Are opioids prescribed to drug users as a part of British Columbia’s safer supply program being diverted and sold on the streets?
The allegation became a hot issue in the B.C. legislature this week, in the wake of a National Post story claiming significant quantities of the opioid hydromorphone being prescribed to people with substance use disorder are being sold or traded for stronger drugs.
“Diverted safe supply pills that used to sell for $10 a pill are now being sold for as low as 25 cents a pill, are now being sold around VGH (Vancouver General Hospital) and downtown because of the government’s flooding of the market,” BC United mental health and addictions critic Elenore Sturko alleged in Question Period.
In an interview, Sturko said she’d heard from several doctors working in the field, who wished to remain anonymous out of fear of professional repercussions, who claimed physicians at St. Paul’s Hospital’s Rapid Access Addictions Clinic had stopped prescribing hydromorphone and were also starting to de-prescribe their patients.
A spokesperson for Providence Health Care, which operates St. Paul’s Hospital, told Global News physicians at the clinic have not stopped prescribing hydromorphone.
“They’re talking about not seeing any overall improvement in the condition of their patients, and also unfortunately seeing an increase in the number of individuals, including youth, coming in with new onset opioid use disorder, which of course is a huge concern,” Sturko told Global News.
“They’re saying they recognize a lot of diversion is happening … they’re turning around and selling those so they can get the street drugs they’re craving, and as a result, other people are then obtaining dilaudid (hydromorphone) and becoming users of that drug, which is actually five times more powerful than morphine.”
Global News spoke with several B.C. doctors who specialize in addiction who also declined to go on camera, but did share similar concerns.
The doctors told Global News they know some portion of the hydromorphone they prescribe is being diverted to the street trade, that they’ve not seen data that shows the program is reducing overdose deaths, and they feel there’s a political climate right now that’s discouraging doctors with dissenting opinions from speaking up.
B.C. issued new guidelines on prescribing opioids to people with substance use disorders early in the COVID-19 pandemic in a bid to reduce street drug deaths and break people with addictions away from drug dealers, and better connect them with health care and services.
As of March, there were 5,044 people provincewide who were being dispensed prescribed safer supply, according to B.C.’s Ministry of Mental Health and Addictions. Providence Health Care was not able to confirm the specific number of patients being prescribed opiates from its rapid-access clinic, but said it was “in the hundreds.”
Advocates for drug users have strongly disputed the concerns about the program.
Sarah Blyth, a long-time harm reduction worker and executive director of Vancouver’s Overdose Prevention Society, said the number of people who actually have access to prescribed safe supply is so small that any drugs being diverted would be a drop in the bucket compared to the volume of toxic drugs on the street.
“People use drugs. They just do. Let’s be completely clear about that,” Blyth said.
“It’s just that dilaudid isn’t a problem. They’re making it into a political problem when it’s not,” she added. “I’m worried about the immediate death of young people.”
Blyth argued that any hydromorphone making its way onto the street would be a net benefit given the high toxicity of street drugs that are already circulating.
The latest report on unregulated drug deaths from the BC Coroners Service found that fentanyl was present in 86 per cent of suspected toxic drug fatalities. The same report concluded “there is no indication that prescribed safe supply is contributing to illicit drug deaths.”
However, it also showed toxic drug deaths continuing to rise, with at least 596 deaths in the first three months of the year, setting the province on track for a potentially record year for drug fatalities.
“They’re dying from fentanyl overdoses, they’re not dying form dilaudid overdoses. The real story is people are dying and it’s horror, it’s just terrible,” Blyth said.
“If there was a person who wants to try drugs that is trying drugs for the first time, I would rather have them use that than what’s out there. You have no idea how many people die — first-time users — from fentanyl. They don’t have the immunity. They haven’t built up the resistance to it. If they use a small amount, it can kill them.”
Mental Health and Addictions Minister Jennifer Whiteside told Global News the province’s safer supply program was developed by public health staff, front-line doctors and addictions specialists, and is working well.
She said data from public health and the BC Coroners Service has shown no measurable increase in the rate of opioid use disorder among youth or increased mortality linked to the program.
“Safer supply is constantly being evaluated and monitored by the doctors who are on the front lines doing this incredibly important work, of working to separate people from the toxic drug supply — doctors and our health-care system, who are wholly focused on trying to save lives in the face of this unrelenting crisis,” she said.
“There is a robust evaluating process underway with public health, with front-line physicians, with academics, who are monitoring and evaluating prescribed safer supply as we move through this program.”
At least 2,314 deaths due to toxic drugs were recorded in 2022, making it the deadliest year on record since B.C. declared a public health emergency in 2016 over toxic drugs.