The silencing of drug addiction experts who criticize ‘safe supply’

The silencing of drug addiction experts who criticize ‘safe supply’

Professor says the B.C. provincial government is censoring him

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Editor’s note: This column has been updated with a response from the British Columbia Centre on Substance Use.

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One of Canada’s leading experts on drug addiction says British Columbia’s provincial government asked him to delete a crucial database in an attempt to censor criticism of the province’s homeless policies. The incident appears to fit within a larger, nationwide campaign to silence experts who believe that, when it comes to homelessness and drugs, Canadian policy-makers are on the wrong track.

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Dr. Julian Somers is a clinical psychologist and distinguished professor at Simon Fraser University, where he directs the Centre for Applied Research in Mental Health and Addiction.

In 2004, Somers established the “Inter-Ministry Evaluation Database” (IMED), which linked data about vulnerable populations across various B.C. ministries — for example: days spent in hospital, detentions and criminal convictions, medications, and income assistance. This helped create detailed pictures of people’s lives, allowing researchers to more accurately measure the impacts of government policies.

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Over the years, the database was used in over 30 provincial reports, 60 peer-reviewed publications and several graduate theses.

Somers then used the IMED for his own $20-million research project into anti-poverty programs in Vancouver. The project randomly divided 497 participants into three groups, giving each a different support program. Using the IMED to follow their lives over five years, it concluded that B.C.’s standard approach to homelessness was ineffective.

In B.C., as in much of Canada, the popular approach is to herd homeless people into housing where most, if not all, residents are fresh off the streets, creating a critical mass of trauma and addiction. These residents are then given a “safe supply” of free drugs and provided few resources for recovery and social reintegration.

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Somers’ study showed that if you house homeless people in a way that disperses them into normal society, and then prioritize rehabilitation, employment and social reintegration, you see a 70 per cent reduction in crimes committed and a 50 per cent reduction in medical emergencies, all without spending more money.

The study confirmed the common-sense notion that it’s better to empower people to get back on their feet, rather than foster dependency through easy access to free drugs.

In a phone call, Somers contrasted Canada’s approach to that of Portugal. The Portuguese are legendary for effectively tackling addiction while decriminalizing drugs, but many don’t realize that their model focuses heavily on rehabilitation.

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The Portugal model model focuses heavily on rehabilitation

“Portugal has 64 therapeutic communities and zero consumption sites. British Columbia has zero therapeutic communities and 40-something consumption sites,” he noted.

Armed with his study results, Somers worked with 14 non-profits to call for reforms to B.C.’s drug and homeless policies. In late February 2021, he presented his findings to several provincial deputy ministers.

A week later, the provincial government sent him a letter demanding that he destroy the IMED within one week. The official explanation was that the database was set to be retired at the end of the month, and that the government was creating its own inter-ministry database that would be broader (i.e. include family and income data) and be more efficient to operate.

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Somers found the explanation implausible, and still does.

He says there was no way to reconstruct the IMED’s core data in the new government project. Many people had consented to having their data used only because they participated in projects specifically related to the IMED, such as Somer’s aforementioned homeless study. That consent was non-transferrable.

The abrupt timing also troubled him, especially because the B.C. Ministry of Health had just renewed its commitment to the IMED for another year.

The abrupt timing troubled him

Somers refused to comply. He alleges that the government responded by simply prohibiting him from updating or analyzing the IMED, or using it for new projects, without the province’s written permission. Dr. Somers says this effectively rendered the database worthless.

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Somers believes that in the nearly two years since, he has been “completely frozen out” by the B.C. government. “This government is actively hostile to the existence of the data, so I’ve completely given up. The work I was doing is no longer viable,” he says.

Somers also alleges that he has been subject to an intimidation campaign by safe supply advocates. He provided a copy of a July 2022 email from the British Columbia Centre on Substance Use, which lobbies for safe supply, showing that they lobbied for a conference to disinvite him from speaking at an academic conference. A BCCSU spokesman said, by email, that the organization raised concerns about what it viewed as the “low quality” of Somers’ research. “There was no request to disinvite the presenter,” the spokesman wrote.

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However, the email to the conference organizers from BCCSU expressed hope that “this work will not be given a credible platform.”

When emailed about Dr. Somer’s allegations, the Ministry of Public Safety and Solicitor General, which had requested the IMED’s deletion, replied that the deletion request “coincided with the expiration of relevant information sharing agreements between Dr. Somers and the Ministries,” and alluded to the superiority of the provincial government’s new, in-house database.

