Juno News - Canada’s harmful “safe supply” agenda (feat. Adam Zivo)

00:00:00.000 Canada is currently facing an opioid crisis, one that has killed over 30,000 people since 2016

00:00:08.620 and is continuing to kill people today. The epicenter of this crisis is British Columbia,

00:00:16.080 which saw over 1,000 drug-related deaths in the first five months of this year alone.

00:00:23.880 Illegal drugs are killing so many people in BC that drug toxicity is now the leading cause of

00:00:30.880 death between people aged 10 and 59. More than homicides, suicides, car accidents and natural

00:00:39.240 diseases combined, the BC NDP and federal liberals have responded to this crisis with a harm reduction

00:00:47.880 and safe supply agenda. The latter consists of the decriminalization of hard drugs in the province,

00:00:56.420 giving addicts a safer supply of drugs, and having injection sites where people can safely

00:01:05.360 consume drugs. While this so-called harm reduction agenda is supported by politicians and activists,

00:01:14.040 the opinions of several experts, as well as the lived experience of people who dealt with safe

00:01:22.280 supply are painting a different picture, one that shows that Canada's safe supply agenda has been a

00:01:32.800 disaster. One of the people bringing light to this issue is National Post columnist Adam Zeevo,

00:01:38.880 who has written several pieces about safe supplies and its harms. He joins me today to discuss this

00:01:46.020 issue. In addition to his journalism on safe supply, Zeevo is known for his coverage of the war in

00:01:53.100 Ukraine. He even spent some time in Ukraine during the war, as well as his coverage of various LGBTQ

00:02:00.000 issues. Adam, thank you so much for joining me. Thank you for having me. So we often hear in the media

00:02:08.360 the terms harm reduction and safe supply, but I'm not sure if Canadians or a good part of Canadians

00:02:14.700 actually know what these terms entail. So how about we start with maybe you explaining what do we mean by

00:02:22.140 harm reduction and safe supply in a Canadian context?

00:02:26.400 So harm reduction refers to a broad umbrella of interventions, which are meant to reduce the harms that

00:02:31.500 drug users experience while they're using. So some examples of harm reduction include needle exchanges,

00:02:38.340 safer injection sites, and safer supply. So harm reduction is considered to be one of the main key

00:02:45.100 pillars of addressing any drug crisis. Now, within this umbrella, you have, you know, safer supply,

00:02:52.620 and safer supply is this idea that we can reduce overdoses and deaths by providing drug users with

00:03:00.040 pharmaceutical alternatives to potentially tainted illicit substances. So in Canada, that means giving

00:03:07.160 people hydromorphone, which is a drug that is as potent as heroin, to try to dissuade people from

00:03:12.820 using illegal opioids, predominantly fentanyl. I do want to flag that there are multiple models

00:03:19.620 of safer supply that exists in the world. The one that exists in Canada is unique and is uniquely

00:03:26.760 irresponsible.

00:03:27.560 Oh, why is it uniquely irresponsible?

00:03:31.020 Well, if you look at safer supply in Switzerland, which has done fairly well, there's a high barrier

00:03:38.140 to access, meaning that it's not as if anyone can come off the street and get on the program.

00:03:43.080 And on top of that, consumption of the drug is typically supervised. In contrast, in Canada,

00:03:48.820 there are, we really emphasize low barriers to access. So anyone can walk in and say,

00:03:55.440 I want to be on safer supply. And as long as they find some trace of an opioid in your blood,

00:04:00.520 you know, they will give you it. As long as you say that you are worried about overdosing on fentanyl,

00:04:04.540 there's no verification of the truth of what you say, aside from that simple blood test.

00:04:10.100 And more importantly, consumption is not supervised. So we hand out large amounts of hydromorphone,

00:04:17.480 which I do want to stress again, is as powerful as heroin. And we don't really confirm whether

00:04:23.240 people consume their doses so they can take it home. Now, why this is a problem? Well,

00:04:30.520 hydromorphone, as powerful as it is, is only one-tenth as strong as fentanyl. You know,

00:04:35.040 it's strange compared to fentanyl as like holding a candle against the sun.

