Canada91Ƶs mental health and addictions minister believes fear and stigma are driving criticism of the government91Ƶs decision to support prescribing pharmaceuticals to drug users to combat the country91Ƶs overdose crisis.
Ya91Ƶara Saks attributes growing pushback to most harm reduction strategies 91Ƶ including federal funding for what are referred to as safer supply programs and the operation of supervised consumption sites 91Ƶ to the discomfort, she says, many feel toward a reality they can no longer ignore.
91ƵThe debate is hard because people have looked away and they can91Ƶt look away anymore,91Ƶ she told The Canadian Press in a recent interview.
That reality would be the country91Ƶs skyrocketing number of overdose deaths. The Public Health Agency of Canada said drug overdoses killed an average of 23 people each day last year. More than 40,000 people have died from opioid-related deaths since 2016, which is when the federal agency began collecting such data.
Data shows a majority of overdose deaths between January and June 2023 involved fentanyl, an opioid experts warn has become increasingly tainted with even more toxic substances.
In just the last two months alone, police and health officials in Saskatchewan, Thunder Bay and Belleville, Ont., have warned about opioids, mostly fentanyl, laced with an animal tranquillizer known as xylazine. Dealers often lace fentanyl with other substances because it91Ƶs cheaper than providing pure opioids.
The overdose crisis worsened during the COVID-19 pandemic, with border closures leading to a more contaminated drug supply and health restrictions resulting in a lack of access to addictions services and an uptick in people using alone, as well as in heavier doses.
That led the federal government to allow users deemed to be at high risk of overdosing to instead be prescribed pharmaceutical alternatives as opposed to taking toxic street drugs 91Ƶ an approach known as providing safer supply.
British Columbia became the first jurisdiction to test out such an approach, with Ottawa also providing funds for pilots in New Brunswick and Ontario. Health Canada reported tablets of the opioid hydromorphone as the most commonly prescribed replacement.
A federally-commissioned review of those pilots found a decreased risk of overdoses and that drug users were able to obtain drugs more safely than through street dealers or sex work.
At the same time, however, it reported that some fentanyl users had too high a tolerance for the amount of hydromorphone they were prescribed. As a result they turned around and sold their prescribed drugs on the street, in what has become known as 91Ƶdiversion.91Ƶ
The issue was flagged by British Columbia91Ƶs Provincial Health Officer Dr. Bonnie Henry as a 91Ƶcommon occurrence91Ƶ in her recent review of her province91Ƶs safer supply program. Henry said it wasn91Ƶt clear how big the problem was.
Critics of the approach have seized on the problem, perhaps none more so than federal Conservative Leader Pierre Poilievre, who has expressed concerns about diverted narcotics ending up in the hands of minors.
Henry noted in her review that reports suggesting this are 91Ƶanecdotal,91Ƶ but underlined that diverting these drugs to people who aren91Ƶt already users poses great harm.
Poilievre, who speaks often about 91Ƶcrime, chaos and disorder91Ƶ in cities, slams safer supply programs as Prime Minister Justin Trudeau91Ƶs 91Ƶfailed hard-drug supply project91Ƶ and vowed to cut federal funding for them if he is elected. He said a Conservative government would put that money into recovery programs.
Saks says she has listened to the concerns around diversion, including from a group of doctors who wrote to her directly. She added that last fall she asked officials to examine the program 91Ƶfrom top to bottom91Ƶ and make adjustments where needed.
91ƵWe stand clear on public health and public safety 91Ƶ diversion is illegal,91Ƶ she said.
Despite the political pushback and worries around diversion, Saks defended the continued funding of 91Ƶsafer supply91Ƶ programs as necessary to save lives, but said it is only one approach to tackle the crisis.
91ƵWhy are we giving in to stigma and fear and not leading the discussion with compassion and trust?91Ƶ
She added: 91ƵA lot of what91Ƶs driving the prescriber alternative debate is anchored, unfortunately by the opposition, in stigma and fear.91Ƶ
But she acknowledged the federal government could also do more to inform people about how such programs work.
91ƵDo we need to help communities get more comfortable with the realities of what is a toxic drug supply poisoning their communities? One-hundred per cent.91Ƶ
Last week Saks visited Belleville, after the eastern Ontario city of 50,000 people declared a state of emergency on Feb. 8 because of overdoses. First responders tended to 17 overdoses in just 24-hours. Ontario Premier Doug Ford91Ƶs office promised more money for the city but said he was not considering offering a 91Ƶsafer supply91Ƶ of drugs.
Saks says her message to those taking issue with harm reduction programs such as those protesting a proposed drug consumption site in Richmond, B.C., is to sit down and talk.
91ƵLet91Ƶs sit down and have the conversation, so that we can see those who are most vulnerable in our communities, and understand how they got there.91Ƶ
91ƵIf it means that we have to have hard conversations in communities, so that they don91Ƶt look away, that they become a community that wants to help.91Ƶ
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