Dr. Andrew Ivsins is a Research Scientist with the BC Centre on Substance Use and Assistant Professor in the Department of Medicine at the University of British Columbia. He employs innovative qualitative and ethnographic approaches to understand how social, environmental, and structural factors shape the health and health inequity of people who use drugs.

Andrew’s recent work has focused on the ongoing drug toxicity crisis, including studies exploring the impact of safer supply interventions on the health and wellbeing of people who use drugs.

We asked Dr. Ivsins about his recent work and his perspective on the recent shift in safe supply drug policy.

Q: Tell me a bit about your recent research projects. What are some findings that you wish more people knew?

Lately I’ve been doing a lot of work around safer supply, now often referred to as “prescribed alternatives”. While it’s calmed down a bit recently, there’s been a lot of negative attention on safer supply, which has unfortunately glossed over the real and important positive impacts of this policy on people who use drugs. One of the most important findings of my work is that providing people with a safer supply of drugs can reduce, or eliminate, the use of highly toxic and unpredictable illicit drugs, ultimately saving people’s lives.

I’m also wrapping up a project (with my colleague Dr. Boyd) that looks at the experiences of receiving safer supply among people living with HIV. One of the things we found is that receiving safer supply can have a positive impact on HIV care by facilitating consistent dosing. For example, participants receiving their safer supply at an HIV care centre every day would simultaneously be reminded to take their HIV medications. I think this is really important as it shows that innovations in harm reduction, and integrating harm reduction with HIV care, has potential to significantly improve the lives of people living with HIV who use drugs.

Q: How has drug policy around safe supply changed over time? What has been the impact?

Having been involved in research on safer supply since the first program started in BC in 2019, I’ve seen the policy change over time. The early shift from witnessed ingestion to permitting take-home doses (which stemmed from COVID-19 pandemic precautions) improved access and uptake. However, the policy remained restrictive in terms of which medications were made available and who could access them. For instance, there’s a program in Vancouver that provides pharmaceutical-grade fentanyl powder, which, from our qualitative evaluation, shows real promise in terms of impacts and outcomes. However, program capacity is limited, and is restricted to residents of Vancouver. Generally, most people receiving safer opioid supply in the province are/were prescribed tablet hydromorphone, where other alternatives, like fentanyl powder, may be more suitable, desirable, and effective.

Another interesting change has been the shift in terminology which occurred in-step with policy changes. What started as safe supply shifted to safer supply, then to prescribed safer supply, and now prescribed alternatives. How we talk about and label things impacts how we view and understand them. The concept of safe supply was not intended to refer solely to prescribed pharmaceutical drugs, but broadly to drugs of known content and potency (including for example unadulterated cocaine, heroin, and methamphetamine). Unfortunately, models that support the provision of these sorts of substances (e.g., compassion/buyer clubs) have not received the support needed to operate legally.

Q: In early December 2025, the BC Government announced changes to safe supply drug policy, requiring observed consumption and eliminating take-home doses. What do you think this means for people who rely on these programs?

This is a significant reversal in safer supply policy, and is going to have a negative impact on people accessing and benefitting from safer supply. We know from the research conducted in BC, and from the research conducted by colleagues across the country, that observed consumption is a significant barrier to safer supply access, uptake, and adherence, especially with tablet hydromorphone safer supply. Requiring multiple daily pharmacy visits, for example, is extremely burdensome and an unrealistic expectation, significantly disrupting daily life. This means less people will be getting regular access to their safer supply medications, which puts more people at risk of toxic drug poisoning and overdose.

Q: What types of collaborative research partnerships exist in your current research and who would you like to collaborate with more?

My work involves collaborating and working with community organizations (e.g., the Dr. Peter Centre), drug user-led organizations (e.g., the Vancouver Area Network of Drug Users), and people with lived experience of drug use. Involving people who use drugs in my work is especially important to ensure ethical, respectful, and community-responsive research. I’m always open to new collaborative opportunities, and would like to expand my work with community-based organizations, especially in rural communities. I also recognize the importance of cross-disciplinary research, and looking forward I want to find ways to build partnerships and collaborate with colleagues in disciplines I’ve yet to work with, such as Architecture and Geography, who will bring unique and important perspectives to this work.