00:04:39.860 And people who are on fentanyl do not get high on hydromorphone. So they don't actually like the

00:04:44.940 drug. It doesn't give them what they're looking for. So they sell the hydromorphone on the streets

00:04:49.360 to purchase harder drugs, predominantly illicit fentanyl.

00:04:53.700 Right. And when they sell hydromorphone on the street, it ends up in the community and

00:04:59.700 it goes into schools, for example. What impacts has this drug that is marketed as a safer supply

00:05:08.260 drug had on the broader community and particularly teenagers?

00:05:11.560 Well, so as you mentioned, it does flood into communities. And when you have a flood of

00:05:16.980 supply, that causes prices to go down. I've spoken with addiction physicians in about five or six

00:05:22.560 different cities, and they've independently told me, you know, no correspondence between them,

00:05:27.720 that in their communities, since safer supply was launched, that the price of hydromorphone,

00:05:34.520 from the street price has gone down by between 70 and 95%. And crucially, these price drops seem

00:05:41.280 to be correlated to proximity to safer supply dispensaries. So for example, in downtown Vancouver

00:05:49.000 in the downtown east side, where there is a whole bunch of these, you know, pharmacies that dispense

00:05:53.360 safer supply, you can buy a 8 milligram tablet of hydromorphone for between one to $2. Whereas if you go

00:06:00.680 slightly outside of Vancouver and you go into the suburbs, tablets begin to cost around $5 to $10.

00:06:08.480 Now, what happens is that people often buy these drugs in these hotspots and then sell them in

00:06:15.180 markets where they're more valuable. And they tend to sell these drugs to opioid naive users for whom

00:06:21.980 the drug produces a high, right? You're not going to sell hydromorphone to fentanyl users because they

00:06:26.140 don't want it. And if you're selling to opioid naive users, that means you disproportionately sell

00:06:31.820 to younger people and to people who are in recovery. Now, younger people are attracted to

00:06:38.980 the drug for a variety of reasons. First of all, it's cheap, right? And for someone who is young,

00:06:44.400 that matters a lot, especially if you're from a lower socioeconomic bracket. And secondly,

00:06:49.520 they don't understand the risks of hydromorphone. It's not stigmatized in the same way that heroin is.

00:06:54.660 And additionally, it is marketed as safe and is technically prescribed from a doctor. It comes

00:06:59.600 from a pharmacy. So they're much more willing to experiment with it versus other drugs, even

00:07:05.220 though hydromorphone is extremely dangerous for them. So essentially what you're saying is that

00:07:10.260 the safer supply agenda has kind of created a new drug deal and a new kind of generation of drug addicts.

00:07:20.140 It has. The problem though is that the government seems woefully uninterested in measuring this impact

00:07:28.560 and they seem to be doing their best to try to minimize this effect. So there's not a lot of data

00:07:35.760 that has been collected on this. And what happens is that, for example, the BC government has often

00:07:42.960 misrepresented data to say that this problem doesn't exist. Now, one thing I want to note is

00:07:48.720 that kids who go on hydromorphone to become addicted, they often then graduate to using fentanyl

00:07:55.040 because you develop a tolerance over time. So you need harder substances in larger amounts to get the

00:08:00.420 same high. And it's not the hydromorphone that tends to kill people. It's the fentanyl that they use

00:08:05.540 after developing the hydromorphone addiction. I'm currently writing the story that, you know,

00:08:10.920 spotlights one such youth in the Vancouver area who had that exact problem. Now, the BC government,

00:08:16.880 in response to my reporting, has really emphasized the fact that they have not seen a rise in a

00:08:22.760 hydromorphone-related deaths in the province. And they say that, okay, based on that, we can see that

00:08:28.220 there is no problem with safer supply. But that's misleading because, of course, you're not going to see

00:08:34.400 that rise in deaths if the hypothesis is that fentanyl kills. Now, I'll just finish my monologue

