Safe supply absolutely needs to come with counseling sessions, not just letting people shoot up their addiction.
Half-assing this won't improve things for anyone.
There's a decent series on the opioid crisis on the Freakonomics podcast and one of the key things they're hitting on is the importance of shame regarding these activities.
You definitely want an environment where people are willing to ask for help without fear. But being so permissive that people stop seeing drug use as harmful, wrong and shameful makes the situation worse for everyone.
This is how we got rates of smoking to go down in the 90s and 00s and stay down.
Yes, prices went up, but it was the removal of advertising, forcing people to go outside to smoke in designated areas and not allowing it in bars and restaurants that really put the nail in the coffin.
Basically, treating smoking as a dirty habit that was socially unacceptable convinced a lot of Boomers and Gen Xers to quit.
Why are we trying to reinvent the wheel with other forms of addiction, when we know what works?
Because some people have to go through the whole process to get to the same result. The same thing happened with vap about a decade ago just on a shorter time scale. At first you could use it anywhere, then it took about a year or 2 before it was treated like normal smoking
This argument ignores the purpose of safe supply and the context of the drugs involved.
Anti smoking measures werent put there because people were OD'ing on cigs cut with Fentanyl or Crack or rat poison. Nobody was getting assfucked in a crackhouse to get $25 together for a carton of Belmont Milds, either.
Spiking the occasional doughnut with poison and creating a greater stigma towards fat people isnt going to end obesity, either, btw.
I think it’s an ideological difference. Which is more important: saving lives of drug addicts or maintaining safe communities?
So many downtown areas have become unsafe, and it’s impacting some of the most vulnerable populations who tend to live there and rely on public transit, such as seniors, students and lower income families.
It’s OK to call something the failed experiment it is and go back to the drawing board.
They use narcan usage as an indication of lives saved; but you only have one, but it can save your life several times until you die anyway because sometimes nobody's there to stab you.
Quite literally the numbers used to justify it are useless statistical nonsense.
I see people around me blame others when their friends die of an overdose.
Here's a hint, it's their friends fault. They took the drugs. They died. Don't take them, don't die.
You want to save lives? Take active steps to get people off drugs.
You want to prolong misery? Keep letting them take drugs till they die.
I couldn’t agree more. It’s absolutely sad, and I do have sympathy for these folks, but we need to stop fooling ourselves that we can help those who don’t want to be helped. Or that removing consequences will somehow result in better outcomes.
Look at the data for Ontario and tell me that our current strategy is working (hint: it’s not).
https://www.publichealthontario.ca/en/Data-and-Analysis/Substance-Use/Interactive-Opioid-Tool
We need to focus 100% of our efforts on reducing rates of initial drug use. We know from alcohol and tobacco use that when and where it’s normalized, usage rates and poor health outcomes go way up. Drugs are no different in that regard; why would they be?
Exactly.
I've looked at some of the websites for "safe" injection sites here in Toronto and they go at great lengths to promote that it's a "judge free" zone and that nothing will be forced onto anyone.
I'm sorry, but if you are a drug addict, you should be judged, stigmatized and rehab *should be* forced on to you.
We need to stop coddling addicts and enabling their addiction -- they need to be put in treatment.
As someone who has undergone treatment, you can’t make people do it. It requires real effort and a desire to stop using. It would be a colossal waste of taxpayer money.
A friend of mine was struggling with addiction, but couldn't get treatment unless he was clean for a week. His withdrawal was fucking terrible and that first week was a never ending goal that he couldn't seem to reach. I wondered if he did get arrested, if it would be helpful, as harsh as his stay would be with the withdrawal symptoms.
In your opinion, would a one week medically supervised jail stay be helpful as a springboard, or is that just wishful thinking?
Is the policy of being clean for a week to get treatment fair?
I wouldn't presume to question your experience. In my experience, the first hurdle to getting sober is surviving the first few weeks. Some people want to get sober but do not have the willpower to make it through those weeks on their own.
I understand you can't force anyone to do anything, but in Portugal, rehab is mandatory for those guilty of drug offences.
What's a colossal waste of money are current Liberal/NDP drug policies, which flood our streets with tax payer drugs, leading to a rise in ODs.
> I understand you can't force anyone to do anything, but in Portugal, rehab is mandatory for those guilty of drug offences.
No it's not. They have a choice between rehab and a small fine.
I believe it also escalates for repeat offences. So a choice between a fine they can't afford, rehab or jail. Eventually checking into rehab is the path of least resistance.
Treatment is indeed voluntary but there are harsh consequences beyond just fines. Here is the legal framework:
[https://www.sicad.pt/BK/Institucional/Legislacao/Lists/SICAD\_LEGISLACAO/Attachments/525/lei\_30\_2000.pdf](https://www.sicad.pt/BK/Institucional/Legislacao/Lists/SICAD_LEGISLACAO/Attachments/525/lei_30_2000.pdf)
Article 15
Sanctions
(...)
2 — Non-pecuniary sanctions apply to drug-dependent consumers.
3 — The commission determines the sanction based on the need to prevent the consumption of narcotic drugs and psychotropic substances.
Article 17
Other sanctions
(...)
2 — Without prejudice to the provisions of paragraph 2 of Article 15, the commission may apply the following sanctions, alternatively to the fine or as the principal measure:
a) Prohibition from exercising a profession or activity, particularly those subject to a licensing regime, when it poses a risk to the integrity of oneself or others;
b) Ban from frequenting certain places;
c) Prohibition from accompanying, hosting, or receiving certain people;
d) Ban on leaving the country without authorization;
e) Periodic reporting to a location designated by the commission;
f) Revocation, prohibition of granting or renewing a license to carry, use, or possess a defense, hunting, precision, or recreational weapon;
g) Seizure of objects belonging to the person that pose a risk to them or the community or facilitate the commission of a crime or other offense;
h) Deprivation of management of a subsidy or benefit granted personally by public entities or services, to be entrusted to the entity conducting the process or the one accompanying the treatment process, if accepted.
I would rather all my tax money be wasted on rehab services that nobody is taking than on safe injection sites that increase crime and filth in our streets.
If people die from doing drugs with readily available mental health / addiction services that is on them.
Current strategies to hold their hand while they use these drugs and bring them back when they OD are bonkers levels of dumb. Then you put them back into the street to be a hooligan till they come back to do some more drugs. Ridiculous.
Glad you got out of it and I have great respect for you for pulling it together. You are loved (but its tough love).
The irony is that they refuse to pay nurses a fair wage for all the extra bullshit they're expected to deal with so they pay temp nurses (and their respective staffing agencies) a fair bit more for the same work.
Take safe injection site convert to a rehab site. No more safe injections. Just rehab. Will be cost neutral compared to blowing money on health professionals and drugs.
As someone who has helped several people quit drugs and has had close relationships with drug addicts, and has a history of addiction myself, often the best possible ideas is to take the shame and secrecy out of the equation. Shame spirals lead to binging. Non judgmental approaches can lead to people making positive changes, and stabilizing their use, being responsible, getting a sharps box, reducing their use, switching their MOA or switching to pharmaceutical alternatives. This does NOT mean allowing abusive or shitty behaviour like stealing or not having boundaries about money or anything like that.
I don’t live in London but National Post frequently posts things about safe supply in BC that are straight-up lies so it makes me hard to trust anything they publish. Also I’ve never heard of this spine infection thing occurring elsewhere despite following this subject quite closely and writing a thesis in a subject adjacent to it (has anyone not this doctor ever spoken about this?) and it’s weird that this doctor isn’t advocating for injectable hydromorphone like that they use at Crosstown Clinic in Vancouver and teaching her patients to use the sterifilter. Plus, every clinic that prescribes safer supply also prescribes OAT and encourages people to do both. Lastly, almost *every* jurisdiction in Canada has increased rates of overdose dose death no matter if they prescribe safe supply there or not. An intervention given to 200 people in one city or like 4K in one province will not impact or reduce the overdose rates of all the thousands of other people using illicit fentanyl and not accessing the program. Even in places with these programs, they are so limited.
That’s not how it works someone addicted to fentanyl doesn’t get off it if they’re forced to go to rehab. They will do until death unless they themselves made the choice to get clean
> stigmatized and rehab should be forced on to you.
1/10th of Canada's population has substance abuse problems. That will cost taxpayers hundreds of billions of dollars per year.
The Freakonomics series was interesting, but that part was unconvincing. Are we really arguing that there isn't shame associated with addiction? Sure, I could accept that there's some point where drug use is so widely accepted that the lack of shame becomes a problem (alcohol is at that point for example, where people will brag about needing wine to get through the day or how drunk they got last night), but for hard drugs, we're so far from that point that it's basically irrelevant.
I'll worry about the many real problems we have, rather than using a far off hypothetical one to justify being a dick to addicts.
Classic government move - we will do the easy bit (supplying more drugs) but not the hard bit (years of sustained mental health, housing, addiction support).
