Prudence, not politics, the right course on safer-supply street drugs

Hey there, time traveller!
This article was published 14/03/2024 (587 days ago), so information in it may no longer be current.

Manitoba may soon be getting its first supervised consumption site for illicit drug users. But it’s unlikely to include a safer drug supply program — like the one in British Columbia — anytime soon.

The main reason: there is still a lack of evidence to conclude that the benefits of providing drug users with safer alternatives to contaminated street drugs outweigh the harms caused by the diversion of those drugs to unintended users.

That’s not wild fear-mongering cooked up by rage-farming politicians such as federal Conservative Leader Pierre Poilievre or Alberta Premier Danielle Smith (both of whom are fiercely opposed to safer-supply programs, mostly for ideological reasons).

There are legitimate concerns that safer drugs prescribed to addicts are being sold on the street, or diverted to people in other ways — including youths — who may not otherwise be exposed to illicit drugs.

It’s happening in British Columbia, where safer supply was introduced in 2021, and it’s something public health officials in Manitoba are keeping a close eye on.

“Some diversion is occurring; however, the extent and impacts are unknown,” a recent report by British Columbia’s provincial health officer found.

“Diversion to people at risk of drug poisoning may be of benefit, while diversion to people who would otherwise not use unregulated drugs is harmful.”

The NDP government in Manitoba has said it plans to establish the province’s first supervised consumption site in downtown Winnipeg. Evidence from around the world has shown that supervised consumption sites, where drug users can legally inject illicit drugs in a safe environment, reduce and reverse overdoses. They save lives.

The sites also provide drug users with access to other harm-reduction services, such as clean needles, syringes and pipes, which help reduce the spread of transmittable diseases. They also connect people with valuable treatment and other programs.

The proposed site in Winnipeg is for people who bring their own drugs. The sites will not supply users with drugs. It’s an important distinction.

The pros and cons of safer-supply programs are not as cut and dried as they are for supervised consumption sites. Despite calls by some for a safer-supply program here, Manitoba officials are taking a wait-and-see approach. And for good reason.

According to the the B.C. report on that province’s “prescribed safer-supply” program, research and data on its benefits and potential harm are limited, mostly because it’s still a new program in Canada.

“Evidence for PSS is promising as it is largely positive, but not at this point strong enough for this intervention to be described as fully evidence-based,” the report says. “The evidence scan demonstrates that more needs to be done to investigate the potential for harm at the population level.”

There is growing evidence that providing prescribed alternatives to contaminated, unregulated street drugs reduces poisoning among users. That, along with safe consumption sites, can be powerful tools in saving lives.

However, in some cases, the prescribed drugs — such as hydromorphone — are not strong enough for some users and are being sold on the street to obtain money to buy more potent drugs.

“Some PSS clients report diverting hydromorphone in order to obtain other substances that better meet their needs or to support others who may not be able to access prescriber-based safer supply,” the report says. “Anecdotal reports have suggested that youth may increasingly be accessing diverted hydromorphone.”

That’s a serious problem. At the same time, data shows there has not been an increase in the number of youths diagnosed with opioid addictions since the introduction of safer supply in B.C. three years ago, the report says. That’s reassuring. Still, far more study and evidence is required before officials can say conclusively that safer supply provides a net benefit to society.

Which is precisely why Manitoba is in no rush to expand the program here.

One of the biggest hurdles in exploring and analyzing harm-reduction programs such as safer supply is they often get politicized by elected officials, such as Poilievre and Smith, and others who are ideologically opposed to them. That leads to misinformation, much of which is circulated on social media and, in turn, contributes to fear.

Future evidence may show that safer supply provides society with a net benefit, especially if public health officials can address the problem of diversion. In the meantime, Manitoba is right to take a cautionary approach.

tom.brodbeck@freepress.mb.ca

Tom Brodbeck
Columnist

Tom Brodbeck is an award-winning author and columnist with over 30 years experience in print media. He joined the Free Press in 2019. Born and raised in Montreal, Tom graduated from the University of Manitoba in 1993 with a Bachelor of Arts degree in economics and commerce. Read more about Tom.

Tom provides commentary and analysis on political and related issues at the municipal, provincial and federal level. His columns are built on research and coverage of local events. The Free Press’s editing team reviews Tom’s columns before they are posted online or published in print – part of the Free Press’s tradition, since 1872, of producing reliable independent journalism. Read more about Free Press’s history and mandate, and learn how our newsroom operates.