The ‘Safe Supply’ Movement Aims to End Drug Overdose Deaths

OOn a Zoom phone call in the morning, several mothers from Canada give all their attention to a young man representing Drug User Liberation Front. Jeremy Kalicum was 26 years old, and that is what their children would have been if they hadn’t died from accidental overdoses.

Kalicum’s tone is urgent as he walks the moms through a PowerPoint presentation explaining why the Liberation Front, known as DULF, wants to protest on International Overdose Awareness Day and hand out illicit drugs. These wouldn’t be the kind that killed their sons and daughters, he assures them; they’d be “safe supply” drugs that have been tested to ensure they’re not laced with lethal fentanyl. “Anyone who wants to find drugs can find drugs,” says Kalicum, reasoning that the best way to save lives is to make sure users are given the safest possible drugs. “The drugs that they’re finding are of unknown quality and unknown potency.”

After 15 minutes of stats and slides, Kalicum, DULF founder Eris Nyx, makes their pitch. They want the mothers from Moms Stop the Harm to come join them and the other activists on their distribution mission. This is a risky and potentially dangerous protest which could land them in prison.

It’s a tough sell, but it’s critical to saving lives, say Kalicum and supporters of the “safe supply” effort.

“I’m not a criminal, and obviously, Moms Stop the Harm aren’t criminals,” Kalicum says. “We’re just sick of it. We’re sick of our friends dying.”

Everybody on the line can relate. Every person on the call has suffered from the effects of the opioid crisis. This epidemic has been a major problem in North America, and Canada in particular. Deaths in the United States rose by nearly 30% to 93,000, a new record. Canada’s death rate increased 89% in the past year.

Behind the numbers lies a cruel irony that every parent listening to Kalicum understands, and that drives the “safe supply” movement: Opioids were perfectly legal when their children were becoming addicted to them, promoted by pharmaceutical giants and doled out by physicians who enabled the crisis by accepting drug companies’ claims they were safe.

Realizing the facts and finding prescriptions difficult to find was too late. Untold thousands of pain-addled patients had become hooked on what opioids provided, as had many young people who’d begun experimenting with the pills recreationally. The streets provided them with heroin and they died from heroin-laced or completely replaced heroin.

An Infected Arc

This is the Opioid Crisis’s arc: from patient to criminal, to more frequently, to early death.

The “safe supply” movement seeks to counter this deadly progression by ensuring the integrity of the dosages that users have been conditioned to crave while providing care that keeps them alive and could wean them off drugs. “It’s not who we are to stand passively by,” says Kalicum. “We’re gonna do something, and we’re willing to take on personal risks to do that. But we can look at ourselves in the mirror and know that we’re doing what’s right.”

Even in Vancouver, a city with a progressive history on the issue of drugs, “doing what’s right” means butting up against an opposing force that still views drugs as a moral failing rather than a medical problem, and that opposes safe distributions. Slowly though, DULF, VANDU and Vancouver Area Network of Drug Users (VANDU) are drawing attention and winning support via a video conference. Kalicum heard at least two moms who offered to help distribute drugs to overdose victims on Aug. 31 despite the possibility of being arrested.

“If we lose some members, that’s okay,” says Leslie McBain, a founding member of Moms Stop The Harm. In 2014, her son was killed as opioid manufacturer Purdue Pharma began to face more lawsuits. Many were unaware of the risks associated with opioids and were still unaware. “He had an injury on a construction site when he was 23, and the doctor just prescribed loads and loads of oxycodone,” she says of her son. “And that was his demise.”

Continue reading: The Worst Opioid Addiction Crisis U.S. History

In the past six years, McBain’s organization has grown to nearly 3,000 members across Canada. Their goal, she says, is to lessen the stigma of addiction and advocate for changes in drug policy in a way that “actually supports the lives of people who use drugs rather than punishes them.”

In 2003, North America’s first sanctioned, supervised safe injection site, Insite, opened in Vancouver after receiving a federal exemption to protect it from the country’s drug laws. Canada currently has 37 sites like this, and there have been no overdose deaths in these supervising locations.

There have been several attempts to create safe injection points in cities across the U.S. that house large numbers of drug addicts, such as New York City, Seattle, San Francisco and San Francisco. But none of them has succeeded legally. Organizations that help most drug addicts are frequently operating without federal and local support.

Kalicum/Nyx have spent many years at the forefront of the drug war. And as the pandemic’s effect on drug use has become clearer, with fentanyl showing up not just in heroin now but in cocaine and methamphetamine, the pair have become bolder in their efforts. They staged their first protest demanding a “safe supply” of drugs in 2020. In April 2021, they distributed “safe” heroin they tested for the first time in downtown Vancouver. They distributed the drugs three months later in front of headquarters police department.

