear their experiences, and those who expressed concern. Experts suggested that a growing body of data shows initiatives such as safe supply and harm reduction actually reduce overdose deaths and hospitalizations and connect people to more healthcare and treatment options. helps.
“As homelessness goes on to describe a safer supply, the increase in crime is actually the opposite of what we’re seeing from the research itself,” said Mish Waraxa, clinical lead for the Parkdale Queen’s West Safer Opioid Supply Program in Toronto.
Here’s what the data and experts say about the effectiveness of Safe Supply.
The video, “Everything is broken”, was shared on the Conservative leader’s Twitter account in November.
It shows Poilievre in the foreground, pointing behind him to a collection of tents along a shoreline in Vancouver, BC, saying that the people in the tents are “addicted to drugs, putting poison in their bodies.”
“The addictions that we see, that have terrorized these people and our communities, are the result of a failed experiment,” Poilievre says in the video.
“It is a deliberate policy to wake up the Liberal and NDP governments to provide taxpayer-funded drugs, flooding our streets with easy access to these poisons.”
The video drew criticism from many in Canada’s political sphere, including former adviser to former Conservative Prime Minister Stephen Harper, Ben Perrin, who said it “reflects tropes that have long been discredited.”
Federal Minister for Mental Health and Addictions Carolyn Bennett called the video “irresponsible”.
Bennett said at a House of Commons committee meeting on 29 November, “It was a shame (to see people living in tents) use their snake oil to slough off.”
“It’s about creating a community of compassion … It’s about containing toxic drug supplies, but (also) it’s understanding addiction.”
A request for comment from Poilievre for this story went unanswered.
Looking at the statistics on opioid deaths paints a grim picture of the deadly and growing toll on Canadians.
A total of 29,052 Canadians have died due to opioids since 2016, according to the latest federal figures released in June.
In 2021, the number of deaths is set to reach an all-time high: 21 Canadians per day will die from opioids, representing a 162 per cent increase from 2016, and a 101 per cent increase from the year before.
A total of 7,560 Canadians died in 2020 from opioid use, up from 3,747 last year.
While these statistics are grim, there is also data to suggest some harm reduction measures that have been implemented are saving lives.
For example, supervised consumption sites across the country received nearly 2.2 million visits between 2017 and 2020, where nearly 17,400 overdoses were reversed without a single death at the site, federal data show.
These visits also resulted in approximately 84,400 referrals to health and social services.
And when it comes to secure supply programs, where patients are given access to prescription pharmaceutical-grade opioids, some recent studies have also shown positive results.
In a review of 10 federally funded Safe Supply pilot projects in three provinces, launched by Health Canada and released earlier this year, participants reported improvements in their lives and well-being.
related news
Clients said that having access to a safe supply of medicines saved their lives, led to greater stability, allowed them to live and hold jobs, and gave them hope for their future.
Another independent study published in September in the Canadian Medical Association Journal (CMAJ) found that secure opioid supply programs can significantly cut emergency department visits and hospitalizations for people at high risk for overdose.
That study looked at individuals who used the Safe Supplies program in London, Ontario, for three years, and found that ER visits and hospital admissions declined a year after participants entered the program.
It also found no increase in health care costs unrelated to infections or overdoses and primary care or outpatient medications after one year.
In addition, there were no opioid-related deaths among those who were part of the program.
Why are opioid deaths still on the rise?
The biggest driver of the overdose crisis in Canada since 2016 has been contamination of the street drug supply with more potent drugs like fentanyl, says Cheyanne Johnson, executive director of the BC Center on Substance Use.
But it has also changed over time, especially accelerating as a problem during the pandemic, when closed borders and suspended treatment programs led to even more contamination and overdoses, she said.
For example, preliminary data for 2022 released by the BC Coroner’s Service found that fentanyl or related drugs were detected in 81 per cent of all illicit drug poisoning deaths in that province.
While Poilievre contrasted the opioid use figures against data from before 2015, when the Liberals won government, Johnson said the spread of fentanyl has changed the realities on the ground.
“It is very difficult to compare the levels of overdoses before 2015 to what is happening now because the supply chain has completely changed,” he said.
Rob Boyd, CEO of Ottawa Inner City Health, said blaming harm reduction programs that have reversed overdoses and that provide access to drugs that are not “poisons” reflects a misunderstanding of the realities of this crisis. Is. Deficiency initiative.
Virtually any front-line worker who supports programs for drug users would agree with Poilievre that detox and inpatient rehabilitation treatment programs need more funding, he said.
But it is not a binary choice of “either-or” harm reduction initiatives such as remediation programs” or “secure supplies,” he said.
Boyd said low-barrier programs, which don’t require complete abstinence, have proven effective in helping people who might not otherwise be able to get help.
“That’s a pretty high threshold for someone who’s injecting fentanyl five or six times a day. We have to be able to start conceptualizing treatment, starting where people are,” he said.
“In some cases, having a secure supply can be a treat for someone because it brings a little stability into their life at that moment or that day.”
Because most Safe Supply pilot programs across Canada have comprehensive supports such as housing, health and social support, clients who regularly receive non-toxic drugs can gradually increase their capacity and motivation to change, they said. Told.
Warska echoed this, saying that the secure supply “keeps people alive until they are able to access other forms of treatment.”
Overall, Johnson says she finds it “disappointing” to see the politicization of the opioid crisis.
“It really stigmatizes them and creates more shame around substance use.”