BC to become first province with prescribed safe supply

[rubecube]

Originally Posted by CliffFletcher

But taxing pot to generate government revenue was one of the justifications - probably the biggest - for legalization in the first place. If the plan at the outset was to tax it at only 5 per cent, legalization wouldn’t have had anywhere near the public and institutional support.







And taxes are only one of the expenses commercial growers and retailers have above those of the black market. Infrastructure, regulation, licensing, employee benefits, marketing - all the costs legitimate businesses have that Terry doesn’t. Legal commercial pot just can’t compete with the black market when it comes to heavy and price-sensitive users.

K thx, Cliff.

[FlamesAddiction]

Would you have to test positive for certain metabolites before you can get a prescription?

I hate to be the example that ruins the cause, but I'll be honest, I love drugs. I haven't been an avid user in a long time, but if I could get them legally and safely, it would be awfully tempting.

[Street Pharmacist]

This needs to be done right, because some of these half measures are making things potentially worse. One clear factor in exacerbating the epidemic is cost. When people got more money from CERB, overdoses went up. BC did a "soft launch" of safer supply and some physicians would prescribe opiates to patients so they would not have to buy illicit opiates off the street of unknown purity and concentration. The way I see it, we have two distinct drivers if the current overdose epidemic:

1) Increased numbers of people suffering from Opioid Use Disorder. The causes of this are many and there's lots of research into this. It's due to increased access on the street and lower costs, increase mental health struggles, more addictive medications, changes in prescribing habits of opioids, and many more. This is the toughest nut to crack as none of these are easy to fix with policy.

2) An increasingly tainted supply that is now using much more potent opiates than before and dosing becomes trickier. Heroine potency didn't change all that much, but the newer synthetic opioids are 1000's of times more potent and trickier to standardize leading to many more overdoses, and we're seeing stimulants and other chemicals finding their way into the supply.


Safer supply only addresses number 2, and while there's no evidence, some are worried it may make number 1) worse by flooding the streets with cheap opiates

https://www.cbc.ca/news/canada/briti...oice-1.6078921

I still support Safe Supply as a concept, but we need other stronger options than simple opioids that Dr's currently use. For example, I had a patient with a daily dispensed prescription for hydromorphone tablets and dextroamphetamine tablets. In regular discussions with this patient, she told me it significantly decreased her need for other substances she would have otherwise purchased. But she's seeing some patients sell their safer supply because they need stronger stuff than what they can get from their Dr. So in order to get the fentanyl they crave, they sell their tablets of whatever the Dr gave them. That has the potential to make cost lower and accessibility of those opiates even higher leading potentially to a worsening of 1). There's a CBC article about this exact phenomenon https://www.cbc.ca/news/canada/briti...oice-1.6078921

[jayswin]

Despite whatever Cliff is on about, Canadians spent $2.6bil on legal weed last year. Are we going to let perfect be the enemy of good in calling legalization a failure?

[Street Pharmacist]

Originally Posted by PaperBagger'14

If the system they design was to supply people free drugs with the intention of weening them off safely, as well as counseling, affordable home services and job placements, I would be 100% for this.

This would also require the ability to test for concentration of drugs in a person's system to assure they aren't buying black market and using the public purse to supplement their addiction, which is sadly what many addicts would do.

There is a way to make this work, carte blanche free drugs for all isn't the answer, neither is imprisoning addicts with non violent crimes.

Firstly, abstinence isn't the goal. Most patients will fail if that's the goal.

What you're describing is already in place and has been for decades in all provinces with methadone, Suboxone, and Kadian. The patient sees a doctor, gets a prescription that they need to go the pharmacy every day for. After a while of clean tests and regular appointments they can get some to take home so they don't need to go to the pharmacy every day.

