Juno News - February 18, 2024


B.C. admits safe supply is broken, seeks to expand anyway


Episode Stats

Length

10 minutes

Words per Minute

186.28333

Word Count

1,933

Sentence Count

134

Misogynist Sentences

1


Summary


Transcript

00:00:00.000 I want to talk about that, but also the broader issue here and what's happening in British
00:00:12.700 Columbia, which is just doubling and tripling and quadrupling down on so-called safe supply.
00:00:19.320 Adam Zivo is a columnist and reporter with the National Post who has written extensively
00:00:23.620 on this, probably more than most others in Canada, and it's always good to have him on
00:00:27.560 the show.
00:00:28.260 Adam, welcome back.
00:00:30.000 Hey, thanks for having me back.
00:00:31.940 Let's just talk about that Richmond video for a moment here before we get into your work
00:00:36.160 on this, because I would say that the guy on the left is probably far more representative
00:00:40.300 of a lot of suburban Canadians on these issues.
00:00:44.600 Well, the thing is that most racialized Canadians don't support the harm reduction radicalism
00:00:50.020 that we see happening throughout Canada.
00:00:53.100 I mean, yes, there's going to be a small portion of activists who think that giving out free
00:00:58.840 drugs is integral to racial justice and social justice.
00:01:01.880 But I mean, most most immigrant communities are actually quite socially conservative and
00:01:06.000 especially for East Asians when they see opioids being handed out so wantonly for them.
00:01:11.740 It's reminiscent of the opioid wars of the 1800s when China was weakened by the UK coming in and
00:01:20.040 essentially plowing their country with opioids.
00:01:21.960 So I can understand there's a bit of colonial trauma there.
00:01:24.120 Yeah, no, that's a fair point.
00:01:26.840 And to bring it back into the provincial realm here, I mean, I remember when supervised injection
00:01:30.540 sites or so-called safe injection sites were seen as tremendously controversial, but now
00:01:35.800 they're just an accepted fact.
00:01:37.700 And the people that were advocating for that have been advocating for safe supply.
00:01:41.700 It's not enough just to give someone a clean room and a clean needle.
00:01:44.640 You have to provide them with so-called clean drugs.
00:01:47.660 And you and I have spoken about this.
00:01:49.600 We had a panel on this show with two of the experts who have spoken out about this.
00:01:53.680 The data are not showing that this is working.
00:01:57.240 And you're saying that BC is aware of that, but it's still proceeding.
00:02:02.080 To some degree, they're aware about that it's working.
00:02:04.660 To another degree, they have access to bad research and they don't fully understand how
00:02:08.300 flawed the research is.
00:02:10.120 So back in January, the British Medical Journal published a study which claimed that safe supply
00:02:15.400 reduced mortality by 55 to 91 percent.
00:02:18.700 And that study was cited by the BC government when they announced that they were going to
00:02:22.220 expand safe supply despite the fact that it was causing community harms.
00:02:26.380 And so I found that study a bit strange.
00:02:28.100 So I reviewed it with a team of seven physicians, as well as a scientist who's trained in stats
00:02:32.160 analysis.
00:02:33.260 And we found that the study cherry picked its data.
00:02:35.820 So there were two ways that it did that.
00:02:37.500 So first of all, half of the people who received safe supply received evidence-based medications
00:02:42.840 such as methadone and suboxone, which are proven to reduce mortality.
00:02:47.280 So obviously, you ask yourself, well, what's actually causing the mortality reductions here?
00:02:51.540 The methadone or the safer supply?
00:02:53.980 The researchers tried to filter out the effects of methadone, but there were really big gaps
00:02:57.880 in their methodologies that were kind of inexplicable.
00:03:00.180 And we found in the data there was a subpopulation of people who had not received these evidence-based
00:03:06.100 medications in the 30 days before receiving safer supply.
00:03:09.040 And for that population, there was no statistically significant reduction in mortality for safer
00:03:15.080 supply patients, which suggests that any mortality reductions that did exist were driven by methadone