00:08:40.320 with one last thing. Sorry for talking so much. No, go ahead. So the BC government released a

00:08:47.180 report last month that included for the first time data on youth drug deaths. And what they tried to

00:08:54.540 bury in the report, but what myself and other physicians, what myself and physicians were able

00:08:58.840 to discover is that, okay, the data was from 2017 to 2022. From 2017 to 2019, 0% of youth drug deaths

00:09:08.620 had any hydromorphone involved. Then safer supply has expanded in 2020, and that number increases to

00:09:15.040 5%. Then 2021, I believe it's 8% or 9%. And then last year in 2022, hydromorphone was found in 22%

00:09:24.440 of youth drug deaths. So that's a sudden and significant spike, which seems to indicate that

00:09:29.680 there's a problem. Drug injection sites have been a kind of a staple of the harm reduction model. And

00:09:36.660 the first one in North America opened in Vancouver. Since the election of Justin Trudeau, there have been

00:09:42.440 many more to have opened across the country, including where I live in Ottawa, where you live in Toronto.

00:09:47.260 What are your thoughts on these sites? Because the people who support them say they offer a safe and

00:09:54.000 clean place for users to inject themselves. There are critics that say that they enable drug use.

00:10:00.560 Should these drug injection sites continue to operate or should they be shut down?

00:10:07.260 Well, I really want to emphasize that safer injection sites are a totally different intervention

00:10:12.360 from safe supply. So while I can speak quite knowledgeably about safe supply, I know much

00:10:17.460 less about safer injection sites, and there are much less or much less confidence about, you know,

00:10:21.940 my opinions there. What I will say is that there is this belief that safer injection sites do reduce harm,

00:10:29.780 but the evidence in support of that seems to be a little bit questionable. And then here's where I'm

00:10:35.800 going into some background information that I haven't publicly reported yet.

00:10:39.240 So Insight, that's the name of the first safe for injection site, which was launched in Vancouver

00:10:44.800 in the early 2000s. Two doctors, Dr. Julio Montaner and Dr. Thomas Kerr, advocated for the creation of

00:10:55.960 that project. And then it was approved. And then the federal government, federal liberals at the time,

00:11:02.140 gave a $1.5 million, I believe, dollar evaluation contract to the BC Center for HIV Excellence.

00:11:12.260 And, you know, at that center, that happens to be where Dr. Kerr and, you know, Dr. Montaner worked.

00:11:19.120 So these two doctors were essentially tasked with evaluating their own project, which was a giant

00:11:24.980 conflict of interest that everyone just ignored.

00:11:26.940 So in subsequent few years, they produced over 30 evaluations of Insight, all of which were co-authored

00:11:35.580 by Dr. Kerr, and all of which, you know, gave glowing reviews to the project and said that it

00:11:41.200 was wonderful and, you know, it was reducing crime and so on and so forth. Well, there was something

00:11:46.900 suspicious there. So the RCMP ended up commissioning an independent researcher to evaluate these

00:11:52.520 evaluations. The guy's name was Colin Mangum. And he did this, I think, in around 2007.

00:11:57.980 And what he found was that these evaluations routinely misrepresented the impact of Insight,

00:12:04.520 overstating positive outcomes and minimizing harms. And I'm going to give you two specific examples of

00:12:10.260 that. So the evaluations claimed that Insight reduced crime. However, when Mangum spoke with

00:12:16.480 police stakeholders, he found that the opposite was true, that crime seemed to significantly increase,

00:12:21.540 resulting in a need for a significant increase in policing in the area. So I believe three police

00:12:28.500 officers approximately were posted 24-7 around Insight, and dozens more were brought into the area,

00:12:34.880 and that reduced crime. But the evaluations claimed that Insight itself reduced crime and, you know,

00:12:42.160 ignored any notes of increased policing. Similarly, Insight claimed to create thousands of referrals

00:12:48.500 to treatment services. When Mangum investigated that, he found out that their definition of referral

00:12:54.800 was just handing someone a leaflet. And when he contacted nearby treatment facilities, he found that

00:13:00.660 none of them said that they had received any referral from Insight. So, you know, we're looking at gross

00:13:06.500 misrepresentation of data, or at least these allegations. Now, this is what Colin Mangum says.

