Q&A: Are fears that young people are getting hooked on prescribed opioids a 'moral panic?'
Researcher says criticism not supported by evidence
A public health researcher whose work focuses on substance use says some media narratives around "safer supply" amount to moral panic.
Safer supply is a term used to describe the practice of providing prescription-grade opioids to people with substance use disorder so they don't turn to the potentially toxic street supply. Some critics say those drugs are not safe and are being diverted into the hands of young people and fuelling the opioid crisis.
But that criticism is driven by disinformation, said Gillian Kolla, an assistant professor of medicine at Memorial University in Newfoundland. Her newly published study is titled Mapping a Moral Panic: News media narratives and medical expertise in public debates on safer supply, diversion and youth drug use in Canada.
Kolla joined London Morning Thursday to share her findings. The following has been edited for clarity.
Q: What are the characteristics of moral panic?
A: Moral panic is basically this attempt to create a widespread feeling of fear over an issue that people disturbed by a situation are perceived to be affecting the moral order or disrupting the ways that things should be.
It's basically an attempt to seize control of the narrative to try to regain control of the public agenda and maintain a particular set of values. And in this case, it's really attempting to maintain a set of values that are driven by very punitive approaches to drug policy.
Q: How did you analyze those media narratives around safer supply?
A: We did a really comprehensive search of the different narratives that had been starting in about 2023.
Around this, we looked particularly at narratives that were focused on the issue of diversion as well as the issue of youth drug use. What we were looking at was really how they might conform to a set of characteristics around moral panics that have been previously identified by other research.
One of the main characteristics is that there's an absence of any empirical evidence and really a privileging of anecdotes, frequently very exaggerated anecdotes and sensational ones, as well as the use of really stigmatizing terms and vilification of people who use drugs, rather than a focus on what the evidence is telling us in what is being published in medical journals around the world.
Q: What impact did these moral panics have on actual policies and the ability of people to get help?
A: The really important part about the arguments we're making in this paper is that moral panics can and do have very real policy effects.
It's really an attempt to kind of shift the discourse and have policy impacted in ways that unfortunately might be really, really dangerous, rather than looking at what the evidence is telling us about how these programs are actually reducing overdose mortality and helping to save people's lives.
Q: What other examples of moral panics have stopped good policy in the past?
A: Insite, which was Canada's first sanctioned supervised injection site, started in Vancouver in 2003. it was subject to a lot of contention just as we're seeing right now. It was also subject to a lot of very strong research. Again, because of this contention and the moral panic that came up about it, we saw the federal government, which at the time, was the federal Conservative government, actually sue Insite to try to get it to close.
This case went all the way up to the Supreme Court of Canada, costing huge amounts of time and money. Insite won, because the court found that the evidence for this in terms of improving people's health was so overwhelming. But unfortunately what that meant is we did not open another supervised injection site in Canada for 14 years until we were in the grips of the current overdose crisis.
We're getting caught up in this moral panic rather than having good, deliberate discussions about how to address the devastating crisis we're facing in this country.
Q: How are the narratives that are being put out about safer supply compare to the situation on the ground?
A: One of the main ones is youth and drug use and overdose. One of the ideas that's been put forward a lot is the concern that youth are going to be using diverted hydromorphone or other medications from safer supply programs and that will cause them to develop an opioid use disorder and put them at risk of death because of it. That's just out of wack with the evidence.
In Ontario, evidence shows that 95 per cent of youth who are dying from overdoses are dying from fentanyl from the unregulated street supply. They're not dying from hydromorphone. The number of cases where hydromorphone was detected in youth deaths actually went down while safer supply was scaling up in Ontario.
The problem is, we're not talking about all the kids who are dying from fentanyl overdoses, we're talking about this boogeyman of people throwing Dilaudid at children on playgrounds, which is just not the case. These moral panics have real effects and distract us from the real issues.