Toxic drug crisis: B.C. experts urge expansion of ‘safe supply’ to save lives

B.C. public health experts are urging the province to expand the current “safe supply” program, which prescribes clean drugs to a few thousand opioid users.

According to Health Canada, safer supply is defined as “providing prescribed medications as a safer alternative to the toxic illegal drug supply to people who are at high risk of overdose.”

0:52 Dr. Bonnie Henry unveils recommendations for ‘safer supply’ program

In her review of B.C.’s safe supply program, provincial health officer Dr. Bonnie Henry acknowledged that “safe supply” means different things to different people.

BC Centre on Substance Use co-medical director Dr. Paxton Bach said the term safer supply is an umbrella which describes a variety of different programs and options – including prescribed hydromorphone tablets and fentanyl patches.

“Free drugs for all, that’s simply not accurate,” Bach told Global News in an interview Thursday.

Bach, an addictions’ medicine specialist at St. Paul’s Hospital, said pharmaceutical alternatives to street drugs are a critical part of the response to the overdose crisis.

“The evidence and the current reality of the toxic drug supply support the concept of a regulated alternative to the drug supply,” Bach said.

Former provincial health officer Dr. Perry Kendall said many of the estimated 225,000 British Columbians using illegal drugs are using opioids.

1:57 Claims of opioid addiction from diverted safe supply

In its current form as a limited prescription program that reaches about 4,500 people, Kendall said safer supply doesn’t go far enough, given that about 100,000 people have diagnosed opioid substance use disorder.

“I think we need to have some serious discussion around going beyond the prescriber model because were just not going to be able to reach the numbers of people who are at risk,” he said.

Kendall, now a public health consultant, said safer supply should be expanded and tested in a pilot to access more people and minimize unintended consequences like the diversion of drugs.

“If we really want to stop the death rate or the brain disease rate, brain death rates, were going to have to replace the toxic drug supply with a safer supply,” Kendall told Global News in an interview Thursday.

British Columbia’s chief coroner agrees.

Lisa Lapointe, who is retiring in mid-February, said B.C. needs to scale up as a province, and unless people are freed from the toxic illicit market, they will continue to die by the hundreds and thousands as they have in recent years.

1:00 Illegal drug store selling heroin, meth, cocaine in downtown Vancouver for safe supply

“To keep falling back on old practices that have not been effective, we just can’t do that,” Lapointe said Thursday.

“It’s not what some people would characterize as just giving away drugs to drug users, that’s not what it’s about — it’s about keeping people alive by separating them from the toxic market.”

Kendall also supports the potential sale of safer supply in regulated hard drug stores – similar to the province’s public and private cannabis and liquor retailers, a move he said would require exemptions under the federal Controlled Drugs and Substances Act.

“You could do it to such a point that you would maybe be slightly undercutting the illegal drug market,” Kendall said.

“We’re smart enough to do it, whether we care enough to do it or whether were politically brave enough to do it or politically honest enough to do it is another question.”

1:44 British Columbians supports safe supply, not decriminalization

When asked if she would support hard drug stores in B.C., Lapointe referenced a November 2023 BC Coroners Service Death Review Panel which recommended consideration be given to means testing whether drug users could access a paid safer supply model.

“You wouldn’t want to create a regulated model where people would be able to buy drugs or receive drugs and then turn around and sell them to get other drugs,” Lapointe said.

Lapointe said if someone is diagnosed with an opioid use disorder that is a medical condition, they should be entitled to treatment including prescribed safer supply, based on means testing just like other medications.