Every time opioids have become more accessible, it's been accompanied by an addiction crisis. Opium in China, morphine in the 19th century, Bayer heroin in the early 20th century, oxycontin in the late 20th/early 21st century. Diversion of "safe supply" drugs exacerbating existing addiction problems and expanding the number of addicts is depressingly predictable.
It often seems like activists concerned with drug addiction miss the fact that the drug use *is* the problem. The homelessness, disease transmission, overdoses, social dysfunction, and crime all follow from the drug use. The fact that we talk about drug use instead drug *abuse* suggests another way we've lost the plot here: these are pharmacological substances with positive and negative effects. When used for pain management, particularly temporarily, the benefits outweigh the negatives. Using them for recreation or getting high is abusing them. When these drugs don't kill their users quickly with overdoses, any experienced medical professional can tell you stories about all the other nasty consequences that manifest with chronic use. Preventing overdoses with things like safe supply is at best a means of buying time to get people into recovery. If you can't get them into recovery, you're just prolonging the time it takes for drug abuse to kill them.
Thanks for all your work on this file, Adam. The gaslighting around safer supply is similar to the gaslighting around puberty blockers. Ideological capture makes evidence based decision making next to impossible. Aside from confirmation bias, too many people have invested too much personal credibility to walk back unfounded beliefs. (See also the general unwillingness of politicians and media to correct false claims of mass graves, and of prosecutors to own up to wrongful convictions.)
Excellent work. However, the fact this needed to ever be so researched and proven to anybody, over such a predictably flawed policy in the onset, really speaks to the overall disconnect between this government’s policies and good decision-making practices generally. This piece is merely another head-shaking example of that disconnect.
This must be true. A disabled neighbour whose pain is not being addressed by her doctors is now self medicating w street hydromorohone. Says its cheap enough that even she can afford it. She is fragile in a wheekchair. Oh boy.
I think part of the rationale for gov't supplied drugs is crime reduction. If crime is in fact reduced then this partially offsets the negative impacts described in Adam Zivo's article. Any data or anecdote on this? GG
One of the things that drives me bonkers about this topic is the lack of values discussion. Anyone wondering if this is a good policy or not is shut down as being "anti science" far too often as a way to avoid discussing the baked in ethical assumptions. So flooding the country with easily accessible opioids might or might not reduce deaths at the expense of possibly creating more addicts. Thats a question that in good faith might be able to be answered to some useful degree with rigorous and sincere scientific study. Lets say this policy creates 1 new addict for every life saved as a side effect. OK, I probably would be on board with that still. What if it creates 10 new addicts for every life saved ? What if the number is 100 ? The scientific method is not going to answer what the acceptable number is for everyone in the community. We as a community should be deciding what tradeoffs we are ok living with through our elected representatives, not unaccountable academics nor public heath bureaucrats. I am 100% pro science. What I dont want is some new self appointed priestly class telling us what is and is not morally good while they contort and abuse the word "science" to get their way and shutdown people who they dont agree with.
This, from Grizwald just below (or above), is absolutely true: "Good intentions count for nothing, we need to be clear-eyed about actual outcomes." Vancouver is full of performative good intentions, and sidewalk corpses.
There is an old South Park episode where religion is abolished in the future and Richard Dawkins is the new God. He has basically replaced mainstream religion with an equally dogmatic atheistic ideology which spawns its own warring factions that squabble over trivial things. The point being that you can see dogmatic ideologies that resemble religious fervor outside of actual religion. Clearly the advocates of safe supply are one of them.
Where is the actual evidence that providing addicts with "safer" supply is better than no drugs at all?
It stands to reason that to get out of an addiction one would certainly need help (social programs, therapy, etc), but it is dubious to think that drugs would solve the problem drugs caused in the first place...
Am I missing something?
Anecdotally, I'm currently taking hydromorphone to trait pain after a surgery. It doesn't even work on that particular pain as well as OTC drugs like advil and tylenol, though the pain is pretty mild, so it may be more effective on more intense pains.
The opioid crisis is complex. Through a number of articles, the writer has clearly established his views on this issue and can be reliably be expected to write from a single perspective. Thus those who are against safe supply are “experts” while those who believe in the approach are “activists”. The information presented absolutely is concerning but I have no confidence that it adequately addresses the issue or the body of evidence.
