Juno News - February 18, 2024B.C. admits safe supply is broken, seeks to expand anyway
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Summary
British Columbia is doubling and tripling down on so-called "safe supply" in an effort to combat the growing opioid addiction crisis in the province. But is it working? And is it even working? To find out, we speak with Adam Zivo, a columnist and reporter with the National Post, who has written extensively on the issue.
Transcript
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I want to talk about that, but also the broader issue here and what's happening in British
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Columbia, which is just doubling and tripling and quadrupling down on so-called safe supply.
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Adam Zivo is a columnist and reporter with the National Post who has written extensively
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on this, probably more than most others in Canada, and it's always good to have him on
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Let's just talk about that Richmond video for a moment here before we get into your work
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on this, because I would say that the guy on the left is probably far more representative
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of a lot of suburban Canadians on these issues.
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Well, the thing is that most racialized Canadians don't support the harm reduction radicalism
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I mean, yes, there's going to be a small portion of activists who think that giving out free
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drugs is integral to racial justice and social justice.
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But I mean, most most immigrant communities are actually quite socially conservative and
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especially for East Asians when they see opioids being handed out so wantonly for them.
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It's reminiscent of the opioid wars of the 1800s when China was weakened by the UK coming in and
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essentially plowing their country with opioids.
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So I can understand there's a bit of colonial trauma there.
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And to bring it back into the provincial realm here, I mean, I remember when supervised injection
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sites or so-called safe injection sites were seen as tremendously controversial, but now
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And the people that were advocating for that have been advocating for safe supply.
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It's not enough just to give someone a clean room and a clean needle.
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You have to provide them with so-called clean drugs.
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We had a panel on this show with two of the experts who have spoken out about this.
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And you're saying that BC is aware of that, but it's still proceeding.
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To some degree, they're aware about that it's working.
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To another degree, they have access to bad research and they don't fully understand how
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So back in January, the British Medical Journal published a study which claimed that safe supply
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And that study was cited by the BC government when they announced that they were going to
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expand safe supply despite the fact that it was causing community harms.
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So I reviewed it with a team of seven physicians, as well as a scientist who's trained in stats
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And we found that the study cherry picked its data.
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So first of all, half of the people who received safe supply received evidence-based medications
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such as methadone and suboxone, which are proven to reduce mortality.
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So obviously, you ask yourself, well, what's actually causing the mortality reductions here?
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The researchers tried to filter out the effects of methadone, but there were really big gaps
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in their methodologies that were kind of inexplicable.
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And we found in the data there was a subpopulation of people who had not received these evidence-based
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medications in the 30 days before receiving safer supply.
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And for that population, there was no statistically significant reduction in mortality for safer
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supply patients, which suggests that any mortality reductions that did exist were driven by methadone
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The second thing is that they measured mortality reductions after one week, which is really,
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And if you want to make a comparison, imagine if there was a new kind of insulin and some
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researchers said, well, we're going to just study what the impact of the insulin is
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after one week instead of looking at long-term outcomes of repeated administration over the
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And when we looked at the data, we found out that the mortality rates between the safer
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supply and the non-safe supply patients was more or less the same after one year, indicating
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that whatever mortality reductions we saw after one week, if they even existed at all, were
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So this study, which showed that safer supply does not work, was repackaged as evidence that
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Now, do you think this is an example of, you know, because there are lots of situations
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in which researchers start out down a path and they don't really realize or for whatever
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reason that what they're doing is maybe not providing the best picture or the most whole
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Do you think it's people that are deliberately designing studies so that they yield a particular
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It would be hard to say how much of it is deliberate, how much of it is just a certain
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What I will say is that safer supply advocates do have a tendency to exaggerate the quality
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Well, they were most caught on self-reporting studies, which you and I have talked about
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in the past of, you know, how do you feel about this program?
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You know, Andrew, I'm going to give you some free drugs.
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Do you feel like this program, which gives you free drugs that you can sell on the street
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Well, I guess that means it works and we're not going to ask anyone else.
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So they did a quality study, but the study didn't give them the results that they wanted
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So once again, it's just really, I don't want to say that this is intentional because
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that's hard to prove and I don't want to be sued for definition.
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Yeah, and I think that it is impossible to separate out ideology here and ideology among
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Now, look, if you want to say this is our position, this is what we believe, this is what
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But it's when people are trying to hide what is ideological behind science that I tend to
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Yeah, I mean, look, so I was at the Canadian Society of Addiction Medicine's annual scientific
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So I met a lot of safer supply advocates in real life and seem to be ideological and they're
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kind of like they're zealots and you can show them whatever evidence that you have that
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this doesn't, this is working, that it's being diverted and they do all sorts of mental
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So around that time, I was working on a piece where I had found dozens of examples of people
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selling thousands of safer supply hydromorphone pills on Reddit.
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And I was sitting beside a safer supply advocate in a, in a presentation.
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And afterwards I showed her all of this and she was saying, well, how do we know that it's
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And there was some specific packaging, which is only used in safer supply.
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And she was saying, well, how do we know that, you know, drug dealers didn't go and
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get that from the garbage and then put, you know, fake drugs in it.
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And they were doing whatever they could to delegitimize this.
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And after a while, it just seemed like they were unwilling to accept the possibility that
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And I can understand that psychologically because no one wants to admit that this thing
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that you've staked your identity in, that you've put so much of your effort into advocating
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How do BC health officials square the fact that this situation has just become such a major,
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a major issue in BC relative to other provinces?
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I mean, what, why do they think that their approach is working when their outcomes don't
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seem to be better than elsewhere in the country?
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Well, I mean, the way that they're looking at it is that they have this hypothesis, which
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And then when they don't see any evidence of that, they say, well, that just means that
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So in the way that they are framing it, it is impossible to disprove their hypothesis,
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which basically justifies the infinites, the infinite expansion of safer supply.
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But we do have to keep in mind that many researchers are activists at heart, and they really strongly
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advocate for drug legalization and safer supply as a step towards that.
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And I do want to stress that many of the people who are in this space right now who control
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addiction policymaking, they don't come from a medical background.
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You know, they don't actually have medical degrees oftentimes.
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Many of them come from public health, which is much less rigorous.
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And then they basically have displaced the addiction physicians who are actually fully
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So the people who are calling the shots are not fully educated on this matter.
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And that was, I mean, the phenomenon we had discussed was on this panel that you were on
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on the show a few months back with Sharon Koivu in London, Ontario, my city, where, you
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know, here she's an actual physician, but she's kind of on the sidelines when a lot of these
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people you've just described seem to be setting the agenda.
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Well, and that's the problem, right, is that from what I heard, it is the mainstream position
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in addiction medicine that addiction physicians and psychologists do not support safer supply.
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And that's what I heard at the very beginning when I was researching this.
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And no one wants to speak up about it because they were afraid.
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They were afraid that they would be cyberbullied by harm reduction activists.
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They were afraid that they would lose access to federal grants.
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And slowly that culture of fear has dissipated.
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But fundamentally speaking, addiction physicians are being sidelined and they are being told that
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So harm reduction activists, for example, Zoe Dodd in Toronto, she's like one of the main
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She has explicitly said that she wants to dismantle addiction medicine.
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Thanks for listening to The Andrew Lawton Show.
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