Illegal drugs have been a prevalent and growing problem in Canada, and over the past 25 years the use of opiates/opioids, methamphetamine, cocaine and its derivatives have been at a consistently high level across the country. During this time, the rise of fentanyl has had a devastating effect on people who use drugs. At time of writing, more than 21,000 people have died from preventable toxic drug poisonings, a.k.a. fatal overdoses.
The fentanyl discussed here is not the legally produced opioid that has legitimate uses but rather, the illegally produced kind. Criminal manufacturing has seen fentanyl used as an additive for other drugs to increase the effect or value of those street drugs, or in the manufacture of counterfeit “look-alike” drugs emulating Oxycodone and others. They are easily manufactured, needing only the precursors or ingredients, which can be bought over the dark web; additives for bulk; food colouring; and a pill press. Criminals have and are feeding a demand that may have begun with drug users looking for a replacement opioid from their heroin mainstay, but fentanyl has quickly risen to the front of the line in the illegal provision of synthetic opioids in Canada.
This has been a growing problem, with the U.S., Canada, United Kingdom and others seeing dramatically increased use, and as a result, an ever-increasing overdose problem — culminating in almost 17 deaths per day in Canada alone. This would be a national health emergency any time, but is greatly magnified during COVID as health care tries to manage the pandemic while struggling to support this already difficult-to-access client group.
Overall, Canada has responded to addiction by targeting the elimination of drug use. Often this focuses on different programs aimed at the person who uses drugs, not the community generally. But focusing just on the individual user sells short the wider impacts of some programs. A case in point is the discussion surrounding “safe supply” of drugs — which usually takes the form of alternative drug therapy or replacement drug therapy.
Safe supply can replace “street drugs” with a substitute that can help the individual, through a public health model. It can reduce harm, ensure medical engagement/oversight and provide a health response to a health problem.
But an area that is seldom discussed and often overlooked is the overall impact that a safe supply program could have on the general public. When I worked as the police chief in Ottawa, I saw first-hand the impact the illegal drug trade had on the community — not just the drug trafficking itself but the impact of that drug trade on the community as those affected by addiction participated in ever-increasing criminal activity to address their dependent substance use. Often their offences were considered minor — by the police and the community — but as the drug trade grew so did the number of offences and community impact. When I met with residents in communities such as Vanier, Lowertown and others, citizens were clear they wanted less crime and a feeling of safety with less criminality in their community.
So, in considering the provision of a “safe supply,” a secure/predictable supply of pharmaceutical alternatives to toxic street drugs, there is another positively impacted recipient: the community. A community will see less crime being committed as those who would have engaged in crime to purchase illegal drugs will not have to do so; they’ll be receiving their drugs through a medical facility using a public health model.
Of note is that the Canadian Association of Chiefs of Police have come out in support of safe supply, as they believe it will make communities safer.
Saving lives is always the most important outcome of safe supply. But in and of itself this has not been enough to persuade society to support drug policy reform. We must articulate other benefits in order to build support to champion and support these ideas.
Sen. Vern White is a former chief of the Ottawa Police.