The hard bit is the bit that costs loads of money, Even for people who aren't suffering with addiction, almost no one but the wealthy get mental health help. I asked my family doctor for therapist recommendation to help me deal with the stress of caregiving for two ill parents, one who treats everyone like garbage all the time. He said they start at $225/hour. There is none available through OHIP anymore unless they work in hospitals where they deal with inpatients, Psychiatrists where I live have a 2-3 year waiting list and don't actually do therapy. They see you once every 2 months and throw pills at you.
And a lot of those $225/hr therapists are unbelievably bad at their jobs. I got some therapy for my teenage son and was genuinely shocked at how bad it was. The therapist would not shut the fuck up and let my son talk. Even I know that is not how therapy is supposed to work. Like he would just straight up ignore stuff my son would say. Pretty sure the low supply is what allows these unqualified people to enter the profession.
We tried 3 different therapist and the best one was some student still in the university doing some sort of government program which was free.
Yes! I always say that bad therapy is worse than no therapy and people act like I’m bonkers and don’t want people to get help. Like no, I’m just realistic that therapy doesn’t always help.
Psychotherapists and clinical social workers are less, usually between $125-$175. I realise that's still not affordable for many. You can also try a local university counselling program. Some have Master's level students who take on clients are they are supervised by registered clinicians.
Thanks! But yeah..$125-$175 is pretty unaffordable since I had to take off work for it. ANd therapy isn't that effective if you only go once every 6 weeks or whatever lol. I'm taking them to appointments constantly, and there are no government programs that I know of that provide any relief to caregivers even though they want them out of long term care as much as possible :/ . It's just a shitshow.
I appreciate it tho!
Exactly, we just do not have the resources for the "perfect" solution. The moral choice would be to make the decision with the greatest impact, which IMO is forced rehabilitation.
Portugal does both, but the article I linked elsewhere in these comments says that the treatment part is breaking down, with a year-long wait for those who even bother to choose treatment.
There's just no money nor resources to deal with the sheer magnitude of the problem. We can't even keep our regular healthcare system up and running properly despite it eating up a whopping [30-40% of provincial and territorial budgets.](https://www.cma.ca/how-health-care-funded-canada)
Unless people are willing to accept a *significant* increase in their income tax, then nothing is going to change.
> Portugal does both, but the article I linked elsewhere in these comments says that the treatment part is breaking down, with a year-long wait for those who even bother to choose treatment.
People don't want to pay taxes to treat addics.
Yep. 100% a half-assed approach. Drug users absolutely should not be facing jail time, but with decriminalization and safe supply of hard drugs there has to be some sort of rehabilitation/therapy component.
Portugal tried that, and they've been held up as the model for decriminalization in other jurisdictions. The trouble is, we have indeed chose to half-ass it, since there is no push to treatment alongside decriminalization and safe supply. We're just handing people the paraphernalia and even the drugs and turning them loose to use wherever they damn well please.
Portugal is now reconsidering the wisdom of their decision:
https://www.washingtonpost.com/world/2023/07/07/portugal-drugs-decriminalization-heroin-crack/
> Portugal is now reconsidering the wisdom of their decision:
That link constantly gets posted with the claim that Portugal is reconsidering their policies because that's the editorial position the authors of that took. However the content of the article itself doesn't support that claim.
It instead says Portugal was successful at all their objectives:
>Within a few years, HIV transmission rates via syringes — one the biggest arguments for decriminalization — had plummeted. From 2000 to 2008, prison populations fell by 16.5 percent. Overdose rates dropped as public funds flowed from jails to rehabilitation. There was no evidence of a feared surge in use.
That was followed by a recession which led to an 80% drop in funding, shifting the work to non-profits. Yet despite that, Portugal still maintained usage rates "below European averages".
There was an election and a change in government to a more Conservative Party - that party defunded the drug program that was so successful, and allowed it to fall into disarray and now they are saying it doesn’t work.
The media and public never really understood the legal framework in Portugal and oversimplified the entire model, making it seem like there were no consequences or very structured support systems. Also, no one ever mentions the preventive and educational aspects of it.
Portugal has one of the lowest usage rates of illicit drugs in the EU and also one of the highest acceptance rates of rehabilitation.
Prior to their decriminalization policy that focuses on support rather than punishment, they were among the worst in EU.
Perfect is the enemy of good.
Canada just did the decriminalization part without adding the support.
I was an addict for 20yrs
Getting clean is a choice
I was dying and almost blow my head off.
That was thee day I got clean 2009
Safe supplies would have never helped me.
I worked and spent every cent on my habit.
Never give an alcoholic a drink
These addicts when arrested either go to jail or have monitory lock up rehabilitation.
I’m one of the lucky ones I guess
I know lots of beautiful woman that died from addiction paying for drugs stripping of hooking.
It seems that these morons were just handing out dilauded which was, predictably, being diverted to the streets.
I have an incurable disease that requires regular IV infusions for the rest of my life. When I go to get my infusion, I am treated with dignity and respect. The infusion clinic is clean, safe, and the nurses serve snacks. Why can't we provide that to opioid addicts? Why can't they walk into a nice clean clinic, be treated with respect, and have their medicine administered by nurses (thereby eliminating the possibility of diversion)?
>But it's too expensive! Our taxes will go up!
My medication costs $2500/month. Morphine is $15 for 90 tablets.
>But they deserve to suffer and die because drug addiction is a moral failure.
It isn't.
In Portugal they decriminalized all drugs and opened a bunch of state owned rehab centres with mandatory attendance for addicts. It was working but police stopped registering people as much and rehabs backed up with people ending up on waitings lists for months. Now drug use is on the rise again.
I spoke to a psychiatrist about this recently. Treat it as an addiction sure. It’s medical.
But no province is building a large scale inpatient facilities to deal with them. Safe supply is prolonging the problem. We need large institutional care where addicts get voluntarily (or involuntarily) institutionalized for 90-180 days to clean up, get skills, have transition work etc.
Homelessness often leads to addiction so transitional housing/employment is needed as well. No province is willing to do this though.
If this doesn’t happen we might as well offer MAID to addicts. Death may be preferable to living on the streets addicted to hard drugs. Many don’t like that sentiment but if we aren’t even going to try to fix it let them have the option to choose a more dignified end.
Literally all it does is lessen the amount of dead people in the streets. It doesn't stop people from being addicted. It's stupid people tout it as a solution when all it does is prolong a life of misery. Sure it's great they don't die young but instead die middle aged, but their quality of life is still awful.
That’s what I believe. If we were trying to keep addicts alive so we could actually **treat** them I would agree with safe supply. Many are unhoused, get physically or sexually assaulted, sell their bodies or end up committing petty crimes to fuel their addiction. It’s sad the provincial governments have not bothered to deal with this beyond the hand waving and safe supply.
Safe supply is to keep addicts alive long enough to get them into medical treatment, not in spite of.
You need to adjust your view of who drug users are.
Yes they are the addicts you see on the streets but those have a surprisingly low rate of death all things considered.
But the teens looking to escape their life for a bit. The banker who bumps at lunch to get through the day. The construction worker with a sore back whon self medicates after doctors won't renew their prescriptions etc.
Those are who uses and sadly who dies more often as those will hide their use from their peer group so they take street drugs alone and OD.
And the numbers will shock you if you look into them. If you include socially and legal drugs like alcohol and weed about one in 5 Canadians will fight an addiction at some point in their lives.
They are not low all things considered. When you see a dead homeless person it's not a banker on his Sunday off lmao. It's a homeless person who overdosed on drugs
No shit.
But you never see the banker who died at home. And you'll never hear about it because the family will just say sudden heart failure etc.
The vast majority of drug deaths are male between the ages of 24 and 35 single with a steady if not well paying job(s).
Most have zero interactions with the police before they OD.
The homeless crack zombie you see are just the top of the iceberg. Same as how they homeless are the top of those without a home or precarious housing.
And before you start source badgering let me introduce you to this amazing resource called Google that scapes the internet for you./s
But seriously I'm on mobile and going from memory on the above from a stats Canada data set from a couple years ago. After reading the report I checked with family and friends who are paramedics in BC and their view is the homeless population provides about 75% of the OD but because they are "safe" when they do drugs with a friend standing by they only provide about 25% of the drug deaths.
The general population makes up the difference which I found shocking.
Where did I say safe supply is bad? It's just highly ineffective at solving the drug problem. Stop imagining arguments and use your eyes to read what I say
>Literally all it does is lessen the amount of dead people in the streets. It doesn't stop people from being addicted. It's stupid people tout it as a solution when all it does is prolong a life of misery. Sure it's great they don't die young but instead die middle aged, but their quality of life is still awful.
That's the comment I originally responded to and my only point was not all drug users are the street addicts you called out.
I didn't see any that said you are against safe supply.
You're the one taking umberage at my tone and if I offended im sorry for that.
My point is only that drug users is a much larger category of people than you appear to define in your response.
