Ottawa outreach worker estimates that up 90 per cent of local addicts are 'diverting' their government-supplied drugs to the black market
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David McEvoy was a heroin addict for 30 years before he got sober in the early 2010s. He stayed away from Ottawa’s drug scene after that and was largely ignorant of its dynamics until three years ago, when he began working as an addiction outreach worker specializing in overdose prevention and education.
McEvoy says that upon re-engaging with local drug users, he quickly noticed that an overwhelming majority of safer supply clients were diverting their taxpayer-funded drugs to the black market. These clients would receive what he described as “insane” amounts of hydromorphone, an opioid as potent as heroin, which they would then immediately trade or sell to acquire illicit street fentanyl, he said.
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“You can stand in front of just about any of these pharmacies that are involved in this — usually close to the safer supply prescribing office — and you can sit outside for five minutes and watch all kinds of transactions going down,” he told me. “I’ve seen this first hand in front of one of the pharmacies near where I work. I’ve watched exchanges. Like when someone’s walked out of their pharmacy with their prescription at 9:30 in the morning and sold their whole prescription to some guy for cash.”
Based on what he has witnessed and heard through his community work, McEvoy estimates that roughly 90 per cent of safer supply clients in Ottawa divert most or all of their hydromorphone. He says they are often “quite open” about their practices and that these clients, who often mistake him for an active drug user, routinely try to sell their safer supply to him, too. “I get offered those Dilaudids (the brand name for hydromorphone) daily, OK — so I know that’s where they’re coming from.”
Many harm reduction advocates, including federal Minister of Mental Health and Addictions Ya’ara Saks, claim that safer supply diversion is not a widespread problem — but McEvoy dismisses these people as out of touch.
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“When I hear someone say there’s no diversion, I want to say, ‘Come with me for one night — come with me for one night and then you figure this thing out. Or spend an hour in front of the pharmacy at 9 o’clock in the morning and you tell me there’s no diversion,” he said. “You can’t be there and look at the problem with these people and say there’s no diversion. You just can’t.”
McEvoy is similarly dismissive of the narrative, popular among some activists, that safer supply diversion is a form of “mutual aid” or “compassionate sharing.” Based on his experiences, most people sell their hydromorphone tablets to drug traffickers who go on to resell them at higher prices. He says this market is so established that many clients pre-sell their safer supply before they even acquire it.
According to McEvoy, rampant diversion has caused a dramatic collapse in the street price of hydromorphone, with sometimes fatal consequences.
Pharmaceutical opioids have always been diverted, to some extent, so hydromorphone has been available for purchase on the black market for decades. However, McEvoy says that when he was a heroin user in the 1990s and 2000s, four-mg tablets of hydromorphone were a rare commodity and had a “very steady” price of $25 (adjusting for inflation, that equals to $35-$50 today). As they were so expensive, he and his friends would use them only when there was no heroin available.
But eight-mg tablets, which are the typical dose distributed through safer supply, now sell for approximately $2 each in Ottawa, he said. His price estimate is corroborated by his addiction physician, Dr. Lisa Bromley, who is kept apprised of front-line realities by the over 100 current and former drug users she treats in the city. Upon adjusting for differences in dose size, this equates to a 97-98 per cent reduction in price from 20 years ago. He notes that this phenomenon has been limited to hydromorphone, and that the prices of other pharmaceutical opioids have remained relatively stable.
Based on what McEvoy has witnessed as a grassroots outreach worker, he believes that the low price of hydromorphone is hooking new people on opioids and making it easier for them to escalate their use, which is creating more fentanyl users. He also believes that diverted safer supply is dissuading people from seeking treatment — why get clean when pharmaceutical opioids are so cheap and readily available?
“It’s just … it’s created more addicts,” he said. “I mean, these people paid more for cigarettes. It was crazy.”
He shared the story of two friends who, despite being wary of narcotics, developed severe opioid addictions due to diverted hydromorphone.
The first friend started using eight-mg tablets to treat his chronic pain, as he was unfamiliar with the drug and believed it was no stronger than Tylenol-3. He quickly spiralled into severe addiction and subsequently died. While hydromorphone likely did not directly kill him, it clearly initiated his addiction and self-destruction. Similarly, the second friend believed that hydromorphone couldn’t possibly be that strong due to how cheap it was — but then he, too, got hooked and destabilized.
McEvoy is perplexed by the fact that safer supply programs distribute as many as 30 hydromorphone tablets a day to a single individual, while just two or three of these tablets was enough to satisfy him when he was an addict.
The outreach worker said that safer supply activists are “well intentioned” but “unfortunately, they made an error” in providing addicts with an overabundance of free drugs and not supervising their consumption, which has led to unintended consequences. “While I may not have the answers, I quite recognize something that’s making the problem worse.”
I offer McEvoy’s testimony to anyone who still wishes to pretend that these programs “save lives” and are not, in fact, being widely defrauded and quite possibly fuelling overdoses and deaths.
National Post
Adam Zivo is Executive Director of the Centre For Responsible Drug Policy.
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