Is There A Difference? Legalization Versus Regulated Safe Supply – Absolutely!

Safe Supply Versus Legal 

Let’s not keep you in suspense. Right up front, these two concepts are as different as night and day. Join us as we take a look at the horrendous world of addiction, the toxic drug crisis, and some options to help.

A Far, Far Step

A lot of reading and a lot of research has suggested that there is an opportunity for a regulated safe supply, which is a far, far step from legalization. Let's push aside legalization for a minute and think about safe supply. If we ever implemented a broad, encompassing regulated safe supply model instead of small trials, it would probably best look like a controlled process administered by health professionals, most likely via an ongoing prescriptive model, meaning people with substance disorders would be in constant active treatment. Picture it like having a personal coach on your journey to recovery, a doctor or clinic who will keep you on track and help you dodge the poison lurking around every corner offered by unscrupulous drug dealers.

Before We Start

Most importantly, it is essential to recognize that substance disorders/addiction is a complex issue that affects people differently. It's like being stuck in a maze with a different path for each person. Only your path can lead to an exit. Any other person’s path just leads to blocked walls and frustration. That's why we are developing diverse harm reduction and treatment options. It's like having a buffet of solutions to choose from because let's face it, one size does not fit all on this rollercoaster ride. We're all about embracing the unique needs and challenges of each person with addictions and their road to a healing journey.

One More Tool of Harm Reduction

Until we find solutions that significantly fix the underlying causes of the drug crisis, advocating for harm reduction is a good option. Programs like providing safe injection sites or access to new/unused needles help keep people safe and alive. The intention behind these initiatives is to reduce harm and prevent overdose deaths. It's like giving someone a life jacket in the stormy sea of addiction, keeping them afloat and giving them a chance to swim towards safety. These strategies aim to keep people alive and create opportunities for engagement and support that may eventually lead to recovery. We're all about throwing lifelines and building bridges towards a brighter future.

Acknowledging that addiction can cause brain changes is also crucial and fundamental in understanding the overall crisis. Addiction can turn your brain into a trickster, hijacking your impulse control and leading to a cycle of self-harm. It's like having a mischievous gremlin in your head, constantly whispering in your ear, "Go ahead, just one more time." Frankly, the lack of impulse control is the fundamental definition of addiction. This is why comprehensive treatment programs are essential, focusing on addressing the underlying factors contributing to addiction while providing recovery support. It's like having a superhero team that knows all the tricks of the trade, helping you battle the evil forces of addiction.

Back to Legalization Versus Safe Supply

Legalization is a HUGE step beyond a regulated safe supply. They are NOT the same! Personally, safe supply in my opinion is a much better road than legalization. Having uncontrolled (broad legalization) access to such powerful substances is a red flag, particularly for our society at this time. It's like opening Pandora's box and hoping for the best. Our policies addressing the drug crisis should be all about harm reduction, not harm multiplication! There is a risk of going too far, too fast. Better to walk before we run.

Safer Supply - The Controlled Buffet

Imagine you're at a buffet. You've got a plate in your hand, and you're ready to pile on the food. But instead of a free-for-all, there's a chef at each station, serving you the right amount of each dish. That's what a safer supply is like. It's not about giving free rein to drug use; it's about controlling it in a way that minimizes harm and maximizes health outcomes.

Think about this picture I’m painting. Remember the last time you were at a buffet and you saw that one person that went back for food six times? Then there’s you with your plate of salad sticking to your diet, which we think is awesome. However, not everyone has your fortitude. Some people need help controlling impulses. One hundredfold for people with serious substance disorders.

A safer supply means that people with substance disorders are given access to regulated, pharmaceutical-grade drugs. This can reduce the risk of overdose and infection from unregulated, often contaminated, street drugs and supplies. It's like choosing to eat at a restaurant with an A-level health grade posted in the window instead of a back alley food stand. Moreover, a safer supply can help to break the cycle of crime often associated with drug use. If people can access what they need through legal, safe channels, they're less likely to turn to illegal activities to support their addiction. It's like having a specialized grocery store in your neighbourhood just for your needs versus having to steal food to survive.

Legalization: The Unrestricted Candy Store

Now, let's talk about legalization. Picture a candy store where anyone can grab whatever they want, whenever they want. Sounds like a recipe for lots of people ending up with diabetes or other health disasters, right? That's what full-blown legalization could look like. I’m not saying it would, but I’m also not sure we’re quite ready for that model either. Legalization could potentially lead to increased drug use due to easier access and reduced stigma. It's like opening the floodgates and hoping everyone knows how to swim.

Moreover, it could also lead to more people trying drugs out of curiosity, potentially leading to more cases of addiction. It's like adding a roller coaster to a playground with no ride supervision and hoping the kids use it responsibly. Furthermore, while legalization could reduce the crime associated with drug acquisition, it could also lead to an increase in drug-related accidents and health issues. It's like giving everyone a car but not teaching them how to drive.

