Discontinued Canadian Safe Supply Program Was Working, Study Shows

by Sidney Sauer, from Filter Mag – read the source article here

Facing right-wing backlash, harm reduction initiativesaround Canada have steadily been rolled back. Safer opioid supply (SOS) programs—which provide pharmaceutical-grade opioids in lieu of unpredictable street supply—have been one major target, including through legislation restrictingpharmacies’ “high potency” opioid distribution and ending take-home programs.

Despite waning political support, researchers evaluating the impact of Canadian SOS programs continue to find profound benefits.

A new study published in the International Journal of Drug Policy followed 100 SOS participants in southwestern Ontario and found an extreme reduction in overdose risk. While 60 percent of participants had experienced an overdose in the six months prior to joining the program, only 15 percent experienced an overdose in the six months after.

“Seeing this type of very significant decrease in overdoses after people started a prescribed safer supply program is a very strong finding,” study co-author Dr. Gillian Kolla, of Memorial University of Newfoundland, told Filter. “Even people who continued to sometimes use fentanyl still had this significant decrease in overdose.”

“The value of this study is not just the results, but where it fits … Several other studies using different methodologies are all pointing to this significant decrease in overdose.”

The program, administered by Sanguen Health Centre, ran from July 2021 through October 2023. The researchers surveyed all participants about their overdose history, health, substance use and general wellbeing as they joined the program, and they repeated the survey six months later. Of 162 total participants, 100 completed both surveys.

To ensure that discounting the 62 participants who left the study did not inflate the results, the researchers also ran a worst-case scenario analysis, where they assumed that anyone who did not return for the follow-up survey experienced an overdose.

Even under the most conservative scenario, they still found that the SOS program substantially decreased overdose risk.

“The value of this study is not just the results—which are important—but where it fits within the larger research base on this topic,” Kolla said. “Several other studies using different methodologies are all pointing to this significant decrease in overdose among people receiving safer supply.”

Among them, an Ontario study found that the benefits of SOS rival methadone. Research from British Columbia reported a substantial decrease in overdose mortality following SOS prescription. Qualitative research has also suggested that SOS not only decreases overdose risk but also contributes to general health, feelings of stability and connection to resources like housing.

The program highlighted in Kolla’s study was itselfdiscontinued in 2023, due to insufficient funding.

Positive findings continue to emerge around the country, even though its provinces implement SOS programs in quite different ways.

“In Canada, the health care system is largely provincially funded and directed,” Kolla explained. “[T]here’s a lot of latitude in how things can be quite different from one place to the next.”

In Ontario, SOS programs primarily operate through primary care settings, providing more robust linkage to general care. Programs in British Columbia, on the other hand, are more commonly attached to addiction medicine contexts. Studies have shown benefits to both.

But despite the growing consensus on the value of SOS programs among Canadian researchers, Canadian drug policy is moving in the opposite direction—cutting their funding and restricting their scope.

The program highlighted in Kolla’s study was itself discontinuedin 2023, due to insufficient funding.

In Kolla’s opinion, Canada’s policy rollbacks on safe supply are motivated by a moral panic.

“While the program’s structure is changing, Sanguen remains deeply committed to harm reduction and advocating for innovative solutions to the ongoing drug poisoning crisis,” the program’s website reads.

In Kolla’s opinion, Canada’s policy rollbacks on safe supply and other elements of harm reduction, without careful consideration of the available science, are motivated by a moral panic.

“I think that, unfortunately, the idea of providing care and support to people who use drugs is sometimes so controversial in some quarters that we ignore our best available evidence,” she said. “And it’s a shame because we’re in the midst of such a devastating overdose crisis.”

Canada’s track record as a harm reduction pioneer has provided unprecedented data on the efficacy of safer supply and other harm reduction initiatives, including vending machines, decriminalization and overdose prevention centers. Political pushback, however unwelcome, can also inform international efforts to build lasting measures. Even as the future of Canadian harm reduction is uncertain, its past continues to serve as a powerful guide.

“We’ve seen a really significant growth in the amount of evidence on safer supply in the last five years,” Kolla said. “We’ve got this accumulating evidence that safer supply can be one of numerous tools in the toolbox.”