None of this goes away until the cost of living is dealt with. No matter how many institutions are built, the drug problem will continue to multiply until people have viable options out of poverty and ready access to their basic needs.
I think Alberta was shunning safe supply and re-directing the money to build 6000 more treatment/rehab beds, to cut down wait times for treatment, and to offer it free... but of course CBC ran articles against it because they shunned safe supply
Can you provide a source for that idea? As someone living in Alberta I haven’t seen or heard fuck all about the opioid crisis from our government.
In fact they got a lot of flack for actively making the situation worse during the coldest time of the year, tearing down encampments and throwing out tents and heaters.
https://www.cbc.ca/amp/1.5793854 this one talks about no fees for addicts
https://www.cbc.ca/player/play/video/1.7124629
Trying to find the one where they get a bunch of "experts" saying it's a worse idea than safe supply.. been 2 months since I saw it..
Grew up in London, moved for work. Visited a few months ago after a couple years out of province. Things have visibly gone downhill since I lived there.
But if they reduce crime, reduce strain on already on the brink hospitals and actually stop people from overdosing while helping them get their life in order then it’d be worth the price.
To be more specific, "safe supply *without the social supports*" has worsened the addiction crisis.
If we want to employ the Portugal model that doesn't just mean turning on a faucet for safe drug supply, it means providing a whole world of addiction and social supports that governments have completely failed to provide.
Yeah, safe supply is doing what it's supposed to, which is not "fixing the problem". It is not supposed to fix the problem. It's supposed to stem the bleeding a bit while we fix the problem with other means
> stem the bleeding
This point bears emphasis.
Like even in areas where ODs are up, OD-related *deaths* are down. We're getting more ODs, but crucially, fewer fatalities.
Now we just need to ratchet up proper addiction counseling and the various other supports Portugal implemented to make their decriminalization actually work.
Because in Canada, we half ass everything. It's our national motto.
Safe supply keeps addicts alive until they can get treatment. If all we're doing is offering safe supply without funding a treatment path, then it doesn't work.
Why do you think alcoholism is such a major issue? We have tons of safe supply, tons of safe consumption sites, not nearly enough treatment facilities.
The issue is that in a lot of cases, we're offering access to safe supply too early and too often, without addressing any of the issues that contributed to the addiction in the first place.
Safe supply should be a thing that happens when someone has failed all other attempts to get well or is SO deep in addiction that's necessary just to keep them from dying temporarily. But if you don't address the trauma, abuse, poverty, homelessness, behavioral issues, mental health problems, physical health problems that led to them developing the problem in the first place... they're highly likely to just end up back there again.
I'm not in Ontario, I'm in Nova Scotia. But what I see happening here a lot is people going into detox, getting weaned down on methadone for 2-3 weeks, and then discharged right back to the environment they were in with a referral to see a therapist... in 1-2 years, because of the backlog.
It's gotten better, but in some places MMT is also backlogged severely, or impossible to access, etc.
People who became addicted through overprescribing face issues, too. It's almost impossible to get secondary services like physio or get into the pain clinic for proper management because of backlogs.
Most of the research shows that addressing the whole person while providing long-term support (6 months to a year) preferably in a residential facility and/or sober living facility, is what works best. But that literally doesn't exist in a lot of places. Here you can't even really access residential rehab unless you pay upward of $40,000.
At this point I’m wondering if they just wanted to implement the worst possible approach to a “safe supply” so they could watch as the situation deteriorates over a few years and this allows them to implement harsher penalties against addicts and users in the future.
We’ve already seen in some cities a reversal of the decriminalization of public drug use.
Which, is just another avenue to criminalize poor and homeless people.
Most people who abuse hard narcotics have had severe trauma in their lives.
The biggest difference more often than not, as to whether or not they are committing a crime, is if they have a job to support themselves and a home to abuse drugs in.
People want to pretend that everyone who is an addict is a transient who just one day decided to throw their life away.
Truth is there’s lots of every day users who mask their addiction well enough to get through life.
We just see the worst of the worst, on the streets, nowhere to go, future is grim, past is just as grim.
Tell that person that they will be treated as a criminal if they do drugs in the streets…if they’re cognizant enough to make sense of what you’re saying they’ll just laugh at you, every day of their life is a living hell worse than the worst possible day any of us could ever imagine.
This is why criminalizing drug use, and addiction m, is so stupid.
You can’t criminalize someone who repeatedly makes the same self destructive decisions (I use the term decision there loosely) every day while any future or hopes they once had slowly disappear.
I mean, you can, but it accomplishes nothing.
The criminal justice system is massive. It employs hundreds of thousands of people in Canada, if not millions, in a variety of areas.
Anyone who doesn’t think the government and institutions aren’t mindful of that fact, and the importance in making sure there are enough inmates to warrant the people employed at said facilities is very delusional.
I live in a town full of drunks, but functional working drunks. If the local gas station started giving out free booze, the whole town would become a slum.
Dr. Henry's latest recommendations for BC include charging the street price to avoid diversion, but David Eby disagrees with her on a fundamental level.
Can you reference where she says that? I don't want to read the report but basic keyword search wasn't helping me.
[https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/reports-publications/special-reports/a-review-of-prescribed-safer-supply-programs-across-bc.pdf](https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/reports-publications/special-reports/a-review-of-prescribed-safer-supply-programs-across-bc.pdf)
Safe supply isn’t meant to get people off drugs. It meant to stop them from dying from tainted drugs and to stop them from spreading diseases. If addicts aren’t willing to get treatment no one can help them.
So as a society we should allow their decisions to negatively impact everyone else?? They are dragging down our healthcare system, increasing the cost of policing, and making everywhere less inhabitable.
There are 43 federally funded rehabs in the entire country. If an addict in a big city wants to get clean, they need to wait a minimum of 6 months to get into the program; and in some areas up to a year. So they can't even get the help they need, when they need it. Anyone who knows anything about addiction and addicts know that they will change their mind in a day, let alone a fucking year. It's a system designed to let those fail
This shit is ridiculous. We have no problem funding groups to give people drugs, but the government refuses to supply any more money to social services to help addicts get clean.
This country is fucked
https://www.freedomaddiction.ca/blog/how-canadian-government-rehab-centres-are-failing-addicts/
It seems like the only thing this program is doing in cities like London, Toronto etc. Is giving addicts the ability to do drugs safely, at the cost of everyone else in the area. It's not solving anything, preventing some overdose deaths, sure, but is it worth it considering the impact? It has to be paired with more services that will make them not addicts, otherwise it's a waste.
As per [https://www.canada.ca/en/health-canada/services/opioids/responding-canada-opioid-crisis/safer-supply.html](https://www.canada.ca/en/health-canada/services/opioids/responding-canada-opioid-crisis/safer-supply.html)
"The eligibility criteria for safer supply services depends on those who deliver the services. For some services, participants require a diagnosis of substance use disorder. **Others are open to anyone using illegal drugs, because of their high risk of overdose due to the toxic illegal drug supply."**
Doesn't seem too difficult to me. So either prove you are an addict or in some places you don't even have to.
So, let's think about this. If you have a population of 1000 addicts and that number increases by 10 per month also you have 5 deaths per month and 5 people recover from their addiction and become functioning members of society (all numbers are made up here). Then the number of addicts you see at any given time is \~1000.
But now we introduce a safe supply of drugs and the number of deaths drops to 1 per month. Well, you'd see the number of addicts growing every day and think the situation is worse but is it?
Depends on what you're looking for. If you're looking at lives saved, then safe supply is doing a decent job of that. But if you're looking at output at a communal level, safe supply is doing a horrendous job, and is working against the best interest of everyone.
Going on your example, the drop in deaths means that there will be slightly more addicts on the street with a growth rate of about 1% a month, which would compound over time. Meaning about 10% from 10 months isn't 1100, but more than 1100. That is **very** bad because overtime the population increases, and so does the 1% compound.
Unless that 5 recovery a month figure goes up to match the number of new addicts + those that have avoided death each month, you are now looking at a grimmer situation in the long term.
If each addict requires $20,000 to treat, you also just increased treatment costs against tax payers proportionately by the number of new addicts requiring treatment. If it works out to at scale populations, this is a huge boom in costs to functioning members of society. And because the population of addicts is compounding, the longer this is left alone, the worse the costs will be over time.
Factor in worse economic troubles in Canada in the future, situational issues, and a cheap supply of drugs on the market made safe by the government and one really wrong move could cause a supercharged epidemic of drug abuse that makes that 1% figure bigger.
Tldr: You prevent some deaths, but you cause a chronic population of addicts to increase exponentially at a faster rate than before.
Making it dangerous and harder doesn't solve the problem either, it just pushes it into dark corners. (also, you know people aren't picking up a drug habit because of safe supply, right? Or how difficult it is to even qualify for that matter).
