Question Period Note: Safer Supply

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• Our Government is taking a number of actions to address the overdose crisis, including supporting safer supply pilot projects to build evidence around this promising practice.
• Safer supply involves the use of prescribed, regulated pharmaceutical-grade drugs as an alternative to the highly toxic and unpredictable illegal drug supply.
• Safer supply aims to prevent overdoses and save lives by providing prescribed, regulated drugs, as part of a range of prevention, treatment and harm reduction services.
• We are working with partners and stakeholders, to help expand safer supply to help save lives.

IF PRESSED ON WHY TO SUPPORT SAFER SUPPLY
• People with lived and living experience with drug use and community organizations have explained the importance of access to safer supply as one additional tool to help save lives.
• Safer supply services involve the use of prescribed, regulated pharmaceutical-grade drugs as an alternative to the toxic and unpredictable illegal drug supply. These services are overseen by an authorized health professional.
• These services can help improve health outcomes for people who use drugs, reduce reliance on the illegal drug supply, and connect them to other health and social services, including treatment for those who are ready.

IF PRESSED ON THE REQUEST FOR EXEMPTION FROM DRUG USER LIBERATION FRONT (DULF) ET VANCOUVER AREA NETWORK OF DRUG USERS (VANDU)
• On August 31, 2021, Health Canada received a request from DULF in coordination with VANDU for a subsection 56(1) exemption to operate a Safe Supply Fulfillment Centre and Cocaine, Heroin and Methamphetamine Compassion Clubs. This model would involve the sale of tested illegal drugs purchased from illegal vendors on the dark web.
• Supplying drugs from illegal vendors is not a viable option for advancing the objectives of the CDSA, namely the protection of public health and the maintenance of public safety. For this reason, Health Canada issued a letter of refusal on July 29 2022.

IF PRESSED ON FEDERAL PROCUREMENT OF DRUGS USED IN SAFER SUPPLY PROGRAMS
• The provision of health care services is, with a few exceptions, a provincial and territorial responsibility.
• There are a number of prescription drugs approved by Health Canada that provinces, territories, and authorized health practitioners can access for substance use disorder treatment and safer supply programs.
• Provinces, territories, and individual medical prescribers are best placed to determine the demand for and use of these medications.

The overdose crisis continues to have devastating impacts on individuals, families, and communities. According to the latest national data, there was a total of 30,843 apparent opioid toxicity deaths between January 2016 and March 2022. A total of 1,883 apparent opioid toxicity deaths have occurred so far in 2022 (January – March). This is approximately 21 deaths per day. The COVID-19 pandemic has also contributed to the worsening overdose crisis, with some communities reporting record high numbers of overdose deaths, hospitalizations, and emergency medical service calls.

The illegal drug supply contains strong opioids, such as fentanyl, and other toxic substances such as benzodiazepines, which are causing high rates of overdoses and deaths. Many stakeholders are calling for greater access to pharmaceutical-grade medications as an alternative to the toxic illegal drug supply to help save lives – a practice often referred to as safer supply.

Current safer supply programs in Canada provide prescriber-led access to medications for people at risk of overdose, primarily as a harm reduction measure, as part of a continuum of care that may include other treatment and harm reduction services. Currently, these services must operate within the legislative and regulatory framework for controlled substances in Canada (i.e., the Controlled Drugs and Substances Act (CDSA) and Food and Drugs Act).

At this time, a number of safer supply programs exist in Canada, mainly in British Columbia (BC) and Ontario. Existing programs range from more medicalized models (e.g., requiring multiple daily site visits to a clinic) to lower-barrier models (e.g., “MySafe” model in which prescribed medications are dispensed directly to program clients through a secure machine).

Health Canada has funded 27 safer supply pilot projects through the Substance Use and Addictions Program (SUAP). This includes supporting a range of service delivery projects in British Columbia, Ontario, Quebec and New Brunswick, research/knowledge transfer and exchange projects, and a National Safer Supply Community of Practice to help share knowledge amongst stakeholders. There are also a number of safer supply services operating without SUAP funding, mostly in BC.

Health Canada is supporting two assessment and evaluation projects related to federally-funded safer supply projects. This includes an independently-conducted preliminary assessment of ten safer supply projects in Ontario, British Columbia and New Brunswick. Health Canada is also supporting an arms-length evaluation of eleven safer supply pilot projects funded through the Canadian Institutes of Health Research (CIHR).

Health Canada has taken a number of actions to reduce regulatory barriers to accessing medications used in both safer supply programs and medication-assisted drug treatment programs. In 2019, diacetylmorphine was added to the List of Drugs for an Urgent Public Health Need, and Health Canada approved a new indication for injectable hydromorphone as a treatment option for adults with severe opioid use disorder. In 2020, Health Canada issued a temporary exemption to the Controlled Drugs and Substances Act to facilitate prescribing with flexible treatment options (e.g. allowing prescribers to use verbal prescriptions for narcotics and allowing pharmacists to extend and renew prescriptions). In 2022, Health Canada approved diacetylmorphine as a new treatment option for adult patients with severe opioid use disorder.

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