I don't know if we can say that B.C.'s a failure, at least not yet.
We've heard so much talk about evidence today. I think it was Mr. Weiss who said something about there being no evidence.
Rather than going into evidence for exactly what, I did want to look at one of the pieces of evidence that Gord Johns cited. The Globe and Mail talked about it. It was the BMJ article that came out in January, which certainly seemed, at least in looking at it initially, to provide pretty good support for the idea that safe supply seems to work.
The study found that safe supply “dispensations of one day or more were associated with reduced all cause mortality”—I won't give you the numbers—“and overdose related mortality”. Furthermore, if a supply was dispensed more than four times, there was an even further decrease in mortality.
However, that's not a randomized control trial. That's a cohort study, so I started thinking about it and looking at who their cohort was. They're comparing this group of people who get safe supply with another group of people who don't get safe supply and they're saying that those with safe supply are less likely to die from overdose or die overall.
When you make up that study, for that cohort that is not getting it, where do you get those people's names from? I looked it up. One of the sources was the DAD, the discharge abstract database. These are people who are being discharged from the hospital with a diagnosis. They'd been admitted because of an overdose. They've done it before. They've done it to a degree that they've actually had to be hospitalized for it.
Perhaps this is a sicker group—a group that's more likely to overdose beforehand. When you're comparing the two groups, of course those who have a higher risk are going to show up in the study as having died more often, either from overdose or everything else.
In addition, I looked at their study limitations. One of the limitations was, they said, that perhaps some of the people they put in the safe supply category were actually getting narcotics because they had cancer or something else, which really puzzled me. How could you leave that?
I'm not sure how good these data are about the benefits. It also doesn't calculate any costs due to diversion on the street.
What other evidence is there? I looked at the CMAJ article out of London. That seemed to be looking more at decreased infections with safe supply, which is a different issue.
Last of all, the BMJ study came to the rather interesting conclusion that safe supply dispensation “did not significantly modify the odds of all cause or overdose related acute care visits.” People who got the safe supply were just as likely to have to go to the emergency room or something with an overdose, but they didn't die. Maybe that's because they were on narcotics. As a lot of people know, if you don't take narcotics, you lose the tolerance for it. Those who get safe supply are on it all the time. They're tolerant. If they overdose, they're less likely to die.
I wanted to ask you all about the evidence from the BMJ study. How good is it?
I want to put this in in case I get cut off because I run out of time. Could you please provide this panel with what evidence there is in terms of the scientific research about safety and benefits?