British Columbia’s toxic drug crisis has claimed over 14,000 lives since 2016. In response, the province introduced a controversial program offering prescription alternatives to street drugs. This safer supply program has become a heated topic, with some praising its potential to save lives and others raising concerns about unintended consequences.
Two recent studies published in major medical journals paint contrasting pictures of the program’s impact.
Does safer supply lead to more hospitalizations?
A study published in JAMA Internal Medicine by Dr. Shawn Bugden, Dean of the School of Pharmacy at Memorial University of Newfoundland, and his colleagues, found a possible association between the program’s launch and a rise in opioid overdose hospitalizations across B.C.
Importantly, the study doesn’t claim a direct cause-and-effect relationship. Bugden acknowledges other possibilities.
“Is it possible that putting more opioids into the system is not necessarily the solution, even though a common-sense approach to suggest a safer supply of drugs would be helpful? I don’t think we really know those answers,” he said to CBC. He highlights the need for “careful evaluation” to ensure the program functions as intended.
Another study, published in the British Medical Journal by Dr. Paxton Bach, an addiction medicine physician at St. Paul’s Hospital in Vancouver and co-medical director of the B.C. Centre on Substance Use, and his team, arrived at a different conclusion. Their research suggests participation in the program is linked to a significant decrease in deaths from all causes, including overdoses. This benefit was most pronounced for those receiving multiple dispensations of safe-supply medication.
Bach emphasizes the need for long-term data, saying to CBC, “The total reduction really depends on how long you’re participating.”
He also questions the findings of the JAMA study, suggesting their approach assumes a static situation without the program, which he finds unrealistic considering the constantly evolving nature of the drug crisis.
Divergent views and the need for more research
Both studies agree on the need for further research to definitively assess the program’s effectiveness. The B.C. Ministry of Mental Health and Addictions finds the British Medical Journal study encouraging, highlighting its potential to prevent deaths and improve lives. They criticize the JAMA study for overlooking factors like the changing toxicity of street drugs and variations in healthcare access.
The program also faces criticism regarding potential drug diversion. B.C. Premier David Eby’s government maintains there’s no evidence of widespread diversion, while federal opposition leader Pierre Poilievre has pledged to shut down the program entirely if elected.
British Columbia’s safer supply program is a complex issue with no easy answers. While the two studies offer contrasting viewpoints, they both contribute valuable insights. Other provinces such as Ontario are also combating this ongoing crisis.
Continued research is crucial to determine the program’s long-term effects and its role in tackling the ongoing public health emergency.
