Juno News - The hidden harms of ‘harm reduction’ (ft. Adam Zivo)

00:00:00.000 I wanted to turn to the left coast or the west coast depending on how you refer to it with all

00:00:14.280 due respect to our friends and followers in British Columbia but in BC there was a rather

00:00:20.160 dismal Supreme Court ruling the BC Supreme Court the other day in which they effectively said that

00:00:26.640 if you try to get drug users out of playgrounds where children are congregating it's somehow a

00:00:34.200 violation of the drug users constitutional rights this is not just a reasonable concession that you

00:00:40.580 could make while letting people do their drugs everywhere else in BC which is the province's

00:00:44.720 policy no it's a violation of their constitutional rights so what more backwards and I will say

00:00:50.280 authentic display of how British Columbia is viewing this than that ruling and this comes at a time

00:00:56.380 where there was a rather unique report that came out from the Mcdonald-Laurier Institute by National

00:01:01.920 Post columnist Adam Zeebo who's been on the show before looking at the effects of BC's so-called

00:01:07.860 safe supply policy and if you followed this issue on this show or elsewhere in the past you know that

00:01:12.840 the word safe is a misnomer if ever there was one but figured we'd delve into both of these issues

00:01:18.560 Adam Zeebo returns here Adam good to talk to you thanks for coming back on good to good to talk to

00:01:23.740 you too thanks for having me back so let's just start with the supreme court ruling I hear me this

00:01:27.800 this is a system in Canada the legal system that will say that any constitutional right if you want

00:01:34.540 free speech if you want freedom of expression all of that is subject to all of these caveats and

00:01:39.300 exceptions and carve-outs and balancing against other peoples and here we have an example where

00:01:44.160 to say that we don't want drug users on playgrounds you can just go 50 meters away doesn't seem like

00:01:51.460 that big a concession but they're saying oh no no drug users have rights well so their argument

00:01:56.760 essentially is that if you ban people from using drugs in public spaces that will encourage them

00:02:03.100 to use alone and then if they use alone they're more likely to die of an overdose therefore uh banning

00:02:09.400 public drug consumption endangers drug users lives uh in a way that is just not acceptable uh that's a

00:02:16.600 very questionable argument uh I think that there isn't really any strong evidence behind that argument

00:02:21.760 from my understanding uh and I think that if it really were the case that allowing people to use

00:02:27.160 drugs in public decreased overdoses and deaths you'd see that reflected in the overdose data in BC uh since

00:02:34.120 they began their decriminalization experiments back about a year ago but we haven't seen that so I

00:02:39.160 really questioned how the judge is coming to the conclusion that the argument made by harm reduction

00:02:43.600 activists is a persuasive one yeah and I would say going back a year is uh one area but BC has had

00:02:51.320 for many many years the most permissive approach to drugs anywhere in the country we've had I mean

00:02:57.540 the original fight over so-called harm reduction was a center in British Columbia insight and that's

00:03:02.760 going back close to 20 years now maybe at least 15 16 years uh you've got these safe supply programs

00:03:09.260 that have been in effect and yet BC is still uh the worst as far as overdoses are concerned so I mean

00:03:14.580 the stated goal behind a lot of these programs just isn't panning out in the data well the problem

00:03:21.140 is that for for many BC addiction policymakers they don't seem to actually care about real research a lot

00:03:27.200 of the research in this space is very low quality or you know has often sometimes been biased uh even

00:03:34.100 for example insight a lot of the research that was produced around that in 2003 to 2007 uh was

00:03:40.480 produced by individuals who had lobbied for the creation of insight to begin with so there was a

00:03:44.600 lot of conflict of interest there and they were criticized for you know coming to misleading conclusions

00:03:49.040 so you can look at the numbers here and you can say well obviously this isn't working but these

00:03:54.340 harm reduction activists don't seem to really care right all they'll say is that well that just means

00:03:59.100 that we need more harm reduction uh they don't see a lack of success as anything against them they

