On Sept 24, BC Greens announced a “health-focused” plan to expand prescribed safer supply of opioids and make regulated hard drugs available without a prescription through “non-medicalized” avenues such as drug user compassion clubs.
This direction is at odds with both the governing NDP, who began to roll back decriminalization in the spring, and BC Conservatives, who have pledged to end decriminalization completely. Premier David Eby and BC Conservative Leader John Rustad have both said legalization is not an option if they form government.
Yet legalization of all drugs is basically what the Greens are proposing.
Fact checks
The backgrounder to the Greens news release says, “most people who are dying are not diagnosed with a substance use disorder – rather, they are recreational users accessing a poisoned supply.”
Fact: According to the 2022 B.C. Coroner’s Death Panel Review report, “73 per cent of decedents were identified as using illicit drugs on a regular or chronic basis and 13 per cent were identified as using illicit drugs occasionally/infrequently. The pattern of use remains unchanged since the last death review panel.”
“We know that the only evaluated compassion club model has been the single most effective intervention into the crisis to date,” says Tyson Singh Kelsall, in the Greens press release.
Fact: Presumably Singh Kelsall is referring to the Drug Users Liberation Front (DULF) survey of 47 Downtown Eastside members following the group’s distribution of tested illicit meth, cocaine and heroin. While it’s true members reported satisfaction and reduced harms while participating in the drug program, it’s a stretch to characterize this as the single most effective intervention. By what measure and compared to what?
The venerable Stanford-Lancet commission on the North American opioid crisis for instance recommends any drug approval processes should consider “the risk of a drug being misused” and include “pragmatic clinical trials on the risks and benefits of opioids.”
The drugs in the DULF study were provided for free, participants in Downtown Eastside are also usually paid a fee for their time when speaking with any researchers and must commit to being allies of the Vancouver Area Network of Drug Users (VANDU) movement (which has drug legalization as a core goal), and were likely even paid to answer DULF’s survey questions. So, not an objective scientific study by any measure. It’s not clear whether this survey formed part of the “evidence-based” research the Greens are relying on to support their legalization bid.
The Greens revived the spectre of Prohibition, repeating the inaccuracy that more deaths were caused by tainted booze than when alcohol was legalized.
Fact: Evidence indicates overall deaths associated with alcohol declined during prohibition.
The Greens proposal to legalize drugs relies on organized crime exiting the drug trade once regulated alternatives are available and assumes people with crippling meth and opioid addictions won’t take too much and overdose on legal drugs.
Fact: Addiction to meth and opioids is a proven escalating condition, which is why people can begin with a prescribed Percocet or OxyContin opioid and progress to heroin and fentanyl. The body can quickly develop tolerance to the drugs, requiring greater and greater potencies to stave off withdrawal and cravings. This is widely recognized as the main reason safe supply hydromorphone doesn’t work to deter people from buying illicit fentanyl. Fentanyl is a much stronger opioid than hydromorphone, despite it being many times stronger than heroin, and can barely be felt by regular fentanyl users. Which is why so many safe supply patients are selling their prescribed hydromorphone into the black market to buy illicit fentanyl.
Also, there is no evidence to suggest that legalizing illicit severely addictive drugs will vanquish the black market but there is evidence showing that adding more addictive drugs to the market will increase addictions. Even after cannabis – a much less addictive drug than meth, crack, or fentanyl – was legalized in Canada, an illicit market for cannabis continues to flourish.
“We are guided by evidence and rooted in the belief that government should focus on saving lives and ensuring services are available to all British Columbians. People cannot seek treatment or recovery if they are not alive, which is why regulated pharmaceutical alternatives to the toxic illicit drug market must be part of the response to this public health emergency,” the Green release states.
Fact: There is no evidence that legalization works anywhere in the world because illicit drugs are not legalized anywhere in the world. Neither does B.C. have any data supporting the assertion that safe supply/prescribed alternatives are stopping people from using fentanyl or preventing overdose deaths – the two main stated goals of the safe supply program. In fact, there is evidence of widespread diversion of safe supply indicating many patients are selling their prescribed drugs to buy illicit fentanyl.
The difficulty in making any claims of ‘evidence’ of efficacy related to safe supply lies with the unscientific quality of existing studies. Most safe supply studies are based on self-reporting by patients, selective data, don’t account for confounding factors, and lack critical analysis or measurable outcomes.
The BC NDP has also made the claim that safe supply keeps people alive so they can get treatment. However, after fours years delivering safe supply, the government has provided no data demonstrating safe supply has successfully led individuals into treatment or recovery.
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