More than 130 experts in substance use call on Federal Government to continue to support and scale-up Safer Supply Programs

Amidst worsening drug poisoning crisis, Canada must show leadership to stop the deaths

For immediate release, Thursday, December 14, 2023 – As funding for 21 currently operating safer supply programs across Canada is set to end in March 2024, 131 Canadian experts in substance use – including researchers, front-line physicians and nurse practitioners working directly with people who use drugs at high risk of overdose – are calling on federal, provincial and territorial governments to ensure stable funding for currently operating safer supply programs. Highlighting the need for scale-up of safer supply programs in areas of highest need, they are also calling for support for comprehensive research and evaluation of these programs, and collaboration with people who use drugs to deliver a regulated drug supply. 

The open letter released today highlights the strong and growing evidence on prescribed safer supply programs as a critical intervention to address the drug toxicity overdose crisis, including over 20 published research studies and program evaluations. Importantly, this research uses multiple methodologies, in several different provinces, to document how clients of safer supply programs experience dramatic drops in rates of emergency department use, hospitalizations, infection complications, and healthcare costs after beginning to receive safer supply. Additionally, participants in safer supply programs consistently report decreased use of unregulated fentanyl, decreased rates of overdose, and improved health and stability in their lives. The evidence is clear and mounting.

“I have been doing this work for years, and safer supply is an important new tool. We are seeing that safer supply is another road to stability for those failed by other treatment models – people are overdosing less, getting housing, reconnecting with loved ones and returning to work or school”, said Jess Hales, a nurse practitioner and safer supply prescriber in Toronto. “The current research really shows what those of us doing front-line work have been seeing for years: safer supply works. This combination of expertise and strong evidence should not be ignored.”

Critics of prescribed safer supply programs express concern that program clients will divert their medications and cause harm through new opioid use or opioid-related deaths. Yet, monitoring in BC and Ontario does not support this claim, with population-level and coroner’s data showing no increase in deaths from hydromorphone (one of the safer supply medications prescribed in Canada) and no new onsets of opioid use disorder among youth.

“We take diversion seriously and work with clients to understand their needs. We have protocols in place to address this, and have been reporting on it in our evaluations ,” said Dr. Andrea Sereda, a physician and safer supply prescriber in London. “But it’s also striking how some of these anecdotes about diversion repeat stigmatizing narratives about people who use drugs that have been used to stop the expansion of harm reduction and stifle changes to drug policy for decades. We cannot let narratives of fear get in the way of an evidence-based, life-saving intervention in a deadly crisis”.

Importantly, safer supply has reached a group of individuals for whom traditional health care and previous treatment programs have not worked, who were often without a primary care provider before starting in a safer supply program, and who have complex health and social needs. 

“One of the important findings of the research thus far is that safer supply programs are filling a critical gap in the health care system by providing care to people who all too often fall through the cracks,” said Dr. Gillian Kolla, a researcher at the University of Victoria. “The bottom line is that ending funding for safer supply programs will predictably lead to increased deaths among people currently receiving safer supply. People will lose access to a pharmaceutical medication of known dose and composition, and be forced to return to a volatile and toxic drug supply.”

The signatories of this open letter are calling on federal, provincial and territorial governments in Canada to:

  1. Work together to ensure stable and ongoing funding for currently operating prescribed safer supply programs and scale-up programs in areas of high need. 
  2. Support research and evaluation of prescribed safer supply to ensure that this intervention is being provided in a way that is safe and effective for individuals and their communities, and decisions regarding safer supply are evidence-based.
  3. Engage in collaboration with people who use drugs to develop new programming to deliver a regulated drug supply, in line with recent recommendations from the Chief Coroner of BC Lisa Lapointe.

The drug toxicity overdose crisis in Canada is a major public health emergency, taking the lives of  21 people every day. There is a history of contentious and highly politicized debates delaying the implementation and scale-up of life-saving harm reduction programs, despite research evidence showing positive benefits. The resistance to safer supply programs is not justifiable based on the current evidence. Scaling back these programs will result in unnecessary deaths as people are forced to return to an unregulated drug supply composed of fentanyl, and will slow efforts to develop new interventions to end overdose deaths..  

Read the full letter here.

For interviews, please contact:

Jess Hales, Nurse Practitioner, Safer Opioid Supply Team in Toronto

Dr. Gillian Kolla, University of Victoria

Dr. Andrea Sereda, Physician, London Intercommunity Health Centre