Safer supply pilot project will study viability for small cities and rural communities

A photo of white pills in a bottle.
Originally published:

Yesterday morning, the Peterborough 360 Degree Nurse Practitioner-Led Clinic announced a new safer opioid supply research and pilot project for Peterborough. Safer supply programs provide pharmaceutical opioids to drug users as a replacement for risky street-acquired opioids.

The clinic is researching the potential for safer supply programs in small urban and rural environments like Peterborough.

According to a media release, the program began in April. In its first year, the project will bring together “prescribers, pharmacists, addictions treatment providers, harm reduction professionals and people who use drugs to work with us to develop a model of safer supply that can work for Peterborough.”

The second year of the program will be the execution of a small-scale pilot program for 10 patients to receive safer supply services. Researchers will evaluate the results over a 8-10 month period. 

During yesterday’s press conference, executive director of the 360 Clinic Suzanne Galloway noted that the intention is to start the project small and determine whether there is capacity to scale it up after the pilot period ends. 

Local politicians, staff from the Peterborough 360 Degree Nurse Practitioner-Led Clinic and Trent University answer questions from the media during a press conference held over Zoom on Monday May 17, 2021.

Safe supply is a treatment and harm reduction strategy that helps those seeking support for substance use disorders and addiction. These programs provide patients pharmaceutical opiates prescribed by medical professionals so that patients can use drugs without fear of a poisoned or toxic supply.

Over the past year, the Peterborough public health unit has issued numerous warnings about drug poisonings and increasing signs of toxic substances in drugs sold on the street. In the first four months of 2021, the health unit reports that there have been 20 suspected opioid-related deaths. 

In their warning of suspected poisonings in Peterborough from May 3, the public health notice read, “street drugs may be cut or mixed with toxic substances. Beware that even a small amount of drug can cause a fatal poisoning.”

The illicit drug supply has been identified as a main driver for opioid overdoses in Canada, and safe supply programs pose a solution that prevents overdoses and deaths. It’s also a solution that comes from within the community: “People who use drugs have been calling for safe and regulated drugs for decades,” writes researcher Magnus Nowell.

A legal and regulated supply of opioids lowers the risk of unknowingly consuming dangerous substances.

Nowell notes that services like consumption and treatment sites, overdose prevention sites, and naloxone distribution programs reduce the number of overdose deaths, but don’t necessarily reduce the number of overdoses that occur. He writes that providing a legal and regulated supply of opioids stands to reduce the number of overdoses overall.

Project coordinator Nancy Henderson also sees it as an alternative to current treatment models, like opioid agonist therapy, which involves taking long-acting opioid medication (e.g. methadone) that prevents withdrawal symptoms and cravings. “Opioid agonist therapy works really well for the people whose goal is to abstain from drugs,” says Henderson. “But the safer supply program is another option for those who are not retained on the agonist program.”

Safer supply programs differ from agonist models in that physicians and/or nurse practitioners provide pharmaceutical opioids to patients to replace the drugs acquired from the street. The thinking behind safer supply is to provide another option for people who use drugs other than abstinence from substances.

It’s a strategy that executive director of the 360 clinic Suzanne Galloway says will meet people where they are at. “Part of meeting people where they are at is helping them with their current goals,” she says. “An individual’s goal might not be to reduce their drug use, so [our role] will be working with that individual and assessing what prescribing makes sense.”

Galloway hopes that this approach will allow the clinic to make connections with clients in a new and positive manner that more effectively contributes to the individual’s overall health.

Galloway points to previously completed safer supply pilot programs in Toronto, London, and Ottawa that have shown positive results for patients and the community, including reduced rates of overdoses and overdose deaths, reduction in intravenous drug use, reduction in health care costs and more. She says this program will fill a gap in the research on how a safer supply program can be offered in small urban and rural settings.

The project is receiving $200,000 in funding from the Government of Canada’s Substance Use and Addictions Program to run over 27 months, ending in June 2023. The release also notes that the cost of medication for participants in the pilot program will be covered by a provincial drug plan.

Galloway says the program is starting with 10 participants so that the clinic can keep providing these services to those selected individuals after the funding ends. [end]