By Joanne Csete and Richard Elliott
The dramatic increase in overdose mortality in North America since 2000 and spikes in harmful drug use in other parts of the world in recent decades challenge drug policy-makers to broaden their definition of harm reduction. Ensuring access to a safe supply of drugs for those obtaining adulterated drugs from illegal markets must be an essential element of preventing overdose and reducing the harms of overdose. Safe supply initiatives, including but not limited to the provision of legally regulated medical-grade heroin or hydromorphone in humane and non-stigmatizing ways, are well justified by the state obligations to protect the right to life and the right to health.
Such initiatives go beyond established harm reduction measures that may protect against infectious disease transmission but do not address the problem of toxicity of drugs obtained from unregulated illegal markets. It is argued here that the safe supply obligations of governments with respect to psychotropic drugs are analogous to other state responsibilities in the area of consumer protection and extend to all people using any kind of psychotropic substance. Safe supply measures, as with all health and harm reduction programmes, must be designed, implemented and evaluated with meaningful participation of people who use drugs.
This article was part of a Special Issue in the International Journal of Drug Policy. Read the full Special Issue here.