Juno News - February 18, 2024


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

Mentioned
Adam Zivo Andrew Lawton Show Sharon Koivu Zoe Dodd
Feds wasted millions on ArriveCan app Convoy organizer reflects on two-year anniversary of Emergencies Act

Episode Stats


Length

10 minutes

Words per minute

186.28

Word count

1,933

Sentence count

143

Harmful content

Misogyny

1

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Summary

Summaries generated with gmurro/bart-large-finetuned-filtered-spotify-podcast-summ .

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

Transcript generated with Whisper (turbo).
Misogyny classifications generated with MilaNLProc/bert-base-uncased-ear-misogyny .
Hosts, guests, and mentioned names generated with spaCy (en_core_web_sm), reconciled against Wikidata.
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 0.90
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.
00:09:53.760 Like, onrás.
00:09:58.160 It's not a heart.
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