Adam Zivo: Can we now admit that concerns with safer supply aren't disinfo?

While some government stakeholders have finally admitted that safer supply harms communities in some ways, they’ve decided that this doesn’t matter that much.

A photo of diverted safe supply drugs shared on social media, saved and shared by the author of this article.

By: Adam Zivo

About a year ago, I came across an incredible story.

I was in the midst of writing an article about Dr. Julian Somers, an addiction psychologist who alleged that the B.C. government was punishing him for criticizing the province’s housing and drug policies. Through him, I connected with a handful of addiction experts who were deeply concerned about “safer supply” — an experimental drug policy that distributes free addictive drugs to mitigate the consumption of illicit street substances.

These experts alleged that safer supply drugs were being widely resold (“diverted”) on the black market, and that this was flooding some communities with opioids and crashing their street price, leading to a troubling wave of new addictions, especially among youth. They also claimed that there was no real evidence base for safer supply, and that most of the studies that supported the strategy were so low-quality that they would be considered unusable in most health-care settings.

I was shocked, but also a little skeptical. Was safer supply really as disastrous as these addiction physicians and psychologists made it out to be?

Seeking clarity, I spoke with 14 specialists (plus a handful of pharmacists) early last year, many of whom were distinguished leaders in their fields. They all said the same thing: safer supply was destroying lives, not saving them. As these interviewees were scattered across the country and often did not know each other, the possibility of collusion seemed negligible. But my investigation was obstructed by the fact that very few people wanted to speak on-record.

Though interviewees told me that discomfort with safer supply was the mainstream position in addiction medicine, they were worried about facing professional retaliation, including loss of access to federal grants, for publicly criticizing it. They also feared being cyberbullied by harm reduction activists, who are notoriously vicious on social media.

Ultimately, only five of these 14 experts went on record, although these sources included prominent names such as Dr. Meldon Kahan (one of Ontario’s leading addiction physicians) and Dr. Jennifer Brasch (the most recent past-president of the Canadian Society for Addiction Medicine).

I made my initial findings public in a 10,000 word exposé which was published in the National Post last May.

I will never forget the anxiety and anticipation I felt the morning it went out. It was, by far, the most meticulous story I had ever produced and was, at that point, perhaps the longest article printed in the history of the National Post. I had spent months working on it, and the newspaper’s editors had spent weeks on revisions and legal vetting. We knew that what we were presenting to the public was airtight.

The exposé sent shockwaves through Canada and irrevocably changed the narrative around safer supply. Shortly after its publication, Conservative Leader Pierre Poilievre put forth a motion calling upon safer supply programs to be defunded. The motion ultimately failed, but it was a move that had been unthinkable until then.

Though I expected some pushback on my work, I did not expect harm reduction activists and their government allies to entirely dismiss its credibility. Yet that is exactly what they did. I was immediately bombarded with claims that my reporting was inaccurate and that the doctors I had interviewed were untrustworthy and essentially the equivalent of anti-vaxxers.

I was told that I was presenting “unfounded anecdotes” and “disinformation,” and that I was a “grifter” who was inventing stories out of thin air. My critics rarely addressed, let alone refuted, any specific points I had brought up. Oftentimes, they seemed ignorant of what I had actually written.

However, around this time, I learned through some contacts that, behind closed doors at least, some important stakeholders within the federal and B.C. governments were scared shitless. So it was not altogether surprising that, just a few weeks later, the B.C. government announced that it had ordered a review of its safer supply hydromorphone program (hydromorphone is an opioid as potent as heroin and is the primary drug distributed through safer supply). 

Through my network of physicians, I learned that the review was going to take months to complete and that it would involve extensive consultations with the province’s clinicians and drug users. So I kept that in mind and spent the rest of the year further investigating safer supply and corroborating my findings through new sources — something which was not that hard to do, given how significant the diversion problem was. 

I interviewed eight youth in B.C. who testified to the disastrous impacts safer supply diversion had had on their classmates and friends. Seven former addicts in Ontario told me that the majority of safer supply patients (an estimated 50-80 per cent) were selling most of their free drugs. I took screenshots of over 50 of examples of safer supply being trafficked online (accounting for thousands of pills) along with discussion threads where drug users and dealers openly joked about defrauding the programs, which they said was handing out opioids “like candy.” (One of those images, cropped to fit, is the photo at the top of this article. Original here.)

Through these stories, the Overton window on this issue shifted and it became increasingly acceptable for health-care professionals to publicly criticize safer supply — so they did. 

