Citation

Fischer B, Robinson T. J. Stud. Alcohol Drugs 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Alcohol Research Documentation, Inc., Rutgers, The State University of New Jersey)

DOI

10.15288/jsad.23-00195

PMID

37796625

Abstract

North America has been home to an unprecedented crisis of drug overdose deaths, driven largely by drug users' exposure to highly potent and toxic, illicit opioid drugs (e.g., fentanyl). While a large and diverse menu of interventions (e.g., targeted prevention or treatment measures) has been implemented or expanded in Canada, these have not effectively managed to revert and reduce this death toll. Given the fact that these interventions do not directly aim to address toxic drug exposure as the primary vector and cause of acute overdose deaths, public health-oriented 'safer drug supply' measures have been initiated in local settings across Canada. These 'safer supply' initiatives provide users with prescribed, pharmaceutical-grade drug supply with the aim of reducing overdose and death risks. These measures have been criticized, but also mis-construed from several angles, for example, as representing inadequate medical, or even unethical and harmful practice. Related concerns regarding 'diversion' have been raised. In this Perspective paper, we briefly address some of these issues, and clarify selected issues of elementary concepts, practices, and evidence related to 'safer supply' measures. These measures are also discussed in reference to other, comparable types of public health-oriented emergency health or survival care standards, while considering the extreme contexts of an ongoing, acute drug-death-crisis in Canada.

Language: en

Keywords

Canada; public health; Drugs; treatment; death; overdose; ‘safer supply’; diversion; interventions