Canada’s Mental Health Minister Defends ‘Safer Supply’ Approach to Drug Crisis

Canada’s mental health and addictions minister, Ya’ara Saks, has said that the government’s decision to support prescribing pharmaceutical alternatives to drug users as a way to combat the overdose crisis is based on evidence and compassion, not on stigma and fear. Saks has responded to the criticism and opposition that the government’s ‘safer supply’ strategy has faced from some quarters, and has explained the rationale and benefits of the approach. In this article, we will examine the arguments and implications of the ‘safer supply’ strategy, and how it aims to save lives and reduce harm.

The Challenge: A Deadly and Worsening Overdose Crisis

Canada is facing a deadly and worsening overdose crisis, which has claimed the lives of tens of thousands of Canadians in the past few years. According to the Public Health Agency of Canada, more than 20,000 people died from apparent opioid-related overdoses between January 2016 and September 2020, with an average of 17 deaths per day in 2020. The majority of these deaths involved fentanyl, a highly potent and often adulterated opioid that has flooded the illicit drug market.

The overdose crisis has been exacerbated by the COVID-19 pandemic, which has disrupted the drug supply chain, reduced the access to health and social services, and increased the isolation and stress of drug users. The pandemic has also increased the demand for drugs, as many people have turned to substance use as a coping mechanism for the mental and emotional challenges posed by the public health emergency.

The overdose crisis is not only a tragedy for the individuals and families affected, but also a burden for the health care system and the society at large. The crisis has increased the costs and pressures on the emergency and hospital services, as well as the law enforcement and justice systems. The crisis has also eroded the social and economic potential of many communities, especially those that are marginalized and vulnerable.

The Strategy: ‘Safer Supply’ of Pharmaceutical Alternatives

In response to the overdose crisis, the federal government has adopted a comprehensive and evidence-based approach, which includes various measures, such as:

• Expanding the availability and accessibility of naloxone, a medication that can reverse the effects of an opioid overdose, and providing it for free to anyone who needs it.
• Supporting the operation and expansion of supervised consumption sites, where drug users can consume their substances in a safe and hygienic environment, under the supervision of trained staff who can provide emergency care and referrals to other services.
• Increasing the funding and resources for harm reduction, treatment, and recovery programs and services, which can help drug users reduce the risks and harms associated with their substance use, and assist them in their journey towards recovery and wellness.
• Decriminalizing the possession of small amounts of drugs for personal use, and diverting drug users from the criminal justice system to the health and social services system, where they can receive the help and support they need.

One of the key components of the government’s approach is the ‘safer supply’ strategy, which involves prescribing pharmaceutical alternatives to drug users who are at high risk of overdosing or experiencing other harms from the toxic and unpredictable street drugs. The ‘safer supply’ strategy aims to:

• Reduce the demand and dependence on the illicit drug market, which is the main source of the fentanyl and other contaminants that are causing the majority of the overdose deaths.
• Provide drug users with a consistent and regulated supply of drugs, which are of known quality, quantity, and potency, and which can be consumed in a safer and more controlled manner.
• Establish a therapeutic relationship between drug users and health care providers, who can monitor and adjust the dosage and frequency of the prescribed drugs, and offer other medical and psychosocial interventions, such as counselling, education, and referrals.
• Enhance the dignity and autonomy of drug users, who can make informed and voluntary choices about their substance use, and who can access the prescribed drugs without fear of stigma, discrimination, or criminalization.

The ‘safer supply’ strategy is not a new or radical idea, but a well-established and widely practiced medical intervention, which has been proven to be effective and beneficial in many countries, such as Switzerland, Germany, and the Netherlands. The ‘safer supply’ strategy is also supported by various health and human rights organizations, such as the Canadian Medical Association, the Canadian Public Health Association, and the Canadian Human Rights Commission.

The Criticism: ‘Safer Supply’ as a Source of Controversy and Opposition

Despite the evidence and endorsement of the ‘safer supply’ strategy, the government’s decision to support and fund the strategy has faced criticism and opposition from some quarters, who have raised various concerns and objections, such as:

• The ‘safer supply’ strategy is a form of drug legalization or promotion, which will encourage and enable more drug use, and create more addiction and dependence among drug users.
• The ‘safer supply’ strategy is a waste of public money and resources, which could be better spent on other priorities, such as prevention, education, and enforcement.
• The ‘safer supply’ strategy is a violation of the international drug conventions, which prohibit the production, distribution, and possession of certain drugs, except for medical and scientific purposes.
• The ‘safer supply’ strategy is a threat to the safety and security of the public and the communities, as it will increase the availability and accessibility of drugs, and create more crime and violence.

The Response: ‘Safer Supply’ as a Matter of Evidence and Compassion

In response to the criticism and opposition, the mental health and addictions minister, Ya’ara Saks, has defended the government’s support for the ‘safer supply’ strategy, and has argued that the strategy is a matter of evidence and compassion, not of stigma and fear. Saks has said that:

• The ‘safer supply’ strategy is not a form of drug legalization or promotion, but a form of harm reduction and treatment, which aims to save lives and reduce harm, not to increase drug use or addiction. The strategy is based on the recognition that drug use is a complex and chronic health condition, which requires a continuum of care and support, not a moral judgment or a criminal sanction.
• The ‘safer supply’ strategy is not a waste of public money and resources, but a wise and prudent investment, which will generate significant savings and benefits for the health care system and the society at large. The strategy will reduce the costs and pressures associated with the overdose crisis, such as the emergency and hospital services, the law enforcement and justice systems, and the social and economic losses. The strategy will also improve the health and well-being of drug users, and enable them to participate and contribute to their communities.
• The ‘safer supply’ strategy is not a violation of the international drug conventions, but a legitimate and lawful exercise of the government’s sovereign right and responsibility to protect the health and welfare of its citizens. The strategy is consistent with the objectives and principles of the drug conventions, which allow for the medical and scientific use of certain drugs, and which call for a balanced and human rights-based approach to the drug problem. The strategy is also in line with the recommendations and guidance of the World Health Organization, the United Nations Office on Drugs and Crime, and the International Narcotics Control Board.
• The ‘safer supply’ strategy is not a threat to the safety and security of the public and the communities, but a benefit and a boon, as it will reduce the demand and dependence on the illicit drug market, which is the main source of the fentanyl and other contaminants that are causing the majority of the overdose deaths. The strategy will also reduce the crime and violence associated with the drug trade, and improve the social and environmental conditions of the neighborhoods and areas affected by the drug problem.

‘Safer Supply’ as a Necessary and Effective Strategy

The ‘safer supply’ strategy is a necessary and effective strategy to address the overdose crisis, which has claimed the lives of tens of thousands of Canadians in the past few years. The strategy is based on evidence and compassion, not on stigma and fear, and it aims to save lives and reduce harm, not to increase drug use or addiction. The strategy is also supported and endorsed by various health and human rights organizations, and has been proven to be effective and beneficial in many countries. The government’s decision to support and fund the ‘safer supply’ strategy is a commendable and courageous move, which deserves recognition and appreciation, not criticism and opposition.