British Columbia’s “Safe Supply” Program A Tacit Admission That Drug Prohibition Kills and Legalization Saves Lives

The Wall Street Journal reported today that British Columbia has decided to address its growing drug overdose rate (largely fueled by fentanyl‐​tainted drugs) with a program called “Safe Supply.” Under this new policy, health care practitioners are permitted to prescribe legal, pharmaceutical‐​grade substitutes for drugs obtained on the black market, so that users of illicit drugs can get something approaching their preferred drug experience and avoid withdrawal, without having to turn to the dangerous black market that is powered by drug prohibition. Of course, not all the people who take advantage of the program are addicted to these drugs. Many are chemically dependent and are using the drugs to avoid the misery of withdrawal. For example, under the program, providers can prescribe legal drugs such as hydromorphone ( Dilaudid —twice the potency of heroin) as a substitute for heroin and other morphine derivatives. Dexedrine (dextro‐​amphetamine) can be prescribed as a substitute for cocaine or street methamphetamine (there is also a pharmaceutical‐​grade methamphetamine called Desoxyn that is legal but uncommonly prescribed by physicians). They may also prescribe legal, pharmaceutical‐​grade fentanyl. Recipients of the drugs are not required to enter rehab programs and are not restricted to receiving them in special clinics, such as methadone clinics. Canada, like the U.S., saw a dramatic increase in overdose deaths in 2020—a 62 percent increase to be precise, 851 of which were in British Columbia. Vancouver’s Insite , the first safe consumption site in North America, was established in 2003. Largely due to its success in reducing overdose deaths, reducing HIV and hepatitis, and bringing people with addiction into treatment, safe consumption sites have now proliferated throughout Canada. There are currently 38 government‐​approved facilities. The “Safe Supply” program grew out of an emergency measure implemented in March 2020 by British Columbian public health officials, concerned that the stay‐​at‐​home orders and closures of many facilities impeded drug users’ access to safe consumption sites On July 15, 2021, the British Columbia Ministry of Mental Health and Addictions announced it was transforming what had been an emergency measure into official policy. Its press release stated: BC health authorities deserve applause. But think about what this means. While many drug policy reformers point to Portugal’s drug decriminalization as a model for reducing death, disease, and substance use disorder, the fact remains that drug users in Portugal must still obtain their drugs from the dangerous black market, where dosage, purity, and contamination of the drugs are unknown. On the other hand, “safe supply” programs employ legal drugs. These drugs are pure, unadulterated, and packaged in accurate dosages. And, under the program, providers may prescribe them to people who are not interested in reducing their drug dependence or getting treatment for addiction. Just like doctors practice harm reduction when they prescribe blood pressure or diabetes medication to their patients who are unable or unwilling to alter their unhealthy lifestyles, “safe supply” allows them to practice harm reduction on patients with drug dependency or addiction. Hopefully, British Columbia’s novel approach will gain wider acceptance. If so, it will provide a “real world” lesson that drug prohibition kills and legalization saves lives.