An expert panel is urging the B.C. government to immediately expand public access to safer supply, billing the program as the “fastest way to reduce deaths” amid the worsening toxic drug crisis.
The death review panel, convened by B.C.’s chief coroner last December, presented its findings Wednesday. It determined prescription-free, quality-controlled drugs is the most viable, scalable short-term option to save lives with an estimated 225,000 British Columbians currently at risk of drug injury or death.
“With the passing of each day, week, month and year, we risk becoming numb to the scale of this emergency as the current devastation becomes the norm,” panel chair Michael Egilson said in a press conference.
“The current medical model for provision of safer supply faces as a number of overwhelming challenges, including scalability, geographic reach within the province, and the adequacy of available drugs to meet the needs of people accessing the unregulated drug market.”
Mental Health and Addictions Minister Jennifer Whiteside has already rejected the panel’s recommendation, stating an expansion to prescription-free substances is “not under consideration.”
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The panel’s findings reflect criticism that advocates have advanced for years, stating the current safer supply model primarily serves people who already have access to the health-care system, limits the types of medications that can be prescribed, and is only accessed by some 5,000 people monthly.
Expansion of those programs would place additional burden on B.C.’s strained health-care system, the group notes, recommending instead that the system be reviewed and enhanced to ensure “maximum effectiveness,” while non-medical options are created and implemented.
“Existing responses, initiatives and services, and their associated allocated resources have not been commensurate with the urgency, magnitude and the scope of the crisis,” Egelson said. “While the highest rate of death is in Vancouver’s Downtown Eastside, with a rate of death at 10 times the provincial average, 85 per cent of the deaths are occurring elsewhere in urban, rural and remote centres throughout B.C.”
Other recommendations include an application from B.C. to the federal ministers of health and mental health and addictions for another exemption to the Controlled Drugs and Substance Act that would allow prescription-less access to the class of opioid and stimulant drugs to people otherwise at risk of dying from a toxic substances. The province’s Ministry of Mental Health and Addictions should also develop an application process allowing agencies to apply for the authority to distribute those substances, it says.
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Mental Health and Addictions Minister Jennifer Whiteside penned a letter to the coroner on Wednesday, confirming B.C. will not move forward with no-prescription safer supply.
“Our government is very focused right now on scaling up access to treatment and recovery spaces for people, working on ensuring we have the harm reduction mechanisms in place that we need, working with our health system to ensure that mental health and substance use is really, truly part of our health care system, part of primary care,” she said in an interview.
“Any model that looks at withdrawing medical oversight from that process is not a direction that we’re moving in. We think the health-care system has a very important role to play in supporting individuals who are struggling with addiction, who need access to both harm reduction supports on their journey, on their way to treatment and recovery. That’s the work that we’re scaling up.”
Whiteside said the province is not ruling out the expansion of access to prescribed pharmaceutical alternatives.
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During Wednesday’s press conference, B.C. Chief Coroner Lisa Lapointe said she had not seen the minister’s letter yet, but reaffirmed the panel’s “clear” recommendations as well as their expertise and lived experience.
“This is their advice and I stand by their advice,” she told reporters. “Safer supply is an absolutely essential component.”
Lapointe’s office reported another 175 lives lost from the toxic drug supply in September, bringing the death toll to more than 13,000 people since the province declared a public health emergency in 2016. Unregulated drug toxicity is the leading cause of death in B.C. for people between 10 and 59, accounting for more deaths than homicides, suicides, accidents, and natural diseases combined.
Last year alone, paramedics in B.C. attended more than 33,000 drug poisonings — an average of 92 per day.
The province is currently in the midst of Canada’s first experiment with decriminalization; on Jan. 31, its exemption to Controlled Drugs and Substance Act took effect, allowing adults to possess 2.5 grams or less of opioids, crack, cocaine, methamphetamine and MDMA for personal use.
Since then, multiple municipalities have mulled or passed legislation to restrict public drug-use, citing health and safety concerns, increased crime, litter, and more. Responding to those concerns, last month the provincial government tabled legislation that if passed, would ban drug use at beaches, sports fields and parks, as well as within six metres of a bus stop or the entrance to a business or residence.
That builds on an existing prohibition on personal drug-use possession in playgrounds, spray pools, wading pools and spray parks, granted in the aftermath of the start of decriminalization.
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Like Whiteside, BC United critic for mental health and addiction Elenore Sturko said she rejects the premise of non-medically supervised “so-called safe supply.”
“It’s not a model that’s used in other locations that has been successful in tackling significant drug problems,” she said at the legislature.
“This is a medical issue and so we need to continue to address it as a medical issue, and recognize the importance of continuing to include medical practitioners, particularly those with significant expertise in addictions … in forming our treatment plans.”
Sturko also raised concerns with the rollout of B.C.’s current safer supply program, including the diversion of some prescribed drugs to street-level sale as well as recent search warrants executed as part of an investigation against a Vancouver drug advocacy group that has received provincial funding.
Two people were arrested and the Drug User Liberation Front’s contract with Vancouver Coastal Health was cancelled last month.