Every time opioids have become more accessible, it's been accompanied by an addiction crisis. Opium in China, morphine in the 19th century, Bayer heroin in the early 20th century, oxycontin in the late 20th/early 21st century. Diversion of "safe supply" drugs exacerbating existing addiction problems and expanding the number of addicts is depressingly predictable.
It often seems like activists concerned with drug addiction miss the fact that the drug use *is* the problem. The homelessness, disease transmission, overdoses, social dysfunction, and crime all follow from the drug use. The fact that we talk about drug use instead drug *abuse* suggests another way we've lost the plot here: these are pharmacological substances with positive and negative effects. When used for pain management, particularly temporarily, the benefits outweigh the negatives. Using them for recreation or getting high is abusing them. When these drugs don't kill their users quickly with overdoses, any experienced medical professional can tell you stories about all the other nasty consequences that manifest with chronic use. Preventing overdoses with things like safe supply is at best a means of buying time to get people into recovery. If you can't get them into recovery, you're just prolonging the time it takes for drug abuse to kill them.
Thanks for all your work on this file, Adam. The gaslighting around safer supply is similar to the gaslighting around puberty blockers. Ideological capture makes evidence based decision making next to impossible. Aside from confirmation bias, too many people have invested too much personal credibility to walk back unfounded beliefs. (See also the general unwillingness of politicians and media to correct false claims of mass graves, and of prosecutors to own up to wrongful convictions.)
Excellent work. However, the fact this needed to ever be so researched and proven to anybody, over such a predictably flawed policy in the onset, really speaks to the overall disconnect between this government’s policies and good decision-making practices generally. This piece is merely another head-shaking example of that disconnect.
This must be true. A disabled neighbour whose pain is not being addressed by her doctors is now self medicating w street hydromorohone. Says its cheap enough that even she can afford it. She is fragile in a wheekchair. Oh boy.
I think part of the rationale for gov't supplied drugs is crime reduction. If crime is in fact reduced then this partially offsets the negative impacts described in Adam Zivo's article. Any data or anecdote on this? GG
One of the things that drives me bonkers about this topic is the lack of values discussion. Anyone wondering if this is a good policy or not is shut down as being "anti science" far too often as a way to avoid discussing the baked in ethical assumptions. So flooding the country with easily accessible opioids might or might not reduce deaths at the expense of possibly creating more addicts. Thats a question that in good faith might be able to be answered to some useful degree with rigorous and sincere scientific study. Lets say this policy creates 1 new addict for every life saved as a side effect. OK, I probably would be on board with that still. What if it creates 10 new addicts for every life saved ? What if the number is 100 ? The scientific method is not going to answer what the acceptable number is for everyone in the community. We as a community should be deciding what tradeoffs we are ok living with through our elected representatives, not unaccountable academics nor public heath bureaucrats. I am 100% pro science. What I dont want is some new self appointed priestly class telling us what is and is not morally good while they contort and abuse the word "science" to get their way and shutdown people who they dont agree with.
This, from Grizwald just below (or above), is absolutely true: "Good intentions count for nothing, we need to be clear-eyed about actual outcomes." Vancouver is full of performative good intentions, and sidewalk corpses.
Yup and crime is not rising either ask the AG
There is an old South Park episode where religion is abolished in the future and Richard Dawkins is the new God. He has basically replaced mainstream religion with an equally dogmatic atheistic ideology which spawns its own warring factions that squabble over trivial things. The point being that you can see dogmatic ideologies that resemble religious fervor outside of actual religion. Clearly the advocates of safe supply are one of them.
Where is the actual evidence that providing addicts with "safer" supply is better than no drugs at all?
It stands to reason that to get out of an addiction one would certainly need help (social programs, therapy, etc), but it is dubious to think that drugs would solve the problem drugs caused in the first place...
Am I missing something?
Anecdotally, I'm currently taking hydromorphone to trait pain after a surgery. It doesn't even work on that particular pain as well as OTC drugs like advil and tylenol, though the pain is pretty mild, so it may be more effective on more intense pains.
The opioid crisis is complex. Through a number of articles, the writer has clearly established his views on this issue and can be reliably be expected to write from a single perspective. Thus those who are against safe supply are “experts” while those who believe in the approach are “activists”. The information presented absolutely is concerning but I have no confidence that it adequately addresses the issue or the body of evidence.