By Adam Zivo
May 9, 2023
Source: National Post
Photo Source: Unsplash,
Opioids Series: Opioids in Canada
In this special report, columnist Adam Zivo details how drugs handed out for free are being sold on the black market to fund fentanyl addictions
“Safer supply” advocates want you to believe that their solutions to Canada’s addiction crisis are working. They claim that by providing drug users with free, government-funded substitutes for potentially tainted illicit substances, overdoses can be reduced and lives can be saved. Canada is in the midst of an opioid crisis that has killed over 35,000 people since 2016. So why wouldn’t someone support this solution? Well, it turns out that much of what has been said about safer supply is exaggerated or simply untrue. Since early January, I’ve been conducting an investigation into Canada’s safer supply programs and the research they rely on. I’ve interviewed 20 health-care experts, including 14 addiction medicine specialists. The on-the-ground realities they describe are often disturbing. According to a number of addiction physicians, a significant portion of the safer supply drugs being freely distributed through government-funded programs are not actually being consumed by their intended recipients. Instead, these drugs are being sold on the black market at rock-bottom prices, typically to fund the ongoing purchase of illicit fentanyl. Safer supply programs do not curb the fentanyl market — they subsidize it. Physicians also report that, because of this black market resale (which is formally called “diversion”), communities across Canada have been flooded with cheap opioids. According to some of the experts I spoke to, this has caused the street price of hydromorphone (the primary opioid dispensed at safer supply sites) to drop by an estimated 70-95 per cent in cities with safer supply programs. Drug users have been telling addiction physicians that, like a geyser, diverted hydromorphone flows from these cities to other markets where opioids are rarer and sell for higher prices. Hydromorphone is allegedly being resold across Canada and even in other countries, which is lining the pockets of drug dealers and gangs. According to a 2017 study published in Psychopharmacology, a peer-reviewed scientific journal, hydromorphone has “similar subjective and physiological effects as heroin,” but is “more potent than heroin.” Another 1990 study, published in The Journal of the International Association for the Study of Pain, estimated that hydromorphone is actually five times stronger than heroin. Drastic increases in the availability and affordability of hydromorphone has had negative consequences. Physicians are reporting a new wave of opioid addictions that has been particularly pronounced among youth. Recovery-oriented treatment programs have also been devastated. Addiction physicians report that many patients who were once thriving in recovery are now relapsing. Patients are either abandoning treatment to enrol in safer supply programs, or are being pulled back into addiction by abundant and cheap hydromorphone purchased off the streets. When drug users actually consume their safer supply, the results can still be disastrous. Several interviewees confirmed that hydromorphone tablets, which are designed for oral consumption, are frequently crushed for intravenous injection, potentially leading to excruciating and disfiguring infections that have paralyzed some patients. After reviewing key government documents and contacting Health Canada and the relevant ministries in Ontario and British Columbia, it seems clear that Canadian policymakers are aware of many of these issues, but are either uninterested in addressing them or are actively trying to suppress public awareness of what a disaster safer supply has been. Some government-sponsored bodies are even trying to re-brand opioid diversion in positive terms, and have employed narratives about “compassionate sharing” and “mutual aid” that front-line addictions physicians have called “outrageous” and “not my reality.” For many of Canada’s addiction physicians, the mainstream position regarding safer supply seems to be a mix of discomfort and skepticism, but they are being ignored. Critics say they are often subject to harassment or professional retribution, creating an atmosphere of fear and self-censorship. On the whole, Canada’s safer supply program closely resembles the OxyContin scandal of the mid-1990s and 2000s, when Purdue Pharma encouraged doctors to overprescribe opioids, fuelling an ongoing opioid crisis that has led to hundreds of thousands of deaths throughout North America. Now, a new wave of the opioid epidemic is brewing under our noses, destroying lives and communities, and the response from our government has been to sweep it under the rug. Some of the people I have spoken to for this story are given colour-based pseudonyms (i.e., Dr. Blue and Mrs. Crimson), due to concerns about the retaliation they might experience if connected to either this story or my future reporting on Canada’s failing drug policies. As addiction physicians are particularly vulnerable, their pseudonyms have been made gender-neutral.
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