“Safer supply” alternatives to toxic unregulated drug markets
BMJ 2024; 384 doi: https://doi.org/10.1136/bmj.q6 (Published 11 January 2024) Cite this as: BMJ 2024;384:q6Linked Research
Effect of Risk Mitigation Guidance opioid and stimulant dispensations on mortality and acute care visits
- Adam Holland, clinical research training fellow1,
- Thomas D Brothers, resident physician*2,
- Dan Lewer, consultant in public health*3,
- Olivia M Maynard, senior lecturer in psychological science*4,
- Mat Southwell, project executive*5
- 1University of Bristol, Oakfield Grove, Clifton, Bristol BS8 2BN, UK
- 2Division of General Internal Medicine, Department of Medicine, Dalhousie University, Halifax, NS, Canada
- 3Bradford Institute for Health Research, Bradford Institute for Health Research Temple Bank House, Bradford Royal Infirmary, Bradford, UK
- 4University of Bristol, School of Psychological Science, Clifton, Bristol, UK
- 5European Network of People who Use Drugs
- *These authors contributed equally and are listed in alphabetical order
- Correspondence to: A Holland adam.holland{at}bristol.ac.uk
In Canada, an average of 22 people died from opioid toxicity each day in the first six months of 2023, with 84% of these deaths involving unregulated fentanyl.1 In response to this crisis of drug related deaths, people who use drugs have advocated for models of “safer supply.” These interventions range from the testing and distribution of drugs by activists to the prescription of pharmaceuticals by clinicians and the legal regulation of drug manufacture and supply.2
In a linked paper (doi:10.1136/bmj-2023-076336), Slaunwhite and colleagues evaluated the effects of a prescribed safer supply intervention in British Columbia that was introduced in response to the dual public health emergencies of toxic drug deaths and covid-19.3 Safer supply became particularly important during the pandemic as border closures worsened the volatility of drug supply and the risks of withdrawal and overdose were exacerbated during isolation and quarantine.4 The provincial government issued “Risk Mitigation Guidance,” which allowed clinicians to prescribe opioids and stimulants to people at risk of overdose, withdrawal, or other drug related harms.5
Safer supply is controversial among some physicians and researchers, who have raised …
Log in
Log in using your username and password
Log in through your institution
Subscribe from £173 *
Subscribe and get access to all BMJ articles, and much more.
* For online subscription
Access this article for 1 day for:
£38 / $45 / €42 (excludes VAT)
You can download a PDF version for your personal record.