00:04:05.240 just see it as evidence of you know of that we need more drugs yeah and you did in in your report

00:04:12.020 and impeccably researched by the way it's like 36 pages now there's you know credits and cover and all

00:04:16.760 of that but uh you did this report from mcdonald laurier institute looking specifically at uh the safe

00:04:21.680 supply fentanyl tablet uh program here and i first off why did you focus in on on that issue

00:04:27.820 well i focused on the issue because i was emailed by two addiction physicians who thought the whole

00:04:32.060 thing was ludicrous right and and so essentially if you know since your listeners aren't fully

00:04:36.640 familiar with this whole issue uh starting in august bc uh permitted the province-wide prescription

00:04:43.160 of safe supply fentanyl tablets and sue fentanyl uh and they they did this really you know quietly there

00:04:51.380 was no press release uh there's been no media on it which is really odd because usually

00:04:57.220 harm reduction advocates advertise when they expand safer supply and so i started looking

00:05:02.440 into it and i realized that the way that they were expanding safe supply fentanyl was grossly

00:05:06.780 irresponsible uh so the current system that we have today where we distribute hydromorphone which

00:05:12.240 is basically heroin is already broken because we don't require supervised consumption so people

00:05:17.440 sell their safer supply drugs on the streets so we decided to give out fentanyl and we decided

00:05:22.880 to put in no no requirement for safer like for supervised consumption so now we're creating a

00:05:28.200 system that is set up to essentially flood communities with fentanyl in addition to government

00:05:32.320 heroin which you know i personally think is irresponsible and i think many people would agree

00:05:36.360 with me and i will say it's not just a theoretical issue that these are ending up in the illegal

00:05:43.500 uh drug trade i mean there have been a number of demonstrable cases in bc and also in ontario

00:05:49.160 where people can pretty well prove how these drugs are ending up uh just being trafficked

00:05:55.180 well that's the thing is that so here's the thing when it comes to scientific informal studies of

00:06:01.000 diversion that's what they call it when this is sold to the you know to the streets none of these

00:06:05.500 studies are happening because harm reduction activists aren't interested in exploring this issue

00:06:10.520 uh and the federal government despite throwing a hundred million dollars in safer supply has not

00:06:15.160 funded one study that seriously looks at diversion the only research that's being done into diversion

00:06:20.200 is essentially act asking drug users who are on safer supply do you divert and if so why so obviously

00:06:26.680 that's incredibly biased you know hey are you selling your drugs if so why are you doing it um and

00:06:33.000 they'll you know they'll whitewash it they'll say oh it's just mutual aid or whatever um so what i've been

00:06:38.040 doing is i've been you know for the past year speaking to different stakeholder groups about safer

00:06:42.200 supply and i've just consistently been hearing from people that yes this diversion is happening

00:06:46.840 you know i heard that from over 30 addiction physicians i interviewed former drug users in

00:06:52.840 london ontario i interviewed online drug users on reddit who were openly selling safer supply and

00:06:58.680 posting photos with prescriptions and validating that safer supply i've spoken with over 50 youth who

00:07:04.200 talk about how hydromorphin is a big issue in their schools and how their peers are getting it from safer

00:07:08.680 supply so it's it's ridiculous to me that people are saying that this is not a big problem but the

00:07:14.040 thing is that our federal government and the bc government and these harm reduction activists do

00:07:17.400 not care you you can it it's like pointing to the sky and saying the sky is blue and they say well how

00:07:23.160 do you know that it's completely irrational is there i i think i may know the answer to this but i i may

00:07:30.040 not i we we had i mean when you were on the show previously we we had you alongside uh two experts

00:07:35.560 who have themselves been very gung-ho for harm reduction and then eventually had a bit of

00:07:40.920 uh buyer's remorse about that when they followed the data but i'm wondering if among the people

00:07:46.600 that are still advocates in general for harm reduction if they're all the same if they're all

00:07:51.800 about this you know this sort of wasteland approach that we see in bc or are there moderates that i guess

