CAPUD's Jordan Westfall- Speech at CIHR’s Opioid Crisis Knowledge Translation workshop

safe supply

January 22nd, 2019

Ottawa, Ontario

Canadian Institute of Health Research's Opioid Crisis Knowledge Synthesis Workshop

Safe supply means providing people with safe, regulated drugs that provide the euphoria people seek when buying street drugs like fentanyl or heroin.

Safe Supply is not any of the existing oral treatments. It’s not Kadian, it’s not suboxone, it’s not methadone.

CAPUD differentiates safe supply from OST because if we did not, the government will continue to beat the dead horse that is opioid substitution therapy.

Safe supply means providing people with the drugs they want, how they want them. It’s a simple idea with powerful implications. It means protecting human rights… it can allow people to thrive again, to live again, and it means not just surviving, but greatly decreasing the likelihood of suffering an overdose at all.

Why do we need it?

At the most basic level, we need a safe supply, because otherwise we will continue to die at alarming rates. Life expectancy in Canada will continue to fall. In the US, it has fallen for three years straight, in part because of the overdose epidemic.

We need safe supply to change society. We want respect and acceptance and a society that recognizes a person’s right to use drugs, by allowing access to these substances in a safe regulated way.

Safe supply legitimizes us as human beings, not addicts or junkies, but people that do not deserve a preventable death simply on the basis of what we put in our bodies, or whether we enter treatment or choose to continue using.

Why don’t we have it?

The government continues to invest millions in policy that has already failed us.

Contamination of the drug supply worsens and instead of giving people safe drugs, we give them the ability to check how toxic their drugs are, but very little alternative to using them.

We already know how poisonous they are. It’s written on toxicology reports across the country.

This is an example of drug policy that is reliant on the war on drugs surviving to have any utility.

You wouldn’t bring your prescription to a drug checking service because you already know exactly what’s in it.

Safe supply is a threat to some in government and research, because it means moving past harm reduction and OST as focal points of drug policy. Many of yesterday’s progressives are today’s moderates. They seem more comfortable with a false sense of unity then open discourse. They are content with incremental change based upon the status quo, but to us, the status quo amounts to thousands of dead.

Safe supply changes the conversation. As threatening as it may be to some, safe supply means hope for thousands of others at risk of overdose.

What should be focusing government funding on are the following:

1. Adopt a strategy that accepts a person’s choice to use drugs and be explicit about it. Make it clear in our drug policy that drug use is not wrong, but like other activities certain cautions need to be taken.

2. We expect a human rights-based drug policy to be working toward a framework based on the availability of a legal safe supply of drugs that people currently seek on the street, upon which the other interventions, such as methadone, suboxone, Kadian, abstinence treatment, education, build on. We do the same thing with alcohol. Research funding and grants should be focused on expanding access to safe supply.

3. Any strategy to exit this overdose crisis will not rely on coercing people into treatment and improving treatment. Yes treatments should be improved, and society should be improved to allow for people to have more meaningful lives, but treatment is not sufficient to end the crisis and it is harmful and stigmatizing to those choose to continue using drugs and who do not want treatment. Consider safe supply to be treatment for a systemic issue and not an individual.

4. Maintain respect for the harm reduction principle. It is not just a way to keep people alive until they get into treatment. It respects the legitimacy of a person’s choice to consume drugs, and seeks to remove barriers from that person’s ability to consume drugs in a safe and dignified way. Harm reduction reduces the harms of drug prohibition, not drug use.

5. Abandon the intensity model of treatment. In BC and soon, across Canada new injectable opioid guidelines will be released .. These guidelines expect people to fail several different oral treatments before accessing hydromorphone and heroin. Doctors need the ability to offer both a safe supply or an oral treatment as first line interventions. Conclusion-

Speaking as someone who used prescription drugs like oxycontin and dilaudid, as well heroin and fentanyl, I can tell you with certainty that a safe supply is needed like no tomorrow- because for eleven people across Canada today, there will not be a tomorrow at all. Some would prefer the steps we take to ending this trauma to be in tiny increments. I couldn’t agree less.

Dr. Martin Luther King described white moderate support of civil rights as basically, “I agree with you in the goal you seek, but I don’t agree with your methods of direct action to obtain it”. According to Dr. King, such a person lives by a convenient notion of time that amounts to “this isn’t the right time.” Eleven people died today. We don’t have anymore time.