Safe supply isn’t opioid agonist therapy
Whether accidental or intentional, some public health and elected officials (including former federal addictions minister Carolyn Bennett) confuse PSAD/safer supply with the well-studied and proven opioid agonist therapy (OAT). But the two approaches are worlds apart in intent, effect and outcomes.
PSAD is experimental, OAT is tried and true. While OAT doesn’t work with everyone, it is acknowledged worldwide as the gold standard in opioid treatment.
Where safe supply substitutes one intoxicant for another to be consumed unsupervised, with no path out of addiction, OAT medications are prescribed to help people quit illicit and prescribed opioids drugs, and stabilize their lives.
Unlike PSAD/safe supply which intoxicates to the point of euphoria, OAT pharmaceuticals – predominantly methadone and buprenorphine (Suboxone) – are slow-acting opioids prescribed to help a person manage withdrawal and cravings without delivering a ‘high.’
OAT has helped innumerable people return to work, re-energize relationships, and live more productive lives. Many remain on OAT longer-term, and many more have used it as a stepping stone to abstinence.
Portugal doesn’t have safe supply
Last year, when B.C.’s legislative health committee chair, Niki Sharma (now the province’s Attorney General) asked João Goulão, director-general of Portugal’s drug program, if his country had trouble convincing doctors to prescribe safe supply, he asked her to repeat the question.
When Goulão finally understood the program Sharma was referring to, he was unenthusiastic.
“I have visited, for instance, in Switzerland, facilities that provide heroin. They do not substitute with methadone or buprenorphine. They provide, to the opiate users, the heroin itself. As far as I know, the outputs for those programs are not brilliant,” he understated.
Portugal doesn’t offer PSAD/safe supply.
Goulão would know. Before overseeing Portugal’s much-respected, yet-to-be-replicated drug strategy, he and another family physician opened the country’s first methadone clinic in 1988. That modest beginning has flourished into a vast and readily accessible network of OAT treatments across Portugal.
It was Goulão and his partner’s successful treatment model – personal, small-scale, rooted in community, with a range of other primary health care services – that preceded Portugal’s subsequent countrywide treatment system, largely perceived as the most successful drug program in the world.
Unlike Canada and British Columbia’s near-singular focus on harm reduction, and now safer supply, Portugal’s five-pillar drug strategy balances prevention, dissuasion, treatment, harm reduction and social reintegration – which our elected officials pretend to espouse, but have yet to implement.
The whole Portugeuse strategy is anchored in preventing and dissuading people from doing drugs, and there is an array of free treatment and recovery options available across the country.