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Abstract
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KEY POINTS
People who use drugs have an increased risk of death owing to the toxic, unregulated drug supply.
Providing a safe supply of substances, including opioids such as hydromorphone and fentanyl, and psychostimulants, may reduce the risk of overdose death, decrease other harms of substance use and support patient engagement in care.
Safer Alternatives for Emergency Response (SAFER) is a low-barrier, flexible safe supply program that provides several medication options, including fentanyl, and is integrated with other health care and social services.
Harm reduction, primary care and treatment for substance use disorders can effectively coexist.
Between January 2016 and June 2021, 24 626 people died from opioid toxicity in Canada.1 A key driver of this ongoing public health crisis has been the infiltration of illicitly manufactured fentanyl and other dangerous adulterants into the unregulated drug supply. Although a range of educational, harm reduction and substance use disorder (SUD) treatment interventions have been implemented and expanded in response, these efforts have not been sufficient, and the number of deaths from drug poisoning continues to rise. Furthermore, a substantial proportion of people do not access conventional treatments; for instance, only a minority of patients with opioid use disorder regularly receive treatment medications.2 Emerging evidence also suggests that the changing drug supply has negatively affected the effectiveness of these medications, including the efficacy of buprenorphine among people using fentanyl compared with those using heroin.3 An additional concern is unintentional exposure to fentanyl among people who use substances such as stimulants and the emergence of other contaminants such as benzodiazepines...
Language: en |