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.

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.
