Prescribed Safer Alternative Programs are Saving Lives
Written by Comms Team, March 4, 2024
I read with interest the February 23rd article “Opioid crisis won’t abate without treatment options, supportive housing: Peterborough MP Michelle Ferreri”. In Canada, one person died nearly every hour in the first six months of 2023 due to opioid toxicity, largely involving fentanyl. As the Medical Officer of Health, I deeply appreciate the Chamber of Commerce conversation and MP Ferreri’s attention to the drug poisoning crisis.
I appreciated the discussion that the MP highlights on intertwining social determinants of health such as housing, and the need for a comprehensive approach to treatment for people who use opioids. Here in Peterborough, where we have adopted the Housing First philosophy, we know that people can address other challenges in their lives much better when they have a roof above their heads. The early successes of people living in the City of Peterborough’s new modular housing project are evidence of this.
I read MP Ferreri’s comments on programs with a prescribed alternative to toxic street drugs, sometimes called “safer supply” with some concern. MP Ferreri suggests that “there’s data to show it doesn’t help anyone”, although no specific data was cited. In recent years, harm reduction and substance use has been subject to significant attention and misinformation that risks catching a program that is saving lives in the crossfire. I know the health care providers prescribing safer alternatives to toxic drugs are dedicated and saving lives here in Peterborough, and I want to ensure the community is aware of the current state of the evidence on this topic.
In a study published in the British Medical Journal last month, it was shown that safer supply dispensing of opioids in British Colombia was associated with reduced mortality from all causes, and specifically from overdoses. Receiving safer supply for one day or longer led to a 61% reduction in all cause mortality and a 55% reduction in overdose related mortality compared to those not on the program.
Additionally, a recent scoping review published in the International Journal of Drug Policy found that prescribed safer opioid supply programs are associated with beneficial client outcomes including improved physical and mental health, improved quality of life, and low rates of opioid toxicities.
The British Columbia Chief Medical Officer of Health’s report on prescribed alternatives highlighted that some diversion may be occurring, but that this may be less harmful than non-pharmaceutical more toxic street drugs available and aren’t increasing supply or access to drugs.
Addressing the harms related to opioid-use requires a systems-level response that includes a continuum of services and programs designed to prevent and reduce harms, as well as get people who are ready access to lifesaving treatment.
This approach, often called the 4 Pillar Approach includes a range of activities from increasing the availability of naloxone and harm reduction supplies, enhancing the availability and accessibility of services, criminal justice reforms including decriminalizing possession for personal use, addressing the stigma through community education and advocacy for policy and systems change, and provision of safe supply and supervised consumption services to combat an increasingly toxic drug supply and prevent fatal overdoses.
There is no silver bullet in the response to the growing drug poisoning crisis and no one approach address the opioid poisoning crisis on its own. Harm reduction, including the safer supply programs here in the community, are necessary and complementary to other approaches including treatment and prevention. These evidence-based strategies and all activities and more are needed if we’re to work together to counter the drug poisoning crisis.
To make meaningful and lasting change to address the ongoing drug poisoning crisis, I am very aligned with MP Ferreri that the social determinants of health and gaps such as housing need urgent attention. The trauma and adversity that people in our community are facing in the continued crisis need our collective and collaborative attention. All responses that the evidence shows are effective, including greater access to prescribed safer alternative programs are desperately needed to start to reverse this crisis.
Dr. Thomas Piggott
Medical Officer of Health and CEO
Peterborough Public Health