A Panel with Adam Zivo, Dr. Rob Tanguay, & Member of Parliament Garnett Genuis
April 3rd TEUS Convention Centre 1:30 PM TELUS ROOM 104/105
Dr. Rob Tanguay – Safe Supply: Why all the fuss?
About this Session
Safer Supply, otherwise known as public supply of addictive drugs (PSAD) or risk mitigation prescribing, has made headlines in Canada as governments role out access to prescription replacements for illicit and possibly toxic substances. The use of medications for opioid use disorder (MOUD) is an evidence-based and first-line approach to initial stabilization and treatment of opioid addiction. Addiction medicine practitioners have long argued the effectiveness of methadone which was met initially with pushback and scrutiny. Is it possible that safer supply could save lives? Is it the public health magic wand it is hyped to be? What are the harms of replacing illicit and potentially toxic fentanyl and analogues? This will be discussed and more as we look for answers to deal with the Opioid Crisis.
Learning ObjectivesAnalyze the outcome data for safer supply programs
1) Analyze the outcome data for safer supply programs
2) Apply evidence-based guidelines for the treatment of opioid use disorder
3) Mitigate risks of prescribing potentially addictive and dangerous medicationsAnalyze the outcome data for safer supply programs
1) Oviedo-Joekes E, Guh D, Brissette S, et al. Hydromorphone Compared With Diacetylmorphine for Long-term Opioid Dependence: A Randomized Clinical Trial. JAMA Psychiatry. 2016;73(5):447–455. doi:10.1001/jamapsychiatry.2016.0109
2) Nguyen HV, Mital S, Bugden S, McGinty EE. British Columbia’s Safer Opioid Supply Policy and Opioid Outcomes. JAMA Intern Med. 2024 Jan 16:e237570. doi: 10.1001/jamainternmed.2023.7570. Epub ahead of print. PMID: 38227344; PMCID: PMC10792500.
3) Matthew Bonn, Adam Palayew, Natasha Touesnard, Thomas D. Brothers, and Claire BodkinJournal of Studies on Alcohol and Drugs 2023 84:4 , 648-650
4) Roberts, E., & Humphreys, K. (2023). “Safe Supply” initiatives: Are they a recipe for harm through reduced health care input and supply-induced toxicity and overdose? Journal of Studies on Alcohol and Drugs, 84, 644–647. doi:10.15288/jsad.23-00054
MP Garnett Genuis – The History of Safe Supply
About this Session
As a Member of Parliament, I have a unique window into public policy debates and the factors that drive them. The goal of my presentation will be to educate conference attendees about some key issues shaping the recovery and the safe supply policy conversations in Canada. While debates are often framed publicly in terms of which policy approaches serve the wellbeing of substance users, the interests of corporations manufacturing and marketing substances and their ability to promote their interests under the guise of advancing the public interest has been a key underlying driver of policy outcomes.
My presentation will explore the history of opioid sales and marketing and how those profiting from opioid sales influenced the public conversation and key policy decisions. The approaches that these companies took were designed to maximize and maintain their profitability. While the over-promotion of opioids by corporations is now widely condemned as a key driver of the opioid crisis, the same essential logic of the approach they promoted persists in modern safe supply program.
When examining current policy around substances, we will look at how corporate agendas and interests may be shaping the policy conversation today, what parallels exist between the past and the current corporate framing of public conversations around substances, and how current practices may be driven by corporate interests instead of by an effective evaluation of the interests of users. I will advance the thesis that the program of over-promotion and over-prescription of Oxycontin by Purdue Pharma was the original safe supply program and that modern safe supply programs can be understood as a continuation of this past approach. Modern safe supply programs are driven by similar interests and carry similar problems.
Through my presentation, attendees will come to understand the following:
1) The history of the opioid crisis and the role played by corporate interests, as well as the tactics pursued by corporations to advance their interests.
2) The role played by corporate interests in the current safe supply conversation and the similarities and differences between past and present ‘safe supply’ programs.
3) Possible public policy responses to substance use issues that do not prioritize corporate interests at the expense of the needs of affected communities.
Adam Zivo – Media, Policy, Government and Safe Supply
About this Session
Canada’s federal government, along with some provincial governments, believe that “safer supply” programs are an effective intervention for reducing overdoses and drug-related deaths. However, there is compelling evidence that most of the drugs distributed through these programs are diverted onto the black market, and that these diverted drugs are spurring relapses and new addictions, especially among youth. Organized crime is allegedly profiting from the abuse of safer supply programs, and it appears that, even when used as intended, some safer supply drugs can cause debilitating infections.
Government stakeholders and public health researchers have been reluctant to explore the harms of safer supply, and, in some cases, they have been actively hostile to the possibility that the intervention may not work as intended. As such, much of the evidence of safer supply’s harms has come from journalistic sources.
Adam Zivo is Canada’s leading journalist on this topic. In May 2023, the National Post published a 10,000 word expose of his which outlined the problems of safer supply. He has since written several follow-up articles on the issue. In this session, Zivo will summarize his findings, describe the challenges of reporting on this topic, and address some of the main criticisms of his work.
1) Participants will learn about the main harms associated with safer supply.
2) Participants will learn about the challenges associated with journalistic reporting on safer supply.
3) Participants will hear rebuttals to the main criticisms levied against journalistic work criticizing safer supply.
Zivo, Adam. 2023a. “Drug Fail: The Liberal Government’s ‘Safer Supply’ is fuelling a New Opioid Crisis.” National Post (May 9). Available at https://nationalpost.com/feature/how-the-liberal-governments-safer-supply-is-fuelling-a-new-opioid-crisis
Zivo, Adam. 2023c. “Doctors Fed Up with Activists Gaslighting Them over‘Safer Supply.’” National Post (November 16). Available at https://nationalpost.com/opinion/adam-zivo-doctors-fed-up-with-activists-gaslighting-themover-safer-supply.
Zivo, Adam. 2023e. “Liberals Rely on Poor Quality Research to Defend Safer Supply.” National Post (May 19). Available at https://nationalpost.com/opinion/adam-zivo-liberals-rely-on-poor-quality-research-to-defend-safer-supply.
Zivo, Adam. 2023g. “Safer Supply Doctor Wants More Critical Debate About the Program.” National Post (May 25). Available at https://nationalpost.com/opinion/safer-supply-doctor-wants-more-critical-debate-about-the-program.
Zivo, Adam. 2023h. “A 14-Year-Old Is Dead. Her Dad Blames ‘Safer Supply’Drugs.” National Post (May 31). Available at https://nationalpost.com/opinion/adam-zivo-teen-dies-from-overdose-after-becoming-addicted-to-drugused-in-safer-supply