A Deeper Look

The concept of a regulated safe supply, however, is one more harm reduction tool, that acknowledges that a one-size-fits-all solution doesn’t fit everyone. It's like having a Swiss army knife in your pocket, equipped with all the tools you need to navigate the tricky waters of substance dependencies. The debate around drug legalization is complex and multifaceted, with valid arguments on both sides. While some advocate for legalization as a means of regulation and harm reduction, others have concerns about potential negative consequences, such as increased accessibility and societal impacts. It's like walking a tightrope, trying to find the perfect balance between freedom and safety.

We would take a moment to point out the incongruities of our social norms. For example, alcohol is an incredibly powerful drug. It also is at least ten times more harmful in deaths, health outcomes, and costs to taxpayers than unregulated drugs in Canada, yet it is legal. Tobacco is no cakewalk either. The harm done by smoking is horrendous in society. It just takes 20 to 30 years to develop. We should ask ourselves why the double standard, but that’s for another time and article.

Again, we’d point out that legalization doesn’t seem like a viable option to us either. Certainly not at this time in our current society. However, a safe regulated supply might be a good compromise. It would most importantly provide options to people with substance disorders who would then be able to turn away from unregulated sources of drugs. It's like giving them a safe harbour in the storm, a place where they can find the help and support they need.

Uncle Harry’s Used Cars

Understandably, people have misperceptions about the difference between both concepts. Hopefully, we’ve cleared up some of these with facts. That’s why we’d rather look towards regulated safe supply as a potential option that could be added to harm reduction tools. It's like choosing the mechanical-certified used car on a major car maker dealer lot versus Uncle Harry’s Used Cars which has a sign that says, “30 seconds or 30 feet, whichever comes first”. Finding the middle ground of safe supply that adds more harm reduction tools is all about minimising harm and maximising support.

The decision to prescribe drugs should always prioritize patient safety and consider the potential risks and benefits. However, it is worth noting that the approach to drug policy and addiction treatment is continually evolving as new research and evidence emerge. It's like a puzzle that we keep piecing together, finding new pieces and rearranging the old ones to create a clearer picture of what works best.

Ultimately, the goal is to find a balanced approach that combines effective prevention, treatment, harm reduction strategies and public safety models. It's like a recipe for success, mixing all the right ingredients to create a tasty dish of recovery. This includes creating comprehensive programs that address the underlying issues driving addiction, providing access to evidence-based treatments, and implementing measures to reduce the harms associated with substance use. Much like building a fortress, protecting individuals and communities from the destructive forces of addiction.

Safe Supply – Diverted To Children

Somebody’s going to say, “Yeah, but those prescribed drugs will get sold or given to kids.” Let's talk about the diversion of drugs from the BC Safe Supply trials for a moment. Some people are worried that drugs from the safe supply will end up in the hands of children or others. However, the existing statistics from the BC Coroner's Office prove otherwise. Currently, there is very little proof to support such claims. Can it happen? Certainly. Hence another reason a regulated supply is the best model at this time. People requiring a safe supply would only ever be given exactly the amount that they need – no extra to give or sell to others.

Is it possible that some small number of people getting safe supplies will sell them for stronger street drugs? Sure. The prescribers of safe supply have safeguards to weed out those people so they can be removed from the program. Also, the continuous monitoring by the BC Coroner watches the percentages of safe supply drugs found in overdose deaths. Any significant rise would automatically create a strenuous review of safe supply programs.

The truth is, that diversion happens with all kinds of products that people desire. Just think about bootleggers who sell alcohol to children or the black-market cigarettes that circulate today. Diversion is not a new phenomenon—it's something that has always existed. Research supports this understanding, showing that diversion occurs in various contexts. So, while concerns about diversion are valid, it's important to recognize that it's not unique to the safe supply trials. Like all harm reduction strategies, the balance between the incredible good they can do versus the small potential of harm to others needs to be considered. That is why we have expert scientists and health professionals who set up and monitor these programs.

Wrapping Up

So, as we wrap up this rollercoaster of discussion, remember that addiction is a complex beast that requires a multifaceted approach. It's like taming a wild dragon, using every tool in our arsenal to ensure success. While the debate between legalization and regulated safe supply rages on, let's keep our eyes on the prize: creating a world where addiction is understood, treated, and prevented with compassion and effectiveness. Together, we can make a difference and help those in need find their way back to a brighter future.

The Author: Ron Merk – Ron advocates for people and families experiencing concurrent disorders. Much of this article is evidence-based. Check out the references below! Any opinions are mine.

References:

Foreman-Mackey A, Pauly B, Ivsins A, Urbanoski K, Mansoor M, Bardwell G. Moving towards a continuum of safer supply options for people who use drugs: A qualitative study exploring national perspectives on safer supply among professional stakeholders in Canada. Subst Abuse Treat Prev Policy. 2022 Oct 8;17(1):66. doi: 10.1186/s13011-022-00494-y. PMID: 36209227; PMCID: PMC9547673.

BC First Nations Health Authority - FAQ on Safer Supply

Washington State Health Care Authority - A Presentation On Safe Supply

Health Canada - Info on Safer Supply

Check out the Canada National Safer Supply Community of Practice - Website