I got downvoted in BC sub for talking about this caveat to the program. Lmfao. Idiots always jump straight to ignoring blatant problems. I wonder why that is. It's not like idiots can't handle hard work. Many can. So why do they always bury their head in the sand
Hypothesis: the "safe supply" providers are so fixated on preventing overdoses that they are willfully blind to the harms that safe supply either cause or exacerbate. So long as overdoses go down, which to be fair they do seem to do, they get to wave a checkered flag proclaiming victory and push to expand safe supply programs ever further.
Put another way, this is a multivariate problem / equation and it's problematic at best to emphasize only a single variable in that equation while all but ignoring the others. Even if overdoses drop say, 10%, is that worth it if it drives other associated health or criminal issues up say, 25%?
You’re right. “Safe supply” has one goal and metric. Reducing overdose deaths. Everything else including the substantial collateral damage to the community is ignored. Hell, even the drug user’s health doesn’t matter. The only goal is to prevent overdoses. Nothing else matters. It’s like advocates are wearing blinkers and refuse to see the consequences.
>“Safe supply” has one goal and metric. Reducing overdose deaths. Everything else including the substantial collateral damage to the community is ignored. Hell, even the drug user’s health doesn’t matter.
Yeah, because health and community welfare is supposed to be managed by the government, not NGOs trying to provide a very specific service. We should be mad that regional health authorities aren't getting the funding they need from the provinces to get these people off the streets and into rehab. It's a horrible pattern that you see across the country: local governments that are uniquely equipped to serve their constituents are drowned out and financially cut off by distant legislatures.
Safe supply has a role in a much broader tapestry of harm reduction/recovery strategies. But it's been implemented without sufficient guardrails to such a degree that one wonders if this is intentionally set up to fail.
This confuses me. It is entirely possible to do "safe supply" programs without diversion, we know it because we've been doing methadone for the past 40 years.
What is different about these programs that give people dilaudid vs the programs that give people methadone? Are they just not watching as hard?
On methadone you have to take it in front of the pharmacist, they have to watch you swallow it, then they test your urine to make sure it has methadone in it. After several months of trust, they eventually let you take home 6 doses and you only have to take 1 per week in front of the pharmacist. Thanks to these, you don't hear doctors and cops complaining about prescription methadone on the street. Diversion happens but it's hard to do and rare.
It sounds like they didn't bother with any of those checks and balances, and just went straight to giving it away? Why? What did they expect would happen?
Methadone and Suboxone are considered treatments.
“Safe supply” is specifically an unmonitored, unwitnessed program. My understanding is it’s designed to be more encouraging for those who would feel some kind of stigmatized if they were watched. People feel shame for whatever reason so getting to do their drugs in the safety and privacy of their own home removes a barrier.
To the average person, the difference probably doesn’t matter. Prescribed Methadone, suboxone, sublicade, hydromorphone etc are all “safer” options than whatever people get on the streets currently so we really should hope they’ll turn to those.
Remember: safe supply isn’t to get people off the addiction. It’s so they don’t get poisoned by the shitty street drugs. We should also remember that even choosing to pursue the safer option is one step closer to recovery.
I don't think the government handing out free drugs is one step closer to recovery - the uptick in usage (public and private) seems to nip that idea in the bud entirely. It's simply one less thing an addict needs to worry about while pursuing their foul addiction.
Don't really see the benefit to society of less stigma, less shame, and less danger when dealing with substances that cause enormous social and societal strain.
Methadone, Suboxone, and Sublocade specifically are opioid-agonist treatments and are not like hydromorphone. The former three actively block the brain's opioid receptors so users don't experience that "high" feeling. Not the case with hydromorphone.
As far as I know, safe supply doesn't offer OA Treatments.
Yes, thanks for summing that up. I believe suboxone also builds tolerance against future overdoses. So all three sound like better options than hydromorphone but for one reason or another, not everyone jumps to it. Wouldn’t it be nice if they did? That’s not the reality and I think a lot of people miss that complexity.
What if I told you that "safe supply" isn't for making less people addicted to a given substance. But for offering an untainted supply so they don't die. So they can seek treatment BECAUSE THEY AREN'T FUCKING DEAD.
But we stop short of actually doing anything about any of the contributing factors to addiction. Addiction is usually the last step, and a symptom of a larger issue. That issue usually being mental health related. And a lot more recently opioid addiction stems from a prescription that gotten out of hand.
It a complicated thing and there is no ONE magical answer that will solve it all for everyone. But I can tell you this. No one gets better from their addiction if they're dead.
I don't understand why they don't round all these criminals up and toss them in prison to sober up for 3 years with a highly supervised release and regular drug testing.
A safe supply is only one facet of the harm reduction approach.
Hard to say it’s been proven a theory when it’s only been in place for a few years and the country lacks the resources and/or willingness to implement other measures that should help improve the situation.
and at most 7k in BC ever had access to it, many only for the two week period when staying in COVID isolation hotels, when there are 100k people diagnosed with opioid use disorder in the province and half the people who die of overdose don’t have OUD.
Considering a lot of it is a disease of despair it isn't surprising that JUST 'safe supply' isn't working. You have to show people a future where addiction holds them back so that they make the right choices. Right now even if these addicts get cleaned up there isn't anything really waiting for them to actually have that promised improved life. Like it is often said, this is a symptom of a larger problem, one that can't be solved by being hard on crime.
Most major cities are experiencing this. Ottawa's downtown is basically taken over by drug users and the homeless, and even safe supply places are closing down because of dangerous conditions.
This type of stuff is useless without the added supports.
First clue: There's no such thing as a "safe" supply of deadly narcotics to addicted people. The whole idea is a sham and ridiculous in it's assumptions.
Its an absolute failure that Safe Supply has somehow made it 100x easier to get access to the drugs fueling your addiction but make it incredibly hard to get access to proper treatments. FFS if were going to drugs more accessible then why TF do you force addicts to go to great lengths to get suboxone? Why TF do you force them to commute to a pharmacy EVERY SINGLE DAY all in fear that addicts may instead sell these instead BUT YOU DON'T SHOW THE SAME ATTITUDE FOR FUCKING FENTANYL.
All this talk of safe supply and yet hardly any doctors except those specializing in addiction are willing to write an addict a script of suboxone, FFS why cant safe supply be offered for treatments?
I don't care how you try to spin it. Safe supply was an absolute idiotic idea. Does not work, brings crime, death, filth.. you don't treat an addiction by feeding it. Absolutely ridiculous.
Safe supply absolutely needs to come with counseling sessions, not just letting people shoot up their addiction. Half-assing this won't improve things for anyone.
There's a decent series on the opioid crisis on the Freakonomics podcast and one of the key things they're hitting on is the importance of shame regarding these activities. You definitely want an environment where people are willing to ask for help without fear. But being so permissive that people stop seeing drug use as harmful, wrong and shameful makes the situation worse for everyone.
Some behaviours should remain stigmatized
This is how we got rates of smoking to go down in the 90s and 00s and stay down. Yes, prices went up, but it was the removal of advertising, forcing people to go outside to smoke in designated areas and not allowing it in bars and restaurants that really put the nail in the coffin. Basically, treating smoking as a dirty habit that was socially unacceptable convinced a lot of Boomers and Gen Xers to quit. Why are we trying to reinvent the wheel with other forms of addiction, when we know what works?
Because some people have to go through the whole process to get to the same result. The same thing happened with vap about a decade ago just on a shorter time scale. At first you could use it anywhere, then it took about a year or 2 before it was treated like normal smoking
Cause this country is full of bleeding hearts
This argument ignores the purpose of safe supply and the context of the drugs involved. Anti smoking measures werent put there because people were OD'ing on cigs cut with Fentanyl or Crack or rat poison. Nobody was getting assfucked in a crackhouse to get $25 together for a carton of Belmont Milds, either. Spiking the occasional doughnut with poison and creating a greater stigma towards fat people isnt going to end obesity, either, btw.
I think it’s an ideological difference. Which is more important: saving lives of drug addicts or maintaining safe communities? So many downtown areas have become unsafe, and it’s impacting some of the most vulnerable populations who tend to live there and rely on public transit, such as seniors, students and lower income families. It’s OK to call something the failed experiment it is and go back to the drawing board.
They use narcan usage as an indication of lives saved; but you only have one, but it can save your life several times until you die anyway because sometimes nobody's there to stab you. Quite literally the numbers used to justify it are useless statistical nonsense. I see people around me blame others when their friends die of an overdose. Here's a hint, it's their friends fault. They took the drugs. They died. Don't take them, don't die. You want to save lives? Take active steps to get people off drugs. You want to prolong misery? Keep letting them take drugs till they die.
I couldn’t agree more. It’s absolutely sad, and I do have sympathy for these folks, but we need to stop fooling ourselves that we can help those who don’t want to be helped. Or that removing consequences will somehow result in better outcomes. Look at the data for Ontario and tell me that our current strategy is working (hint: it’s not). https://www.publichealthontario.ca/en/Data-and-Analysis/Substance-Use/Interactive-Opioid-Tool We need to focus 100% of our efforts on reducing rates of initial drug use. We know from alcohol and tobacco use that when and where it’s normalized, usage rates and poor health outcomes go way up. Drugs are no different in that regard; why would they be?
