Drug supply is constantly in flux. When you buy drugs on the street, you don’t always know what you’re getting. One article reports that since the COVID-19 pandemic, drugs are less available, less potent, more dangerous and more expensive.
Because of the unsafe supply of drugs, more people are overdosing, sometimes resulting in death.
In 2020, 6,306 people died from apparent opioid toxicity deaths across Canada, compared to 3,668 people in 2019.
With 708 deaths, Alberta has the second-highest number of deaths in the country, behind B.C., between January to June of 2021.
When looking at harm-reducing strategies, experts in the medical field say it is a complex situation requiring multiple approaches.
Claire O’Gorman is a registered nurse with years of harm reduction experience both in B.C. and Alberta.
More and more, she says she is seeing fentanyl mixed with other drugs like benzodiazepines. A combination that has proven to be more deadly because naloxone, a medicine that counters the effects of opioid overdoses, does not affect benzos.
She says this issue requires the whole community to be involved with a multi-pronged approach.
“There is no silver bullet here,” she says.
But, there are solutions. One way to reduce opioid overdoses in Alberta is safe supply. This means providing medical-grade opioid prescriptions to patients so that they don’t have to use illicit, and often unsafe, opioids.
The Alberta government has convened a committee to examine safe supply. They are accepting written submissions until March 4 and are expected to deliver their report later this spring. But the committee’s work has not always gone smoothly. The NDP members resigned earlier this month, saying the committee’s work was a “political stunt” designed to discredit safe supply.
Advocates say policy changes are needed
Kym Porter says Alberta needs to change its drug policies and the federal government needs to declare a state of emergency.
“It can’t happen fast enough and it’s like we are dragging 400,000 pianos behind us … it just has to happen sooner than later,” she says.
Porter’s son died of a fentanyl overdose five years ago. She has since joined Moms Stop The Harm to advocate for harm reduction. She says that if she could provide one resource to people who use drugs, it would be prescribed opioids.
“We wouldn’t need a supervised consumption site if we had safe supply,” she says.
A Calgary woman, who has asked us to use the name Ophelia to talk openly about her opioid prescription, receives a safe supply of hydromorphone, a strong painkiller. Her medication is for Dilaudid tablets, the brand name for hydromorphone, which she can easily make into an injectable solution.
Every morning, Ophelia goes to the pharmacy to pick up her prescription for the day and takes 24 milligrams of hydromorphone in her first shot.
She takes another dose when she feels her body needs it as the day progresses.
“I’ve been able to train my body to kind of only alert me once the shot has completely run out,” she says.
Porter says people who use safe supply end up cutting back on the amount they use since they don’t have to worry about when or where they’ll find their supply.
Ophelia says that safe supply works for her because it gives her the ability to live a full, balanced life.
“I’m actually happy and I have so much hope for the future,” she says.
Ophelia’s situation is a rare occurrence in Alberta. But Switzerland has had great success with their safe supply program.
Switzerland has successfully reduced mortality related to opioids by 64 per cent since 1995, due in part to their substitution program.
Addiction Suisse says Switzerland offers a substance substitution program replacing illegal drugs with prescriptions for methadone, buprenorphine and morphine, which have similar effects to opioids such as heroin. In 2020, more than 16,000 people accessed the substitution treatment.
While Switzerland has taken great strides in combating the opioid crisis, Alberta’s access to safe supply is few and far between.
Harm reduction at home
Euan Thomson, owner of Raft Brew Labs, whose business partners with Each + Every, a harm reduction collective, believes the most important thing that needs to change within the Alberta healthcare system is to create a low-barrier safe supply program.
“Providing easier access to the drugs that they’re going to be using anyway from the street supply would be a huge step in the right direction,” says Thomson.
He says there is a fear of prescribing opioids within the medical field, thinking it adds to the opioid crisis. But Thomson believes that physicians could play a big part in the solution, especially since opioid prescriptions are only available through physicians.
O’Gorman believes that decriminalizing street drugs is the key to breaking down the fear and stigma attached to drug use. Through this societal change, she says safe supply could become a reality in Alberta.
“It really takes totally reimagining what this could look like and how drugs could be treated in our society,” she says.
Thomson believes we must start discussing safe supply, low-barrier programs and moving towards a regulated market.
“We need people to know what they’re taking,” he says.
Ophelia says that because of the safe supply she receives, she has not overdosed in more than a year and now has the time and energy for other pursuits.
“Once I no longer had to worry about [my drug supply], I had energy that I could put into working, projects, studying, doing art and maintaining friendships,” she says.
“My life is better than I ever could have imagined and that’s because of safe supply.”