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A bit of clarity about the term “moral entrepreneur,” which I learned about this week from a new paper in a scientific journal that maps the moral panic about prescribed safer supply in BC. (If you haven’t read it, you should!) Moral entrepreneurs are “key players in the production of moral panics, particularly those engaged in efforts to adopt or shift norms of acceptability around deviance.” They are often but not exclusively politicians or special interest groups. In the scientific essay (link below! 👇 ) the term is used to encompass key addictions medicine physicians, politicians, media commentators (e.g. newspaper columnists), representatives of for-profit “recovery” organizations, and special interest groups. From the paper: “An identification of the diverse motivations underpinning the actions of moral entrepreneurs is beyond the scope of this analysis, though emerging evidence suggests economic interests and profit motives of certain actors as playing an important role for some.” The important thing to note about moral entrepreneurs: THEY MAKE CLAIMS ABOUT HARMS WITHOUT EVIDENCE. The timeline is all laid out in the paper, with the available research and data laid out. Link 🔗: sciencedirect.com/science/ar… #ToxicDrugCrisis #CdnPoli #BCpoli #MoralPanic #MoralEntrepreneurs

I watched yesterday’s federal @HOCCommittees on Health meeting about the toxic drug crisis. This time it was police leaders from BC and Canada talking about decriminalization, tools they need, diversion of prescription meds and harm reduction. Over the course of 2 hours every one of them said again and again: IT’S FENTANYL THAT’S KILLING PEOPLE. They said they are focusing their resources on what’s doing the most harm: FENTANYL. WHEN ASKED about diversion of safer supply they said: the diversion of Rx meds has been happening on our streets for decades; it now includes safer supply; it’s NOT the driving cause of deaths … FENTANYL IS. They said the issue of diverted prescription drugs on the streets PALES IN COMPARISON to the problem of FENTANYL. But despite Canadian police leaders stating clearly and repeatedly that they’re focused on the problem that’s killing thousands of Canadians every year, Conservative MPs @LailaGoodridge & @ToddDohertyMP & BC United MLA @ElenoreSturko continue to fear monger over prescribed safer supply (recognized as a “limited street-level issue” by the President of the BC Association of Chiefs of Police). This is heartbreaking. I want to believe that deep down we all want to come to the table, find solutions and save lives … but if not even the testimony of police chiefs and commissioners can move you off your political talking points then you really don’t care, do you? The lives of people’s children, partners, siblings, parents & friends being lost to toxic fentanyl do not matter as long as you get the chance to take shots at your political rivals. SAD. Clip here:parlvu.parl.gc.ca/Harmony/en… #ToxicDrugCrisis #CanPoli #HESA

It was eight years ago today that the Provincial Health Officer declared a Public Health Emergency due to the toxic illicit drug supply. It isn’t better today. It’s much, much worse. The UNREGULATED drugs people buy from the illicit drug supply (NOT resold prescriptions, which are regulated) continue to grow more unpredictable, potent, addictive and dangerous. Our efforts to stop the rising death rate haven’t been enough. We’ve scaled up treatment and tried every intervention currently available under the law to limit deaths (and even changed some laws) but as more adulterants enter the drug supply, those interventions become less effective. So this is a heartbreaking anniversary. We can all see the devastating impacts on communities across BC (and North America) and most of us have now been touched by it. My heart goes out today, and every day, to everyone who has lost a loved one to this terrible epidemic. My biggest wish is that one day these sad anniversaries will be in the rearview mirror. I promise you that all of us working on the frontlines of this will keep fighting, keep trying to help individuals, and keep advocating for solutions. #toxicdrugcrisis #bcpoli

#BREAKING: BC drug deaths down in February The monthly report from the BC Coroners Service on February’s illicit drug toxicity deaths is out today. FIRST, A REMINDER: we are extremely fortunate in BC to have a coroners service that places importance on expedited toxicology testing so that we can have comprehensive data ASAP. NO OTHER PROVINCE IN CANADA is tracking toxic drug deaths as closely, quickly, or publicly providing the level of detail & data that BC is. Many provinces haven’t even fully reported numbers from 2023 yet. You can’t solve a problem if you don’t know the scale of it. In this regard, BC is setting a high bar for every other jurisdiction is North America. A couple of highlights from February: ➡️ 177 people died from toxic drugs. That’s an 11% drop from last Feb, and a 12% drop from January this year. Unlike some provinces that spin their data, we’re not taking a victory lap. Every one of those 177 people was someone’s family or friend 💔 There’s a lot more work to do! ➡️ Smoking is now the most common form of consumption by far (71%), with only 12% of those who died having injected drugs. Which really shows the need for outdoor overdose prevention services! ➡️ Related to this week’s relocation of the Thomus Donaghy OPS, Vancouver City Centre continues to have the second highest number of deaths in VCH, with a rate of 89.6 per 100k people. ➡️ THERE IS NO EVIDENCE THAT PRESCRIBED SAFER SUPPLY IS CONTRIBUTING TO UNREGULATED DRUG DEATHS. In 2023/24, hydromorphone was detected in only 3% of toxic drug deaths & not at a level to cause death. Read the report for February here 🔗:app.powerbi.com/view?r=eyJrI… #ToxicDrugCrisis #BCpoli #CdnPoli #HarmReduction #Recovery #AllTheTools

