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Four-month delay in prescribing safe drug supply costing lives, says B.C. advocate

Click to play video 'B.C. nurses join the battle against the province’s overdose crisis' B.C. nurses join the battle against the province’s overdose crisis
(Sept. 17, 2020) B.C. nurses join the battle against the province's overdose crisis – Sep 17, 2020

On Saturday, it will have been four months since provincial health officer Dr. Bonnie Henry issued a public health order allowing registered nurses and registered psychiatric nurses to prescribe pharmaceutical alternatives to street drugs.

The order, issued under the Health Professions Act, authorizes the prescriptions in a bid to reduce the number of people dying from toxic street drugs, while providing opportunities for ongoing care, treatment and support.

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Clean drugs offered to users in Ontario to prevent death – Sep 18, 2020

The order was lauded by everyone from government officials to community advocates as something that could have a real impact on slowing the deadly overdose crisis — B.C.’s first ongoing public health emergency.

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“That wasn’t a gesture or symbolic hope for us. It was a real thing,” advocate Karen Ward told Global News.

But four months on, Ward is frustrated that the order hasn’t actually been put into action yet.

Read more: More health professionals can now prescribe safe drug alternatives to battle overdose crisis

“This is an emergency now. It has been an emergency, this is like the 1,736th day of emergency,” Ward said. The opioid crisis was declared a public health emergency in B.C. on April 14, 2016.

“But it doesn’t feel like an emergency. When Dr. Bonnie Henry gives an order, a provincial health order (for) COVID, it’s the next day. Because it matters.”

While nurses aren’t actively prescribing controlled substances as alternatives to street drugs yet, the Ministry of Mental Health and Addictions said work is well underway to implement the public health order.

“Dr. Henry included a number of conditions in her order that nurses need to meet before RNs and RPNs can start prescribing,” a spokesperson said in an emailed statement.

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“That is why nurses will begin prescribing through a phased approach as soon as each component is ready, with the first small cohort of nurse prescribers beginning training in the winter of 2021.”

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The B.C. Nurses Union, meanwhile, told Global News it expects to see the first cohort underway this month, with a second beginning in February.

Read more: ‘I’ve been brought back to life six times’: How a B.C. man escaped the Downtown Eastside alive

But Ward said this is a time for urgent action, and she doesn’t understand why existing prescription guidelines for doctors couldn’t simply be adapted for nurses.

“This isn’t rocket science, you know? This isn’t COVID, frankly. We don’t have to discover what the solution is. We know what it is,” she said.

“With the number of people who are dying, or how quickly it’s getting worse, this is not something that we need to discuss in a committee.”

The ministry says it is emphasizing safety as it works to determine guidelines.

“This is ground-breaking and complex work, involving many aspects of the health-care system. B.C. is innovating from the ground up and we have to make sure patient safety is paramount every step of the way,” the spokesperson said.

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One-on-one with Dr. Bonnie Henry on B.C.’s overdose crisis – Sep 30, 2020

Ward said while the ministry has been focused on those guidelines, more than 450 people have died.

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Data from the BC Coroner’s Service shows that 453 people in B.C. died of illicit drug overdoses between September and November of 2020. Data for December 2020 or January 2021 was not available at time of publication.

Read more: Illicit drug deaths in B.C. higher than homicides, car crashes, suicide, COVID-19 combined: report

Ward said it’s not just a matter of fentanyl or other toxic substances that’s killing people who use drugs — it’s also about the inconsistencies in the street supply.

The levels of certain substances in each dose go up and down, Ward said, and with that, people’s tolerance to those substances changes, sometimes with a fatal effect.

“They can’t tell what they’re using because it’s unregulated, because they’re buying on the streets. I mean, the point of safe supply is about knowing what you’re using, always being able to have that knowledge to know what you’re putting in your body,” Ward said.

“This is so, so degrading, what we’re putting people through for no reason.

In the meantime, Ward said advocates are finding bodies on the street.

“And people are losing whatever hope they had,” she said. “I’m worried that I am too.”

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 — With files from Amy Judd