“Disastrous results”: BC addiction counsellor says students increasingly addicted to safer supply drugs

Lower prices, mental health issues are factors in teens turning to diverted government-supplied opioids

AI dramatization of a teenage girl abusing prescription opioids.

Matthew Beasley, a Vancouver-based counsellor specializing in addiction recovery, tells a familiar tale. More and more young people are using drugs – but there’s a difference this time. Now, the provider is often the government’s “safer supply” programs, which are rapidly making their way across the country.

Beasley is one of the scores of healthcare workers who have seen an uptick in minors using opioids over the past few years, following the increasing prevalence of safer supply programs in the province. While his clinic used to almost exclusively see adult clients, it is now servicing an increasing number of adolescents who need help transitioning off methadone, a medication used to treat opioid addiction.

According to Beasley, many younger patients developed their addictions after accessing safer supply opioids. These teenagers did not purchase their opioids directly from safer supply patients, and instead relied on drug dealers who, lurking around high schools, would emphasize the origin of the drugs.

Safer supply, an initiative that has been supported by various Canadian government bodies since the late 2010s, is meant to prevent overdose deaths by providing drug users with regulated forms of addictive drugs. People who use risky street drugs such as fentanyl receive sterile and less potent opioids, such as hydromorphone, that are less likely to harm them.

However, health care workers and former drug users say that those receiving opioids from safer supply clinics often sell them on the black market in a process called “diversion,” and then use the proceeds to purchase their original substance of choice. Once these diverted drugs, which the government itself originally provided, filter into surrounding communities, they are often accessed by youth, leading to new addictions and overdoses.

Though there is no formal research to link safer supply to increased rates of illegal opioid use, Beasley’s report corroborates those of many others working on the frontlines of Canada’s overdose crisis, including a letter from 72 doctors criticizing Canada safer supply programs published earlier this month.

Other indicators of diversion include RCMP drug seizures; a sharp uptick in youth drug deaths that involve safer supply medications; and significant drops in the street price of addictive drugs provided through the programs.

Minors at major risk

Beasley said that there are many reasons why young people are particularly susceptible to taking diverted hydromorphone, including peer pressure, more risk-taking behaviour, and mental-health issues exacerbated by the pandemic.

“This is a really heartbreaking element of it: opioids are not only a fantastic physical pain number, they’re also a fantastic emotional pain number. The experience of being under the influence of an opiate is often described as that feeling of a warm hug, or being wrapped in a warm blanket,” he said. “It speaks to a lot of people out there feeling very isolated.”

Beasley also thinks young people are particularly drawn to hydromorphone as they believe that it may be safer for them as it originates from government sources. “I do worry that safer supply is being equated with totally safe supply or risk-free supply or something like that, especially when it's being used by people that it wasn't intended for,” he said.

Safer supply has already led to tragic results in the Metro Vancouver area, with several teenagers testifying that they, and their friends, developed opioid addictions after experimenting with “dillies,” a slang term for hydromorphone tablets that originate from safer supply clinics. After using these tablets for several months, some of these teens graduated to using fentanyl.

Matthew Beasley, an addiction counsellor, says that youth are increasingly accessing diverted hydromorphone originating from “safer supply.”

Supplying alternatives

Even though Beasley disagrees with the fundamentals of safer supply, he still speaks in favour of other harm reduction practices. As a former drug user himself, he agrees with carefully decriminalizing drug use in order to reduce stigma, but fears that safer supply programs risk leaning too much in the opposite direction.

“Perhaps we've gone a bit too far along the lines of not expecting people to change when it comes to addiction,” he said.

Safer supply programs are often confused with opioid agonist therapy (OAT), a recovery-focussed treatment which has existed in Canada for decades. Like safer supply, these programs provide milder opioids, but differ in that they focus on managing withdrawal symptoms, not inducing euphoria. Patients are then slowly eased off their opioids.

Unlike safer supply, OAT generally requires that patients consume their drugs under strict supervision at pharmacies and clinics, which mitigates diversion. “One of the benefits of having supervised consumption sites was that they were supervised. It wasn't the government handing out substances that then could be used elsewhere,” Beasley continued.

According to the Government of Canada’s website on safer supply, “the goal of traditional OAT is for a patient to stop taking drugs” whereas safer supply programs “are often more flexible and do not necessarily focus on stopping drug use.”

Beasley is a fan of Portugal's addiction policies, which combine drug decriminalization with significant investments into addiction treatment. He believes this model is superior to what is occurring in B.C., where treatment options are underfunded and inaccessible. “Decriminalization without the increase in addiction treatment availability is just going to lead to disastrous results. We have been seeing that unfortunately,” he said.

Beasley said that at the core of the issue is that safer supply only cares about preventing overdose risk while not paying enough attention to long-term health.

“Keeping people alive is certainly one goal of health care. I'd argue that wellness and flourishing are other elements of health care that get missed when it's kind of like, okay, well, we just need to prevent overdose,” he said. “That's step one, yes. But we also need better support for recovery treatment.”

[Article by Maeve Ellis]