As illicit drug toxicity increases, what about safe supply?

As a response to the increasing toxicity of drugs in the illicit market, the provincial government took steps to be one of the first jurisdictions to provide illicit drug users access to a safe supply of a pharmaceutical grade opioid alternative.

With more than 1700 British Columbians perishing to a drug poisoning last year, there needs to be a greater sense of urgency to address gaps in the safe supply program identified by advocates. I ask the Minister what she is doing to address them.

[Transcript]

A. Olsen:

Our drug supply is becoming increasingly toxic. January saw 165 lives lost due to the illicit drug toxicity in British Columbia. That is the highest-ever recorded in January and following the all-time yearly high we saw in 2020 of over 1,700 lives lost. One in five of those suspected deaths in January noted extreme fentanyl concentrations, the largest recorded to date of up over 10 percent from this time last year. Over 700 lives have been lost since safe supply measures were announced in September.

The promise of safer supply being prescribed through nurses has fallen short. Those trying to access prescription opioids through their doctors have been met with stigma. The prescribed narcotics have been low potency, compared to the street-grade fentanyl currently in circulation. It’s not curbing their addiction. We must do better.

My question is to the Minister of Mental Health and Addictions. There are gaping holes in our patchwork for safe supply. We need immediate, non-stigmatized, effectively dosed and consistent access to save people from the poisonous drug supply. What many have shared with us is that safe supply needs to be a realistic alternative. If it’s not, people will just return to the supply on the street.

What specific steps has the minister taken to close the gaps in B.C.’s safe supply?

Hon. S. Malcolmson:

The border closures and social distancing requirements of the pandemic have exacerbated the overdose crisis — the number of deaths having been brought down for the first time in B.C.’s history, in the year 2019, is a tragedy. To be fighting two public health emergencies at the same time and to have such a disastrously increased toxicity of illicit drugs has lost more lives this past year than ever. And to the families that have lost loved ones and to those who are working hard to save them, I’d just say: I’m so sorry.

I’m so sorry. I’m grateful to, for example, nurse prescribers who are stepping up. We now have 30 new practitioners spanning out across the province in every health authority. We have an increasing number of addiction medicine doctors that are working on developing the guidelines for safe supply for expanding additional substances.

Both medication-assisted treatment and safe supply are vital. In every case, because this hasn’t happened in Canada before, patient safety is at the forefront. We continue to take our guidance from addiction medicine doctors who are working on prescriber guidelines on the framework to deliver safe supply, but to do it in a way that keeps patient safety at the forefront. Again, my gratitude to those who are breaking new ground. In Canada, no one else has done this.

Thank you to the member for the advocacy. You’re right. We are going further, and there’s much more to do.

Mr. Speaker:

Member for Saanich North and the Islands on a supplement.

A. Olsen:

Thank you to the minister for the response. As the minister noted, 30 registered and psychiatric nurses in our province were to be trained to receive prescribing powers for Suboxone, a prescription opioid and the alternative to the illicit street supply. They were supposed to have this training and be in place by the end of February.

Now this is an important step, as the minister noted, and one that is a precedent for jurisdictions in North America. But we are a province of millions, and the overdose crisis affects all communities. I’m happy to hear that these psychiatric nurses will be in communities across the province, but just 30 nurses with prescribing power after nearly five months after safe supply measures were promised does not reflect the urgency that’s needed to support drug users in British Columbia.

Allowing for greater access to one prescription opioid alternative does not reflect the diverse range of substances used in this province nor the efficacy of providing pharmaceutical-grade versions of illicit substances that reduce reliance on the toxic street market and can save lives.

My question is again to the Minister of Mental Health and Addictions. I just want to confirm that those nurses that were promised are in place and have received those prescribing powers. How is the minister supporting the expansion of access across the province?

Hon. S. Malcolmson:

Meeting on Friday with the First Nations Health Authority, they were able to report that they have nurse prescribers in some of their communities already. These are people that were trained in early February. So that access, particularly to remote and northern communities, is particularly welcome.

That was just the first cohort of nurses that were trained to be medication-assisted prescribers. This isn’t the same as safe supply, although that is our long-term hope. That guidance is still being developed by the medical community. This isn’t a question of what’s happening inside the ministry. This is the work that doctors and medical professionals are doing to ensure that the right types of medications are included in the guidance and that the guidance supports both patient safety and prescribers.

Again, in Canada, we are breaking new ground on this. We are taking new trainees all the time. The additional guidance that dictates how the medical community will make decisions about what type of medication-assisted treatment or safe supply is delivered to people with addiction-use disorders is something that is entirely in the hands of the medical community. We are working as fast as we can to expand that work, to support that work, because it can save lives.