Is it safer for the community to have more people with HIV or hepatitis walking around? Or OD'ing at higher rates because of laced drugs?
At the point we’re at now, probably. Those diseases now have cures/very effective treatments than can be administered if someone decides to get clean.
Exactly. I've looked at some of the websites for "safe" injection sites here in Toronto and they go at great lengths to promote that it's a "judge free" zone and that nothing will be forced onto anyone. I'm sorry, but if you are a drug addict, you should be judged, stigmatized and rehab *should be* forced on to you. We need to stop coddling addicts and enabling their addiction -- they need to be put in treatment.
As someone who has undergone treatment, you can’t make people do it. It requires real effort and a desire to stop using. It would be a colossal waste of taxpayer money.
A friend of mine was struggling with addiction, but couldn't get treatment unless he was clean for a week. His withdrawal was fucking terrible and that first week was a never ending goal that he couldn't seem to reach. I wondered if he did get arrested, if it would be helpful, as harsh as his stay would be with the withdrawal symptoms. In your opinion, would a one week medically supervised jail stay be helpful as a springboard, or is that just wishful thinking? Is the policy of being clean for a week to get treatment fair?
If he can’t stay clean for a week, he needs to undergo medically supervised detox. Only then can you enter rehab.
I wouldn't presume to question your experience. In my experience, the first hurdle to getting sober is surviving the first few weeks. Some people want to get sober but do not have the willpower to make it through those weeks on their own.
I understand you can't force anyone to do anything, but in Portugal, rehab is mandatory for those guilty of drug offences. What's a colossal waste of money are current Liberal/NDP drug policies, which flood our streets with tax payer drugs, leading to a rise in ODs.
> I understand you can't force anyone to do anything, but in Portugal, rehab is mandatory for those guilty of drug offences. No it's not. They have a choice between rehab and a small fine.
I believe it also escalates for repeat offences. So a choice between a fine they can't afford, rehab or jail. Eventually checking into rehab is the path of least resistance.
Treatment is indeed voluntary but there are harsh consequences beyond just fines. Here is the legal framework: [https://www.sicad.pt/BK/Institucional/Legislacao/Lists/SICAD\_LEGISLACAO/Attachments/525/lei\_30\_2000.pdf](https://www.sicad.pt/BK/Institucional/Legislacao/Lists/SICAD_LEGISLACAO/Attachments/525/lei_30_2000.pdf) Article 15 Sanctions (...) 2 — Non-pecuniary sanctions apply to drug-dependent consumers. 3 — The commission determines the sanction based on the need to prevent the consumption of narcotic drugs and psychotropic substances. Article 17 Other sanctions (...) 2 — Without prejudice to the provisions of paragraph 2 of Article 15, the commission may apply the following sanctions, alternatively to the fine or as the principal measure: a) Prohibition from exercising a profession or activity, particularly those subject to a licensing regime, when it poses a risk to the integrity of oneself or others; b) Ban from frequenting certain places; c) Prohibition from accompanying, hosting, or receiving certain people; d) Ban on leaving the country without authorization; e) Periodic reporting to a location designated by the commission; f) Revocation, prohibition of granting or renewing a license to carry, use, or possess a defense, hunting, precision, or recreational weapon; g) Seizure of objects belonging to the person that pose a risk to them or the community or facilitate the commission of a crime or other offense; h) Deprivation of management of a subsidy or benefit granted personally by public entities or services, to be entrusted to the entity conducting the process or the one accompanying the treatment process, if accepted.
I would rather all my tax money be wasted on rehab services that nobody is taking than on safe injection sites that increase crime and filth in our streets. If people die from doing drugs with readily available mental health / addiction services that is on them. Current strategies to hold their hand while they use these drugs and bring them back when they OD are bonkers levels of dumb. Then you put them back into the street to be a hooligan till they come back to do some more drugs. Ridiculous. Glad you got out of it and I have great respect for you for pulling it together. You are loved (but its tough love).
Rehab services = doctors, nurses, counselors, facilities, etc. We can’t even keep our ERs open. I don’t understand how we properly fund rehab.
The irony is that they refuse to pay nurses a fair wage for all the extra bullshit they're expected to deal with so they pay temp nurses (and their respective staffing agencies) a fair bit more for the same work.
Take safe injection site convert to a rehab site. No more safe injections. Just rehab. Will be cost neutral compared to blowing money on health professionals and drugs.
You really think a safe injection site costs the same as a rehab clinic?
Sure why not? And if my grandmother had wheels, she'd be a wagon.
Sure you can. Jail or rehab, choose.
As someone who has helped several people quit drugs and has had close relationships with drug addicts, and has a history of addiction myself, often the best possible ideas is to take the shame and secrecy out of the equation. Shame spirals lead to binging. Non judgmental approaches can lead to people making positive changes, and stabilizing their use, being responsible, getting a sharps box, reducing their use, switching their MOA or switching to pharmaceutical alternatives. This does NOT mean allowing abusive or shitty behaviour like stealing or not having boundaries about money or anything like that. I don’t live in London but National Post frequently posts things about safe supply in BC that are straight-up lies so it makes me hard to trust anything they publish. Also I’ve never heard of this spine infection thing occurring elsewhere despite following this subject quite closely and writing a thesis in a subject adjacent to it (has anyone not this doctor ever spoken about this?) and it’s weird that this doctor isn’t advocating for injectable hydromorphone like that they use at Crosstown Clinic in Vancouver and teaching her patients to use the sterifilter. Plus, every clinic that prescribes safer supply also prescribes OAT and encourages people to do both. Lastly, almost *every* jurisdiction in Canada has increased rates of overdose dose death no matter if they prescribe safe supply there or not. An intervention given to 200 people in one city or like 4K in one province will not impact or reduce the overdose rates of all the thousands of other people using illicit fentanyl and not accessing the program. Even in places with these programs, they are so limited.
That’s not how it works someone addicted to fentanyl doesn’t get off it if they’re forced to go to rehab. They will do until death unless they themselves made the choice to get clean
> stigmatized and rehab should be forced on to you. 1/10th of Canada's population has substance abuse problems. That will cost taxpayers hundreds of billions of dollars per year.
Treatment is not incarceration.
The Freakonomics series was interesting, but that part was unconvincing. Are we really arguing that there isn't shame associated with addiction? Sure, I could accept that there's some point where drug use is so widely accepted that the lack of shame becomes a problem (alcohol is at that point for example, where people will brag about needing wine to get through the day or how drunk they got last night), but for hard drugs, we're so far from that point that it's basically irrelevant. I'll worry about the many real problems we have, rather than using a far off hypothetical one to justify being a dick to addicts.
Link? Or how would I find the specific episode?
[I believe it's covered in episode 587](https://freakonomics.com/podcast/why-has-the-opioid-crisis-lasted-so-long/).
I would think asking for help would be less shame inducing than actually living the cliche drug addiction life.
Classic government move - we will do the easy bit (supplying more drugs) but not the hard bit (years of sustained mental health, housing, addiction support).
The hard bit is the bit that costs loads of money, Even for people who aren't suffering with addiction, almost no one but the wealthy get mental health help. I asked my family doctor for therapist recommendation to help me deal with the stress of caregiving for two ill parents, one who treats everyone like garbage all the time. He said they start at $225/hour. There is none available through OHIP anymore unless they work in hospitals where they deal with inpatients, Psychiatrists where I live have a 2-3 year waiting list and don't actually do therapy. They see you once every 2 months and throw pills at you.
And a lot of those $225/hr therapists are unbelievably bad at their jobs. I got some therapy for my teenage son and was genuinely shocked at how bad it was. The therapist would not shut the fuck up and let my son talk. Even I know that is not how therapy is supposed to work. Like he would just straight up ignore stuff my son would say. Pretty sure the low supply is what allows these unqualified people to enter the profession. We tried 3 different therapist and the best one was some student still in the university doing some sort of government program which was free.
Yes! I always say that bad therapy is worse than no therapy and people act like I’m bonkers and don’t want people to get help. Like no, I’m just realistic that therapy doesn’t always help.
Psychotherapists and clinical social workers are less, usually between $125-$175. I realise that's still not affordable for many. You can also try a local university counselling program. Some have Master's level students who take on clients are they are supervised by registered clinicians.
Thanks! But yeah..$125-$175 is pretty unaffordable since I had to take off work for it. ANd therapy isn't that effective if you only go once every 6 weeks or whatever lol. I'm taking them to appointments constantly, and there are no government programs that I know of that provide any relief to caregivers even though they want them out of long term care as much as possible :/ . It's just a shitshow. I appreciate it tho!
