Better health, fewer overdoses reported by safe supply users in self-survey

Backers of a London, Ont., program that provides a safe supply of opioids to prevent fatal drug overdoses are pointing to survey results from participants who report the approach is leading to better health outcomes. 

London's Safer Opioid Supply program (SoS) was started in 2016 and operated by the city's InterCommunity Health Centre at a time when increased toxicity in the supply of street drugs — particularly fentanyl — led to massive increases in fatal overdoses across the country. 

The safe-supply approach is controversial but in 2020 a federal government grant helped fund 25 safer supply programs across the country. It led to London's program to more than double its client roster, which is now 239 people. 

In addition to health supports, clients are provided hydromorphone tablets or slow-release oral morphine as a way to have them avoid an unsafe supply of street drugs. The program participants are people who suffer from opioid addiction and are considered to be at high risk for a fatal overdose.

The InterCommunity Health Centre released a report Thursday of self-reported data from the program's clients. The data was gathered during two different periods: one in early 2022 (75 surveys) and another in early 2023 (95 surveys).

Among the 2023 respondents, half reported their fentanyl use had decreased while 11 per cent said it had stopped completely since starting the program. 

The survey data also suggest a decrease in the number of overdoses for program participants. No clients in the 2023 responses reported an overdose in the past month with 15 per cent of clients reporting having experienced an overdoes in the last six months.

A total of 63 per cent of the program participants who responded said their use of stimulants, which includes methamphetamine, had decreased since entering the program. 

Participants report fewer ER visits

Program participants were asked if they'd visited an emergency room in the past six months. In the 2022 group, 28 per cent of respondents said they had gone to emergency while 24 per cent in the 2023 groups said they'd been to an ER. This is down from a 41 per cent response to the same question in 2021. 

In the 2023 group, 78 per cent reported their involvement in criminal activities decreased or stopped completely since starting safer supply.

In an online news conference Thursday, advocates for the program said that, while safe supply shows promise in helping cut down the number of fatal overdoses, there remains barriers. B.C. academic Dr. Gillian Kolla of the Canadian Institute for Substance Use Research was involved in studying the London program. 

She said program participants become vulnerable if the safe supply is interrupted in the event a client ends up in jail or hospital.

"We know that after these periods their fatal overdose rate goes up dramatically," said Kolla. "We've seen this in multiple countries."  

Kolla said while the results are encouraging, she'd like to see safe supply programs expanded beyond limited programs so their effectiveness can be better demonstrated. 

"We've never seen a scale up of resources on harm-reduction or evidence-based treatment to match the rapid rise in overdose deaths that's related to the unregulated presence of fentanyl in the drug supply," she said.