#143: The Unintended Consequences of Canada’s ‘Safe Supply’ Program with Addiction Expert Dr. Sharon Koivu

In this episode of Hart2Heart, Dr. Mike Hart sits down with addiction specialist from London, Ontario, Dr. Sharon Koivu. Dr. Koivu offers a unique perspective on the origins and consequences of ‘Safe Supply’ initiatives, which were initially introduced to combat the opioid crisis. They discuss the complexities of addiction medicine, the unintended consequences of ‘Safe Supply’ programs, and the urgent need to regain focus on the four pillars to approach addiction: harm reduction, treatment, prevention, and enforcement. 

Guest Bio and Links:

Dr. Sharon Koivu is an Addiction Medicine Consultant for both London Health Sciences Centre and St. Thomas Elgin General Hospital. She has practiced addiction medicine and palliative care in a number of settings over the past 20 years. Dr. Koivu enjoys teaching, has been involved in research projects on infectious complications of injection drug use, and is committed to harm reduction and advocacy for meaningful change.

Resources/ Glossary of Terms:

Safe Supply Program: A harm reduction approach where regulated opioids are prescribed to individuals with substance use disorders to prevent the harms associated with unregulated street drugs.

Hydromorph Contin: A long-acting opioid, previously used as a substitute for OxyContin, known to cause significant complications when injected.

Dilaudid: A brand name for hydromorphone, an opioid used for pain management, now commonly prescribed in Safe Supply programs.

Dr. Sharon Koivu: 'Safe supply' has only worsened the addiction crisis in London, Ont.

Show Notes:

• (0:00) Welcome back to the Hart2Heart Podcast with Dr. Mike Hart   

• (0:15) Dr. Hart introduces guest, Dr. Sharon Koivu to the listeners 

• (1:30) Dr. Koivu gives a brief introduction of herself 

• (4:00) Intro and intention behind the Safe Supply program

• (8:45) Dr. Koivu explains the unexpected rise in severe infections due to Safe Supply

• (12:30) The link between opioid diversion from Safe Supply and organized crime

• (15:00) The data speaks - increasing opioid use

• (21:00) Police data of how many dilaudid have been seized off the streets 

• (27:30) Safe Supply's impact on the youth and the rise of fentanyl use

• (31:00) Psychological and social effects of opioid addiction on youth

• (35:30) The challenges faced by healthcare providers in managing patients on Safe Supply

• (41:00) “So, essentially, dilaudid or D8s, they are more or less like a gateway drug to fentanyl.”

• (43:00) Opioid use and effects on the developing brain 

• (48:00) Four Pillars to help with addiction

• (51:00) CPSO does not monitor Safe Supply prescribers 

• (56:30) Supervised injection sites and consumption sites  

• (1:03:00) 2023 Paper of The SOS Program

• (1:11:00) The need for comprehensive addiction treatment

• (1:15:30) Closing thoughts

---

Dr. Mike Hart is a Cannabis Physician and Lifestyle Strategist. In April 2014, Dr. Hart became the first physician in London, Ontario to open a cannabis clinic. While Dr. Hart continues to treat patients at his clinic, his primary focus has shifted to correcting the medical cannabis educational gap that exists in the medical community. 

Connect on social with Dr. Mike Hart:

Social Links:

• Instagram: @drmikehart

• Twitter: @drmikehart

• Facebook: @drmikehart