Exactly, we just do not have the resources for the "perfect" solution. The moral choice would be to make the decision with the greatest impact, which IMO is forced rehabilitation.
Portugal does both, but the article I linked elsewhere in these comments says that the treatment part is breaking down, with a year-long wait for those who even bother to choose treatment. There's just no money nor resources to deal with the sheer magnitude of the problem. We can't even keep our regular healthcare system up and running properly despite it eating up a whopping [30-40% of provincial and territorial budgets.](https://www.cma.ca/how-health-care-funded-canada) Unless people are willing to accept a *significant* increase in their income tax, then nothing is going to change.
> Portugal does both, but the article I linked elsewhere in these comments says that the treatment part is breaking down, with a year-long wait for those who even bother to choose treatment. People don't want to pay taxes to treat addics.
This is 100% it. Slap a bandaid on it, complain that the infection hasn't gone down, and use that to justify not even paying for the bandaid.
It's like this effort is designed to fail or something.
Yep. 100% a half-assed approach. Drug users absolutely should not be facing jail time, but with decriminalization and safe supply of hard drugs there has to be some sort of rehabilitation/therapy component.
Portugal tried that, and they've been held up as the model for decriminalization in other jurisdictions. The trouble is, we have indeed chose to half-ass it, since there is no push to treatment alongside decriminalization and safe supply. We're just handing people the paraphernalia and even the drugs and turning them loose to use wherever they damn well please. Portugal is now reconsidering the wisdom of their decision: https://www.washingtonpost.com/world/2023/07/07/portugal-drugs-decriminalization-heroin-crack/
Portugal was all filled with opiod users. There was a high percent of their population hooked and needed to get off it.
> Portugal is now reconsidering the wisdom of their decision: That link constantly gets posted with the claim that Portugal is reconsidering their policies because that's the editorial position the authors of that took. However the content of the article itself doesn't support that claim. It instead says Portugal was successful at all their objectives: >Within a few years, HIV transmission rates via syringes — one the biggest arguments for decriminalization — had plummeted. From 2000 to 2008, prison populations fell by 16.5 percent. Overdose rates dropped as public funds flowed from jails to rehabilitation. There was no evidence of a feared surge in use. That was followed by a recession which led to an 80% drop in funding, shifting the work to non-profits. Yet despite that, Portugal still maintained usage rates "below European averages".
There was an election and a change in government to a more Conservative Party - that party defunded the drug program that was so successful, and allowed it to fall into disarray and now they are saying it doesn’t work.
Where have I heard that story before?
The media and public never really understood the legal framework in Portugal and oversimplified the entire model, making it seem like there were no consequences or very structured support systems. Also, no one ever mentions the preventive and educational aspects of it.
Portugal has one of the lowest usage rates of illicit drugs in the EU and also one of the highest acceptance rates of rehabilitation. Prior to their decriminalization policy that focuses on support rather than punishment, they were among the worst in EU. Perfect is the enemy of good. Canada just did the decriminalization part without adding the support.
I was an addict for 20yrs Getting clean is a choice I was dying and almost blow my head off. That was thee day I got clean 2009 Safe supplies would have never helped me. I worked and spent every cent on my habit. Never give an alcoholic a drink These addicts when arrested either go to jail or have monitory lock up rehabilitation. I’m one of the lucky ones I guess I know lots of beautiful woman that died from addiction paying for drugs stripping of hooking.
Rich people get abstinence rehab, poor people get drug acceptance
*Government in general half-assing literally everything*
Edmonton has an injectable dilaudid program so medication can't be diverted. It's witnessed by nursing staff.
I 100% thought they were cooking tiny eggs 😆
Good luck getting enough staff for that. Especially when counselors can make more money dealing with less extreme clients.
It seems that these morons were just handing out dilauded which was, predictably, being diverted to the streets. I have an incurable disease that requires regular IV infusions for the rest of my life. When I go to get my infusion, I am treated with dignity and respect. The infusion clinic is clean, safe, and the nurses serve snacks. Why can't we provide that to opioid addicts? Why can't they walk into a nice clean clinic, be treated with respect, and have their medicine administered by nurses (thereby eliminating the possibility of diversion)? >But it's too expensive! Our taxes will go up! My medication costs $2500/month. Morphine is $15 for 90 tablets. >But they deserve to suffer and die because drug addiction is a moral failure. It isn't.
I live in London and can confirm. It's a mess. I don't know what the solution is, but agree that safe supply isn't helping matters.
Criminal law enforcement and reopening asylums. Maybe it makes sense why they had so many asylums in the old days.
In Portugal they decriminalized all drugs and opened a bunch of state owned rehab centres with mandatory attendance for addicts. It was working but police stopped registering people as much and rehabs backed up with people ending up on waitings lists for months. Now drug use is on the rise again.
Imprisoning people with mental addiction issues is incredibly ineffective and just makes the issues worse.
[удалено]
I spoke to a psychiatrist about this recently. Treat it as an addiction sure. It’s medical. But no province is building a large scale inpatient facilities to deal with them. Safe supply is prolonging the problem. We need large institutional care where addicts get voluntarily (or involuntarily) institutionalized for 90-180 days to clean up, get skills, have transition work etc. Homelessness often leads to addiction so transitional housing/employment is needed as well. No province is willing to do this though. If this doesn’t happen we might as well offer MAID to addicts. Death may be preferable to living on the streets addicted to hard drugs. Many don’t like that sentiment but if we aren’t even going to try to fix it let them have the option to choose a more dignified end.
Literally all it does is lessen the amount of dead people in the streets. It doesn't stop people from being addicted. It's stupid people tout it as a solution when all it does is prolong a life of misery. Sure it's great they don't die young but instead die middle aged, but their quality of life is still awful.
That’s what I believe. If we were trying to keep addicts alive so we could actually **treat** them I would agree with safe supply. Many are unhoused, get physically or sexually assaulted, sell their bodies or end up committing petty crimes to fuel their addiction. It’s sad the provincial governments have not bothered to deal with this beyond the hand waving and safe supply. Safe supply is to keep addicts alive long enough to get them into medical treatment, not in spite of.
You need to adjust your view of who drug users are. Yes they are the addicts you see on the streets but those have a surprisingly low rate of death all things considered. But the teens looking to escape their life for a bit. The banker who bumps at lunch to get through the day. The construction worker with a sore back whon self medicates after doctors won't renew their prescriptions etc. Those are who uses and sadly who dies more often as those will hide their use from their peer group so they take street drugs alone and OD. And the numbers will shock you if you look into them. If you include socially and legal drugs like alcohol and weed about one in 5 Canadians will fight an addiction at some point in their lives.
They are not low all things considered. When you see a dead homeless person it's not a banker on his Sunday off lmao. It's a homeless person who overdosed on drugs
No shit. But you never see the banker who died at home. And you'll never hear about it because the family will just say sudden heart failure etc. The vast majority of drug deaths are male between the ages of 24 and 35 single with a steady if not well paying job(s). Most have zero interactions with the police before they OD. The homeless crack zombie you see are just the top of the iceberg. Same as how they homeless are the top of those without a home or precarious housing. And before you start source badgering let me introduce you to this amazing resource called Google that scapes the internet for you./s But seriously I'm on mobile and going from memory on the above from a stats Canada data set from a couple years ago. After reading the report I checked with family and friends who are paramedics in BC and their view is the homeless population provides about 75% of the OD but because they are "safe" when they do drugs with a friend standing by they only provide about 25% of the drug deaths. The general population makes up the difference which I found shocking.
Where did I say safe supply is bad? It's just highly ineffective at solving the drug problem. Stop imagining arguments and use your eyes to read what I say
>Literally all it does is lessen the amount of dead people in the streets. It doesn't stop people from being addicted. It's stupid people tout it as a solution when all it does is prolong a life of misery. Sure it's great they don't die young but instead die middle aged, but their quality of life is still awful. That's the comment I originally responded to and my only point was not all drug users are the street addicts you called out. I didn't see any that said you are against safe supply. You're the one taking umberage at my tone and if I offended im sorry for that. My point is only that drug users is a much larger category of people than you appear to define in your response.
Yeah it doesn't stop being addicted. It isn't a solution, it just stops deaths. Nothing I said is untrue.
None of this goes away until the cost of living is dealt with. No matter how many institutions are built, the drug problem will continue to multiply until people have viable options out of poverty and ready access to their basic needs.
I think Alberta was shunning safe supply and re-directing the money to build 6000 more treatment/rehab beds, to cut down wait times for treatment, and to offer it free... but of course CBC ran articles against it because they shunned safe supply
Can you provide a source for that idea? As someone living in Alberta I haven’t seen or heard fuck all about the opioid crisis from our government. In fact they got a lot of flack for actively making the situation worse during the coldest time of the year, tearing down encampments and throwing out tents and heaters.
https://www.cbc.ca/amp/1.5793854 this one talks about no fees for addicts https://www.cbc.ca/player/play/video/1.7124629 Trying to find the one where they get a bunch of "experts" saying it's a worse idea than safe supply.. been 2 months since I saw it..