00:07:57.800 for lack of a better term that are saying well hang on i kind of agree in principle but i can't go that

00:08:01.880 far well i mean so here's the thing there's a lot of moderate people who are in for harm

00:08:06.520 reduction harm reduction itself is not a bad thing you know it is a key pillar for addressing the

00:08:11.000 opioid crisis in addition to let's say prevention and treatment and education but it is a very big

00:08:17.000 umbrella that includes a wide scope of intervention some of which are better than others well yeah i mean

00:08:21.960 just to interject there it used to be that harm reduction was about the needles and the pipes you use

00:08:27.560 not the giving out drugs yeah look harm reduction was championed in the late 80s and 90s uh primarily

00:08:34.760 by hiv researchers who wanted to decrease hiv infection rates because people were using dirty

00:08:39.960 needles and that was very effective and you know you had needle exchange programs that demonstrably

00:08:45.400 decreased rates of transmission for hiv and other blood-borne illnesses and then these researchers

00:08:51.080 ended up rebranding themselves as addiction experts in the 2000 and 2010s and they started you know

00:08:56.360 implementing more questionable interventions uh many of the people i've spoken to they're

00:09:01.720 almost all of them accept the need for harm reduction in some capacity and even some of them

00:09:06.840 accept the need for safe supply in some capacity where it's much much much more tightly controlled than

00:09:12.760 what we see today um so there's this wide gradients of approaches to harm reduction but bc has taken the

00:09:20.440 most extreme and most irresponsible one and then vilified anyone who opposes it as being i don't

00:09:27.880 know some kind of backwards troglodyte despite the fact that most of these people support harm reduction

00:09:32.920 in some capacity what are their benchmarks for success i mean because because again even no matter

00:09:39.720 how cynical i get there must be some target that they're pointing to as evidence that it's working

00:09:45.320 what is that oh okay so there's three different kinds of studies that support safer supply all of

00:09:51.720 which are deeply flawed so the first one is where they just interview drug users on safer supply and

00:09:57.160 when the drug users say oh this is great it makes me happier i'm overdosing less they say oh that's

00:10:01.640 subjective evidence that this works it's basically it's a customer testimonial uh so that's not valid at all

00:10:08.440 the second level is doing uh quantitative studies but the underlying data is still self-reported so

00:10:15.720 essentially they had a whole bunch of surveys say you know rate from the scale of one to ten uh how you

00:10:21.400 feel about x or has this happened to you in the past have you overdosed yada yada yada um and so you can

00:10:27.640 crunch those numbers so there's less they're less open to misinterpretation than let's say you know an

00:10:32.440 interview but ultimately self-reported data you know the drug users know what kind of results they

00:10:39.640 need you know to get to continue having access to their drugs so it's also not trustworthy the the

00:10:45.080 third level and this is the one that's more complicated for people to wrap their heads around

00:10:49.240 so there's a recent study that came out last year in ontario that used ontario's administrative health

00:10:54.360 data to show that safer supply programs did have positive impact on their clients but there's a huge

00:11:00.760 huge caveat here so safer supply programs don't just give you free drugs they also give you access

00:11:06.840 to significant wraparound supports like social housing uh primary care uh sorry blanked out there's a few

00:11:16.440 other ones on top of that uh but the the study made no attempt to discern whether positive impacts came

00:11:23.960 from the wraparound supports or the free drugs so uh i'll just finish this monologue uh the comparison

00:11:30.760 would be like imagine a really obese man and you you put him on a diet plan and you give him access to

00:11:37.400 a personal trainer and you give him access to a life coach and a psychologist and then you give them

00:11:41.960 a free piece of cake once a week and he loses weight and you say well obviously giving cake is what caused

00:11:49.080 him to lose weight well no well that's what this kind of study is like yeah yeah there goes my there

00:11:54.920 goes my new year's strategy for weight loss there a cake cake a week keeps the pounds off well no that's

00:12:00.120 quite fascinating and and you know the one thing i will also point out is that i don't hear in the rhetoric

