With drug poisoning (overdose) now the leading cause of death in British Columbia, there remains an urgent need to invest in and scale up safe supply programs in addition to supporting existing models, broadening the range of safe supply medications and removing barriers to access. We also need to address the root cause of this crisis: a toxic, unregulated drug supply.
What we do not need are more police crackdowns directed at people who are stepping up to save lives and who are forced to do so illegally because of government inaction.
As harm reduction nurses, we condemn the recent Vancouver Police Department arrests of Drug User Liberation Front organizers.
DULF uses a compassion club model to openly distribute tested supplies of cocaine, heroin and methamphetamine for people's personal use. They support their members to have control over what drugs they procure by checking the ingredients and screening for adulterants, such as fentanyl, benzodiazepines and tranquillizers.
As informed consumers, people can avoid the volatility of the unregulated drug supply. This supply problem and the harms that come from it exist because of significant policy gaps and clawbacks to the implementation of harm reduction and safe supply nationally, notwithstanding some important progress being made.
DULF’s efforts ought to be acknowledged as life-saving given that the alternative for many people who use drugs is turning to an unregulated, poisoned and therefore unpredictable drug supply. Compassion club models offer a far safer avenue, and there have been no overdose deaths reported in relation to substances procured through DULF.
As with other safe supply programs, DULF members have reported an improved quality of life alongside fewer experiences of overdose, hospitalization and drug-related violence, including negative interactions with police. This program offers a low-barrier, person-centred and impactful intervention that is mitigating overdose risk while contributing to broader improvements in health and social well-being.
These gains should be not criminalized but celebrated, supported and evaluated through continued research.
Now is not the time to strong-arm an end to community-led models of safe supply. In fact, it is time to scale them up, while also protecting them. This could be achieved with a Section 56 policy exemption allowing community-led compassion clubs to provide controlled substances. Such exemptions are already granted to other community harm reduction services, including drug checking. Moving to support DULF’s efforts with this exemption is an actionable step elected officials and policymakers can take to help address the drug poisoning crisis.
It is also past time to bolster these community initiatives by ramping up regulated models of safe supply within and beyond the health-care system. As nurses, we have a duty to provide and advocate for safe, compassionate, competent and ethical care that is based on evidence. When it comes to substance use, we know that the gold standard is for care to be based on a harm reduction approach.
Yet what we frequently see across the research, policy and practice contexts in which we work is a rallying against harm reduction. This is reflected within anti-safe-supply efforts, which have been critiqued by Canada’s addictions minister for being ridden with “damaging” backlash and “misinformation.”
Allowing the anti-safe-supply movement to drive continued inaction, misinformation and now police crackdowns is a drug policy failure. We know from the past seven years of this worsening drug poisoning crisis that the current intervention landscape is not doing enough to meaningfully address overdose risk, mortality and the ripple effects and collective grief felt across our communities.
What we need is concerted action to improve the full continuum of substance use services, with harm reduction — including compassion clubs and other models of safe supply — representing a key pillar of this continuum.
Some may argue that expanding the substance use treatment system is a more appropriate response to the drug poisoning crisis. While treatment is an important part of the continuum, robust harm reduction interventions, such as safe supply, do not need to come at the expense of treatment and recovery efforts. Harm reduction and treatment approaches can, and should, work together to save and improve lives.
Nurses know that providing access to a regulated drug supply is an effective, evidence-based response to the drug poisoning crisis. We also know that advancing safe supply in an equitable way will require a diversity of approaches, including but not limited to community-led models such as DULF’s compassion club. As such, we stand firmly with drug user advocates in condemning police raids against DULF and others who are taking action to redress the harms of prohibition. With upwards of six people now dying of overdose each day in British Columbia, the consequences of cracking down on compassion clubs and safe supply are deadly.