Canada’s Culture of Death: It would kill us to admit safe supply is harming youth
Activists ignore evidence that harm reduction causes harm
The Aristotle Foundation’s July article Harm-reduction activists defend safer supply with conspiracy theories details how harm-reduction activists continue to defend safe supply in the face of evidence that safe supply is in fact harming youth. These programmes distribute free addictive drugs — predominantly hydromorphone, a heroin-strength opioid — under the assumption that this practice saves lives by mitigating use of riskier street substances.
Author Adam Zivo points out that most safer supply clients sell or trade almost all of their hydromorphone on the black market to acquire stronger illicit drugs, which then floods communities with the opioid and fuels new addictions among adults and youth. According to Centre for Addiction and Mental Health data, between 2021 and 2023, the number of Ontario students who reported using pharmaceutical opioids for “non-medical” purposes skyrocketed by 71%, while the number of students who said that it is easy to obtain such opioids rose by 42%. This timeframe corresponds to when safer supply became widely available in Ontario.
Harm reduction is a lucrative business which receives funding from all three levels of government. The 2023 federal budget allocated $359.2M over five years, starting in 2023-24, to support the Canadian Drug and Substances Strategy which guides the federal government's work “in an effort to save lives and minimize substance-related harms for people who use drugs and alcohol, their families, and communities.”1 The 2023 budget includes $144M for Health Canada’s Substance Use and Addictions Program to fund community-based supports, and evidence-based health interventions. The 2022 budget allocated $100 million to SUAP.
While some projects funded by SUAP relate to alcohol and tobacco, many target illegal drugs, in particular opioids. In October 2023, Health Canada announced more than $21 million to support community-based organizations that address harms related to substance use. The Health Canada website currently lists 99 active projects.2 Below, a few examples with title, project description and federal contribution:
Safer opioid supply program
This initiative will help reduce harms related to the toxic illegal drug supply by providing prescribed opioids to patients with opioid use disorder.
Project duration: March 31, 2020 to March 31, 2024
$ 6,510,007
Safer Supply Program
This initiative will increase the capacity of the current prescribed alternatives program and provide wraparound care for participants.
Project duration: April 1, 2021 to March 31, 2024
$ 3,974,873
Alberta Harm Reduction Project
This project will work with partner organizations to enhance and complement existing harm reduction services in 10 communities in Alberta dealing with a growing demand for harm reduction services. Those communities will include Calgary, Medicine Hat, Lethbridge, Edmonton, Fort McMurray, Grande Prairie, Hinton, Edson, Whitecourt, Jasper and Red Deer.
Project duration: February 14, 2023 to February 28, 2025
$ 4,000,000
Urban Health and Overdose Prevention Effort: Urban HOPE
This project will expand clinical and outreach services at the Centre's existing Urban Health Program for individuals who use the toxic street drug supply in downtown Ottawa. This program will provide primary care, mental health and addictions services, harm reduction, case management, care coordination, system navigation, referrals to wraparound services, coaching, counselling and practical support.
Duration of project: March 13, 2023 to March 31, 2025
$ 1,353,365
Harm Reduction Pilot Program Incorporating Cannabinoid Therapy
This project will provide medically prescribed cannabis to members of the Natoaganeg First Nation who are currently using opioid agonists such as methadone and suboxone. The objective is to determine if this combined medication approach helps people reduce and/or replace opioid medications and follow the individuals to determine the impact of cannabis on their treatment, recovery, and life.
Project duration: May 12, 2023 to March 31, 2025
$ 1,193,514
Leading Change to Systems that Perpetuate Stigma around Substance Use: Moving from Engagement to Action
Through this initiative, the organization will work with trained peer leaders who will help influence decision makers of organizations that serve people who use substances. These efforts will bring system-level changes to reduce substance-related stigma within their respective organizations.
Project duration: March 1, 2021 to March 31, 2025
$ 3,313,767
I am not aware of any study that provides a breakdown of how much is spent on harm reduction by the federal government, the various provincial and territorial governments and municipalities. At the provincial level, British Colombia was the first province to introduce safe supply in 2021; that year’s provincial budget allocated $22.6 million over three years for safe supply services. B.C.’s New Democratic Party government congratulated itself on expanding access to prescribed safer supply drugs to reach more people and save more lives. “Prescribed safer supply is part of B.C.’s ongoing work to improve services for people with substance use challenges and to end the criminalization of people who use drugs, to reduce stigma and enhance support.”3
Harm reduction receives considerable funding, undoubtedly in excess of the figures I have been able to find. Professional and academic careers, jobs and paycheques depend on its continuation; admitting that it is a flawed, or failed, experiment would entail reputational and financial loss. And so the advocates continue to shout ‘people will die,’ defend, deflect, ignore harms and protect fiefdoms.