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Malcolm Jolley: From Cape Town to Canada: Niagaran wines with a South African spirit

Commentary

In 2005, Marlize Beyers, who has a Bachelor of Science in Viticulture and Oenology from Stellenbosch University, had been making wine in South Africa for a couple of years when her husband, Meiring, got a dream engineering job in Canada. He was to apply his specialty, researching the fluid dynamics of snow, and when Beyers landed in the Great White North she must have wondered if she’d have to make a career change.

“Luckily, there was a wine region, Niagara, nearby, so I could get a job and continue to make wine,” she explained in a Cape Dutch accent when I spoke to her recently over Zoom from her home in Hamilton, Ontario.

Beyers began making wine in Niagara at Flat Rock Cellars on the elevated lands of the Twenty Mile Bench. After she took a break to have her first child, Harald Thiel, the founder and proprietor of nearby Hidden Bench, invited her to make wine a little further west in Niagara, which she did for the better part of seven years.

Geographically, the Niagara wine region is best known for its limestone soils and the micro-climate created by the interaction of deep Lake Ontario and the continuous cliff of the Escarpment. But Niagara’s other great geographical advantage is its proximity to Toronto. It’s 400 kilometres from Vancouver to Penticton and more than 600 between Calgary and Penticton. By contrast, it’s less than 100 kilometres from Toronto City Hall to Beamsville and the western end of Niagara wine country. (Though many may prefer having to scale mountain passes to battling the traffic on the Queen Elizabeth Way.)

In the 2000s and 2010s Beyers was in the middle of a heady time in Niagara as the Toronto restaurant scene exploded. Times were good and discretionary income and expense accounts grew. The new trend of interest in local food quickly translated to interest in local wines and Ontario wine went from a term of derision to a shibboleth of gastronomic savvy. Money, thirsty collectors, and curious sommeliers power charged the scene, and the winemaking was innovative and forward-thinking.

In 2017, when Beyers left Hidden Bench to join her old South African employer, Bruce Jack, she took that energy and spirit of adventure with her. Beyers, who kept her principal address in Ontario, became a flying winemaker. She became a winemaker at Jack’s The Drift Estate in the Overberg Highlands, about 170 kilometres southeast of Cape Town. She also formed a consultancy partnership with Jack, Resolute Wine Works, with projects in South Africa, Chile, Napa, Spain, and… you guessed it: Niagara.

Resolute Wine Works currently consults at Beyer’s first Canadian employer, Flat Rock Cellars. But I came to talk to Beyers, who I knew from her days at Hidden Bench, because of a bottle from the first vintage of an entirely new project: The Long Way Home Chardonnay 2022.

Made from fruit picked at Hidden Bench’s Felseck vineyard, I received the bottle by way of South African serendipity. My friend, the winemaker Norman Hardie, whose family immigrated to Canada when he was a schoolboy, was making a personal Christmas delivery on my street when I ran into him walking my dog.

“Malcolm,” he said excitedly as he went through the boxes of wine in the back of his car, “you have to try this Chardonnay, it’s amazing.” I briefly looked forward to one of his own, but he explained with a smile that the bottle he was handing me was made by Marlize Beyers who was making wine in Canada again: “You’ll love it.”

He wasn’t wrong. The Long Way Home is an impressive, rich, and powerful yet lean wine, like a long-distance runner. Crisp and citrus with food-friendly acidity, but tempered with a luxurious touch of custard cream. And, though it’s bone dry, I found honeyed notes on a marathon finish, once it’s opened up. I had looked Beyers up and sent her an email before I finished the first glass.

When I spoke to Beyers, and said I thought her wine would make a very good excuse for a long lunch at a fancy restaurant, she laughed and protested a bit. “I’m not a fancy winemaker,” she said, “I just try and bring out the best from the fruit I’m working with. Once you’ve done all the work in the vineyard, you shouldn’t have to do too much in the cellar.”

Then, as Beyers walked through how she made the wine, she surprised me by telling me that the yellow straw-coloured wine had in fact been subject to skin contact, the process that normally turns white wines into orange ones. There was no sign of pigment in the glass, by my eye, and no sign of skin tannin by my palate. 

