More than 50 research scientists, doctors and people who use drugs say the conclusions of a report on safe supply commissioned by an Alberta legislative committee are unsupported and “potentially dangerous” to people who use drugs.
The report, “Public Supply of Addicted Drugs: A Rapid Review,” by four researchers affiliated with Simon Fraser University, concludes there are no documented benefits of safe supply, a harm reduction strategy that separates people from an increasingly poisoned and unpredictable drug supply by providing regulated, pharmaceutical-grade dosages of typically criminalized substances.
It was commissioned and paid for by the Alberta Health Ministry.* The four NDP members resigned in February saying the process was a sham designed to support the United Conservative Party’s anti-harm reduction agenda.
In an open letter to the Alberta panel Monday, 53 experts from across B.C., Alberta and Ontario warned the report is deeply flawed and should not be used to inform the panel’s recommendations.
The report fails to acknowledge evidence documenting the beneficial impacts of safe supply and prematurely discounts its life-saving potential, they wrote.
It is also “critically low-quality,” according to a standardized research assessment they conducted, the letter said.
“Clearly, accepting the status quo is not acceptable, and we must explore novel interventions with potential to save lives,” reads the letter, published by the BC Centre on Substance Use.
“Safer supply is one such intervention, and until we have high quality outcome data from safer supply evaluations, reports such as the one discussed herein are unhelpful and potentially dangerous.”
And another Monday letter from the Canadian Association of People Who Use Drugs expressed deep concerns that the perspectives and expertise of drug users was ignored by the report.
“As the people most affected by the current contaminated drug supply, we were disappointed to see this offensive and flawed report come from researchers working at a Canadian university, and request that you give no serious consideration to it when deliberating safe supply policy,” wrote association executive director Natasha Touesnard to the Alberta panel.
“We are the true experts, who live by the philosophy ‘Nothing about us without us.’”
More Albertans died of toxic drugs in 2021 than in any year on record, with 1,758 deaths. For the first time, that’s more per capita deaths than B.C., where 2,232 people died of toxic drug poisonings.
Alberta’s United Conservative Party government, which has fought a number of harm reduction efforts since taking power in 2019, convened a panel of legislators to examine the possibility of implementing safe supply in December.
A number of research and advocacy organizations, including the BC Centre on Substance Use and Moms Stop the Harm, have withdrawn from the chance to present to the panel for fear of legitimizing what they say is a biased process.
Four researchers at Simon Fraser University’s Centre for Applied Research in Mental Health and Addiction — Julian Somers, Dr. Paul Sobey, Dr. Akm Moniruzzaman and Stefanie Rezansoff — were commissioned by the safe supply panel to report key evidence on the efficacy of safe supply. Their report, published last month, is not peer-reviewed.
The report’s authors concluded there is “no evidence demonstrating benefits” of safe supply.
Experts, including B.C. provincial health officers, chief coroner and drug user advocacy groups, have repeatedly called for safe supply to prevent deaths while other supports are increased and issues like criminalization, poverty, racism, poor housing and stigma are addressed.
The two letters released Monday say the report’s authors ignored evaluations of safe supply that have taken place in Canada and reach conclusions “not based on scientific evidence.”
They also point out what they consider several false claims made about the nature and definition of safe supply made in the report.
“While they do not cite any evidence demonstrating that safer supply interventions are ineffective or harmful, the report’s authors still claim that this is a dangerous and unethical form of intervention with immense potential for harm,” read the BC Centre on Substance Use letter. “They write that the provision of safer supply will be ‘associated with highly probable adverse effects,’ but fail to cite empirical work to support this claim.”
SFU report co-author Somers told The Tyee in an email, “We summarize and reference the abundant evidence that chronic consumption of opioids and stimulants causes harm to humans. This is not controversial.”
The politicization of research on substance has been seen time and time again, centre research director Thomas Kerr said in an interview, including in a controversial and widely-criticized report on supervised consumption sites ordered by the Alberta government in 2019.
“The authors may have done good science in the past… but the report just doesn’t hold up,” said Kerr, who co-ordinated the letter.
“When we see what we’ve been doing hasn’t been working enough, usually that motivates us to try something new and innovative. But you don’t pronounce an intervention a failure before an evaluation is complete.”
In an emailed statement to The Tyee, Somers characterized support for safe supply as “providing addictive drugs without reservation,” and said he and co-authors were more concerned with “evidence-based interventions that address root causes of addiction.”
“We’ve had little time to examine the letter but are enthused that our review has elicited such an impassioned reaction from Canada’s ‘harm reduction’ establishment,” he wrote.
The BC Coroners Service has consistently reported that the majority of people dying are not addicted and the current safe supply options are not contributing to deaths in B.C.
The unprecedented toxicity of the supply is killing people no matter how frequently they use, and is not an addiction crisis, a recent death review panel convened by the chief coroner found.
Kerr hopes the Alberta panel, which has extended its review process, will take the extra time to reflect on the growing and promising evidence in support of safe supply.
Safe supply needs to be in place to allow further evaluation, he said. “It could save a lot of lives, but we need to find that out.”
* Story updated to correct information about who commissioned and paid for the report.
Moira Wyton, Local Journalism Initiative Reporter, The Tyee