00:13:11.960 So it's an allegation that hasn't been fully proved yet. I don't want to be sued by these guys by

00:13:16.780 claiming that it's an objective fact. But, you know, it's a pretty serious allegation. So when people

00:13:22.120 say that, you know, safer injection sites work, and that we just keep on investing in them, we have to be

00:13:28.240 mindful of the fact that the evidence base for these interventions is quite questionable.

00:13:35.820 Right, for sure. Another thing that liberal drug policy supporters claim works is decriminalization,

00:13:45.900 and they'll point to Portugal that decriminalized drugs, and they went from having high overdose rates,

00:13:51.720 high use of heroin, to having some of the lowest in the European Union. When BC decriminalized drugs,

00:13:59.720 that didn't stop it from having the highest cause of death be illegal drug use. So what are the

00:14:07.480 Portuguese doing differently from Canada and British Columbia, in particular?

00:14:14.200 Okay, quick question. Am I allowed to swear?

00:14:17.400 Sure, I think we might bleep it out, but go ahead.

00:14:21.520 Okay. So you know what, the Portuguese model has historically done quite well. And what Canada's done

00:14:29.400 is implemented the shitiest possible version of that model. So what Portugal did is that it 0.90

00:14:36.000 decriminalized possession and purchase of small personal amounts of drugs. Everything else

00:14:44.560 remained criminalized. So if you sell the drug, it's still criminalized. If you have larger amounts of

00:14:49.460 drugs, it's still criminalized. It's just that, you know, if you get caught with a small amount of

00:14:54.180 cocaine or a small amount of pot, you're not going to be sent to the criminal justice system.

00:14:59.400 Now, what happens instead is that they have something known as dissuasion commissions.

00:15:04.260 And dissuasion commissions are composed of a lawyer, a social worker, and a psychiatrist.

00:15:09.820 And together, they evaluate someone who has been caught with drugs and figure out what to do.

00:15:15.260 And they have punitive powers, such as being able to temporarily block access to welfare,

00:15:19.760 or levy fines, or ban someone from going to certain people or places.

00:15:23.200 And they use these powers to heavily pressure, but not necessarily force someone to go into

00:15:30.060 treatments. And treatment facilities are, you know, widely available and very well funded in

00:15:34.760 Portugal. So what happens essentially is that, you know, you have what you would normally have in

00:15:40.620 society. There's accountability for drug use of all types. It's just that at the lowest level,

00:15:45.620 they have an alternative system that keeps people out of the criminal justice system,

00:15:49.600 doesn't burden them with criminal records that ruin their lives, and tries to divert people to

00:15:55.540 the healthcare, to the healthcare system, rather than throwing them in jail. And that all makes

00:16:00.640 sense. Now, what BC has done is they basically said, okay, let's just decriminalize small amounts

00:16:07.820 of drugs, but put in almost no effort into diverting people into healthcare and treatments.

00:16:13.520 So, you know, Portugal has these dissuasion commissions, where there's actually, you know,

00:16:20.140 punitive powers that force people into treatment. Whereas in BC, if you're caught with a small

00:16:26.460 number of drugs, small amount of drugs, you are just given a pamphlet that, you know, tells you about

00:16:32.860 treatment options, as if you, as a drug user, were not already aware of this. So it's a joke,

00:16:39.120 right? Like, it's completely, there is no real attempt to push people towards treatment. We're

00:16:44.600 just letting people do what they want with impunity. And we're seeing the negative impacts of that

00:16:49.580 already. So do you think that, I mean, some of the activists in BC call for destigmatization? And,

00:16:57.580 you know, there's other aspects of society that we've moved to maybe destigmatize, and the one I'm

00:17:02.760 thinking the most of is mental health. We've talked about a good way to have people come out and

00:17:07.740 explain their mental health issues is to have it destigmatized. But they also want to destigmatize

00:17:13.580 drug use. Do you think that it's important for drugs to kind of stay stigmatized? How do we find

00:17:19.360 a balance where people are not ashamed to be open about their addictions while also maintaining a

00:17:25.440 notion in society that, no, you should not be using these drugs?