The Ministry also said that, in January 2022, Dr. Somers was informed that he could have continued access to the IMED until March 2023 to allow “existing projects to conclude” and “select” published findings to be replicated in the new government database.

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The Ministry did not respond to my question concerning why the initial IMED deletion request was done so abruptly. The Ministry also did not respond to a direct question about Dr. Somer’s accusation of being “frozen out” of governmental communication, nor did it explain why, ten months after first ordering the deletion of all IMED data, it changed its mind and allowed Dr. Somers conditional access to the database.

Other public health and addiction experts say they are unsurprised at the suggestion that there is political pressure being placed on researchers whose findings are inconvenient for governments.

Dr. Kelly Anthony, a lecturer at the University of Waterloo’s School of Public Health Sciences, called the B.C. government’s abrupt request to delete the IMED “concerning, considering the deeply politicized nature of Dr. Somers’ work.”

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She also said she wouldn’t be surprised if Somers was being punished for criticizing the government’s commitment to “safe supply.” Anthony believes safe supply is poorly researched and “consigns the addict to be a slave forever,” but says that in her experience, many academics are uncomfortable publicly criticizing it due to silencing, shunning and political pressure.

This sentiment was echoed by Dr. Vincent Lam, the medical director of Coderix Medical Clinic, an addictions clinic in downtown Toronto. Lam is not familiar with the specifics of Somers work but he has publicly criticized safe supply as irresponsible. He told me that at least 10 of his colleagues have privately messaged him to express similar concerns about the potential harms of flooding communities with free opioids. He said they all, too, shared their discomfort with speaking up in a politicized environment where experts are punished if they ask the wrong questions.

National Post

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Is safe supply for opioid use effective? Here’s what the experts, data say – National

Is safe supply for opioid use effective? Here’s what the experts, data say – National

Front-line staff of Canada’s opioid crisis say damage reduction approaches like safe materials for those people navigating compound use are clear even amid renewed political debate close to the difficulty.

Debate all-around risk-free offer a short while ago reignited right after Conservative Party Leader Pierre Poilievre posted a video to his Twitter account saying initiatives like harmless intake websites and supplying a safer offer of medications to persons in the throes of habit “will only guide to their ultimate fatalities.”

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Amid grim opioid dying projections, Ottawa faces phone calls to move quicker on safe and sound provide

World News spoke to specialists who have been functioning on the frontlines of the opioid crisis to hear their experiences, and all those who weighed in voiced issues. A rising overall body of information, specialists instructed, indicates initiatives like risk-free provide and hurt reduction really decrease overdose fatalities and hospitalizations and help connect people to more health treatment and treatment selections.

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“To describe harmless supply as producing homelessness, as producing an enhance in criminal offense is genuinely just the reverse of what we’re seeing from the investigation alone,” claimed Mish Waraksa, medical guide for the Parkdale Queen West Safer Opioid Supply Application in Toronto.

Here’s what the info and experts say about the usefulness of safe offer.

The video, “Everything is damaged,” was shared in November on the Conservative leader’s Twitter account.

It shows Poilievre in the foreground, pointing behind him to a collection of tents along a shoreline in Vancouver, B.C., saying the people today in the tents are “hopelessly addicted to drugs, placing poisons in their bodies.”

“The addictions that we see, that have terrorized these folks and our communities, they are the result of a failed experiment,” Poilievre says in the video.

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“This is a deliberate policy by woke Liberal and NDP governments to provide taxpayer-funded medications, flood our streets with easy accessibility to these poisons.”

The video clip drew criticism from many in Canada’s political realm, like a former adviser to former Conservative key minister Stephen Harper, Ben Perrin, who mentioned it reflected “tropes that have prolonged been discredited.”

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Safe use forefront of countering the overdose disaster, prime minister claims

Federal Mental Health and fitness and Addictions Minister Carolyn Bennett, known as the video “irresponsible.”

“Using (people dwelling in tents) as props to peddle his snake oil was disgraceful,” Bennett mentioned at a Residence of Commons committee meeting on Nov. 29, stressing that all federally-funded harm reduction initiatives are rooted in proof-dependent results.

“This is about generating a community of compassion… this is about the poisonous drug provide, but (also) it’s understanding dependancy.”

A request for remark from Poilievre for this story went unanswered.

Hunting at the knowledge on opioid fatalities does paint a grim photo of the deadly and developing toll the opioid disaster is getting on Canadians.

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A full of 29,052 Canadians have died due to opioids due to the fact 2016, according to the most current federal data released in June.