‘Maybe this is a good idea’

“History has shown that moving these initiatives forward often takes some form of civil disobedience from community groups,” says Kalicum. Along with the needle exchanges, illegally set up overdose prevention stations were first established. “It took people giving needles out themselves before the government thought maybe this is a good idea,” he says.

This duo is an example of contrasts. Nyx (30), a transwoman covered in tattoos and witty is Nyx. Kalicum, however, is straighter, more serious, and subdued. “I look like a criminal,” jokes Nyx. “Jeremy looks like he could be your best friend’s son.”

Both bring with them a long history of drug abuse to their activism. Nyx was born in the Toronto suburbs. The organizing director of the Tenant Overdose Response Organizers and executive director of the Coalition of Peers Dismantling the Drug War; she says she’s used drugs since the age of 12 or 13, is estranged from her family for being queer and trans, and in turn experienced housing instability.

In 2019, after being laid off from the British Columbia Center for Disease Control, Nyx was hired to organize a conference on “safe supply.” She and Kalicum met in person for the first time at that conference after weeks of planning calls, bonded over their shared mission, and created DULF.

Kalicum was raised by a single mother on disability in the port city of Nanaimo, where he says his family was in “great need,” and he fell into drugs and petty crime at a young age. Eventually, a local charity put him through school in a suburb of Chicago until he moved back to Canada to complete his bachelor’s degree in chemistry and biology.

Continue reading: The Community in Crisis

His experience with that charity helped steer Kalicum into his current activism, which includes buying drugs on the dark web and testing them for evidence of fentanyl before they’re distributed as part of the “safe supply” movement. “That organization met people where they’re at and worked to improve their lives without any expectation of return,” he says. “And that’s what I strive to put forward into the world.”

Much of DULF’s work focuses on “harm reduction,” which historically involves providing clean needles to prevent the spread of infection and disease, along with antiseptics, condoms, and anything else that might help safeguard drug users. It’s been shown to improve health outcomes that often lead to recovery. Studies in Vancouver over a long period have demonstrated that people who use drugs are more likely than others to be admitted into a detox program. This can also save money for taxpayers.

In the early ‘90s, when Switzerland was dealing with a growing heroin epidemic, it began making methadone available. To curb the overdoses, HIV infections and general drug abuse, it created a prescription program to prescribe heroin for certain users. These programs have increased the number of heroin users, as well as overdose deaths and HIV rates. The United Kingdom, Canada, Denmark and Germany have also started similar programs.

Kalicum’s return to Nainaimo in 2016 coincided with the declaration of the opioid crisis as a public health emergency. After being shocked at the sheer number of fatalities in his city, Kalicum contacted a local councilor who advocated for safe drug consumption. Kalicum worked to set one up in Nanaimo, on Vancouver Island, and remembers, “that’s when I learned the value of direct action.”

In 2019, after moving to Vancouver, he joined the BC-Yukon Association of Drug War SurvivorsThe agency, which advocates for drug users, was founded under Ann Livingston’s mentorship. She is considered to be a leader in harm reduction. Kalicum began to see it as his “moral imperative” to work around the legal system to save lives. Around that time, he also learned of “compassion clubs,” first used by terminally ill people to access cannabis for pain before it was legal. They provide safe access to drugs as well as a place where drug addicts can monitor one another and share their experiences.

Kalicum was shaken by his arrival in Vancouver at a time when drug deaths were on the rise. “Before I came to Vancouver, I’d never seen a dead body before,” he says. “And that summer, I’d seen several.” Currently almost six people die each day in British Columbia, according to the B.C. Coroners Service. Nyx states that she can respond to at most one overdose every week. “That f–ks a person up and creates an incredible amount of PTSD,” she says.

Nyx and Kalicum know that they can’t wipe out drug use, but neither do they see that as something that should be done. “The thing about drugs is most people use them at least at some point,” Nyx says, citing coffee, cigarettes, alcohol, marijuana and prescription meds. Most people, she notes, use these substances and are not out of control or in what is often called “chaotic” use. “I don’t want to die. I’m a perfectly functional member of society, and most people who use drugs are,” she says.

Continue reading: An Opioids-related Mother’s Painful Loss

Nyx believes that it would make sense to focus on those who are self-destructive and out of control than to restrict the supply. Nyx also argues for ensuring the safety of all drug users.

This is an example of how alcohol prohibition can be used as a teaching tool. Although the Prohibition Era was only in effect from 1920 to 23, it is instructive that drinking became a crime underground, and took place in basements and speakeasies. The alcohol was mixed in bathtubs or buckets. There were no labeled bottles. It was extremely dangerous for people to not know what proof they were drinking.

Today’s illegal drug markets operate in the same way. No one has any idea what they’re buying on the street in unmarked bags. “Regulation will save people’s lives,” Nyx says.

