Safe Supply Interview: Michael Nurse and Andre Hermanstyne

Michael Nurse: Andre, I want to thank you for being here. For agreeing to share your perspective on some of the findings from the Imagine Safe Supply research. Could you talk briefly about your background, like your pursuits, your work, and how you came to be experienced and interested in the concept of safe supply?

Andre Hermanstyne: I am a former substance user. I’ve tried every substance at least once from fentanyl to crystal meth; f. I have held many different positions on the frontlines of the Social Work field, including for Black CAP, creating Canada’s first harm reduction program focusing on the needs of African, Caribbean, and Black (ACB) people. I’ve worked also for the Jewish response to homelessness. and for public health as a counsellor at the primary injection site located at Dundas Square in the heart of Toronto.  I believe in and access safe supply programs. I’m really interested in commenting on this research because change only occurs once there is suitable data to support necessary changes. I feel like as somebody who is a racialized person, that we are often left out of the discussion while harmful effects impact us at higher rates than many other cultural groups. 

Michael Nurse: As you are speaking of safe supply, what is your understanding of the purpose of safe supply. Why safe supply?

Andre Hermanstyne: So right now, there is a poisoned drug supply. So, for instance when a person purchases fentanyl there is a reasonable expectation that fentanyl is what they will receive. Often this is not the case as its often adulterated and mixed with different agents. Some of these agents are supposed to create an additive effect in order to produce a better high. But the result is lowering the respiration of the user to the point where they stop breathing and eventually die. Safe supply provides a pharmaceutical equivalent of street drugs. So, like the hydromorphone or, Dilaudid, many people are also being prescribed morphine in a slow-release form called Kadian. Many users like the pills so that they can inject them and use them in a safe way. Now these are manufactured pharmaceuticals, and we know exactly what is in it. How much the dosage is and that they are not adulterated. So as a result, my understanding is that it has resulted in a lot less death. 

We know that people who use drugs struggle with a lot of complex issues. And some of those issues can be addressed  when they come in weekly to access their safe supply through an appointment with their Doctor.– dental care and health care and things of that sort can also be addressed just by virtue of them coming in to access safe supply. 

Michael Nurse: OK, that’s a very significant point, thank you for sharing that. And thank you for such an articulate response to that question. I would like us to focus on some selected findings from the Imagine Safe Supply research related to safe supply for African, Caribbean, and Black (ACB) people and their communities. Findings from the research indicate that some of the challenges to effective safe supply services for ACB communities include a lack of culturally specific harm reduction spaces for ACB people, a need for harm reduction services developed for ACB people, and significant absence of ACB people in leadership and decision-making for frontline services. Considering these expressed concerns and challenges, how prepared would you say the ACB community are for delivering safe supply services that are accessible and relevant for ACB people who use drugs?

Andre Hermanstyne: We are ready for it because if you look at some of the stats around incarceration rates and when I think of my own personal experience of being incarcerated, it was as a direct result of an era of problematic substance use. Selling drugs just to support my habit. Stealing things, committing robberies and stuff like that. Now I don’t have to engage in those type of behaviours. I know I can go to my doctor and get what I need. Such a relief, I haven’t had a criminal charge in over a decade. 

Michael Nurse: But reflecting on the challenges that were mentioned from the findings, do you think that these are things that need to be addressed for safe supply to be effective?

Andre Hermanstyne: Yes. How they are addressed, I don’t know. I don’t have the answer for that but yes, they do definitely need to be addressed. 

Michael Nurse: OK yea so, some of the findings from the research suggest that effective and sustainable safe supply for ACB people and their communities require an approach and understanding that is uniquely ACB. And by uniquely ACB I’m talking about services that are developed to respond to aspects of culture, language, nationality, class difference, between and within ACB communities. So we are looking at challenges and aspects of the ACB community that need to be considered to develop safe supply. How does the idea of ACB specific safe supply correspond to your vision of safe supply services for ACB people? 

Andre Hermanstyne: I think that it is needed. A culturally specific approach is needed. 

Michael Nurse: Another key finding indicated that for safe supply to be successful in ACB communities an involvement of ACB women at all levels, particularly in leadership roles, is essential. And considering that many ACB homes are led by women, what are your thoughts about the importance of Black women in the development and practice of safe supply for ACB people? 

Andre Hermanstyne: I had some time to really think about this question and how I want to respond to this. So, my wife and I   had a friend, whom was pregnant and gave birth to twins. Now the twins decided to come early, and the woman gave birth at 23 weeks which was just a little over half of the full 40-week process and extremely premature. They were girls. Both parents were ACB people. The girls ended up surviving. What the doctor said, which I found to be very interesting, was the reason that they survived was because they are Black females. And out of every child that is born with any type of challenges around the birthing process, the Black female has the highest chance of survival. So that speaks to the strength of Black women and the need to heal a lot of the trauma that we as Black men have inflicted on Black women and that was experienced by the transatlantic slave trade. So, I think it is important that we heal, we spend some time healing our Black women and they are in my estimation a critical piece to the development and success of any program especially this one.

Michael Nurse: You are talking about in general as well? 

Andre Hermanstyne: Yes, and specifically to this program of safe supply. 

Michael Nurse: What is the uniqueness that you see for Black women in the development of ACB services? I know some people say that Black women do most of the caring in the community, that Black women are involved in organizing support for people. Do you see this as a significant factor? 

Andre Hermanstyne: Absolutely. Not only from those viewpoints but just the strength that a Black woman possesses just by her presence alone. Her knowledge and her insights are needed. We can’t move forward without the Black woman. 

Michael Nurse: That’s a very deep answer, thank you for that. Another question, the research heard that religion and faith influences stigma about drug use in ACB communities. And that it would be important to find ways to engage religious leaders in addressing stigma or harm reduction or even safe supply. What are your thoughts on this issue? 

Andre Hermanstyne: I totally agree that we need to address the stigma that is associated with religion because from a religious aspect these are sins. Drug use is sinful behaviour. So, it’s an all-or-nothing kind of abstinence-based approach. But a harm reduction approach, we meet people where they are. I think engaging those ministers who have more of a progressive stance and encouraging them to then bring that message, or package that message to deliver it to ministers who hold more conservative values.  

Michael Nurse: And you know, I’m going to say I always learn from talking with you. And even that comment that you made about reaching out to the more progressive ministers to get that connection is a distinction that I really didn’t consider. Is there anything that you would like to say about safe supply for ACB people that we haven’t covered here?

Andre Hermanstyne: No, but it just seems that you guys are on the right path and like I said earlier we can’t have anything without the necessary research. And you know the challenges that we’ve had working together at Black CAP, just to get funding for ACB programming. And even after I left, I heard that the drop-in had been cancelled because the building management didn’t want  people who are using substances attending any program held in that building  So, I mean we need to start knocking over some of these barriers and having a space for people who are Black who are choosing to use drugs, that they can feel safe. And live. 

Michael Nurse: Andre, I want to thank you for being here. And for being open to sharing your experience and expertise on this topic. 

Andre Hermanstyne: Thank you so much Michael and if at any point you have any more questions or whatever feel free to just give me a call.

Michael Nurse:  Thanks Andre. 

Andre Hermanstyne: Thank you very much, I appreciate you Michael man. 

Michael Nurse: I appreciate you too my brother. 

Imagine Safe Supply is a community-based research project that explored participation in safe supply in Canada for people who use drugs and frontline workers. For more information on this research please visit here.

About Canadian Drug Policy Coalition

Advocating for public health- and human rights-based drug policy grounded in evidence, compassion, and social justice