Grew up in London, moved for work. Visited a few months ago after a couple years out of province. Things have visibly gone downhill since I lived there.
Where isn’t this true in Ontario?
A lot more money for public systems like asylums
But if they reduce crime, reduce strain on already on the brink hospitals and actually stop people from overdosing while helping them get their life in order then it’d be worth the price.
100%. It's the cheaper solution in the long run, and actually helps the people and helps protect the public in the interim.
To be more specific, "safe supply *without the social supports*" has worsened the addiction crisis. If we want to employ the Portugal model that doesn't just mean turning on a faucet for safe drug supply, it means providing a whole world of addiction and social supports that governments have completely failed to provide.
Yeah, safe supply is doing what it's supposed to, which is not "fixing the problem". It is not supposed to fix the problem. It's supposed to stem the bleeding a bit while we fix the problem with other means
> stem the bleeding This point bears emphasis. Like even in areas where ODs are up, OD-related *deaths* are down. We're getting more ODs, but crucially, fewer fatalities. Now we just need to ratchet up proper addiction counseling and the various other supports Portugal implemented to make their decriminalization actually work.
The Portugal model has its limits too. Rehab centers all maxed out, have waiting lists, and drug abuse and overdoses are on the rise again there.
Because in Canada, we half ass everything. It's our national motto. Safe supply keeps addicts alive until they can get treatment. If all we're doing is offering safe supply without funding a treatment path, then it doesn't work. Why do you think alcoholism is such a major issue? We have tons of safe supply, tons of safe consumption sites, not nearly enough treatment facilities.
Was it ever about reducing addictions? Wasn’t it just about reducing the potential for spreading HIV or Hep c etc.?
Neither. It was meant to destigmatize and reduce overdose deaths.
It failed big time with both these points.
The issue is that in a lot of cases, we're offering access to safe supply too early and too often, without addressing any of the issues that contributed to the addiction in the first place. Safe supply should be a thing that happens when someone has failed all other attempts to get well or is SO deep in addiction that's necessary just to keep them from dying temporarily. But if you don't address the trauma, abuse, poverty, homelessness, behavioral issues, mental health problems, physical health problems that led to them developing the problem in the first place... they're highly likely to just end up back there again. I'm not in Ontario, I'm in Nova Scotia. But what I see happening here a lot is people going into detox, getting weaned down on methadone for 2-3 weeks, and then discharged right back to the environment they were in with a referral to see a therapist... in 1-2 years, because of the backlog. It's gotten better, but in some places MMT is also backlogged severely, or impossible to access, etc. People who became addicted through overprescribing face issues, too. It's almost impossible to get secondary services like physio or get into the pain clinic for proper management because of backlogs. Most of the research shows that addressing the whole person while providing long-term support (6 months to a year) preferably in a residential facility and/or sober living facility, is what works best. But that literally doesn't exist in a lot of places. Here you can't even really access residential rehab unless you pay upward of $40,000.
At this point I’m wondering if they just wanted to implement the worst possible approach to a “safe supply” so they could watch as the situation deteriorates over a few years and this allows them to implement harsher penalties against addicts and users in the future. We’ve already seen in some cities a reversal of the decriminalization of public drug use. Which, is just another avenue to criminalize poor and homeless people. Most people who abuse hard narcotics have had severe trauma in their lives. The biggest difference more often than not, as to whether or not they are committing a crime, is if they have a job to support themselves and a home to abuse drugs in. People want to pretend that everyone who is an addict is a transient who just one day decided to throw their life away. Truth is there’s lots of every day users who mask their addiction well enough to get through life. We just see the worst of the worst, on the streets, nowhere to go, future is grim, past is just as grim. Tell that person that they will be treated as a criminal if they do drugs in the streets…if they’re cognizant enough to make sense of what you’re saying they’ll just laugh at you, every day of their life is a living hell worse than the worst possible day any of us could ever imagine. This is why criminalizing drug use, and addiction m, is so stupid. You can’t criminalize someone who repeatedly makes the same self destructive decisions (I use the term decision there loosely) every day while any future or hopes they once had slowly disappear. I mean, you can, but it accomplishes nothing. The criminal justice system is massive. It employs hundreds of thousands of people in Canada, if not millions, in a variety of areas. Anyone who doesn’t think the government and institutions aren’t mindful of that fact, and the importance in making sure there are enough inmates to warrant the people employed at said facilities is very delusional.
Never attribute to malice what can easily be explained by incompetence
Hey, I like drugs. Wow free drugs!
Ridiculous How about stop supplying and get these people back on their feet? What a soft country
I live in a town full of drunks, but functional working drunks. If the local gas station started giving out free booze, the whole town would become a slum.
Maybe it would be better to charge for it then, like is done with alcohol.
Dr. Henry's latest recommendations for BC include charging the street price to avoid diversion, but David Eby disagrees with her on a fundamental level.
Can you reference where she says that? I don't want to read the report but basic keyword search wasn't helping me. [https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/reports-publications/special-reports/a-review-of-prescribed-safer-supply-programs-across-bc.pdf](https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/reports-publications/special-reports/a-review-of-prescribed-safer-supply-programs-across-bc.pdf)
Can't imagine why giving free drugs to addicts hasn't worked in reducing the numbers.🤷
"We gave people drugs, and they started doing more drugs!" .. shocking
Safe supply isn’t meant to get people off drugs. It meant to stop them from dying from tainted drugs and to stop them from spreading diseases. If addicts aren’t willing to get treatment no one can help them.
So as a society we should allow their decisions to negatively impact everyone else?? They are dragging down our healthcare system, increasing the cost of policing, and making everywhere less inhabitable.
https://www.cambridgetoday.ca/local-news/first-year-review-of-kitchener-safe-injection-site-highlights-success-in-reversing-potentially-fatal-overdoses-4205139
Providing safe supply actually reduces the impact on the healthcare system. That's the entire point of it.
You have to supply the building, employ people, supply the 'safe supply', and people still overdose.
There are 43 federally funded rehabs in the entire country. If an addict in a big city wants to get clean, they need to wait a minimum of 6 months to get into the program; and in some areas up to a year. So they can't even get the help they need, when they need it. Anyone who knows anything about addiction and addicts know that they will change their mind in a day, let alone a fucking year. It's a system designed to let those fail This shit is ridiculous. We have no problem funding groups to give people drugs, but the government refuses to supply any more money to social services to help addicts get clean. This country is fucked https://www.freedomaddiction.ca/blog/how-canadian-government-rehab-centres-are-failing-addicts/
It seems like the only thing this program is doing in cities like London, Toronto etc. Is giving addicts the ability to do drugs safely, at the cost of everyone else in the area. It's not solving anything, preventing some overdose deaths, sure, but is it worth it considering the impact? It has to be paired with more services that will make them not addicts, otherwise it's a waste.
You mean giving addicts a steady stream of addicting drugs is worsening their addiction? You dont say...
r/NoShitSherlock
Fucking shocker... You mean just handing out free drugs to addicts doesn't help them?
I'm curious how easy you think it is to get prescribed safe supply or even who qualifies for it...
As per [https://www.canada.ca/en/health-canada/services/opioids/responding-canada-opioid-crisis/safer-supply.html](https://www.canada.ca/en/health-canada/services/opioids/responding-canada-opioid-crisis/safer-supply.html) "The eligibility criteria for safer supply services depends on those who deliver the services. For some services, participants require a diagnosis of substance use disorder. **Others are open to anyone using illegal drugs, because of their high risk of overdose due to the toxic illegal drug supply."** Doesn't seem too difficult to me. So either prove you are an addict or in some places you don't even have to.
Helen Keller could have seen that “Safe Supply” without witnessed consumption, would be a disaster. We just made 10x more addicts and saved no one
So, let's think about this. If you have a population of 1000 addicts and that number increases by 10 per month also you have 5 deaths per month and 5 people recover from their addiction and become functioning members of society (all numbers are made up here). Then the number of addicts you see at any given time is \~1000. But now we introduce a safe supply of drugs and the number of deaths drops to 1 per month. Well, you'd see the number of addicts growing every day and think the situation is worse but is it?
Depends on what you're looking for. If you're looking at lives saved, then safe supply is doing a decent job of that. But if you're looking at output at a communal level, safe supply is doing a horrendous job, and is working against the best interest of everyone. Going on your example, the drop in deaths means that there will be slightly more addicts on the street with a growth rate of about 1% a month, which would compound over time. Meaning about 10% from 10 months isn't 1100, but more than 1100. That is **very** bad because overtime the population increases, and so does the 1% compound. Unless that 5 recovery a month figure goes up to match the number of new addicts + those that have avoided death each month, you are now looking at a grimmer situation in the long term. If each addict requires $20,000 to treat, you also just increased treatment costs against tax payers proportionately by the number of new addicts requiring treatment. If it works out to at scale populations, this is a huge boom in costs to functioning members of society. And because the population of addicts is compounding, the longer this is left alone, the worse the costs will be over time. Factor in worse economic troubles in Canada in the future, situational issues, and a cheap supply of drugs on the market made safe by the government and one really wrong move could cause a supercharged epidemic of drug abuse that makes that 1% figure bigger. Tldr: You prevent some deaths, but you cause a chronic population of addicts to increase exponentially at a faster rate than before.