The difference here is that only those three are used for Opiate Use Disorder. A doctor may not prescribe hydromorphone or oxycodone to a patient who plans to use it for anything but pain control. These patients get referred to a clinic that prescribes Opiate Agonist Therapy (OAT) which is usually a methadone clinic. This doesn't work for those who don't find these option effective, and those who don't want to go to a methadone clinic due to the attached stigma. The reason we need clean drug tests to give doses to take home is to decrease risk of overdose.

You can't make the getting therapy contingent on clean drug tests. What drugs are off limits? Alcohol? Marijuana? Do we not pay for inhalers if people keep smoking? Do we tell people they can't use the hospital if they catch COVID and aren't vaccinated? I can tell most people that what they think of people with Opioid Use Disorder is wrong. They aren't looking for fun most of the time. They're looking for escape and to stop feeling sick. You give them that and most aren't going to go looking for a good time very often. Bottom line: we can pay for this in increased hospital/infectious disease/paramedic/crime costs, or we can pay for it by decreasing all that

[Cowboy89]

Originally Posted by undercoverbrother

I think this could be a good thing, especially if it facilitates help some individuals kick their habit through gradual reduction in strength of what they are using.

Safe supply, just like safe injection sites has nothing to do with reducing junkies. In fact there will be many more junkies around because less of them will OD. That in of itself could be a good thing, but it’s not going to stop anyone from using.

[PepsiFree]

Originally Posted by Cowboy89

Safe supply, just like safe injection sites has nothing to do with reducing junkies. In fact there will be many more junkies around because less of them will OD. That in of itself could be a good thing, but it’s not going to stop anyone from using.

That’s not really true. It has a lot to do with reducing drug use over time and the limited information we have so far from programs that have been around for a few years is that it has a beneficial impact on drug use, participation in preventative healthcare, and the involvement in criminal activities. This is all in addition to stopping people from dying, of course.

Saving lives isn’t just something that “could” be a good thing, it’s an indisputably good thing. A “junkie”’s life isn’t worth less than yours. But yes, it can absolutely help people get off drugs down the line.

[Cowboy89]

Originally Posted by PepsiFree

That’s not really true. It has a lot to do with reducing drug use over time and the limited information we have so far from programs that have been around for a few years is that it has a beneficial impact on drug use, participation in preventative healthcare, and the involvement in criminal activities. This is all in addition to stopping people from dying, of course.

Saving lives isn’t just something that “could” be a good thing, it’s an indisputably good thing. A “junkie”’s life isn’t worth less than yours. But yes, it can absolutely help people get off drugs down the line.

Giving people drugs isn’t going to stop them from taking drugs. Saving them from ODs, yes, but 10 years from now there’s not going to be less drug use in BC. Reducing drug addiction is much harder work than simply giving people safe supply.

[FlamesAddiction]

Humans have been trying to find ways to get high since forever. Asking people not to get high is like asking them to abstain from sex. It might work for some people, but a lot, if not most people, will still do it even if there are health risks (alcohol for example).

I think the better approach would be to put research and development into safer recreational drugs. I don't know if it is possible with current science, but a drug that gets you high, can't be metabolized enough to cause an over dose, and nullified effectiveness for a period of time after using, would be a good was to avoid deaths and habitual use.

Come on scientists, do your thing.

[rubecube]

Originally Posted by Cowboy89

Safe supply, just like safe injection sites has nothing to do with reducing junkies. In fact there will be many more junkies around because less of them will OD. That in of itself could be a good thing, but it’s not going to stop anyone from using.

A good way to help is to stop using dehumanizing language, such as "junkies."

[afc wimbledon]

Originally Posted by FlamesAddiction

Humans have been trying to find ways to get high since forever. Asking people not to get high is like asking them to abstain from sex. It might work for some people, but a lot, if not most people, will still do it even if there are health risks (alcohol for example).

I think the better approach would be to put research and development into safer recreational drugs. I don't know if it is possible with current science, but a drug that gets you high, can't be metabolized enough to cause an over dose, and nullified effectiveness for a period of time after using, would be a good was to avoid deaths and habitual use.

