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In an effort to defend Canadas disastrous safer supply drug strategy, Associate Health Minister Carolyn Bennett, who is responsible for the program, has cited a new study, which suggests that safer supply actually works. However, the research referenced by the minister is, according to experts, of low-quality. No responsible politician should use it to guide high-stakes addiction policy.

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The MySafe program is a safer supply initiative that has used vending machines to dispense opioids since 2020. The evaluation argues that the machines have been a qualified success and that, while nearly every study participant continued using illicit drugs, they used less, experienced fewer overdoses, were more financially secure and reported improved health.

That sounds great, except theres a catch: these findings are so flimsy that its difficult to draw any firm conclusions from them.

The MySafe evaluation is a qualitative study, meaning that, rather than crunching hard data, it relies on semi-structured interviews with 46 individuals who had used MySafe for at least one month. These interviews were gathered in late 2021 and early 2022, and then interpreted and summarized by the studys authors.

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While qualitative studies may be acceptable in other fields, using them to guide policy and practice is unthinkable in most health care settings, especially when peoples lives are at stake.

Dr. Sharon Koivu, an addiction physician with the London Health Sciences Centre (LHSC), says that qualitative research is unreliable because it is vulnerable to being manipulated by researchers, who can control the results that are generated using this method.

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Safer supply programs involve the use of a potent opioid which has significant risks and dangers. They require studies consistent with the higher standards of pharmaceutical research, said Dr. Koivu, who believes that higher quality evidence, such as randomized control trials, should be used to investigate safer supply.

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According to both doctors, the study failed to address the fact that those interviewed for the study had extremely strong financial incentives to prolong their access to safer supply opioids, which are often sold on the black market for profit.

There is no way to evaluate the accuracy or truthfulness of participants responses, said Dr. Somers.

Dr. Koivu said that, throughout her long career of studying drug-related infections, she has found that patients lie to researchers out of fear of losing access to their preferred drugs.

When asked about how the CMAJ study compares to other research that supports safer supply, Dr. Koivu said, Essentially all studies on safer supply are qualitative. They rely heavily or exclusively on self-reporting. There is no attempt to ensure the authenticity of the reporting.

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Yet the CMAJ study is more concerning than most, because not only does it rely on weak and unreliable qualitative data, its very design is inadequate.

Similarly, Dr. Somers said that the studys interview questions seemed to avoid broaching topics which could reflect poorly on safer supply for example, the study included no questions exploring the well-documented problem of pimps, abusive spouses and drug dealers confiscating opioids from vulnerable safer supply recipients.

Both doctors noted that the study made no attempt to compare safer supply with other evidence-based addiction interventions.

Due to privacy concerns, the transcripts from the interviews gathered for the MySafe evaluation are not available to the public only a small number of excerpts have been shared in the final report, making it impossible to properly evaluate the study.

National Post

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Adam Zivo: Liberals rely on poor quality research to defend safer supply - National Post