New research out of Ontario is generating conversation in the Canadian medical community about the potential benefits and cautions of the safe supply of opioids.
The study, published this week in the Canadian Medical Association Journal, suggests providing drug users with prescription opioids, in place of illicit street drugs, can significantly and immediately reduce emergency room visits and hospitalizations for people at high risk of overdosing.
“People have been looking to this as the first piece of evidence that’s really quantitative and quite rigorous,” said Dr. Tara Gomes, the study’s lead author.
The study followed two groups of London, Ont., residents diagnosed as having an opioid-use disorder. One group, compiled of 82 residents, was entered into the Safer Opioid Supply (SOS) program. The other group was not exposed to the program. After monitoring each test group for one year, the study concluded that in the residents in the SOS program, rates of emergency department visits and hospitalizations decreased significantly.
“These were findings we weren’t seeing when we looked at similar people also living in the same city who also had an opioid-use disorder but who were not accessing the program,” said Gomes.
The new evidence comes months after the Alberta government all but closed the book on safe supply as a potential tool in tackling the opioid epidemic.
Back in June, Alberta’s special select committee to examine safe supply quietly released its final report, which concluded the practice can lead to “increased addiction and overdose.”
The report was largely based on a Simon Fraser University review that concluded there was “no evidence demonstrating benefits of (Public Supply of Addictive Drugs).” Following its release, dozens of scientists and researchers wrote a letter to the select committee which said the Simon Fraser review was “flawed” and “not based on existing evidence.”
In an interview with Global News, Dr. Julian Somers, who co-authored the Simon Fraser Review, said that if the Ontario study had been released months ago, it still would not have changed their conclusion regarding safe supply, mainly because it does not address the causes of addiction, such as chronic homelessness.
“The findings are not so spectacular anyway,” Somers said. “As long as you’re ignoring the causal factors, you’re tinkering at the edges and spending more money.”
In recent months, opioid-related deaths have been trending downward in Alberta. According to a government data dashboard, there were 92 opioid-related deaths in July 2022, the fewest since April 2020. A government news release called the recent trend “a positive sign.”
An Edmonton doctor cautions it’s too early to to say whether the current approach to the opioid epidemic is working.
Dr. Ginetta Salvalaggio, a family doctor who served on the opioid poisoning committee for the Edmonton Medical Zone Staff Association, said the Alberta government should reconsider safe supply as part of its opioid strategy, in light of the new Ontario research.
“It is possible that some of those government-introduced policy measures and investments are helping but ultimately they are addressing addiction. That is not what is driving this crisis. What is driving this crisis is a toxic drug supply,” said Salvalaggio.
“And if the government policy levers were actually doing something here, we wouldn’t also see similar patterns over the short term in B.C.”
B.C. data shows opioid-related deaths have also trended downward in the first half of 2022, however there have been small spikes in the summer months.
Ultimately, Gomes hopes her study can help inform government policy decision-making at all levels.
“I think what I see often in government is that there is an attempt to come back and see what is changed.”
“I don’t know when Alberta might reconsider the evidence around safe supply. Hopefully as work like this evolves, there will be that understanding that maybe those decisions that were made in the past were based on old evidence and there’s new evidence that needs to be considered,” said Gomes.
“I think the more we speak about this evidence, the more we encourage others to try and replicate these findings.”
Global News requested an interview with Alberta’s associate minister of addictions, Mike Ellis, but did not hear back.
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