This one is still really on my mind. If you’re fighting to cancel or restrict safer supply programs, this is what you’ll leave people with 👇 New veterinary tranquilizers showing up in the illicit drug supply are even stronger than xylazine, aka “tranq” or “tranq dope,” which we’re already seeing. That’s the one known to cause NECROTIZING FASCIITIS. It’s a vasoconstrictor - it slows blood flow to tissue & leads to terrible skin infections. The addition of these drugs to high-potency opioids & benzos puts users in a deep state of unconsciousness, causes a decrease in blood pressure and heart rate and slows breathing. They can’t be reversed with naloxone (though it will reduce the effect of any opioids present, so should still be tried). THIS IS WHAT WE MEAN WHEN WE TALK ABOUT THE TOXIC UNREGULATED DRUG SUPPLY. Think about that. #toxicdrugcrisis #bcpoli #ableg #safersupplysaveslives

I’m in disbelief at the Saskatchewan government’s announcement that it’s restricting safe supplies for drug use. The bizarre move to restrict clean needles isn’t going to reduce drug use & overdose deaths, but it WILL increase rates of HIV transmission… in the province that already has the highest rate in the country BY FAR! (National 2021 HIV diagnosis rate: 3.8/100k. Saskatchewan rate: 20.3/100k) 🤯🤯🤯 The problem with a 1-to-1 needle exchange is people will be more likely to use someone else's if they don’t have a needle to turn in. If you want to promote recovery options: print info on needle packages. If the problem is littering, provide disposal boxes. Educating drug users on harm reduction doesn't encourage drug use - it encourages safety among people who are already using them. Research also shows it’s those moments of human connection at harm reduction sites that are most influential at getting people to health care and into treatment & recovery. Link 🔗 to story saskatoon.ctvnews.ca/saskatc…

Still feeling grrreat 🎉 about the BCCDC study released yesterday, which shows a safer supply intervention DOES reduce mortality and acute care visits. Once again, BC leads the way on effective, evidence-informed interventions. This is one of the first population-level studies of its kind, and since the opioid crisis is hitting hard globally, expect it to be looked at all over the world 🌎 Let’s look a little closer 👀 The study involved all people in B.C. with a substance use disorder (SUD) who received an opioid or stimulant prescription from March 2020 until August 2021. That’s 17 months of data! It compared 5,882 people with SUD who filled safer supply prescriptions over that timeline with a similar group of people who did not. It found: people who were prescribed pharmaceutical-grade opioids were 55 per cent less likely to die of drug poisoning than people who weren’t. If they received four or more days of safer supply they were 89 per cent less likely to die from drug poisoning 🔥 Compelling results! Safe-supply haters 🤬are already spiralling, especially since such profound results indicate a lot people DO take their meds, rather than “flood” the street supply with resales, killing unsuspecting teens. (Apologies for being flippant, but coroners data is very clear it’s the UNREGULATED street supply of contaminated drugs that are killing people, not prescription 💊 opioids.) Read the linked editorial here bmj.com/content/384/bmj.q6

NEW RESEARCH FROM BC: SAFER SUPPLY WORKS! Cue up the marching band! 🎶🥁🎺🎉🎉🎉 We all care a lot about the escalating toxic drug crisis and have many ideas about what will end this public health emergency. According to an evaluation of the Canadian Drugs and Substances Strategy, between 2017 and 2022, Canada spent more than $800 million on many of those ideas, including: ➡️$433 million on Enforcement (58% of the budget - WOW!) ➡️$134 million on prevention (18% of the budget) ➡️$93 million on treatment (13% of the budget) ➡️$61 million on harm reduction (8% of the budget) (HT to @mindingottawa for alerting me to this excellent resource, though you pretended all $800M+ went to Safer Supply, which is a special kind of BS, since it’s not even a line item here) In fact, only a teeny, tiny amount of the harm reduction budget was spent piloting safer supply programs, introduced in 2020 when the pandemic shut down other harm reduction services. So it’s THRILLING to learn today that those programs WORK! New research from @CDCofBC found people with an opioid use disorder prescribed 1+ day's supply of opioids were 61% LESS LIKELY TO DIE in the following week, compared to a similar group of people who did not receive a prescription. The study looked at outcomes for 5,882 people with opioid or stimulant use disorder who filled a prescription for safer supply between March 2020 and August 2021. This cohort was compared to a very similar cohort that did not receive safer supply. Although this is a pretty small number (less than 1% of BC drug users have been able to access safer supply so far), the research shows that deaths from the toxic drug supply are preventable, and that pharmaceutical alternatives can reduce the risk of death from the unpredictable and toxic drug supply! Woohoo 🎉 Another tool in the toolbox to help us fight this emergency that is killing 7 British Columbians every day. So this means all the “skeptics” out there (aka @adamzivo & friends) will finally quit with the misinfo campaign and get behind an intervention that is proven to save lives, right? RIGHT?? Guys, where’s the marching band? More info about the study here: (link) 🔗 bccdc.ca/about/news-stories/…