Last autumn, 17 addiction experts wrote a public letter to the federal government demanding that safer supply be reformed or abolished. Harm reduction activists responded by smearing them as financially corrupt. Another open letter criticizing safer supply was published just over a month later, this time signed by 35 addiction experts. A prominent harm reduction activist retaliated by penning an article implying that these experts were essentially fascists who would have supported the Holocaust.

While these addiction experts were able to secure, after months of lobbying, a meeting with Minister of Mental Health and Addictions Ya’ara Saks, she subsequently ignored all of the information they presented to her and falsely told the public that opposition to safer supply is rooted in “stigma and fear.”

It was all so wild. No matter what any of these addiction experts said, and no matter what evidence we presented, safer supply advocates within and outside the government repeated the same refrain: “Everything is fine and any criticism of safer supply is conspiratorial disinformation.” 

But then finally — finally! — the findings from B.C.’s safer supply review were made public in a report published in early February. And guess what? They validated pretty much everything I had written about.

B.C.’s top doctor confirmed that safer supply was not “fully evidence based” and that diversion was a “common occurrence” that was causing significant “moral distress” among many of the province's clinicians. The report also confirmed that, because of safer supply, drug users were abandoning evidence-based addiction treatments, such as methadone, and not getting any better. The province discovered that, just as addiction experts had said, vulnerable women were being put under “an immense amount of pressure” by abusive or violent romantic partners to obtain safer supply. According to the province’s investigation, these problems were so commonplace and disturbing that many prescribers were abandoning safer supply. 

The only significant issue that the report did not corroborate was the degree to which teenagers were accessing diverted safer supply, but the government also made no apparent attempt to engage the province’s youth during its investigation, so the lack of evidence in this area is unsurprising.

My God, reading that report was vindicating.

But despite acknowledging that the current model of safer supply is deeply broken, the document advised that access be further expanded, not curtailed. In fact, certain passages suggested, albeit indirectly, that the province should begin distributing free meth (spoiler alert: there is no evidence that giving away free meth saves lives).

These recommendations were based on an “ethical analysis” that, speaking bluntly, had the intellectual sophistication of a second-year undergraduate paper, and which suggested that, when it comes to provincial addiction policy, ideology trumps evidence.

So it seems that, while some government stakeholders have finally admitted, albeit reluctantly, that safer supply harms communities in some ways, they’ve decided that this doesn’t matter that much. We must firehose free opioids upon the masses, consequences be damned.

I imagine that they will come to regret this decision. The wall of silence around safer supply diversion has been breached, and what was once just a trickle of scandal is quickly swelling into a torrent, which will, of course, become increasingly harder to manage.

For example, just a few weeks ago, 72 doctors in B.C., including several distinguished pediatric experts, signed yet another letter criticizing safer supply — and while they were essentially ignored by the government, their advocacy suggests growing discontent among the medical community.

Similarly, one can look at the recent drug seizures by the RCMP.

Last month, officers confiscated over 3,500 safer supply hydromorphone pills from an Indigenous reserve on Vancouver island. Shortly after, a further 10,000 pills, many of which came from safer supply, were seized in the province’s interior. And earlier this week, the RCMP arrested two drug dealers implicated in the trafficking of safer supply.

Though the B.C. RCMP’s top leadership claimed that there is “no evidence” of widespread diversion, my contacts suggested to me weeks ago that this was a politically-motivated decision and that grassroots officers were frustrated by their leaders’ obfuscation on the crisis. These rumours were seemingly validated this week when Northern Beat, a long-form media outlet, published a leaked memo that appeared to impose a pre-election “gag order” on safer supply.

The memo, which was issued the same day that the RCMP’s leadership denied that safer supply diversion is an issue, ordered officers not to directly address controversial subjects, including drug seizures and drug decriminalization, and to instead route relevant media inquiries to central HQ. “It is very clear we are in a pre-election time period and the topic of ‘public safety’ is very much an issue that governments and voters are discussing,” read the document.

So now there’s a new scandal about whether the RCMP is being politically directed to suppress news of safer supply diversion — which, of course, is not a good look for either the B.C. NDP or the federal Liberals.

The safer supply advocates and their government allies keep using falsehoods, misrepresentations, and shoddy arguments to conceal and minimize how truly disastrous their experiments have been. And while that strategy was initially successful, that’s no longer the case. The public increasingly understands that something is amiss and that reports of diversion, and criticism of safer supply, are legitimate.

You can’t whitewash a broken policy forever. Eventually, the truth makes itself known and demands a reckoning. But how many people will have to suffer until then?

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