In order to protect the public and ensure that safe supply programs are reaching the intended target and being used for their intended purpose, certain guidelines and boundaries must be implemented and enforced.
Safe Supply Program Eligibility
In order to participate in safe supply programs, individuals must meet certain criteria:
- Those with a history of ongoing active substance use (opioids, stimulants, alcohol, benzodiazepines, or tobacco)
- Those deemed at high risk of withdrawal, overdose, craving, or other harms related to drug use
- Youth under the age of nineteen may be eligible if there is informed consent by the patient to receive this intervention and additional education and efforts are provided to the individual.
- Pregnant individuals
The eligibility of the candidate must be assessed based on:
- Their active substance use including the type of substance they use as well as the quantity and frequency of use
- Their history of substance use
- Any history of overdose
- Presence of any mental conditions
- Presence of any physical conditions
- Prescribed medications
- Current access to a prescriber i.e. someone who can help deliver the safely supplied substances
Who Is Responsible For Determining Safe Supply Eligibility?
The process in determining what makes an individual eligible to participate in safe supply programs is multi-faceted. On a federal level, the federal Controlled Drugs and Substances Act works to oversee the sale, production and distribution of drugs in Canada.
From there, the provincial government plays a significant role in the accessibility and prevalence of safe supply programs in their jurisdiction by creating guidelines for medical professionals to follow within the region. For example, in British Columbia the provincial government implemented new guidelines regarding safe supply prescribing and access in light of the COVID-19 pandemic. These new guidelines were intended to open up access to safer substances to clients who may be at high risk of overdose. Policy makers within the government must identify the individuals most at risk and provide them with access to safe supply interventions. Once these higher risk individuals are accounted for it is important to then alter these programs or implement new ones which will also suit the needs of clients who are more difficult to identify and who have a broad variety of needs.
Another sector of the government which contributes to providing data and statistics to help inform such policy makers of common trends in safe supply and the people who use it is the research community. These researchers are able to look at current programs and determine what is working and what needs to be improved to better aid people in the community.
As of right now there are few fully established models for safe supply. Many places are currently working to determine the most effective procedures to ensure the safety and wellbeing of their community members. Currently, when it comes down to the individual level, the eligibility of a client is determined by a medical professional or health care worker who is able to assess the patients’ needs and status and determine if they should be eligible for safe supply. The determination of a client’s eligibility often involves the interaction and diagnosis process of a client with a healthcare professional. The professional is able to characterize the client’s substance use patterns and identify what kind of drug user they are and what type of safe supply would be best suited to that individual. If determined eligible, the medical professional may write a prescription for the client in order for them to receive a specific regulated substance at a certain dose specific to the needs of the individual.
One significant Canadian organization whose objective is to increase access and supply to legal and regulated substances is the Canadian Association for Safe Supply. This organization works with a combination of health authorities, governments, people with lived experience and research institutions. They work together to provide more tailored and effective programs for a multitude individuals to have access to regulated drugs in an attempt to limit the risk of overdose and negative implications of unregulated substances
“Safe supply advocates want a low bar for qualification because the higher the hurdle to access the more likely it is the drugs would remain out of reach of the people who need it most.”
– Jason Proctor, CBC News 2020
There are some arguments that the eligibility criteria should to be lowered in that even people who are not daily or habitual users can still overdose and die from illicit drug use. Thus, safe supply should be readily available to a multitude of people with a wide spectrum of needs.
Canadian Association for Safe Supply. (2019). About. Retrieved from https://www.safesupply.ca/
Canadian Association of People who Use Drugs. (2019). Safe Supply Concept Document. Retrieved from https://vancouver.ca/files/cov/capud-safe-supply-concept-document.pdf
British Columbia Centre on Substance Use. (2020). Risk Mitigation; In The Context Of Dual Public Health Emergencies. Retrieved from https://www.bccsu.ca/wp-content/uploads/2020/04/Risk-Mitigation-in-the-Context-of-Dual-Public-Health-Emergencies-v1.5.pdf
Ivsins, A., Boyd, J., Beletsky, L. and McNeil, R.(2020). Tackling the overdose crisis: The role of safe supply. Int J Drug Policy, 80 ,102769. https://doi.org/10.1016/j.drugpo.2020.102769
Proctor,J.(2019). What is ‘safe supply’ of drugs and how would it work? CBC News. Retrieved from https://www.cbc.ca/news/canada/british-columbia/safe-supply-drugs-opioid-1.5281539