00:03:20.200 and suboxone, not by safer supply.
00:03:22.380 But they ignored that.
00:03:23.860 The second thing is that they measured mortality reductions after one week, which is really,
00:03:29.160 really weird.
00:03:30.140 And if you want to make a comparison, imagine if there was a new kind of insulin and some
00:03:34.740 researchers said, well, we're going to just study what the impact of the insulin is
00:03:37.580 after one week instead of looking at long-term outcomes of repeated administration over the
00:03:42.540 course of a year.
00:03:43.840 And when we looked at the data, we found out that the mortality rates between the safer
00:03:48.280 supply and the non-safe supply patients was more or less the same after one year, indicating
00:03:53.420 that whatever mortality reductions we saw after one week, if they even existed at all, were
00:03:58.700 meaningless after a year.
00:04:00.280 But of course, this was omitted as well.
00:04:01.900 So this study, which showed that safer supply does not work, was repackaged as evidence that
00:04:07.240 it does, which I think is unethical.
00:04:09.340 But the BC government didn't catch up on that.
00:04:12.100 Now, do you think this is an example of, you know, because there are lots of situations
00:04:15.540 in which researchers start out down a path and they don't really realize or for whatever
00:04:21.040 reason that what they're doing is maybe not providing the best picture or the most whole
00:04:25.760 picture.
00:04:26.460 Do you think that's the case here?
00:04:27.600 Do you think it's people that are deliberately designing studies so that they yield a particular
00:04:31.340 outcome?
00:04:32.920 It would be hard to say how much of it is deliberate, how much of it is just a certain
00:04:37.960 level of incompetence.
00:04:39.540 What I will say is that safer supply advocates do have a tendency to exaggerate the quality
00:04:45.980 of their research.
00:04:47.360 Well, they were most caught on self-reporting studies, which you and I have talked about
00:04:51.120 in the past of, you know, how do you feel about this program?
00:04:53.900 Great.
00:04:54.180 Yes, it's working.
00:04:55.960 Yeah.
00:04:56.420 You know, Andrew, I'm going to give you some free drugs.
00:04:58.540 Do you feel like this program, which gives you free drugs that you can sell on the street
00:05:02.020 is great?
00:05:02.560 Oh, you think it's great?
00:05:03.540 Well, I guess that means it works and we're not going to ask anyone else.
00:05:06.400 Obviously, that doesn't work.
00:05:08.160 So this is a step up.
00:05:09.900 So they did a quality study, but the study didn't give them the results that they wanted
00:05:13.720 to.
00:05:14.000 So they seem to have misrepresented it.
00:05:16.760 So once again, it's just really, I don't want to say that this is intentional because
00:05:22.500 that's hard to prove and I don't want to be sued for definition.
00:05:25.600 Fair enough.
00:05:26.960 It does raise eyebrows.
00:05:28.560 Yeah, and I think that it is impossible to separate out ideology here and ideology among
00:05:36.320 the research and certainly ideology in BC.
00:05:38.400 Now, look, if you want to say this is our position, this is what we believe, this is what
00:05:42.280 we're going to do.
00:05:43.380 Power to you.
00:05:44.240 Let the voters decide.
00:05:45.640 But it's when people are trying to hide what is ideological behind science that I tend to
00:05:50.700 get a little bit concerned.
00:05:51.800 Yeah, I mean, look, so I was at the Canadian Society of Addiction Medicine's annual scientific
00:05:57.300 conference back in October.
00:05:58.960 So I met a lot of safer supply advocates in real life and seem to be ideological and they're
00:06:05.800 kind of like they're zealots and you can show them whatever evidence that you have that
00:06:10.380 this doesn't, this is working, that it's being diverted and they do all sorts of mental
00:06:14.040 gymnastics.
00:06:14.520 So around that time, I was working on a piece where I had found dozens of examples of people
00:06:20.140 selling thousands of safer supply hydromorphone pills on Reddit.
00:06:24.080 And I was sitting beside a safer supply advocate in a, in a presentation.
00:06:29.000 And afterwards I showed her all of this and she was saying, well, how do we know that it's
