British Columbia will create a provincial policy on illicit drug use in hospital settings in response to concerns from the union representing the province’s nurses that members are increasingly being exposed to drug-related hazards.
Health Minister Adrian Dix said B.C. will convene a task force to standardize existing rules across health authorities “in the next short while.” The provincial policy will, for example, make explicit that patients are only permitted to use substances in designated spaces on or around hospital grounds and be consistent across all hospitals, he said.
“The reality is, we have, on any given day, hundreds of people in our hospitals who face severe addiction issues,” Mr. Dix told reporters on Monday. “As a practical matter, we want to ensure everyone knows what the rules are everywhere.”
The BC Nurses’ Union says while there has always been a degree of illicit drug use on hospital grounds, it appears to have become more permissive since B.C.’s drug decriminalization pilot project began early last year. BCNU president Adriane Gear said members’ concerns have come primarily from the north, on Vancouver Island, and in the Interior, citing as examples nurses in Victoria reporting substance use in the perinatal unit, and a nurse in the Interior reporting being exposed to substance use twice in one week.
“I think there’s confusion around decriminalization,” Ms. Gear said. “Substance use isn’t a criminal matter; it is a health matter. But that doesn’t mean then that people can just consume any time, anywhere. If there have been clear policies, they have not been followed.”
Ms. Gear said the health and safety of staff and patients falls squarely with the health authorities.
A June, 2023, WorkSafeBC inspection focused on exposure to illicit substances and violence prevention at the Vancouver Island Health Authority found that it failed to meet its obligations to adequately train employees on mitigating the risk of exposure to illicit substances, leading to “several symptomatic worker exposures,” according to a compliance agreement report.
B.C.’s drug decriminalization project suffers another blow
The report directed Island Health to implement a safe usage plan, noting that without designated spaces, it is reasonable to conclude that some patients will use substances in unapproved, higher-risk spaces.
In a statement provided by spokesperson Andrew Leyne, Island Health said it has developed and implemented education and training modules on mitigating exposure to unregulated substances and delivering harm reduction and clinical care for those patients. That training has been completed by more than 5,300 employees, representing more than 90 per cent of employees required to participate, and is also mandatory for new hires.
Seonaid Nolan is division head for Providence Health Care’s Interdepartmental Division of Addiction, based out of St. Paul’s Hospital, the primary hospital for Vancouver’s Downtown Eastside. She said what has impacted St. Paul’s is not drug decriminalization, but worsening social determinants of health.
“It is really a constellation of factors like homelessness, increasing poverty, worsening mental health and an increasingly potent drug supply that all come together to contribute to that environment,” she said Tuesday.
“We’ve seen it affect every community across the province and health care workers in particular are being faced with the day to day struggle of caring for this very marginalized, very vulnerable patient population.”
The issue gained attention last week after the opposition BC United surfaced a memo from last July, from GR Baker Memorial Hospital in Quesnel, on patient substance use and possession of substances. The memo stated, among other things, that it is illegal for staff to go through a patient’s personal belongings; that staff cannot confiscate personal items, even if they include illegal drugs; and that “patients can use substances while in hospital in their rooms.”
In response, the Ministry of Health said the hospital memo, while well-intentioned, was poorly phrased, and pointed to the official policy document from Northern Health. That document states that patients are permitted to bring small amounts of controlled drugs into certain areas in health care settings, and that staff should inform them of where then can store, or are permitted, to use those substances.
With a report from Justine Hunter
Andrea Woo