[удалено]
I'm sure yoyr tune would change when its someone you love hiding their habit. But let me guess "it could never happen to *me*!"
Jesus Christ, Reddit.
Safe supply without monitored usage seems like a "solution" that was designed to fail. The drugs should not be leaving the premises.
I don't know how this wasn't predicted. Make it safer and easier to use drugs and more people will do it. Not Rocket science.
Making it dangerous and harder doesn't solve the problem either, it just pushes it into dark corners. (also, you know people aren't picking up a drug habit because of safe supply, right? Or how difficult it is to even qualify for that matter).
Pushing things into dark corners makes them less accessible.
Yeah, the only reason I hadn't picked up fentanyl yet was how hard it has been to procure!
I mean, there's certainly some people who aren't doing heroin because it's not on instacart yet.
I got downvoted in BC sub for talking about this caveat to the program. Lmfao. Idiots always jump straight to ignoring blatant problems. I wonder why that is. It's not like idiots can't handle hard work. Many can. So why do they always bury their head in the sand
Who knew enabling junkies would make shit worse -.-
Everyone, but the "experts."
Yep
Hypothesis: the "safe supply" providers are so fixated on preventing overdoses that they are willfully blind to the harms that safe supply either cause or exacerbate. So long as overdoses go down, which to be fair they do seem to do, they get to wave a checkered flag proclaiming victory and push to expand safe supply programs ever further. Put another way, this is a multivariate problem / equation and it's problematic at best to emphasize only a single variable in that equation while all but ignoring the others. Even if overdoses drop say, 10%, is that worth it if it drives other associated health or criminal issues up say, 25%?
You’re right. “Safe supply” has one goal and metric. Reducing overdose deaths. Everything else including the substantial collateral damage to the community is ignored. Hell, even the drug user’s health doesn’t matter. The only goal is to prevent overdoses. Nothing else matters. It’s like advocates are wearing blinkers and refuse to see the consequences.
>“Safe supply” has one goal and metric. Reducing overdose deaths. Everything else including the substantial collateral damage to the community is ignored. Hell, even the drug user’s health doesn’t matter. Yeah, because health and community welfare is supposed to be managed by the government, not NGOs trying to provide a very specific service. We should be mad that regional health authorities aren't getting the funding they need from the provinces to get these people off the streets and into rehab. It's a horrible pattern that you see across the country: local governments that are uniquely equipped to serve their constituents are drowned out and financially cut off by distant legislatures.
Why do these articles never compare with other jurisdictions in Canada that *don't* have safe supply?
Mini eggs, yum!
Safe supply has a role in a much broader tapestry of harm reduction/recovery strategies. But it's been implemented without sufficient guardrails to such a degree that one wonders if this is intentionally set up to fail.
Just make it illegal to do in public same rules like weed
We need to treat the issues of addiction and get them off the drugs. Clean supply is a failed experiment.
Isn't that what they're designed to do? A lot of corruption and money disappearing with these projects.
This confuses me. It is entirely possible to do "safe supply" programs without diversion, we know it because we've been doing methadone for the past 40 years. What is different about these programs that give people dilaudid vs the programs that give people methadone? Are they just not watching as hard? On methadone you have to take it in front of the pharmacist, they have to watch you swallow it, then they test your urine to make sure it has methadone in it. After several months of trust, they eventually let you take home 6 doses and you only have to take 1 per week in front of the pharmacist. Thanks to these, you don't hear doctors and cops complaining about prescription methadone on the street. Diversion happens but it's hard to do and rare. It sounds like they didn't bother with any of those checks and balances, and just went straight to giving it away? Why? What did they expect would happen?
Methadone and Suboxone are considered treatments. “Safe supply” is specifically an unmonitored, unwitnessed program. My understanding is it’s designed to be more encouraging for those who would feel some kind of stigmatized if they were watched. People feel shame for whatever reason so getting to do their drugs in the safety and privacy of their own home removes a barrier. To the average person, the difference probably doesn’t matter. Prescribed Methadone, suboxone, sublicade, hydromorphone etc are all “safer” options than whatever people get on the streets currently so we really should hope they’ll turn to those. Remember: safe supply isn’t to get people off the addiction. It’s so they don’t get poisoned by the shitty street drugs. We should also remember that even choosing to pursue the safer option is one step closer to recovery.
I don't think the government handing out free drugs is one step closer to recovery - the uptick in usage (public and private) seems to nip that idea in the bud entirely. It's simply one less thing an addict needs to worry about while pursuing their foul addiction. Don't really see the benefit to society of less stigma, less shame, and less danger when dealing with substances that cause enormous social and societal strain.
Methadone, Suboxone, and Sublocade specifically are opioid-agonist treatments and are not like hydromorphone. The former three actively block the brain's opioid receptors so users don't experience that "high" feeling. Not the case with hydromorphone. As far as I know, safe supply doesn't offer OA Treatments.
Yes, thanks for summing that up. I believe suboxone also builds tolerance against future overdoses. So all three sound like better options than hydromorphone but for one reason or another, not everyone jumps to it. Wouldn’t it be nice if they did? That’s not the reality and I think a lot of people miss that complexity.
What if I told you that "safe supply" isn't for making less people addicted to a given substance. But for offering an untainted supply so they don't die. So they can seek treatment BECAUSE THEY AREN'T FUCKING DEAD. But we stop short of actually doing anything about any of the contributing factors to addiction. Addiction is usually the last step, and a symptom of a larger issue. That issue usually being mental health related. And a lot more recently opioid addiction stems from a prescription that gotten out of hand. It a complicated thing and there is no ONE magical answer that will solve it all for everyone. But I can tell you this. No one gets better from their addiction if they're dead.
Duh! Injection sites enable, not help. This is not rocket science.
Safe supply is a shit show here in BC. It's created a ton of social disorder. People need to be apprehended and placed in custody.
I don't understand why they don't round all these criminals up and toss them in prison to sober up for 3 years with a highly supervised release and regular drug testing.
prison won’t fix mental illness but definitely need more psych facilities
Drugs aren’t exactly hard to come by in prison.
They should really be X-raying everyone and everything coming in to stop that source.
You should write the government a letter to suggest that. I’m sure they’ll be grateful for the idea.
I think they would put it right in the recycling bin or its electronic delete it like they do to all letters send in.
Never know if you don’t try!
Do you know what, Why not I will.
[удалено]
A safe supply is only one facet of the harm reduction approach. Hard to say it’s been proven a theory when it’s only been in place for a few years and the country lacks the resources and/or willingness to implement other measures that should help improve the situation.
and at most 7k in BC ever had access to it, many only for the two week period when staying in COVID isolation hotels, when there are 100k people diagnosed with opioid use disorder in the province and half the people who die of overdose don’t have OUD.
Considering a lot of it is a disease of despair it isn't surprising that JUST 'safe supply' isn't working. You have to show people a future where addiction holds them back so that they make the right choices. Right now even if these addicts get cleaned up there isn't anything really waiting for them to actually have that promised improved life. Like it is often said, this is a symptom of a larger problem, one that can't be solved by being hard on crime.
Most major cities are experiencing this. Ottawa's downtown is basically taken over by drug users and the homeless, and even safe supply places are closing down because of dangerous conditions. This type of stuff is useless without the added supports.
You are telling me that giving addicts unlimited free drugs is only making the problem worse you say!? Absolutely Shocked! /s
Color me SHOCKED.
First clue: There's no such thing as a "safe" supply of deadly narcotics to addicted people. The whole idea is a sham and ridiculous in it's assumptions.
Its an absolute failure that Safe Supply has somehow made it 100x easier to get access to the drugs fueling your addiction but make it incredibly hard to get access to proper treatments. FFS if were going to drugs more accessible then why TF do you force addicts to go to great lengths to get suboxone? Why TF do you force them to commute to a pharmacy EVERY SINGLE DAY all in fear that addicts may instead sell these instead BUT YOU DON'T SHOW THE SAME ATTITUDE FOR FUCKING FENTANYL. All this talk of safe supply and yet hardly any doctors except those specializing in addiction are willing to write an addict a script of suboxone, FFS why cant safe supply be offered for treatments?
I don't care how you try to spin it. Safe supply was an absolute idiotic idea. Does not work, brings crime, death, filth.. you don't treat an addiction by feeding it. Absolutely ridiculous.
Progressives think drug addicts and homeless are endangered species that need to be preserved in their natural habitat.