Slowly Dying: 'We’re whitewashing the dangers of powerful opioids'

Obama Administration expert warns Canada's 'safer supply' experiments are replicating lethal outcomes of OxyContin prescription crisis

Kevin Sabet

One of America’s leading drug-policy experts is sounding the alarm on Canada’s “safer supply” programs, alleging that advocates who back these programs are recycling practices used by Big Pharma and Big Tobacco, and warning that the continuation of these programs will reproduce the lethal OxyContin crisis.

Safer supply “perpetuates addiction,” says Kevin Sabet, a former White House adviser who worked within the Clinton, Bush and Obama administrations. Sabet has advised some of the world’s most powerful figures, including Pope Francis, on addiction.

And his writing, which includes two well-regarded books, has been praised as “compassionate” and “meticulously factual.”

He is also refreshingly nonpartisan, having been the only politically appointed drug-policy adviser in both a Democratic and Republican administration.

After relocating part-time to Vancouver in 2020, Sabet became keenly interested in Canadian drug policy. I sat with him for an interview at his home in July, where he shared his concerns.

Safer supply programs, which have been widely available in Canada since 2020, claim to reduce overdoses and deaths by providing free, government-supplied drugs as alternatives to potentially tainted illicit substances.

In Canada, that typically means distributing hydromorphone, an opioid as powerful as heroin, to mitigate fentanyl use.

However, as I learned by interviewing more than 25 addiction experts and numerous community stakeholders (i.e. former drug users), these programs are being widely defrauded. Hydromorphone is not powerful enough to get fentanyl users high, so drug users often sell much, if not most, of their safer supply on the black market to purchase harder substances.

This has flooded some communities with diverted hydromorphone, crashing the drug’s street price by 70 to 95 per cent and creating a tide of new addictions, including among youth.

“I worked for a pretty progressive government," Sabet told me.

"We ushered in the end of the term 'war on drugs' and brought in what we call the public health approach to drug policy — huge increases in treatment and recovery services, and early intervention. Mainstreaming addiction treatment into healthcare. Really seeing addiction as the health issue it is.

But we never fathomed, and could never fathom, implementing ‘safer supply.’ ”

In fact, safer supply gives him “nightmares,” he said, because Americans already underwent a similar experiment in recent memory.

“It’s called the prescription opioid crisis of the 2010s, and it didn’t end well," he said. "It ended catastrophically."