Come on scientists, do your thing.

Isnt that what weed does already?

[PepsiFree]

Originally Posted by Cowboy89

Giving people drugs isn’t going to stop them from taking drugs. Saving them from ODs, yes, but 10 years from now there’s not going to be less drug use in BC. Reducing drug addiction is much harder work than simply giving people safe supply.

Honest question: have you looked into these programs at all, and how they work? Because just repeating the same thing doesn’t make it any more true when you’re talking out of your ass.

Of course it’s much harder work than simply giving people safe supply, but doing that is part of the work. It absolutely does and will continue to reduce drug use, especially in the case of hydromorphone tablets. You’re making the assumption that all drug addicts want to continue being drug addicts. That is a plainly stupid assumption.

[Scroopy Noopers]

Originally Posted by Cowboy89

Safe supply, just like safe injection sites has nothing to do with reducing junkies. In fact there will be many more junkies around because less of them will OD. That in of itself could be a good thing, but it’s not going to stop anyone from using.

Citation needed.

[CliffFletcher]

Originally Posted by jayswin

Despite whatever Cliff is on about, Canadians spent $2.6bil on legal weed last year. Are we going to let perfect be the enemy of good in calling legalization a failure?

I didn’t call legalization a failure. I supported it then and I support it now. Though it certainly has been a disappointment by all of the metrics touted at the outset, from the size of the black market to government revenues to the sales figures and valuations of the commercial players. Anyone who has followed the issue at all recognizes that.

Most marijuana producers in Canada are still reporting staggering losses.

https://www.nytimes.com/2021/04/18/w...struggles.html

The assumptions many Canadians (and most posters on this forum - go back and check) made about the black market for pot going away proved wrong. And assumptions we make about safe supply may prove wrong as well, and for similar reasons: Because users don’t behave the way we expect them to behave, and the black market is incredibly entrenched and efficient.

[Fuzz]

Why do you keep ignoring the massive taxes skewing the market? People are price conscious, they choose the cheep option, which is the un-taxed one.

[blankall]

Originally Posted by Fuzz

Why do you keep ignoring the massive taxes skewing the market? People are price conscious, they choose the cheep option, which is the un-taxed one.

I don't use regularly, so maybe my perspective is different.

I'd much rather spend an extra $1-2 to walk into a store and buy regulated and properly labeled marijuana products. The other option is committing a crime to buy off a sketchball who may take his time to show up.

If I was buying by the once, things could be different? You can buy grams of marijuana from the store for $6.

[CliffFletcher]

Originally Posted by Fuzz

Why do you keep ignoring the massive taxes skewing the market? People are price conscious, they choose the cheep option, which is the un-taxed one.

Those were the tax rates legalized marijuana - and its benefits to society - was sold to the public on. Why are you ignoring that?

[Fuzz]

Originally Posted by CliffFletcher

Those were the tax rates legalized marijuana - and its benefits to society - was sold to the public on. Why are you ignoring that?

Because no one was selling 30-50% taxes. It was closer to 10%.

[FlamesAddiction]

Originally Posted by afc wimbledon

Isnt that what weed does already?

If you consider the effects of THC a good feeling I suppose.

[CliffFletcher]

Originally Posted by blankall

I don't use regularly, so maybe my perspective is different.

I'd much rather spend an extra $1-2 to walk into a store and buy regulated and properly labeled marijuana products. The other option is committing a crime to buy off a sketchball who may take his time to show up.

If I was buying by the once, things could be different? You can buy grams of marijuana from the store for $6.

But that’s my whole point. What law-abiding, safety-conscious, respectable, middle-class citizens would do is not what heavy drug users and addicts choose to do. Making policy based on what we would do in their situation is foolish. I would choose the safe opioid option. But addicts will choose whichever gets them most wasted. As Street Pharmacist warns, that may well mean pocketing the safe, government-issued stuff, selling it, then buying something much more potent (and dangerous) off the street.