00:12:05.480 a lot of discussion about trying to get people off drugs as even being a goal i mean there's a fair bit

00:12:11.000 of resignation that i think underlies a lot of these programs which is well they're using them so we just

00:12:15.960 have to try to get the best outcomes within that well that's the thing is that many people think

00:12:20.840 that safer supplies is compassionate response it's not compassionate we're giving up on people uh

00:12:26.440 we're we're basically giving them palliative care right we're keeping them comfortable until they die

00:12:32.680 uh or until we can give them made um and then how is that compassionate and look theoretically

00:12:40.200 theoretically safer supplies meant to keep people alive until they seek treatments

00:12:44.840 but in practice safer supply programs rarely push people towards recovery i mean it exists in the

00:12:52.120 guidelines of the theoretical thing but people just take their drugs and they sell it and then they

00:12:56.600 buy fentanyl until they die and that's just horrific i i know that your work on on this in the past

00:13:03.000 has been shared notably by by pierre polyev the conservative leader who's taken an interest in this and

00:13:08.120 i i'm wondering though if there were a change in the federal government how much of of what's

00:13:12.360 happening in bc could even change and how versus how much of it is squarely within the provincial

00:13:17.400 jurisdiction i'm actually not entirely sure about the distinction between the federal and provincial

00:13:22.360 jurisdiction here it's murky that's the best i've been able to unearth myself on this well here's the

00:13:27.640 thing so uh safer supply is provided in two main ways so way one is through federally funded programs

00:13:34.040 um and these can be forced into provinces uh there are provinces that have resisted safer supply

00:13:39.800 and the federal government is still funded programs operating within them um though i think alberta has

00:13:44.600 effectively banned safer supply regardless of the federal government's intentions um and then on the

00:13:49.640 second level the provincial government can incentivize people to uptake safer supply or they can for

00:13:55.960 example create uh protocols that allow regular prescribers to prescribe safer supply so you just you know

00:14:02.200 your regular doctor it's outside of a specialized program if the federal government changes you know all the

00:14:07.400 fucking sorry all the funding uh for uh for saying there goes our clean tag on itunes it's been a good 0.91

00:14:13.560 run uh all the funding federal funding for safer supply will go away and all of these projects which 0.97

00:14:18.200 create really terrible research will be take you know they'll be offline which will be great um and what i

00:14:23.960 would love to see is a federally funded investigation into safer supply and federally funded studies into the

00:14:29.080 harms of safer supply and i think it'll be politically difficult for provinces to defend safer supply once they lose

00:14:36.920 federal support uh because what that'll mean is that addiction physicians will start speaking out

00:14:41.560 more many of them are worried about losing access to federal grants uh it means that as more knowledge

00:14:47.080 comes out more people are going to sue provincial governments i know that there are people who are

00:14:50.360 looking into lawsuits right now um and number three just you know once you have more kids and drug users

00:14:57.400 and more evidence coming out this is a disaster you know no one wants to lose their their government i know

00:15:02.040 that the bc ndp is very worried about a conservative resurgence so i think that if safer supply starts

00:15:07.160 imploding they would definitely abandon ship yeah no i think that's a very good point and even just on

00:15:12.120 the the playground topic that we started on i mean that's an issue where parents that otherwise don't

00:15:17.160 care about this are going to all of a sudden become very concerned when they can't even take their

00:15:22.200 kids to the playground and already i hear from people emailing and saying oh my son or daughter is uh in

00:15:27.880 university in toronto and is scared to take the subway like these are this has just become a fact

00:15:33.000 of life now in canada and that is is not sustainable adam zivo great a report for the

00:15:38.280 mcdonald laurie institute on this and also great work in the national post always thank you so much

00:15:43.320 thanks for having me thanks for listening to the andrew lawton show

00:15:46.840 support the program by donating to true north at www.tnc.news

Juno News - January 07, 2024

The hidden harms of ‘harm reduction’ (ft. Adam Zivo)

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