Good morning. Wendy Cox in Vancouver this morning.
A news conference held Monday by the architects of B.C.’s strategy to combat the overdose crisis was an aggressive rebuttal of federal Conservative Leader Pierre Poilievre’s attacks on the province’s attempts to reduce overdose deaths – even if the tone of the news conference was not one of heated condemnation.
No, said Chief Coroner Lisa Lapointe, data do not support the idea that more people are dying with drugs provided by the province’s safer-supply program in their systems. That’s contrary to a March 2 tweet from Mr. Poilievre that said the policy was “flooding the streets with heroin, fentanyl & crack.”
No, said Children’s Representative Jennifer Charlesworth, there is no evidence that hydromorphone, an opioid prescribed to people as a safe alternative to fentanyl, is ending up in the hands of children, as Mr. Poilievre suggested May 12.
But apart from the obvious effort to throw cold water on an overheated political debate, Provincial Health Officer Bonnie Henry was direct when it came to her concerns about the safer-supply program.
As Xiao Xu writes, Dr. Henry said the safer-supply program, launched in 2020, is undergoing a review that could take weeks, months or longer. What emerges from the review could put B.C. once again in the position of experimenting with drug policies not contemplated in most of the country.
Dr. Henry noted the data have shown no increases in opioid use disorder since the advent of safer supply. In fact, it has actually decreased. But she said clinicians are saying that hydromorphone is not meeting the needs of those who use drugs, and she acknowledged that there is a risk that young people are accessing that supply. “We really need to pay attention to this,” she said.
She also acknowledged that it is possible that some people are reselling hydromorphone in order to access stronger street drugs.
Safer-supply programs are very limited, she said: less than 5 per cent of people who use drugs have access to a prescribed safer supply, and that safer supply is hydromorphone. The review will examine whether the safer-supply program should be expanded to include other safer opioid alternatives, and safer alternatives to stimulants like meth. She noted there is limited information on people using powdered fentanyl or pharmaceutical-grade heroin as safer alternatives.
She said the review will also examine whether the distribution of safer-supply drugs needs to be changed because of barriers, including the reluctance of some people to go through the medical system to access the program. She suggested the province needs “a spot somewhere in the middle,” between a restricted safer-supply program and the relatively easy access people have to alcohol. She pointed to the way cannabis is distributed – it is highly regulated by government, but accessible without a prescription – as a possible solution.
“We need to look at non-medical models, but they need to have controls so that it is not something that’s flooding the streets, as the term was used earlier, and it’s not just giving out free drugs to people.”
Dr. Paxton Bach, an addiction-medicine specialist at St. Paul’s Hospital in Vancouver and co-medical director at the British Columbia Centre on Substance Use, agreed that the province’s safer-supply program needs to be expanded.
He said prescribed safer supply has been a tool for clinicians to help support people who are at risk of dying from the toxic drug supply, but that the scale of people at risk of harm and the speed at which that supply is evolving make it impossible for a medical approach alone to address.
Dr. Bach said he agrees with Dr. Henry’s comments that multiple models for accessing a regulated and predictable drug supply are needed, and that appropriate models will vary widely depending on the population, the context and the drug itself.
For example, he said, community-led approaches, such as compassion clubs and co-ops, are a possible way forward. Dr. Bach added that any legally regulated system should balance benefits and harms to ensure that those who access it can consume drugs with relative safety while minimizing potential individual and social harms.
“Our current approach leaves the production and distribution in the hands of organized crime, and they have no such considerations,” he said.
This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief Mark Iype. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.