To stem a surge in drug overdose deaths, Canada is experimenting with a program that provides a steady and safe supply of illicit drugs to users instead of having them rely on street drugs. The program is part of an expanding movement in the country to provide government-funded, pharmaceutical-grade opioids so that users can feel the euphoric high without suffering withdrawal or worrying about the increasingly dangerous supply of drugs tainted by fentanyl or other substances. Critics of the “safe supply” program, a concept that is associated with the broader harm reduction strategies, argue that addicts should instead be directed toward treatment and that providers should be focused on reducing drug use—and not essentially promoting it. Others contend that users should be engaged in medication-assisted treatment (MAT), which combines effective withdrawal medications and counseling. A recent report on safe supply found that such programs echo the overprescribing of painkillers that drive the opioid addiction and overdose crisis in the first place. Supporters claim that the supply is just too dangerous and poses a very real risk of dying. And for those who are not yet ready for treatment, or for whom treatment hasn’t worked, safe supplies can help them avert death. While interest in the safe supply movement is growing in the U.S., it is still technically illegal, although similar strategies—such as safe injection sites—are receiving more attention as part of a harm reduction approach that is now backed by the Biden administration. A better way forward is to use harm reduction as the first step of a comprehensive strategy that eventually provides a pathway to treatment so that we not only save lives but also change them.
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Rosenthal Center for AddictIon Studies