Winemaker Marlize Beyers.

What was going on?

Beyer explained that she became interested in skin contact and maceration for white wines a few years ago when she was more or less forced to experiment with a co-fermentation of Viognier and Malbec at The Drift. When she applies skin contact on white wines, like The Long Way Home Chardonnay in Ontario, or Chenin Blanc in South Africa, she explained she said she does it as gently as possible and likened the process to steeping tea. 

Other than keeping the top of the skins from drying out, she really doesn’t do too much in the cellar. There are no “punch downs” or other manipulations to stir up the fermenting juice and crushed skins. She also ferments the wine at cold temperatures. Beyers explained that she is looking for “floral and fruit character” from chemical compounds in the skins, but without the tannins from the pigment in them that gives red or orange wine a drying or textured mouthfeel.

The 2022 Long Way Home Chardonnay ($50) is available through the Niagara Custom Crush Studio website. The 2023 is being made there now, this time with fruit from just down the road at Malivoire. Since it ships directly from the winery, consumers can order one bottle at a time rather than committing to a whole case.Contact Niagara Custom Crush about shipping outside of Ontario.

Bruce Jack wines are frequently available across Canada. Right now in Ontario, two of The Drift wines that Beyers makes can be ordered online by the bottle through the LCBO Classics program. The Ghost in the Machine Chenin Blanc 2022 ($29) is also a skin contact but is very much a white wine with peach and grapefruit flavours that remind me of mid-Loire white wines from Angers like Savennières or the dry versions of Coteaux du Layon. The grapes are from Beyer’s brother’s farm.

The Ghost in the Machine Shiraz 2021 ($38) is made partly with carbonic maceration, where whole bunches of grapes are piled on top of each other, keeping out oxygen so fermentation happens with carbon dioxide instead. Primarily used in Beaujolais, it gives the wine a big wine fruit character. Look for sour cherries, like in a pie filling, and raspberry seasoned with peppery notes.

Adam Zivo: New ‘landmark’ safer supply study is junk science

Commentary

Last month, the B.C. Centre for Disease Control (BCCDC) announced it had conducted a “landmark study” showing that access to “safer supply” drugs—free, government-funded substitutes for potentially tainted illicit substances—reduces mortality rates among drug users. While the study has been widely promoted in the media and by harm reduction activists, some experts say it is actually inconclusive and misleading.

The study arrives at a particularly sensitive time for safer supply advocates, who claim that the government can reduce overdoses and deaths by providing safer supply.

Over the past year, dozens of addiction experts have said that not only are safer supply drugs being widely resold on the black market, but that there is no actual evidence that safer supply works given that supporting studies typically use weak methodologies that would be unacceptable elsewhere in health-care research.

Federal funding for over 20 safer supply programs is set to expire next month with no word of renewal. As criticism of safer supply continues to intensify, there has been increasing pressure to prove that the controversial strategy is worth supporting.

The BCCDC researchers behind the new pro-safer supply study, which was published in the British Medical Journal, examined the anonymized health data of 5,882 individuals over an 18-month period (between March 2020 and August 2021)—all of whom were diagnosed with opioid or stimulant use disorders.

Some of these individuals received safer supply drugs while others did not. Those who received safer supply were given either opioids (i.e. hydromorphone, which is roughly equivalent to heroin) or stimulants (i.e. Ritalin and Adderall) or a combination of both. The opioids were intended to replace street fentanyl or heroin, whereas the stimulants were meant to replace potentially-contaminated cocaine or meth.

Upon analyzing this data, the BCCDC researchers determined that receiving safer supply stimulants had no significant associations with reduced mortality. However, recipients of safer supply opioids were 61 percent less likely to die (and 55 percent less likely to die of an overdose specifically) within one week of receiving their “safe” drugs. Individuals who received safer supply opioids for four or more days in a single week were 91 percent less likely to die over the following week.

The researchers thus concluded that safer supply is successful.

“This paper is the strongest evidence we have so far, by a large margin, supporting the idea that this can be an effective strategy for reducing overdose death risk,” said Paxton Batch, an expert in addictions medicine at St. Paul’s Hospital and a co-author of the study.

