Provincial public health officer Bonnie Henry is reviewing a program that supplies prescribed alternatives to illicit toxic drugs among concerns that those alternatives are not working and anecdotal reports that they are being sold to secure hard drugs.
But Henry also warned against dismissing the entire safe supply program while joining others in speaking out against the increasingly “divisive” discourse around safe supply.
Henry made these comments Monday (June 5) during a joint appearance with Chief Coroner Lisa Lapointe as well as Jennifer Charlesworth, B.C.’s representative for children and youth and Dr. Kelsey Louie, deputy chief medical officer with First Nations Health Authority.
The safe-supply program mainly involves prescribing hydromorphone, an opioid analgesics that change how the human feels and responds to pain.
Henry said the province started to make safe supplies available in March 2020 when the COVID-19 pandemic intersected with the toxic drug crisis.
“The landscape has changed very significantly since it started in 2020 and as we emerge from the emergency phase of the pandemic, it is time now to re-evaluate and adapt to what we are seeing now,” she said. “We are hearing from clinicians that this prescribing, particularly of Hydromorphone, is not meeting many people’s needs.”
The province has not seen any increase in new cases of what she called “opioid use disorder” since the start of the program.
“This is something we have been following for some time across all age groups,” she said. “In most age groups, it has actually decreased.”
While Henry acknowledged limits in the available data, early evaluations of the safe supply program, medications under the safe supply programs show “some benefit,” at least for certain groups.
“It reduces the risk of death due to toxic drugs, improves engagement and retention in health care, including addiction treatment and improves people’s overall physical, mental health and well-being,” Henry said.
This pending review comes amidst anecdotal reports that prescribed safe drugs are being sold on the illicit market with the money then being used to purchase more powerful illicit drugs.
“One of the challenges, right now, is that we are dealing with a lot of anecdotal information and allegations,” Lapointe said. “Drug trafficking remains a crime and if there is evidence of drug trafficking, law enforcement is responsible for doing what they can.”
Lapointe added that her office has not seen an increase of Hydromorphone in post-mortem testing.
“That doesn’t mean that some of that diversion isn’t happening. But it is certainly being monitored,” she said.
Henry added that Hydromorphone has been on the streets for a long time and the vast of majority of prescribed Hydromorphone is prescribed to people for pain for reasons other than related to the toxic drug crisis.
“We can’t blame it on safer supply because that has been very limited,” she said.
Henry said it is very difficult to determine whether drugs come from a safe supply source or another source. “Will it (diversion) happen? Is it happening? We hear stories. Absolutely, it seems to be happening for some people, but that doesn’t mean that we throw out the whole program.” It means reviewing what people need to make the program work, she added.
Options under consideration during the review include changing the supply of Hydromorphone and expanding the range of safe prescriptions, Henry said. While the review is just starting and could last months, it will include a wide range of players and everything is on the table, she added.
“I absolutely think it needs to include additional medications being available, different models for how you can book and access those medications and continuing surveillance and monitoring, so we can tell if things are working or not,” she said.
While Lapointe said the conference did not respond to any particular person or media report, it does come amid growing criticism of safe supply programs from leading politicians including federal Conservative leader Pierre Poilievre.
“But as my colleagues Dr. Henry and Dr. Charlesworth have said, we have been concerned,” Lapointe said. “(We) are focused on saving lives, we are focused on reducing harms, we have seen far too much harm and far too many lives lost and far too much suffering in our communities and we have been concerned about this increasingly polarized rhetoric that is not informed by evidence, that is not paying attention to evidence.”
Lapointe said it was very really important for the four of them to come together and assure the public that they are looking for any trends or risks to the public.
“But when we see people objectifying populations, setting the Downtown Eastside as an exemplar of everything that is wrong in our province, that disturbs us.”