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Understanding The Moral Panic About Safer Supply

A graffiti in Vancouver asks: "how do we end the drug crisis?". The answer: "Prescription heroin and opium poppy cultivation rights!" is given.

A wall in Downtown East Side Vancouver, Canada. Source: Ted McGrath

Drug policy and harm reduction in Canada are facing an onslaught of reactionary backlashes, misinformation, and racist and classist scapegoating. This clear moral panic on safer supply includes attempts to roll back limited gains around drug decriminalisation, supervised consumption sites, and prescribed safer supply programmes.

We explored this phenomenon in depth in our journal article in the International Journal of Drug Policy, which can be read here.


The long history of moral panics & drug scares

Moral panics around drug use (especially youth drug use) are nothing new. Defined as an attempt to generate concern over issues related to the moral order, moral panics “seize the issue to try and regain control of the public agenda or to (re)impose or maintain their values”.

Moral panics rely on anecdotal and exaggerated claims from unverified sources, which are then amplified by news media. They also scapegoat marginalised groups of people and blame them for longstanding social problems. This vilification is an attempt to cast people who use drugs as dangerous, reckless, or dishonest. We are seeing this unfold in Canada with attempts to blame growing homelessness on drug use, rather than on the affordable housing crisis, inadequate social assistance rates, runaway inflation, and increases to the cost of living.

Drug users’ rights advocates – like the Vancouver Area Network of Drug Users (VANDU), Western Aboriginal Harm Reduction Society, the BC Association of People on Opioid Maintenance, and others before them – have mobilised around the concept of moral panic to identify the way that those who oppose growing movements for justice and health for people who use drugs leverage fear and stigma to advance their agendas. There have been frequent backlashes against providing services for people who use drugs – we’ve seen it in the past towards other harm reduction or healthcare interventions like methadone clinics, needle distribution programmes, naloxone distribution, and heroin assisted treatment. These previous backlashes recirculate narratives that healthcare for people who use drugs represents a threat to the “general” public, presumed to be non-drug using.

These moral panics build upon a long history of drug scares. Canada’s first drug law – the 1908 Opium Act – was passed after a period of anti-Asian and anti-immigrant scapegoating led to race riots targeting Asian communities in Vancouver.  More recently, the 1986 declaration of a drug epidemic by Prime Minister Mulroney led to the acceleration of drug enforcement efforts that targeted Black communities. Each of these moments led to eroded due process rights and civil liberties, longer penalties for drug offenses, mass deportation, vigilante violence, and racialised mass incarceration. These are just a few of the many drug scares that form the basis of the moral panics that we continue to face today.


Disinformation about safer supply in Canada

An example of a headline from the National Post, written by the vocal opponent to harm reduction, Adam Zivo. Source: National Post


Safe supply as a concept and approach emerged from drug users’ groups, and includes models such as prescription-based programmes and community-led compassion or buyers’ clubs (which are currently facing criminalisation in Canada. Today’s backlash against prescribed safer supply – programmes that prescribe pharmaceutical opioids to people at high risk of overdose as alternatives to the toxic, unregulated street drug supply – is the most recent example of this history.

As researchers who study public health and criminal legal responses to the current overdose crisis, we felt there was an urgent need to engage with and respond to the sensationalist and misleading reporting on safer supply which uses unsubstantiated claims and anecdotal evidence to push a narrative that safer supply programmes are generating a “new opioid crisis”.

These claims are remarkably out of sync with the existing evidence on the impacts of safer supply programmes. In particular, a growing body of evidence shows that these small, pilot programmes have led to significant reductions in overdose deaths and improvements in health outcomes. Despite this, safer supply’s detractors continue to traffic in disinformation that is completely contrary to data. A few examples:

  • Claims that rates of ‘addiction’ or substance use disorder are increasing, when data shows they’ve remained stable over the past 10 years across jurisdictions.
  • Claims that there has been a wave of youth initiation to drug use, when data shows this has in fact decreased.
  • Claims that prescribed opioids are a driver of overdose mortality, when close to 90% of deaths in Canada from opioid-related overdose are NOT from prescription pills, but from unregulated fentanyl from street markets.

And while it is both important and necessary to focus on the deaths occurring from overdose among young people, recent data from Ontario shows that 93.5% of overdose deaths among youth are from unregulated fentanyl. It also shows that rates of overdose involving hydromorphone – one of the opioids prescribed in safer supply programmes, as well as for pain – have actually dropped by half since safer supply programmes were scaled up in 2020.


Doubling down on harmful & ineffective punitive policies

The current moral panic around safer supply has revealed new political alliances that include politicians, media commentators, and representatives of for-profit “recovery” organisations. Some medical experts have participated in this moral panic; pundits regurgitate tired tropes of predatory drug dealers targeting school children. They create a bogeyman out of longstanding practices of medication sharing and position subsistence economies as responsible for a range of social harms.

All of this has real-world effects and policy consequences. The moral panic redirects public sentiment away from providing life-saving and essential healthcare and harm reduction services, and instead directs public sentiment toward punitive policies that are known to be harmful and ineffective. Most insidiously, we have seen this with growing calls for forced treatment: while it is positioned as a solution, history and evidence show this is harmful, ineffective, and does nothing to address overdose and drug-related deaths.

The current moral panic presumes and doubles down on the widely dispelled idea that policing, arrests, and jailing people who use drugs can meaningfully reduce negative health outcomes and drug-related harms. Over a hundred years of drug prohibition show us that policing and enforcement efforts do not meaningfully alter drug availability, price, or potency, and instead drive volatility in unregulated drug markets.

The disinformation campaign underway against both safer supply and broader harm reduction initiatives in Canada is purposeful and deliberate. It is being used to serve political ends, ignoring the substantial research evidence that now exists for harm reduction approaches generally, and safer supply specifically. Policy makers are placating critics by closing and/or restricting access to currently available programmes, introducing new barriers that will reduce effectiveness and access. People are being de-prescribed from pharmaceutical alternatives and forced to return to a toxic street supply. This will kill: the province of Alberta, after passing regulation that effectively banned safer supply, has already seen a spike in overdose deaths.

In Canada, 22 people are dying from overdose every day, and almost 90% of those deaths are from non-pharmaceutical sources of street supply of fentanyl which grows more volatile with each passing year. The current moral panic prevents us from addressing the real drivers of overdose and undermines the sorely needed expansion of all available solutions to stop the needless loss of life that continues to devastate us.

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