A Public Supply of Addictive Drugs: A Rapid Review


Over recent decades Canada and the United States have experienced catastrophic increases in addiction and related consequences, including fatal poisonings. In response to the current crisis some have called for a Public Supply of Addictive Drugs (PSAD), referred to by advocates as safe supply. The current review investigates peer-reviewed studies that report original research findings which the authors interpret as indicating the need for safe supply.

Key Findings

Nineteen studies met our inclusion criteria by:

  1. reporting original research findings;
  2. advocating for safe supply; and 
  3. appearing in peer-reviewed journals.

None of the identified studies were systematic reviews, economic analyses, or randomized controlled trials.

None of the identified studies investigated outcomes associated with providing addictive drugs for personal use outside the context of a structured program.

The results most commonly reported confirmed extremely high rates of homelessness, unemployment, food insecurity, and other indicators of poverty and social exclusion among people at high risk for poisoning.

Only one of the included studies recommended specific evidence-based interventions to address the risk factors for addiction reported in their results.

Most of the identified studies (n=15) were conducted in British Columbia by teams with primary expertise in infectious diseases (e.g., HIV).

This review was commissioned by the Alberta Ministry of Health.