00:06:33.840 real?
00:06:34.700 And there was some specific packaging, which is only used in safer supply.
00:06:37.740 And she was saying, well, how do we know that, you know, drug dealers didn't go and
00:06:41.440 get that from the garbage and then put, you know, fake drugs in it.
00:06:45.280 And they were doing whatever they could to delegitimize this.
00:06:49.320 And after a while, it just seemed like they were unwilling to accept the possibility that
00:06:53.040 this program is not working, which is sad.
00:06:56.260 And I can understand that psychologically because no one wants to admit that this thing
00:07:00.180 that you've staked your identity in, that you've put so much of your effort into advocating
00:07:03.380 for might actually be harming people.
00:07:06.840 How do BC health officials square the fact that this situation has just become such a major,
00:07:12.880 a major issue in BC relative to other provinces?
00:07:16.520 I mean, what, why do they think that their approach is working when their outcomes don't
00:07:21.420 seem to be better than elsewhere in the country?
00:07:24.540 Well, I mean, the way that they're looking at it is that they have this hypothesis, which
00:07:27.460 is unfalsifiable.
00:07:29.020 So they say that safer supply saves lives.
00:07:31.960 And then when they don't see any evidence of that, they say, well, that just means that
00:07:35.480 there's not enough safer supply.
00:07:36.880 So in the way that they are framing it, it is impossible to disprove their hypothesis,
00:07:42.640 which basically justifies the infinites, the infinite expansion of safer supply.
00:07:48.820 But we do have to keep in mind that many researchers are activists at heart, and they really strongly
00:07:55.000 advocate for drug legalization and safer supply as a step towards that.
00:07:58.880 And I do want to stress that many of the people who are in this space right now who control
00:08:03.860 addiction policymaking, they don't come from a medical background.
00:08:07.780 You know, they don't actually have medical degrees oftentimes.
00:08:10.900 Many of them come from public health, which is much less rigorous.
00:08:15.440 And then they basically have displaced the addiction physicians who are actually fully
00:08:19.520 trained in this.
00:08:20.840 So the people who are calling the shots are not fully educated on this matter.
00:08:24.360 And that was, I mean, the phenomenon we had discussed was on this panel that you were on
00:08:29.380 on the show a few months back with Sharon Koivu in London, Ontario, my city, where, you
00:08:33.660 know, here she's an actual physician, but she's kind of on the sidelines when a lot of these
00:08:37.720 people you've just described seem to be setting the agenda.
00:08:41.020 Well, and that's the problem, right, is that from what I heard, it is the mainstream position
00:08:47.080 in addiction medicine that addiction physicians and psychologists do not support safer supply.
00:08:51.560 And that's what I heard at the very beginning when I was researching this.
00:08:55.120 And no one wants to speak up about it because they were afraid.
00:08:57.460 They were afraid that they would be cyberbullied by harm reduction activists.
00:09:01.520 They were afraid that they would lose access to federal grants.
00:09:04.580 There was a culture of fear.
00:09:05.820 And slowly that culture of fear has dissipated.
00:09:08.480 And now you see more public criticism.
00:09:12.240 But fundamentally speaking, addiction physicians are being sidelined and they are being told that
00:09:17.620 their very practice is oppressive.
00:09:20.800 So harm reduction activists, for example, Zoe Dodd in Toronto, she's like one of the main
00:09:25.100 ones.
00:09:25.960 She has explicitly said that she wants to dismantle addiction medicine.
00:09:31.900 And how do you deal with someone like that?
00:09:34.960 Yeah, no, that's a...
00:09:36.860 Sometimes they say the quiet part out loud.
00:09:38.920 So I think that's a very good point.
00:09:40.500 Adam Zivo with the National Post.
00:09:42.100 Always a pleasure.
00:09:42.760 Thanks for coming on today.
00:09:44.580 Thanks for having me.
00:09:45.320 Thanks for listening to The Andrew Lawton Show.
00:09:48.360 Support the program by donating to True North at www.tnc.news.
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