We are Healthcare Providers In Support of Safer Supply
by Lisa Baird and Stephanie Cordes
On May 17 2021 the Guelph Community Health Centre opened a Safer Supply program. People with complex addictions can now be prescribed opioids for their addiction from a doctor or nurse practitioner, while accessing wraparound support from a team of healthcare providers.
We, as healthcare providers and Guelph residents, are thrilled about this!
People in Guelph are dying of overdose in record numbers. This Safer Supply program will save lives. The first year of the pandemic saw a 260% increase in suspected substance-related deaths. That statistic includes people we knew personally and professionally, and cared about. Physical distancing measures have resulted in reduced service levels for harm reduction sites that provide care to people who use drugs, and have resulted in people using drugs alone more often, leading to increased risks of drug-related overdose and death.
Opioids sold on the street vary widely in strength and purity, making them much more dangerous and deadly. Since August 2018, 19 Health Alerts have been released warning about dangerous substances circulating in Guelph.
Dr. Dorothy Bakker, a physician on the program’s Clinical Advisory Team, said “We know that when someone who struggles with complex opioid addictions has consistent access to safer, prescribed substances, it reduces the need to engage in behaviours that are associated with the illegal drug trade market, and in many cases, they are able to regain control over their lives.”
Guelph isn’t the first city to have a safer supply program. Other cities have introduced programs to allow low-barrier access to medical-grade opioids, and the data is very promising. One of these initiatives, the safe supply program in the InterCommunity Health Centre (LIHC) in London ON, has been operating since 2016. People qualify for this service if they have been injecting opioids for years and opioid antagonist therapy (taking Methadone or Suboxone) hasn’t worked. They’re given an opioid prescription, and can use it when and where they prefer. The program includes access to nurses, social workers, psychiatrists, and outreach workers. In a span of 4 years they had a 90% retention rate and a 0% death rate in the 118 people accessing this service. Overall health and the rate of homelessness improved, as did the number of criminal activities in order to pay for drugs.
Research shows that safer supply programs lead to reduced rates of infectious disease, less homelessness, increased employment and lower crime rates. If someone who struggles with complex opioid addictions has consistent access to safer, prescribed substances then they no longer need to scramble for cash to illegally purchase drugs on the street. This leads to less desperation, less dangerous and illegal behaviour. Treating drug addiction as a medical problem rather than a criminal issue works out better for everyone.
This year is the 20-year anniversary of Portugal’s pivot away from carceral solutions to health problems. As of the late 90s, 1% of the Portuguese population struggled with heroin addiction. In 2001, the Portuguese government decriminalized drugs. Since then, Portugal has seen dramatic reductions in drug addiction, drug-related overdoses, HIV infections, and drug related crime.
Portugal’s success is due not only to legal changes. Removing criminal penalties for consumption and possession of drugs served to remove much of the stigma, making it easier for people to seek treatment. The significant reduction in costs associated with criminal proceedings for drug offences accompanied a long-term investment in effective public health responses to the crisis they were in.
Which is to say, a health-centred approach of offering people care instead of punishment has been a much more effective approach.
May it be that the widespread decriminalization of drugs occurs in our lifetimes! For now we are incredibly grateful to the Guelph CHC for pushing for the Safer Supply program, and to Health Canada for the funding that makes it possible.
RESOURCES AND REFERENCES
Decriminalization in Portugal: Setting the Record Straight (May) 13, 2021. Transform: Drug Policy Foundation. https://transformdrugs.org/blog/drug-decriminalisation-in-portugal-setting-the-record-straight
Bajekal, Naina (Aug 2018). Want to Win the War on Drugs? Portugal Might Have the Answer. Time Magazine. https://time.com/longform/portugal-drug-use-decriminalization/
Ferreira, Susana (Dec 2017). Portugal’s radical drugs policy is working. Why hasn’t the world copied it? The Guardian. https://www.theguardian.com/news/2017/dec/05/portugals-radical-drugs-policy-is-working-why-hasnt-the-world-copied-it
Smith, Connel (Mar 9 2020). Doctor suggests giving opioid users legal drugs. CBC News, New Brunswick. https://www.cbc.ca/news/canada/new-brunswick/street-drugs-addiction-fentanyl-opioids-safe-supply-1.5489092
Changing Circumstances Surrounding Opioid-Related Deaths in Ontario during the COVID-19 Pandemic: Infographic (n.d.). Public Health Ontario. https://odprn.ca/wp-content/uploads/2021/05/Changing-Circumstances-Surrounding-Opioid-Related-Deaths-Infographic.pdf
Nowell, Magnus (Spring 2021). Safe supply: What is it and what is happening in Canada? CATIE. https://www.catie.ca/en/pif/spring-2021/safe-supply-what-it-and-what-happening-canada