Alberta safe supply report criticized for bias and focuses on prescription drugs

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An Alberta legislative committee exploring the issue of safe drug supply has released a report that critics say is biased and focuses too much on the overprescription of opioids.

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The 57-page report of the Select Select Committee to Review Secure Procurement includes eight recommendations, although adopting a secure procurement program is not one of them.

Associate Minister for Mental Health and Addictions Mike Ellis said in a statement that the government would “carefully consider” the findings.

“As we continue to implement a recovery-oriented system of care in Alberta, work is already underway that aligns with some of the committee’s recommendations,” the statement said.

A spokesman for the UCP caucus, which handles the committee’s investigations, did not respond to a request for comment after the report was released this week without any government announcement.

Safe supply is known as a harm reduction practice in which some drug users are provided with a legal, regulated supply of drugs to help them avoid entering the illicit toxic drug market.

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At least three of the report’s eight recommendations relate to prescription opioids. One calls on the Government of Alberta to prevent “harmful pharmaceutical practices such as the widespread prescribing of full agonist opioids, often used in safe supply practice, which can lead to community diversion and increased addiction and overdoses.

The Edmonton Area Medical Staff Association (EZMSA), which launched an opioid poisoning committee in response to Alberta’s drug poisoning crisis, said the report’s focus on diversion of prescription opioids ignores the current reality.

“While the first wave of the opioid crisis may be linked to pharmaceutical marketing tactics and opioid prescribing incentives, since 2012 there has been ongoing education about restrictions and monitoring of opioid prescribing. opioids by regulatory colleges across Canada,” the EZMSA said. .

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“In fact, since these programs were instituted, the rate of dispensing of opioids has shown a dramatic decline across Canada.

According to the province’s Substance Use Surveillance System, which tracks drug poisoning deaths, 95% of opioid-related deaths in 2021 were due to non-pharmaceutical opioids.

“More regulation on prescribing will not impact the current poisoning crisis – preventable deaths will continue to occur,” EZMSA said.

EZMSA provided a written submission to the Safe Procurement Committee and although the association is listed as a stakeholder, the submission was not included in the final report.

Dr. Bonnie Larson, a professor of family medicine at the University of Calgary who practices primary care and addiction medicine, echoed EZMSA’s concerns.

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She said the recommendations focus on a controlled medical environment, opioid prescribing and diversion prevention, as well as increased law enforcement involvement.

“While we once hoped we could get support to prescribe a safer supply of opioids to people who really need them, this report is not reassuring,” Larson said. “I think it’s actually increased the fear in our community of being disciplined by the government or the government pressuring the college to (surveil) the prescribers.”

Two of the committee’s recommendations call on the government to allow “replacement within the framework of a treatment plan under strict medical supervision in the clinic” and collaborate with the College of Physicians and Surgeons to “ensure that physicians are informed of the criteria for prescribing appropriate opioids.

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About two-thirds of the report consists of a heavily critiqued review by staff at the Center for Applied Research in Mental Health and Addiction at Simon Fraser University (SFU).

While the review found ‘no evidence showing benefits’ of a safer drug supply, more than 50 researchers and clinicians signed an open letter criticizing SFU’s work as ‘extremely low quality’ .

“It’s a biased report, as we knew,” Larson said of the committee’s final report. “It relies on commissioned non-scientific information.”

Accusations of bias have been leveled against the committee since its inception in December 2021.

In February, four New Democrat MPs from Alberta resigned from the committee over concerns that the UCP had “clear intentions of staging a protracted political coup” against harm reduction policies. They also criticized the lack of diversity among the presenters.

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The UCP caucus said the NDP was indulging in its own political stunt by stepping down.

The committee’s work was also rejected by several experts and advocates, including the British Columbia Center on Substance Use, Moms Stop the Harm and Each and Every, who declined to appear before the committee. They raised concerns about the lack of representation of people to whom safe supply is prescribed, the lack of an academic community conducting primary research on safe supply, and the lack of safe supply prescribing physicians.

Other recommendations in the report call on the government to establish a provincial pain management strategy and step up police efforts to guide people towards recovery using “alternatives to the criminal justice system.”

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