00:17:30.800 Well, I want to flag that this is an element of the conversation that I haven't done a substantial

00:17:35.280 amount of research in. So what I'm about to say is based on my personal impressions and it's not

00:17:39.660 scientifically backed. So, you know, take it with a grain of salt. But I think that, you know,

00:17:44.240 obviously some level of destigmatization is important for helping people be more open about

00:17:49.860 their drug use and pushing them towards treatment, right? When someone hides their drug use,

00:17:55.240 it's painful for them and it pushes them into risky behavior versus when they're able to open up to

00:18:01.120 people around them about the fact that they're doing drugs. It helps them, you know, seek out

00:18:06.040 help and support from their close social contacts. So that's important. There's a certain level of

00:18:12.040 destigmatization which is needed. However, we can't destigmatize too much because, you know,

00:18:19.860 when you have higher barriers to using drugs, people use drugs less. If something costs more,

00:18:25.100 you know, you're going to use it less. And stigma is a social, it's a sort of psychological and social

00:18:30.780 cost, right? Like if you're afraid of the stigma of using a drug, you're not going to use it as

00:18:38.300 easily. And, you know, to illustrate that, let's go back to the comparison between hydromorphone and

00:18:43.380 heroin. Heroin is highly stigmatized amongst youth. Hydromorphone is not. Youth are more likely to

00:18:49.300 use hydromorphone because that stigma is not there. So similarly, you know, we don't want people to

00:18:54.440 think that using hard drugs is fine. It's obviously not. It's going to destroy your life. So we need

00:19:01.020 to find that middle ground where we say, if you're using drugs, you know what, you're not a terrible

00:19:05.160 person. We're here to help you, you know, talk about your problems, but also drugs are bad and please

00:19:11.440 don't do them. Right, for sure. I think there's often a need for balance in most days. And unfortunately,

00:19:18.080 because things kind of become politicized, there becomes too extremes and no room for nuance.

00:19:26.380 I mean, you've criticized a lot, safe supply. What would you see as a maybe an alternative? Because

00:19:35.200 I mean, there's, if you look at Vancouver East Side, even Toronto, Ottawa, there are so many drug

00:19:40.280 addicts on the streets that are, you know, it's almost like they're lost souls. These poor people

00:19:45.320 are completely high and not even, you know, maybe conscious that they're living. How do we save these

00:19:51.540 people? How do we get them off the streets, off these drugs and back in society where they belong?

00:19:57.560 Well, I want to, first of all, clarify something. So at the very beginning of our conversation,

00:20:02.500 I had mentioned that there are different models of safer supply. And I'm very much against the model

00:20:08.100 that is in Canada right now, because I think that it's grossly irresponsible. However, the addiction

00:20:13.440 physicians who I've spoken with have identified a model where safer supply could be responsible. And

00:20:18.720 that's something that I broadly agree with. So a model of safer supply that I think could work

00:20:23.920 is one where paradoxically stronger drugs are provided. So hydroborofone doesn't, you know,

00:20:29.580 help fentanyl users. So let's provide people with safe fentanyl. But let's ensure that consumption

00:20:36.020 is supervised. So we're not just going to give you fentanyl and like, you know, send you on your way.

