Recent Canadian Court Ruling Provides a Path Forward for Safer Drug Supply Approach in Harm Reduction
October 29, 2026
Overview
The rate of overdose deaths in the U.S. increased sharply after the introduction of fentanyl into the illicit opioid supply. In Canada, overdose prevention and harm reduction efforts include the provision of a regulated supply of drugs via a medicalized prescription model. A recent court ruling in Canada offers insight into a humane and effective approach to harm reduction efforts not available in the U.S. – providing a safe supply of drugs, both in the medical context and outside of it.
Tens of thousands of people continue to die from drug overdose in the United States every year. Many of these deaths are preventable. The rate of these deaths increased sharply after the introduction of fentanyl into the illicit opioid supply. Much press, some quite sensational, has been given to the “contaminated,” and “poisoned,” drugs available on the street. However, few if any mainstream press outlets go on to note that if this “contamination” is responsible for the increase in overdose and other harms, legal ways to access non-contaminated drugs would reduce that harm.
It’s hard to overstate the damage that criminalization of drugs in the U.S. has done to the people who use those drugs, their families, and society writ large across the globe. Criminalization pushes drug use to the stigma-filled shadows, keeps some people who use drugs from being able to obtain jobs and housing, and limits options for people who use drugs to seek safer alternatives and connect to health services. It also contributes to an unsafe and unstable drug supply.
In Canada, overdose prevention and harm reduction efforts include the provision of a regulated supply of drugs via a medicalized prescription model. This safer supply paradigm has been extensively studied and supported as an effective and preferable alternative to an unregulated illegal drug supply.
However, this medicalized model still left a safer supply out of reach for many people. To address this problem, in 2022, the Drug User Liberation Front (DULF) started a non-medical safer supply program. They obtained drugs from internet sellers, tested those drugs for adulterants, and provided them at cost to members of a compassion club. Police, health officials, and lawmakers initially either supported or tolerated the club – until conservative politicians and public perception of harm reduction began to sour. Suddenly, what was “life-saving work” was re-cast as intolerable law breaking, and the founders of DULF, Jeremy Kalicum and Eris Nyx, were raided, arrested, and convicted of possession of drugs with the purpose of drug trafficking. During the year that DULF’s compassion club operated, not one member died using the safer supply.
In response, DULF brought a constitutional challenge to sections of the Canadian Controlled Drugs and Substances Act, arguing that the parts of the Act infringe on Canada’s Charter of Rights and Freedoms guarantees of life, liberty, and security of person as well as protection against discrimination. The charges that Jeremy and Eris faced could have resulted in life in prison. Instead, on September 29, 2026, a Canadian court stayed their convictions and gave the Canadian Parliament six months to provide a legal path for compassion clubs such as theirs, finding “a non-medical safe supply is urgently needed to save lives.” The judge even declared that Eris and Jeremy, through their work at DULF and their constitutional challenge, had done “the public interest a service at considerable personal cost.”
U.S. law does not currently permit the distribution or use of controlled substances outside of a tightly regulated medical model. For DULF-like compassion clubs to operate legally in the US, federal law would need to be changed to completely shift this model. Even expanding the ability of medical providers to prescribe controlled substances to people who use drugs, like the Canadian medical safer supply model, would require amendments to the federal Controlled Substances Act.
Such change is not impossible. Evidence-based overdose prevention and harm reduction measures that prioritize the safety of people who use drugs, rather than strict criminalization, has been enacted in many countries, saving lives around the world. Drug policy advocates in the U.S. can learn from and be inspired by our neighbors to the North, with the knowledge that while the road here may be more difficult, there is power behind evidence-based action.
This post was written by Amy Lieberman, Deputy Director, Harm Reduction, Network for Public Health Law, and reviewed by Corey Davis, Director, Harm Reduction.
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