The study immediately received somewhat glowing media attention from several media outlets, including the Globe and Mail and CBC, which repeated the BCCDC’s conclusions and added positive quotes from associated researchers and harm reduction activists. No apparent attempt was made to include real critical voices or interrogate the study’s data and methodology.

Two weeks later, the Toronto Star’s editorial board published an op-ed arguing that funding for safer supply must not be discontinued—and cited the BCCDC study as strong evidence of success.

But had the journalists and editors behind these articles done their jobs properly, they would have noticed that something was off. When I forwarded the study to seven addiction physicians and a professional scientist with working knowledge in statistical analysis, they determined that it was misleading and that its conclusions were unsupported.

Dr. Meldon Kahan, one of Ontario’s leading addiction experts, noted that the study’s authors failed to adequately address the fact that half of the patients who received safer supply had also been co-prescribed traditional, evidence-based medications, such as methadone and Suboxone (also known as “opioid agonist therapy” or “OAT”).

It has been conclusively proven that OAT medications significantly reduce opioid overdoses and mortality among drug users. It would thus be incumbent upon any responsible researcher, when studying a population that is using both safer supply and OAT, to verify whether mortality reductions are caused by one or the other.

While the study made some attempts to use statistical analysis to filter out the effects of OAT medications, there were conspicuous gaps in these efforts. For example, no attempts were made to measure what dose of OAT medications study participants received, even though dosage has a significant impact on mortality.

Andrew Leavens, front left, and Carl Gladue, front right, carry an empty coffin during a march organized by the Vancouver Area Network of Drug Users in Vancouver, on Thursday, August 31, 2023. Darryl Dyck/The Canadian Press.

As safer supply patients are generally prescribed stronger doses of OAT compared to other drug users, this raises an obvious question: were they simply dying less often because they were receiving more OAT?

There are strong reasons to believe that the answer is yes.

The study data showed that safer supply patients who did not receive any OAT medications in the preceding 30 days showed no statistically significant improvements in mortality—which suggests that the benefits touted by the researchers were likely primarily driven by OAT, not safer supply.

This issue was actually flagged in the notes generated by the study’s peer review process (which are publicly available), where I found evidence that external evaluators had repeatedly raised concerns about unaddressed data bias. One reviewer, who had “major concerns” about the paper, worried that it was a “big issue” that safer supply seemed to actually shorten survival once OAT was removed as a confounding factor.

I emailed Bohdan Nosyk, the study’s lead public contact, with a list of questions about his team’s work. He provided a detailed response, which I forwarded to several experts for further review. Upon sending Nosyk a second round of questions and concerns, he declined to provide further answers, citing “a need to attend to our other obligations.”

Nosyk claimed that controlling for variations in OAT dosing was something his research team “couldn’t reasonably build into this initial study” given the complex and dynamic ways that OAT medications are used during treatment.

However, Dr. Kahan counter-argued that Nosyk’s comments “don’t make sense” given that administration of safer supply is similarly complex and dynamic. “If they could control for (safer supply) dose and frequency of pharmacy dispensation, then they could also have controlled for the (OAT) dose and frequency of dispensing,” he wrote to me in an email.

While Nosyk acknowledged safer supply appeared to provide no statistically significant improvement for patients who had not received OAT in the preceding 30 days, he pointed out this did not necessarily mean that there was no improvement at all.

In our correspondence, he linked to an article that argued that “statistical significance” is a harmful concept and that less stringent evidentiary standards should be normalized in science.

Nosyk’s argument was technically correct. An effect is only “statistically significant” if it is strong enough for us to be confident that it didn’t occur by chance. Typically, that means ensuring that there is a less than five percent chance that the effect was a fluke. While these evidentiary standards are the norm in most statistical analyses, they can lead scientists to dismiss very weak effects whose existence is unclear.

“This study is indeed a landmark, but not because it shows that safer supply works”

However, a debate about the meaning of statistical significance seemed to miss the point. Nosyk’s study had claimed that safer supply led to a 55-91 percent reduction in mortality—a huge effect. But now it seemed that, once an obvious confounding factor was fully removed, benefits were actually so weak that they were barely detectable if they existed at all.