In 2021, the amount of deaths reached an all-time significant: 21 Canadians for every day died from opioids, which represents a 162 per cent raise from 2016, and a 101 for every cent raise from the year prior to.

A complete of 7,560 Canadians died from opioid use very last yr, up from 3,747 in 2020.

Even though these data are sobering, there is also facts to propose some hurt reduction steps that have been executed are saving lives.

For illustration, supervised usage web pages across the region been given almost 2.2 million visits amongst 2017 and 2020, where by nearly 17,400 overdoses have been reversed devoid of a single loss of life at a web site, federal information reveals.


Click to play video: 'Advocates say Alberta should revisit safe supply in light of new research'


Advocates say Alberta should revisit risk-free offer in gentle of new investigate


These visits also led to about 84,400 referrals to wellness and social companies.

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And when it comes to safer supply plans, exactly where people are given access to prescriptions of pharmaceutical-grade opioids, some new scientific studies have also revealed positive outcomes.

A assessment of 10 federally-funded safer supply pilot assignments in three provinces, commissioned by Well being Canada and unveiled previously this year, cited members reporting advancements in their life and well-getting.

Purchasers claimed having entry to a safer provide of medication saved their lives, designed much more security, allowed them to turn into housed and used and gave them hope for their foreseeable future.

A different impartial research published in September in the Canadian Health-related Affiliation Journal (CMAJ) discovered protected opioid provide packages can appreciably lower down on crisis office visits and hospitalizations for persons at substantial hazard for overdose.

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That review seemed at men and women who utilized a safer source program in London, Ont., for a few years, and located ER visits and healthcare facility admissions declined a person year after participants entered the plan.

It also observed no elevated risk of bacterial infections or overdoses and a drop in wellness-treatment prices unrelated to major care or outpatient remedies following a calendar year.

In addition, there ended up no opioid-connected deaths among the individuals who ended up part of this software.

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Click to play video: 'Safe drug supply key recommendation in reducing toxic illicit drug-related deaths'


Secure drug offer critical suggestion in decreasing poisonous illicit drug-related fatalities


Why are opioid fatalities still rising?

The greatest driver of the overdose disaster in Canada considering that 2016 is the contamination of the street drug supply with more powerful medication like fentanyl, states Cheyanne Johnson, executive director at the B.C. Middle on Compound Use. 

But this has also shifted in excess of time, notably accelerating as a problem throughout the pandemic, when closed borders and suspended treatment programs triggered even far more contamination and overdoses, she claimed.

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For example, preliminary information for 2022 launched by the B.C. Coroner’s Company has located that fentanyl or similar medicine have been detected in 81 for every cent of all illicit drug toxicity fatalities in that province.

Even though Poilievre contrasted statistics on opioid use towards knowledge from just before 2015, which is when the Liberals gained govt, Johnson stated the distribute of fentanyl has altered the realities on the ground.

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“It’s very tough to compare pre-2015 stages of overdose to what is going on now mainly because the supply chain has thoroughly transformed,” she reported.

Blaming damage reduction systems that have reversed overdoses and that present access to medicines that are not “poisoned” shows a misunderstanding of the realities of this disaster, claimed Rob Boyd, CEO of Ottawa Internal City Health, which runs a safer supply program and other harm reduction initiatives.

Virtually any entrance-line worker who supports applications for drug customers would concur with Poilievre that far more funding is necessary for detox and in-individual rehabilitation therapy systems, he said.

But it doesn’t have to be a binary choice of “either” remedy systems “or” damage reduction initiatives like safer offer, he mentioned.

Lower-barrier applications that really do not call for comprehensive abstinence have established helpful at serving to persons who may possibly not if not be able to receive enable, Boyd explained.

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A lot more medical doctors are prescribing opioids to avoid their individuals from dying of overdoses

“That is way too substantial a threshold for any person who is injecting fentanyl five or 6 situations a day. We have to be equipped to start off conceptualizing treatment, commencing where by people today are at,” he mentioned.

“In some instances, safer provide can be a treatment for somebody since it delivers them a little bit of steadiness in that moment or in that working day in their lives.”

Due to the fact most safer supply pilot programs throughout Canada have wraparound supports, these kinds of as housing, wellbeing and social supports, clients who regularly get non-toxic medicines can slowly raise their ability and commitment for change, he stated.

Waraksa echoed this, indicating safer offer “keeps people alive until they are capable to accessibility other varieties of treatment.”

Over-all, Johnson states she finds it “disheartening” to see the opioid disaster remaining politicized.

“It really even further stigmatizes them and generates much more disgrace all around substance use.”