Canada’s top doctor says street drugs in Canada have become so toxic, offering a safe supply of prescription opioids to those who are addicted is one way Canada is “pulling out all stops” to prevent people from dying.
In a year-end interview with Global News, Dr. Theresa Tam said she believes some Canadians may not fully understand the benefits of harm reduction measures like safe supply as a tool to combat the opioid crisis in Canada.
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But such measures are part of a suite of responses that are sometimes necessary, given the significant and deadly toll street drugs contaminated with fentanyl are having across the country, Tam said.
“The opioid and other substance use crises is a major public health concern right now,” she said.
“We don’t know the exact reason, but a toxic, really increasingly toxic, illegal drug supply with fentanyl contaminating 75 to 80 per cent of the supply is a key driver. And so by providing a pharmaceutical, prescription-based opioid drug, (this) is another way that people are pulling out all stops to try and support people in need.”
A total of 32,632 Canadians have died due to opioids between 2016 and June of this year, according to the latest federal data.
It shows that in the first six months of 2022, there were 3,556 apparent opioid toxicity deaths, a grim figure that was already close to the total number of Canadians — 3,747 — who lost their lives to opiates in all of 2020.
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This translates to about 20 opioid-related deaths per day this year and marks a significant increase since the years prior to the pandemic, when highly potent levels of fentanyl became more prevalent in the street drug supply, according to federal data.
For example, in 2016, approximately eight people died per day from opioid overdoses, and in 2018, that number increased to 12 deaths per day.
Among the 20 daily opioid-related deaths from January to June of this year, 76 per cent involved fentanyl and 79 per cent involved opioids that were only non-pharmaceutical, which means these deaths were not from drugs diverted from the legal supply.
A renewed debate about harm reduction measures to address the opioid crisis has been sparked in recent weeks in the wake of comments from Conservative Leader Pierre Poilievre, who has slammed safe supply as a measure that he claims keeps people addicted to drugs.
The federal government funds 17 safe supply pilot projects in four provinces, where patients are given prescriptions of pharmaceutical-grade opioids as an alternative to street drugs laced with fentanyl that could kill them.
“What I don’t support is just perpetuating indefinitely their addiction, as the current approach is doing,” Poilievre said in an interview with Alex Pierson on AM640, a radio station owned by Corus Entertainment, the parent company of Global News, earlier this week.
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“We have these so-called safe supply programs, but the problem with the way they run is that they don’t guide people towards an eventual drug-free life. They keep them in the current state of addiction.”
Instead, he says federal investments should go toward recovery and treatment programs.
In a video he posted to Twitter in November, Poilievre also suggested a rise in violent crime in Canada was linked to the opioid crisis and talked about the need to bring in “tougher laws for the violent re-offenders and the gangsters and organized criminals who are preying upon these addicts.”
Tam stressed that the opioid crisis “is a public health issue, not a criminal issue.”
Taking a public health approach to this crisis requires a whole suite of measures, she said, which includes treatment and recovery programs, but also can sometimes require harm reduction responses.
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“Prevention is important, so is treatment — absolutely important. And supporting people in recovery is important,” she said.
“But the concept of harm reduction is also important in that you need to meet people where they’re at. Some people are just not ready.”
Offering a safer supply of opiates to people who are not yet able or prepared to do the hard work involved in addiction recovery is meant to “prevent deaths so that people can be alive, in fact, to then take up treatment measures when they’re ready to do so,” Tam said.
While some people may not fully understand harm reduction programs, those operating in Canada are being measured and evaluated for effectiveness, Tam added, and some preliminary data released earlier this year has highlighted some successes.
She pointed to an independent study published in September in the Canadian Medical Association Journal (CMAJ) that looked at individuals who used a safer supply program in London, Ont., for three years.
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It found participation in the program significantly cut down on emergency department visits and hospitalizations for people at high risk for overdose.
It also found no increased risk of infections or overdoses and a decline in health-care costs unrelated to primary care or outpatient medications after a year.
In addition, there were no opioid-related deaths among those who were part of this program.
“In fact, the people who joined the program really had a much higher survival than the rest. And then there were wraparound programs in terms of treatment services, social and other services, so that it’s linking individuals to care,” Tam said.
“Providing the data and the evidence is really important and we shouldn’t be putting out these programs without monitoring them, so I’m very happy that these studies are now being published and I think Canada is playing a global leadership role in that.”