Study shows safe supply decreases overdoses

Feb 6, 2024

According to the results of a new research study carried out by the B.C. Centre for Disease Control (BCCDC), prescribing medical-grade opioids significantly reduced the numbers of both deaths and overdoses for B.C. residents.  

Specifically, the study, published in the British Medical Journal, showed that individuals who were at risk of death related to illicit opioid use were 61% less likely to die from any cause in the following week if prescribed at least one day’s supply of a pharmaceutical alternative.  Moreover, this study is also the first to examine the safer supply harms reduction strategy at a population level. It examined anonymized data from 5,882 participants diagnosed with either opioid or stimulant use disorder and who had filled a prescription for pharmaceutical-grade opioids as part of B.C.’s safer supply program between March 2020 and August 2021.

It was also found that the protective effect of the safer supply increased with the number of days opioid medications were accessed. Furthermore, individuals who received four or more days of prescription opioids were 9% less likely to die from any cause, and 89% less likely to die from overdose in the following week.

The research was conducted as part of a collaboration between the Centre for Advancing Health Outcomes, the First Nations Health Authority, the BC Centre on Substance Use (BCCSU), the University of Victoria’s Canadian Institute for Substance Use Research, Simon Fraser University, and the University of British Columbia.

“When we think about our response to the overdose crisis and, of course, the large number of deaths that we’ve seen in recent years, that we have an intervention that was implemented that is showing such a protective effect against deaths is really encouraging,” said Dr. Amanda Slaunwhite, a senior scientist with the BCCDC in an interview.

In addition, Dr. Slaunwhite said that in contrast to the results observed for opioids, stimulant outcomes were “pointing in the right direction,” but their dispensations were not significantly associated with decreased deaths and the sample size was not large enough to demonstrate lasting protective effects.

“We saw a profound impact on reduction in somebody’s overdose death risk the week after they picked up these drugs, to a degree that is really surprising and has enormous potential,” said Dr. Paxton Bach, a specialist in addictions medicine at St. Paul’s Hospital in Vancouver in his interview with CBC News. “This paper is the strongest evidence we have so far, by a large margin, supporting the idea that this can be an effective strategy for reducing overdose death risk.”

Dr. Bach also added that the study has not confirmed whether participants are taking prescribed drugs as intended, and this remains a significant criticism of safe supply programs. “That remains a complicated question,” he said. “This study design cannot speak to that specific question. But as far as the potential that this intervention has for saving an individual’s life who is using these medications instead of a toxic and volatile drug supply, this publication is a really compelling testament to the potential of this type of intervention.”

The latest data provided by B.C. Coroners Service Death Review Panel shows that there have been 13,112 deaths in the province due to toxic overdose since a public health emergency was declared in 2016, and approximately 225,000 individuals remain at risk of injury or death.