It would be a bad mistake to have naturopaths prescribe ‘safer supplies’

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Naturopathic doctors in British Columbia are lobbying the provincial government for the right to prescribe “safer supply” drugs – free, government-funded alternatives to potentially contaminated illegal drugs. Although no decision has been made yet, it would be a terrible mistake to allow these drugs. This wish.

In November, the BC National Board of Naturopathic Doctors (BCND), a volunteer professional group, called for stronger prescribing powers in a letter to the provincial government. The association also called for naturopathic doctors to be allowed to prescribe evidence-based traditional addiction medicines such as methadone and Suboxone, in addition to a safer supply.

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At the time, Deborah Fair, a naturopathic doctor and the organization’s president, told reporters the government “please let us work with you” on the province’s overdose crisis. Dr Farr argued that allowing naturopathic doctors to prescribe safer supplies would improve access for patients while reducing pressure on other health care providers.

But the problem is not that health care providers are too busy to prescribe safer supplies, or that safer supplies take away other tasks. Rather, the truth is that many physicians do not support a safer supply because they believe it is irresponsible and potentially dangerous.

Proponents of safer supplies publicly claim that their ideology is the mainstream position in the world of addiction medicine, but privately acknowledge that safer supplies are being resisted. ing.

For example, at a conference last April, British Columbia’s Chief Coroner Lisa Lapointe, one of the province’s most influential safe-supply evangelists, warned that safe-supply drugs were resold (or “diverted”) on the black market. ) gave a lecture that recognized the frequent concerns of physicians about being exposed to cancer. And in the end, it falls into the hands of young people.

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“There’s resistance. So they’re concerned about diversion. We hear things like that a lot,” said the chief coroner, who is retiring next month. “It’s no surprise that many prescribers are very sensitive about this. The (British Columbia Association of Physicians and Surgeons) was initially uncooperative, writing letters to people who were prescribing. It was like sending a letter saying, “You’re doing something that hasn’t been done before, we’re watching, we’re watching.” to you. ”

There is growing evidence that Safe Supply customers regularly resell tax-funded medicines on the black market and, predictably, these medicines end up being resold on the black market. That has only heightened the skepticism the state’s medical community feels about a safer supply. It leads to more addictions in the hands of young people.

Safe supply activists have produced materials arguing that black market trafficking of prescription opioids is actually a good thing and should be tolerated, but few doctors accept that argument.

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In September, the BC Ministry of Mental Health and Addictions released data showing an 11 per cent drop in the number of people in British Columbia who were prescribed safer medications between March and July 2023. . Harm reduction activists claim the drop has been caused by “myths and misconceptions” about safer supplies (aka reports on diversion and youth addiction).

The British Columbia government has not released updated data on prescriber uptake, but addiction doctors in the province have told me that doctors are abandoning the program.

“Doctors are not convinced by the evidence supporting a safe supply. As doctors face the downside, they are abandoning the program in droves, and now the program is withering away.” said one prominent doctor who cannot publicly criticize safer supplies without risking his job.

Support for the craters is problematic for harm reduction activists because under current rules, safer supplies cannot truly be scaled up without prescriber buy-in. Although there are many specialized safe supply programs and clinics that serve core populations of addicts, their capacity is limited. Full normalization of safer supplies requires the cooperation of everyday physicians.

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In the absence of this cooperation, safe supply activists are trying to find ways to bypass doctors. For example, last November, Lapointe pressured the British Columbia government to adopt a “non-prescription” or “non-medical” model of safer supply, where addictive drugs could be distributed without a prescription. Ta. Basically, it’s selling pharmaceutical heroin and fentanyl as if it were alcohol. . This proposal was quickly rejected by the government.

Another strategy is to simply open up safer supplies to prescribe to lower-tier medical professionals. For example, registered nurses in British Columbia were given the right to prescribe safer supplies in 2020, even though they don’t have the authority to prescribe most other medicines.

In this context, we see lobbying efforts from the naturopathic community following the trend. With many doctors reluctant to hand out opioids like candy, less regulated specialists with limited prescribing authority are starting to step in.

Of course, the level of evidence for a safer supply speaks volumes that are less convincing to regular physicians but more compelling to naturopathic physicians. But perhaps there is a kind of poetry in all this. Natural remedies are pseudoscience, and Safer Supply is no exception.

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