With that in mind, DULF has set out to do with street drugs what’s now common for alcohol and cigarette manufacturers: test ingredients and put clear labels on everything. The “DULF Fulfillment Center and Compassion Club model” acts as a market and consumer protection agency where street drugs are tested and distributed in packaging that states the drugs’ contents.

Nyx designs labels and they work together to promote the cause and raise money to purchase illegal drugs. Then, the drug-users are tested and distributed at demonstrations to those who have already used them. “The free drugs go to the people in the most need,” says Nyx.

The Dark Web

Kalicum describes how the dark internet allows you to buy drugs. It is almost identical to purchasing anything else. “There are sites which are kind of analogous to eBay,” he says, where people can buy, and people can leave reviews for vendors.

“These sites will hold your money in escrow until you get your product. Once you receive it, it is your responsibility to test it. You can either release the funds or create a dispute,” he says. If there is a dispute, the site will appoint a mediator to resolve the matter.

After a dispute, DULF received fentanyl in place of heroin. They were refunded thousands of money. DULF’s main criticism is that there remain unknowns. One example: A criminal organization might sell fentanyl. Kalicum believes that the state of current drug legislation leaves no other option for quality control professionals. “It’s not what we want to do,” says Kalicum, “but we’re forced to leverage the resources that we have access to, and that’s the dark web.”

Monero is a secret cryptocurrency used to pay for drugs. It claims it can’t be traced.

Kalicum became a British Columbia Center on Substance Use’s first technician to start testing street drugs. The technology uses infrared light to tell him what’s in a substance and in what quantity. He hopes to eventually be able mass spectrometry which displays more detail.

Nyx maintains records of all drugs distributed. Every person who receives a dose of drugs is required to complete a simple questionnaire. These questions include: Did you take the drug yourself? Was the user overdosed? How do you rate the drug on a scale from 1-5? Nyx claims that so far none of those filling out the forms has taken overdose. In this early phase, they don’t think that data can be leveraged in any official capacity, but Kalicum says, “it might act as a kind of carrot for researchers to do something substantial.”

Kalicum wants heroin and other drugs to be provided by government agencies or licensed suppliers, just like methadone. This would make it more affordable than illegal markets. “You’d be taking money out of the hands of organized crime,” says Kalicum. “People can get their drugs there, use them, and it acts as a portal to health and social services.”

Vancouver presented its alternative solution to drug problems in May 2021. The Vancouver Model would allow for the decriminalization of simple possession up to a specified amount. This model recognizes the issue of substance misuse and the overdose crisis not as a criminal justice problem. Even so, DULF and many activists feel the proposal fails to address the sourcing of toxic drugs as the main cause of fatalities and that the amounts individuals would be permitted to possess don’t conform to actual patterns of substance use.

Vancouver’s Police Inspector, Phil Heard, who took a leading role in proposing the plan, acknowledges the criticism but says it’s up to scientists, not cops, to study its impacts, assuming the idea is implemented.

DULF has been working hard in the interim to obtain permission for its own plan to be implemented. In August, it submitted a 19-page letter to Canadian health officials asking for an exemption to practice its “safe supply” model. “We are saying this is a health emergency,” says Kalicum. DULF isn’t alone in what some consider radical approaches to the drug issue. Patty Hajdu (Canadian Health Minister) raised the possibility of injectable heroin.

Progress signs

Nyx Kalicum and Inspector Heard presented the model to Staff Sergeant Jason Chan in August. The protest on Aug. 31, marking International Overdose Awareness Day, went without a hitch. None of the mothers who participated were arrested. DULF has also received a “letter of support” for its testing and safe supply plan from Vancouver Coastal Health, a regional health authority with a budget of more than $3 billion dollars. A number of Canadian policy experts signed up, some from Canada, and many others from B.C. Centre on Substance Use, and the Canadian Drug Policy Coalition.

And on Oct. 7, the Vancouver City Council voted to support DULF’s plan, though it only passed after an amendment to ensure that drugs would be purchased through legal means. This would mean activist groups need to collaborate with Fair Price Pharma in order to source, package, and test legal drugs, before dispensing them directly to compassion club members.

Nyx and Kalicum spoke at the meeting, urging officials to take action quickly. Next, determine the exact location of drugs. “What we’re saying is a temporary stopgap. But stop the deaths first, then figure everything out after,” Nyx said.

Every witness to this overdose epidemic is convinced that the situation will only get worse. Heard, the police inspector says 2020 was a “record year,” but “2021, it’s looking to be even more deadly.” Sure enough, the day after the City Council hearing, Nyx witnessed yet another drug death, this time of an 18-year-old.

Even with increasing support she and Kalicum feel exhausted. They’ll need to apply for grants to fund their effort. “We have a colossal amount of work to do,” she says wearily. “People are constantly dying, and there is no end in sight.”

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