How to innovate in an emergency: legal and policy measures to scale up safe supply at supervised consumption services
There has been a growing willingness among federal policymakers to adapt legal frameworks, using existing flexibilities, to reduce barriers to health and harm reduction services for people who use drugs, prompted by the ongoing drug poisoning crisis and more recently the COVID-19 pandemic.
The experience of recent years has demonstrated that evidence-based, human rights–based analyses, combined with community capacity-building, mobilization, and knowledge translation engaging program and policy decision-makers can lead to important legal/policy shifts — creating a more enabling environment to protect the health of people who use drugs.
Safe supply is increasingly considered to be a key harm reduction intervention, including proposals to look beyond strictly medicalized models. In the context of an unprecedented drug poisoning crisis, it is imperative that novel and innovative approaches are explored to address the scalability of safe supply, as a matter of life and death. To meet the diverse needs of people who use drugs, it is also pragmatic and ethically imperative that innovative approaches are adopted to scale up access to safe supply beyond the existing medical model, including within SCS. Although safe supply at SCS is not without its limitations, including with respect to the absence of SCS in many communities and the lack of 24/7 access where they do exist, they are one viable option among the range of services that are desperately needed.
As described above, courts in Canada have repeatedly affirmed the right of people who use drugs to access harm reduction and other health services, and governments have a legal and ethical obligation to ensure access to safe supply and to SCS as a necessary component of the rights to life and to health, among other human rights. While policy and legislative reform requires time, all levels of government also have broad emergency powers allowing them to act swiftly — and to compel other entities to take action. As this report confirms, a diversity of tools is available for law and policy makers to eliminate barriers to safe supply at SCS and begin to fully realize a continuum of options that are accessible and honour the autonomy and human rights of people who use drugs. What we need now is political will.