00:20:41.180 You have to, we'll give you safe fentanyl. You have to consume it while supervised and you stay

00:20:46.560 under supervision. Right. And that prevents you from dying. Um, and rather than using as an

00:20:53.880 indefinite intervention where we just give you drugs until whenever, uh, we instead think of it

00:20:59.840 as a temporary solution with a very specific deadline that is used to help transition people

00:21:07.300 into more traditional forms of care. So let's say you're about to start using suboxone or sublocate

00:21:13.660 and you need some time to transition. I think it would make sense, you know, to provide that

00:21:18.660 patient with a temporary supervised version of safer supply. Uh, that model is being somewhat

00:21:27.320 implemented in Alberta. So Alberta is planning to roll out something known as, uh, I forget the exact

00:21:35.100 term, heroin assistant treatment, something like that. It's like essentially providing drug users with

00:21:41.800 stronger opioids as a temporary measure to transition them to care. So, you know, we're seeing that in

00:21:47.660 Alberta, but once again, like that model of safer supply is so different from what we're doing in BC right

00:21:54.980 now that it's kind of like the same thing in name only. Um, do you think eventually the people in BC are

00:22:04.560 going to realize that maybe they're not doing it right? Or do you think they'll just kind of double

00:22:11.600 down the same way public health leaders have, you know, double down on, on the lockdowns during the

00:22:16.540 pandemics and the masks, even when they have signs to otherwise, or double down on the pediatric, uh,

00:22:22.800 trans healthcare, despite all these de-transitioners coming out? Do you think we're seeing a trend here

00:22:26.920 where they're going to keep on doubling down until there's maybe a change in government?

00:22:30.160 Uh, I think so because the issue has become so political. I think that the federal government

00:22:37.240 will find it almost impossible to let go of this program and admit that something is wrong.

00:22:43.080 Uh, and partially that's because the minister for mental health slash associate health minister,

00:22:48.480 Carolyn Bennett is a bit of an ideologue. You know, I've seen her speeches, I've engaged with her. 0.58

00:22:53.140 Uh, she doesn't seem to be able to critically evaluate study design and she doesn't always seem 0.57

00:23:00.140 like the most astute of thinkers to put it euphemistically. Um, so I don't think that,

00:23:06.720 you know, she'll be reevaluating her beliefs anytime soon. Uh, however, I think that there are some level

00:23:13.560 of changes, um, in BC. So after my report came out, BC seemed to shift course. So initially they denied

00:23:23.440 that anything was a problem. Now CTV and global are also reporting, you know, the same stuff that

00:23:29.020 I'm reporting and we're seeing a shift. So the BC government recently announced they're going to

00:23:33.960 get more funding to opioid agonist treatments. So methadone and suboxone, uh, which is a recovery

00:23:39.840 oriented treatment, which is, you know, an alternative to safer supply and has decades of

00:23:44.220 research behind it. So we're seeing a shift towards recovery oriented care in BC. Um, and from my

00:23:50.820 understanding, you know, I'm aware that some people might be trying to put together lawsuits against

00:23:54.460 the federal governments, people who have been harmed by safer supply. And I think that if these

00:24:00.100 lawsuits do come to the public and, you know, they do percolates and multiply, then that might force

00:24:06.100 the federal government to abandon safer supply unwillingly because the legal and political

00:24:11.840 exposure would be too high. But once again, we need people to file these lawsuits first.

00:24:18.220 Right. For sure. And hopefully, uh, something can be done because I mean, we're, we're talking about

00:24:23.660 people's lives here and it's, it's so sad how people's lives are getting destroyed by, by these

00:24:30.620 drugs and these, you know, supplies, drugs and whatnot. Uh, Adam, thank you so much for, uh, coming

00:24:36.780 to speak with me. I really appreciate your insights on this and the work you do to expose the problem

00:24:42.380 with what's going on right now. And, uh, I'm sure we'll talk again soon.

00:24:46.680 Thank you for having me.

00:24:48.000 I hope that you enjoyed this interview. If you did, please consider making a donation to True

00:24:54.420 North by visiting donate.tnc.news today, because unlike the legacy media, we do not take the Trudeau

00:25:02.100 government's media bailout package. For True North, I'm Ilikante Nautil.

00:25:08.220 Thanks for watching.

Juno News - July 14, 2023

Canada’s harmful “safe supply” agenda (feat. Adam Zivo)

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