Western Standard - ＂The Escalating Craze of Safe Supply Advocacy＂

00:00:00.000 Thank you very much for joining us again today, Adam. I'm certain we'll be able to hear each

00:00:03.500 other this time, right? Yeah, I can hear you just well. Thanks for having me back on the show.

00:00:07.840 So, I mean, I've been watching with interest on social media. Boy, you cover a lot of things,

00:00:12.300 and it's fantastic out there. But the one I do want to discuss has been the safer supply,

00:00:19.260 almost, I say it is a cult-like advocacy. I mean, the people who are pushing for this,

00:00:24.180 just the advocates are getting so extreme, I mean, to the point of looking to sabotage conferences,

00:00:31.660 coming after you, and just a refusal to look at the consequences of these policies. What's going

00:00:37.960 on out there, Adam? Well, I mean, it's a long story. But what I have to say is that addiction

00:00:42.440 policymaking in Canada is dominated by a clique of activists and activist-minded researchers who,

00:00:48.860 for 20 years, have been championing this radical harm reduction ideology that has helped, well,

00:00:56.620 I mean, facilitated countless deaths, because we're really not solving this addiction crisis.

00:01:01.720 They claim to be evidence-based. They're often not. Their definition of evidence is quite questionable.

00:01:06.880 For example, many of the studies that they have, which support safer supply,

00:01:10.600 amount to just interviews with drug users who are on this program. And then the answers given to

00:01:17.520 those interviews are framed as objective proof that it's working. So imagine, for example,

00:01:21.940 you go up to a drug user who is receiving free opioids, and we say, oh, you know, do you like

00:01:26.140 this program? Is it benefiting you? Are you selling the drugs? And the guy says, oh, yeah,

00:01:30.080 it's great. It's wonderful. Of course, I would never sell the drugs. And if I do, it's only out of

00:01:33.540 compassion. There's no downsides. And the researchers say, oh, yeah, you know what? We're going to

00:01:37.440 believe him. And we need to expand safer supply, because this is evidence that this is true. And this is

00:01:42.720 evidence-based policymaking. And it's just absurd. I mean, if it worked, if we could see results,

00:01:47.280 if we could see people's lives really being saved, if we could see a decline in overdoses,

00:01:52.060 a reduction in addiction, I'd support it too. But we're just not seeing it.

00:01:56.960 We're really not. And here's the thing, is that the largest study ever conducted on safer supply

00:02:02.140 was published in January. And it was published in the British Medical Journal. And it claimed

00:02:07.880 that safer supply led to a 55% to 91% reduction in overdose deaths. But I reviewed the evidence and

00:02:15.120 the underlying data with a team of six physicians, all who have a background in addiction medicine,

00:02:19.760 all of whom are distinguished. And we realized that the researchers actually fudged their

00:02:25.700 interpretation of this data. And that when you actually did, when you actually fully filtered

00:02:30.240 out confounding effects and measured long-term outcomes, safer supply had no statistically significant

00:02:36.460 impact on death. So essentially, these researchers found this robust data that showed that safer supply

00:02:44.000 didn't work. And then they misrepresented the data to imply that it did. And I think that that's deeply

00:02:49.440 unethical. Absolutely. But what I don't understand, as I said, is the almost religious, like,

00:02:55.520 hang-up advocates have with it to the point of, again, I was just shocked when you wrote that piece

00:03:01.360 what they were looking to even dye the water in a fountain red, or do things like, where are these

00:03:07.520 people coming from? Why are they so fixated on this? I mean, I understand compassion and concern,

00:03:13.180 then why aren't they looking at evidence-based instead of this strange obsession with this?

00:03:18.580 Well, I mean, there's different groups here, right? So I feel the most compassionate for the

00:03:22.500 grassroots organizers who are dealing with addiction every single day and who are watching

00:03:27.280 their friends and associates die. That's really traumatizing. We've seen such a rise in death

00:03:34.380 over the past 10 years that it's understandable that these activists are desperate in a way,

00:03:40.080 and they are searching for anything which could potentially save their friends' lives.

