Safer Supply is a term used by the Federal Government to describe the continuum of care emerging in response to the overdose crisis. Sunshine Labs has a role to play in ending this crisis by offering controlled substances that can be dispensed by health care workers to those people in dire need.
Safer Supply
In April of 2016, BC declared a public health crisis and by July 2017 the Ministry of Mental Health and Addictions was established. To escalate the response to this crisis, this Ministry launched a new Overdose Emergency Response Center on December 1st, 2017 which coordinates health authorities, frontline workers, peers, non-governmental agencies and First Nations agencies.
Despite concerns that safe supply may cause more harm than good, there is strong evidence that the opposite is true. The Coroner’s Report, Center for Disease Control as well experts in epidemiology all agree that novel approaches are needed and safe supply plays an important role in ending this crisis.
Ethics
Additionally, the Ministry of Health developed the Ethical Decision Making Framework in December 2016 to support healthcare providers. There is an ethical responsibility “to provide services and treatment (including medication) to assist people regardless of their drug use” without imposing conditions or requiring behaviours (ie. abstinence) that are beyond these patients’ ability to achieve.
The Crisis
Between January and October of 2022, 1827 people died from toxic drug supply in BC. Since the crisis was declared, more people are dying, not less. In September 2022, 171 people died. This represents an 8% increase from September 2021. In October 2022, 179 died of overdose from toxic drug supply.
With 90,000 people currently at risk of overdose in our province, only 3329 or 4% of these people were able to access safe supply last year. In September 2021, 5.5 people died everyday. This was higher than any year previous and increased to 5.7 in September 2022. Seventy-one percent of these people are between 30 and 59 years of age which means an entire generation is being affected. Seventy-nine percent of deaths were men. First Nations people are affected at 5.4 times the rate of others. First Nations women died at 9.8 times the rate of other women in BC in 2021.
Safer Supply as defined by the Federal Government
Given the current medical constraints around safer supply, new methods are needed. Public Health supports a harm reduction approach that is flexible and responsive. There are three models used by the Federal Government to define safe supply. The third model is emergent and shows promise in reducing the risks associated with illegal drug use. Programs like Safer in Victoria are funded by Health Canada to research, implement and evaluate efficacy.
1. Traditional: iOAT/OAT (injectable opioid antagonist treatment) Embedded in addiction treatment.
2. Enhanced: a hybrid between Traditional and Flexible. Still embedded within addiction treatment.
3. Flexible: Public Health informed and harm reduction approach. Embedded in primary care.
Towards Solutions
This Flexible Model is already happening within the current regulatory and legislative frameworks. Some of the notable impacts from the Safer Initiative in Victoria include:
- Reduced use of illegal substances
- Safer use practices
- Decreased cravings
- Decreased withdrawal symptoms
- Healed wounds
- Improved mental health
- Increased connection to healthcare
- Less reliance on street economy
- Improved overall function
- Connecting to social supports (housing, ID, income etc)
Safer Supply is one part of a multi-tiered response to the overdose crisis that continues to worsen each year. On November 1, 2022, thirty-seven evidence-based recommendations were presented to the Legislative Assembly of BC by the Select Standing Committee on Health. Three of these recommendations were specifically related to safe supply.
As part of the province’s comprehensive public health response adults will not be subject to criminal charges for personal possession of small amounts of certain illegal drugs beginning January 31, 2023.