Canadian harm reduction activists believe that “safer supply” can reduce overdoses and deaths by providing addicts with easy access to “safe” pharmaceutical opioids—but we already tried this experiment 20 years ago. It was called the OxyContin crisis and it had nightmarish results. So why are we making the same mistakes all over again?
Before the late 1990s, opioid abuse had not been a significant issue in North America for decades. As opioid prescribing was generally restricted to managing pain for terminally ill cancer patients, opportunities for prescription opioids to trickle into the black market and fuel new addictions were limited.
Illicit heroin existed, of course, but it was highly stigmatized, even amongst addicts, which dissuaded people from experimenting with the drug. As a result, heroin’s popularity was mostly limited to small, stable clusters of highly-marginalized users in major urban centres.
North America’s contemporary opioid crisis, which has raged for over two decades and killed hundreds of thousands of people, can be traced back to this point.
Purdue falsely claimed that OxyContin was safe and caused addiction in less than 1 percent of users. The company then commissioned new studies that made similarly false or misleading claims, paid kickbacks to doctors who liberally prescribed the drug, and quietly funded a network of “activist” organizations that propagated the idea that providing opioids for moderate pain was “compassionate.”
By the early 2010s, Purdue Pharma was deluged in lawsuits and record-breaking fines and OxyContin prescribing was severely restricted. Many pill mill doctors were stripped of their licences, and similarly prosecuted or sued.
Yet, by this point, enough addicts existed to maintain a thriving illicit heroin and fentanyl market, so the opioid crisis continues to rage to this day, killing tens of thousands of people annually.
One would think that, given what happened with OxyContin, Canada would be cautious about flooding communities with pharmaceutical opioids—but it isn’t.
The federal government has instead been pushing “safer supply,” a strategy that claims to reduce overdoses and deaths by providing free addictive drugs as an alternative to potentially tainted illicit street substances. Typically, that means handing out hydromorphone, an opioid as powerful as heroin, as if it were candy.
Functionally speaking, the difference between a safer supply clinic and an OxyContin pill mill is often negligible. In both cases, free pharmaceutical opioids are recklessly showered upon addicts, who then resell them to everyone else, leading to misery. The main difference is that, this time, the root of the problem is not a pharmaceutical company, but rather the government itself.