00:03:45.200 But when you're in that kind of mind space, sometimes you're willing to make compromises,

00:03:50.200 and you are willing to believe, to really delude yourself into thinking that something like

00:03:57.940 Safer Supply is an effective intervention, when in reality it's not. I think also there's a lack

00:04:05.660 of understanding of the weakness of the evidence-based in Safer Supply. Many Safer Supply advocates

00:04:11.580 think that these studies are legitimate, but once again, when you break them down, you find that

00:04:17.240 oftentimes they have really weak methodologies or really strange interpretations of data.

00:04:23.280 Yeah, and some of the stuff we can see is anecdotal, but people getting out and being on the streets,

00:04:28.980 paradoxically, one of the commenters saying, and yeah, in Calgary's Beltline, I mean, it's just

00:04:31.920 horrific. It's dystopian. And we know that Vancouver, of course, has really been the epicenter of it,

00:04:37.440 but the failure, unfortunately, of current policies. And I don't think anybody's really found a solution

00:04:42.300 yet, but we just know there's a tragic, horrific problem of addiction going on out there.

00:04:47.240 But some of it's been exposed. I mean, there was a recent piece, I'm forgetting which one it was

00:04:51.180 now. It was, I think, from the UK, but I mean, it was some photojournalism and some fantastic work

00:04:55.480 just to bring it home for people who perhaps don't get out of the suburbs or don't get out of rural

00:04:59.240 areas just to see how awful and terrible this addiction epidemic is. I mean, how it's eating

00:05:05.000 people alive out there. Well, I mean, that's the thing is that we have to all recognize the fact that

00:05:09.060 this is a real crisis that is taking thousands of lives every single year. Overdose is now,

00:05:15.240 over drug-related deaths, like the leading cause of death for youth in BC. And our governments are

00:05:23.060 saying that they're taking this seriously, but they're not. We don't have significant investment

00:05:28.860 into treatment capacity. In BC, for example, it takes a very long time to get into detox. It takes

00:05:33.820 a very long time to get into a rehab center. Same thing in Ontario. In Alberta, it's much better

00:05:39.200 because Daniel Smith has been investing heavily into treatment services, but it's still not where

00:05:44.960 it needs to be. So we constantly talk about this illicit drug crisis and all of these overdoses,

00:05:51.040 but it's really rhetoric. There's no real action here. And even these big interventions like safe

00:05:57.720 supply, people say it's the compassionate thing. Unfortunately, it is actually just the lazy

00:06:03.140 solution. It is the cheap solution because getting people better, giving them the comprehensive

00:06:09.560 supports, the housing supports, the employment supports, the counseling needed for them to reclaim

00:06:15.020 their lives is expensive and complicated. It's much easier and much cheaper just to give people a bottle

00:06:22.120 of pills every day so they can go kill themselves slowly. Yeah. And then not only is it not effective 0.99

00:06:27.840 in getting people, you know, off of their addictions that are slowly killing them. When we get diversion

00:06:33.580 of these, the risk now, and there's evidence starting to show that it's actually causing harm. It's

00:06:39.160 creating new addicts, which is even more devastating. I mean, it's bad enough to have a policy that's

00:06:43.640 ineffective, but this policy could very well be making things worse. Oh yeah, no, though. The safer

00:06:48.800 supply policy is obviously exacerbating the addiction crisis in Canada. And so for viewers who haven't been

00:06:54.800 following the safer supplies, this idea that we give out pharmaceutical alternatives to elicit street

00:06:59.100 drugs, let's say Cory gets addicted to fentanyl because he's really stressed, you know, running

00:07:04.080 this show. You need something to take the edge off. So Cory, you're addicted to fentanyl. You buy your

00:07:09.360 fentanyl off the street. It could be contaminated with xylazine, with other forms of fentanyl, like

00:07:15.060 carfentanil, which is much stronger. The dosage is unpredictable. So there's easily, you could easily