Why weren’t the researchers more forthright about this tension in their paper? Why did they not flag this when speaking to the media? If the benefits of safer supply are so weak that we need to abandon normal evidentiary standards to accept their existence, that doesn’t bode well for the harm reduction movement.

The physicians I consulted with also noted that it was highly unusual that Nosyk’s study exclusively focussed on mortality rates after just one week.

“One-week mortality rates are an unusually short time period to study, and to not report on mortality rates for longer periods leaves one wondering if the data for longer periods did not show any difference between the groups; for example no difference in mortality at a month or year which would make the inferred benefits much less significant,” wrote Dr. Michael Lester, a Toronto-based addiction physician.

Two days after I received Dr. Lester’s note, the scientist who volunteered to assess the study’s statistical analysis confirmed that survival rates for all study participants appeared to have been more or less the same after 52 weeks, regardless if they had accessed safer supply, which suggested that “whatever effect (safer supply) had at the very beginning, hardly mattered at all after a year.”

I asked Nosyk why his team excluded long-term outcomes and only analyzed one-week mortality rates.

“It was important for us to capture the effects of (safer supply) while individuals were receiving it, and measure outcomes in the immediate aftermath of receipt. Just like OAT, or insulin for diabetes, or any number of other medications for chronic conditions, their effects dissipate after discontinuation,” he responded.

His comparison to insulin was illuminating, but perhaps not in the way that he intended.

If a team of researchers examined the impacts of a new type of insulin, it would obviously be preferable to measure both: 1) the immediate impacts of that insulin; and 2) the long-term impacts of its repeated administration. If a research team were to examine only immediate effects, despite having enough data to examine long-term ones, surely that would raise eyebrows?

And surely it would be strange for the researchers to argue, in this case, that this insulin is a promising intervention solely based on immediate impacts, especially if the data suggests hardly any long-term benefits at all.

And yet it seems this is exactly what Nosyk’s research team has done, in its own way.

A sign reading “Safe Supply Now” is seen at a gathering outside the Provincial Court of British Columbia in Vancouver, B.C., Tuesday, Jan. 16, 2024. Ethan Cairns/The Canadian Press.

The physicians I consulted, along with the notes generated by the peer review process, raised a number of other serious concerns regarding the study’s data and analysis.

For example, the British Journal of Medicine’s editors were “puzzled” by the fact that, after one week, safer supply was simultaneously associated with fewer deaths but not fewer overdose hospitalizations. “One would expect these results to be in the same direction,” they wrote.

Some experts I spoke with felt  Nosyk’s team failed to adequately discuss findings on safer supply stimulants—as mentioned earlier, providing such stimulants was associated with no improvements in mortality after one week.

Does this simply mean that safer supply only works for opioids, but not stimulants? Or does this reinforce the argument that the mortality reductions seen with “safe” opioids were actually caused by OAT, as OAT is not used to treat stimulant addiction and thus would not be a confounding factor with “safe” stimulants?

One might expect a fulsome discussion comparing the divergent results of opioid and stimulant safer supply, but that was largely missing.

Interestingly, the fact that safer supply stimulants had no apparent impact on mortality was omitted from the study’s conclusion, which focused exclusively on the benefits of “safe” opioids. As there is a responsibility to spotlight negative results alongside positive ones, one could argue that this omission is subtly misleading, especially considering that many people, including journalists, tend to skip to most studies’ conclusions to understand their findings.

One might ask: why does it matter that this study is misleading? Why does it matter that some researchers claim that safer supply saves lives when their data suggests that this is not actually the case?

The answer is simple: thousands of people are dying every year amid an unprecedented overdose crisis, and if this problem is to be solved, Canada must invest in addiction interventions that work. When bad science creates false hope, it costs Canadian lives.

Despite its flaws, the quality of this study is much higher than what is typically produced by harm reduction activists, so it is unsurprising that many of them are now aggressively promoting this “landmark” research, which they believe vindicates them. But it seems that, as is so often the case with safer supply, the truth is not entirely what it seems.

This study is indeed a landmark, but not because it shows that safer supply works—quite the opposite. A critical look at the data reveals that it is ineffective and that a new path is needed.