UPDATE NEW EVIDENCE: SAFER SUPPLY IS LETHAL IN A WORSENING OPIOID CRISIS, ALWAYS HAS BEEN

Predictably, mounting research confirms opioid substitution therapy (OST) originally by medical dispensing of methadone then buprenorphine, now with new opioids and rebranded as “safer supply”, is no less lethal

by Clark Miller

Published June 13, 2025

From a recent (March 21, 2025) research report in the Journal of the American Medical Association- 

But that’s old news, decades old, the findings predictable. 

Deconstructed in detail here, research spun to appear to support benefit from Canadian safer supply programs using dispensed hydromorphone and morphine in fact point to increased harm including increased high-risk opioid use – the problem purported to be moderated. That’s consistent with in-depth investigative reporting on misuse and diversion of those substitute opioids.  

safer supply implementation in a clinic

The unsupported rationale, medical implementation, contraindicating research base, media enabling, and ultimately lethal outcomes of safer supply are no different for the new opioids in Canada than ever were for the safer supply of methadone and buprenorphine,  those substitute opioids  established as fueling the worsening U.S. crisis

A critically important limitation for this study, not addressed in the report – in fact for all studies of substitute opioid provision over past decades – with predictable significant confounding effects is tied to the certainty that individuals being provided medically dispensed “safer supply” opioids in clinical settings (compared to control populations not receiving safer supply opioids) would have been also provided some combination of training, provision, monitoring, and replenishment of opioid overdose reversal medications including especially naloxone (Narcan) as standard of care practice. It would have been negligent and unethical not to so provide those services. 

As established by remarkable, dramatic reductions in opioid deaths tied directly to such provision of reversal agents, it is certain that as a confounding factor, the role of naloxone would have reduced fatal opioid overdose in the “treatment” (safer supply) populations, requiring the conclusion that, in fact, if opioid OD reversal support were factored out, fatal opioid overdoses did otherwise increase in safer supply populations. 

Disputing that conclusion requires provision of evidence that naloxone provision and support was no greater for opioid users regularly accessing safer supply clinical settings and supports than those not (in comparison populations). 

There are no surprises here, instead predictable outcomes from incompetence- and malfeasance-driven practices and policy and medical misinformation usefully hidden by servant media.

woman holding sign reading "Safe Supply or We Die"

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

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