00:07:20.820 die from buying drugs off the street. So the idea here is that we give you, uh, drugs of a known

00:07:26.360 potency and of a known purity. Uh, so pharmaceutical drugs to keep you alive until you're ready to seek

00:07:31.800 treatment. Sure. That sounds great in theory. In practice though, uh, the drug we give hydromorphone,

00:07:38.780 it's as power as a potent as heroin, but fentanyl is 50 times stronger. So Corey, if you get a bottle

00:07:46.240 of hydromorphone and you take it, it's not going to do anything for you, it's too weak. And so you do

00:07:51.240 the rational thing that any person would do in the situation. You sell your hydromorphone at rock

00:07:56.840 bottom prices because you got it for free and you use that money to buy your drug of choice, which is

00:08:01.440 fentanyl. So not only is this program not mitigating the illicit fentanyl market, it's subsidizing it.

00:08:08.880 And it would actually make more sense for us just to give you cash, right? But to buy your fentanyl,

00:08:16.040 but at this point, because you're selling this, you are flooding communities with hydromorphone.

00:08:21.180 So essentially government heroin, and then because experienced drug users don't want it, it goes to

00:08:26.920 people who are opioid naive. It goes to kids. It goes to people in recovery. The kids will take it

00:08:32.500 because they don't know what it is. You know, it's a pill at a party. They're told it's a prescription

00:08:36.640 pain medication. It's safe. It's from the government. Then they get hooked. Then they

00:08:40.800 graduate on fentanyl and it kills them. This is an absolute disaster.

00:08:45.120 And something else, Jordan, one of my commenters pointed out, which is another thing, you know,

00:08:48.480 we're getting hints of, there might be some people with a vested interest in business interests in

00:08:53.660 being part of the dispersal of the safer supply. I mean, that's kind of a different rabbit hole to go

00:08:58.640 down, but unfortunately some people are finding themselves with a financial interest in the status

00:09:02.680 quo, which is morbid, but another thing to look into.

00:09:06.460 Well, I mean, the problem here is that like clinics can make a lot of money by prescribing

00:09:10.680 safer supply. You have people coming in, you have your patients coming in all the time to get their

00:09:14.860 safer supply prescriptions versus if you put them on sublocate, for example, which is a once a month

00:09:19.820 shot. The pharmacies are making an absolute killing because they dispense the safer supply every

00:09:25.220 single day. So you're paying, you're charging a dispensing fee every single day for every single

00:09:29.680 patients. One doctor I spoke with estimated that a single pharmacy can make $1 million a year off of

00:09:36.100 100 patients. So yeah, Shoppers Drug Mart, for example, gave about $2 million to the BC Center for

00:09:42.760 Substance Use to encourage them to create like training programs for safer supply. And I think

00:09:48.380 that's a huge conflict of interest. Purdue Pharma, which was the, you know, really awful company that

00:09:55.100 was behind the OxyContin crisis and started this whole opiate addiction in the first place,

00:09:59.480 this crisis. They produce Dilaudid, which is the brand version of hydromorphone. So they are making

00:10:06.660 a lot of money off of this as well. And I'm aware of the fact that they are currently lobbying some

00:10:11.580 governments about safer supply. I still need to fully investigate that. So yeah, there's a lot of

00:10:17.560 pharma money involved here, which I think is really concerning.

00:10:19.840 And I guess something that has to be, you know, you put it out as well. I mean, full treatment,

00:10:24.600 the counseling, the housing, the time, it's very expensive. You need facilities, you need trained

00:10:30.200 staff, you need resources. Alberta's working along that course. But I actually have a family member

00:10:36.220 who's been in and out of rehab once now, and it didn't work. It could take multiple visits. And

00:10:42.820 they say, yes, you certainly are addicted, you qualify, come back in 30 days, and we'll probably

00:10:48.440 have a bed for you. But unfortunately, living on the streets for 30 days, you know, your chances

00:10:53.780 aren't looking very good at all. But I guess people have to realize that the investment in these

00:10:58.460 facilities too, as expensive as they sound, we're still paying because the person I'm speaking of

00:11:02.300 was in and out of conventional hospitals, chronically in and out of shelters. Often people are in and out of

00:11:07.920 jail, we're paying anyway. So we can spend those dollars better if we're trying at least, even if

00:11:13.440 there's a limited success rate in rehab. But hopefully we're starting to realize that. I mean,

00:11:19.040 in BC, they've gotten rid of the, you know, the reality seems to be sinking in with that government.

