Exploring Subjectivity Through Safer Supply

Abstract

In 2019, the Canadian government approved the prescription of medical heroin to people with severe opioid use disorder, not as a treatment for addiction, but as a harm reduction tactic to prevent overdose in the face of an increasingly toxic street drug supply (Health Canada 2019). This harm reduction tactic is known as safer supply. Since 2019, the Canadian government has broadened the scope of safer supply to allow physicians to prescribe opioids and other drugs that they deem necessary for their patients (Health Canada 2023). In this thesis, I argue that the regulatory flexibility of safer supply allows physicians to meet their patients where they are, instead of asking them to ascribe to social norms to access care. Safer supply does not seek to end drug use; it only seeks to prevent overdose. Within the clinic, people who use drugs find they are able to understand their drug use through a positive medical/functional model instead of the criminalized model of addiction; many no longer understand their use of opioids to be categorized as addiction at all. Through focusing on personal narratives of addiction and drug use, I argue that many of the harms considered inherent to opioid use within liberal frameworks are caused by the structural violence inherent in the punitive criminalization of drug use. Safer supply allows people to form less pathologized and stigmatized subjectivities of drug use because it does not presume all drug use to be inherently problematic and removes many of the aspects of drug use that people who use drugs find harmful. Accessing safer supply is an act of care of the self and it allows people the space in their lives to begin ethical work. It is critical that as governments develop policy solutions, they consider the voices of people who will use those solutions.