00:11:23.660 Yeah. Well, that's the thing, as you said, our capacity here is quite limited, right? So if

00:11:29.340 someone has to wait 30 days to get into rehab, then that's going to be, that's going to make it very

00:11:33.320 hard for them to get better. Because you make that decision, you want to get better. But then you have

00:11:37.020 to wait 30 days, well, you're going to start using during that period. And then in 30 days, you may

00:11:41.380 not want to go to rehab. It costs a lot to do all of this. As you said, we're already paying a lot.

00:11:49.180 You know, our healthcare system is strained to the max. And part of it is because we have a small

00:11:55.180 number of severely addicted people who are visiting hospitals again and again and again and again.

00:12:01.020 So it would be fiscally responsible for us to put them in a treatment center instead,

00:12:07.420 and could also improve healthcare access for everyone else. It just makes sense.

00:12:13.780 Yeah. Well, it's a large and complicated problem. I mean, part of it too, is at least letting people

00:12:18.680 know so they can let their representatives know, I mean, how acute it is and encourage them. I mean,

00:12:25.080 I think most compassionate people when they realize just how bad it's getting would support

00:12:29.160 the investment in rehab and a results-based policy. But I mean, it takes exposure. It takes

00:12:34.840 letting people know, as I said, if they live in the suburbs and don't get downtown, they might not

00:12:38.220 realize how bad it is until it costs them directly. So I mean, just kind of, you know, to wrap things up,

00:12:43.860 you've been fantastic in covering this and exposing it. Where can people find your work and keep track of

00:12:49.660 what you've been writing on?

00:12:50.540 Well, I mean, I'm a columnist of the National Post, so I think you should subscribe to the paper. It's

00:12:54.200 great. There are also many other great writers there. And then on top of that, I run a non-profit

00:12:59.680 called the Center for Responsible Drug Policy. And we have a little sub-stack called Breaking

00:13:05.000 Needles. So you can go find us at www.breakingneedles.com or responsibledrugpolicies.com. Either

00:13:11.620 will give you access to all sorts of great material on addiction that challenges some of these,

00:13:16.720 you know, narratives of radical harm reduction that have ruined our country.

00:13:21.480 Well, that's it. I mean, you know, just applying some common sense or looking for results. I had a

00:13:26.440 Dr. Monty Ghosh on. He specializes in addiction treatment. And you talked about, you know, we don't

00:13:31.920 have time to go into the whole thing of consumption centers. There was this horrific case of a Vancouver

00:13:35.960 one. I saw it look like an opium den of old with what it turned into. But the effectiveness of safe

00:13:42.120 consumption is typically only good for about 500 yards, he said, from where the addict is. Otherwise,

00:13:47.620 they're not going to travel that far. And we just don't have the resources to set one up every 500

00:13:51.780 yards in every major city. So we've got to think a little harder on it.

00:13:55.080 Yeah. If we're going to spend the money, like rather than spend the money on putting a safe

00:13:58.380 consumption site everywhere, we should be spending money on building up treatment capacity. You know,

00:14:04.220 it's a better investment to get people better than to enable their addictions and let them 0.95

00:14:08.460 slowly kill themselves. Absolutely. Well, thank you very much for joining us today, Adam,

00:14:12.500 and for the work you've been doing and exposing this. I really appreciate it. And I hope we can

00:14:17.320 have you on again sometime soon to talk again. Likewise. Thanks for having me on the show.

Western Standard - July 16, 2024

＂The Escalating Craze of Safe Supply Advocacy＂

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