BC NDP Kill Already Limited Safer Supply Program
BC NDP know their witnessed safe supply policy will be fatal, but pursue it as they cave to right-wing rhetoric: Statement
On Feb. 19, the BC NDP announced new restrictions to the prescription of safer alternative medications in so-called British Columbia. Also known as “safe supply,” these alternatives have been an integral part of health practitioners’ toolkits since first introduced in 2020 during the Covid-19 pandemic, under the direction of Provincial Health Officer Dr. Bonnie Henry.
This sudden move continues the BC NDP-led shift away from the liberatory and life-saving work of harm reduction. It will also place drug users, who make up approximately five per cent of BC’s adult population, at increased risk of death, almost nine years into the province’s longest public health emergency.
“This isn’t in line with evidence. This is a violent, irresponsible response to moral panic and skewed disinformation. The fact that those in power are taking the little bit of autonomy that the most marginalized people have is going to cause great harm. And quite frankly, that’s a really scary thing.” - Heather Tunold, peer harm reduction worker and person with lived experience
The goal of safer alternatives were to provide just that — a prescribed alternative to the unpredictable and toxic street supply of substances. The prescription of hydromorphone or prescribed stimulants for this purpose was a pilot project in safe supply — one that was still heavily restricted and largely inadequate.
Fewer than 5,000 people in British Columbia were ever accessing safe supply hydromorphone — at its peak — despite an estimated 100,000 British Columbians living with a diagnosis of “opiate use disorder” who are at risk of death from the toxic drug supply. Occasional opioid users without this diagnosis have never been offered legal access to a regulated supply. Prescribed stimulants were under-prescribed and the dosage form was inadequate for most stimulant users, offering only an extended-release formula.
“The patchwork of safe supply available in this province was never adequate and restricting it even further as the BC NDP has done will only put my most vulnerable clients at increased risk of death. It’s beyond disturbing to see the government continue to ignore and silence the best evidence we have and do the opposite of what is needed to address the public health emergency. The BC NDP treats drug users as disposable.” - Fraser Macpherson, Registered Nurse
Even for those who could access it, hydromorphone dosing was woefully inadequate for many — with the typical maximum dose approaching only a fraction of what is typical for people who use fentanyl and fentanyl combinations daily. And because the program was only accessible by prescription from a physician or nurse practitioner, those without a regular health care provider were essentially excluded from accessing safe supply — a systemic failure especially felt in rural and underserved suburban areas where fatal overdoses are wreaking devastation. Additionally, these prescriptions often required signing a written contract and agreeing to perform regular urine screening tests to confirm the presence of the drug in the patient’s urine. Urine drug screening is not routinely required for the prescription of opioids for any class of patients other than drug users. Despite these barriers and significant shortcomings, prescribed hydromorphone is the first legal, regulated alternative to street opiates in the province. The newly announced restrictions have essentially killed this limited program — a move pulled directly from the BC Conservatives’ playbook.
Since its inception, the prescription of safer alternatives has received pushback from healthcare workers as well as right wing and centrist politicians, most notably Elenore Sturko, the current MLA for Surrey-Cloverdale. This pushback, reinforced by decisions from the BC NDP majority government, has resulted in a patchwork implementation of the prescription of safer alternatives, where some drug users have been offered the medication as a harm reduction measure, while others in similar circumstances who were also eligible were not offered this medication. Again, only an estimated four to six per cent of drug users in the province were prescribed a safer alternative at the peak of the program.
Predictably, the moral panic and restriction of access to safe supply has incentivized a counterfeit safe supply market, putting people at further risk of overdose death and other toxic supply-related harms.
“We are calling on the government to consider the ramifications of their impulsive, non-evidence-based decision to suddenly discontinue unwitnessed prescribed safer alternatives, and the disproportionate impact this will have on rural and Indigenous communities.” - Jess Wilder, MD, Doctors for a Safer Drug Policy
For years, BC’s former Chief Coroner, Lisa Lapointe, continued to highlight that hydromorphone was not involved in the toxic drug poisoning deaths she was investigating and reporting on. In a study from 2019-2023 on Youth Unregulated Drug Toxicity Deaths, there were zero deaths in which hydromorphone was the only substance detected. The BC Coroner Service Death Review Panel report published in November 2023 clearly called for increased access to safe supply, including access without a prescription.
These calls were echoed by others like Dr. Bonnie Henry, who as recently as December 2024, called for increased access to these medications in the wake of a chilling de-prescribing movement brought on by conservative media reporting, so-called addiction medicine physicians, and the loud voices of right-wing politicians like Sturko.
Drug user activist groups like the Drug User Liberation Front (DULF), Vancouver Area Network of Drug Users (VANDU), Surrey Union of Drug Users (SUDU), Western Aboriginal Harm Reduction Society (WAHRS), and Nanaimo Area Network of Drug Users (NANDU) have been calling for access to a safe, regulated supply of substances for years.
In 2023, DULF engaged in a widely successful pilot project to distribute a safe supply of substances that directly mirrored community usage. Despite the program’s success, the province and police responded by criminalizing DULF’s founders and raiding their homes. They are now facing criminal charges. Drug user groups have been critical of the prescribed safer alternative program as well, due to the numerous barriers to access these medications and to call for more appropriate prescribed alternatives that meet the needs of those who depend on them. Calls for a compassion club model of safe and regulated alternatives to the policed supply have been ongoing for years, including from advocacy groups such as Moms Stop the Harm. The BC NDP has repeatedly refused to implement such a model even when it has been recommended by their own experts and has actively contributed to criminalizing one of the only groups to implement it publicly.
“When the next wave of disruption and civil disobedience crashes over BC’s healthcare system - the province can remember that it abandoned all of us before we abandoned it.
Diversion of a regulated opioid supply when the supply is otherwise contaminated saves lives, yet parties across the legislature are cheering on its restriction while endless death and drug supply-related violence grips our communities. Even more appalling are the masters of public health bureaucrats and physicians who hold the levers of power to do better, but instead choose to soak their hands in blood by simply going along with these political directives. As long as the unregulated drug supply continues to be contaminated, the crisis will continue. But as the province withdraws life saving measures, our communities will take more and more action into our own hands.” - Tyson Singh Kelsall RSW PhD(c), Faculty of Health Sciences, SFU, and social worker with Care Not Cops
Restricting access to prescribed safer alternatives would require people who use drugs to present to a pharmacy every two to four hours to receive a dose of the safer alternative. There is only one 24 hour community pharmacy currently in operation. Pharmacies and the broader healthcare systems are already under incredible strain.
At the same time that the BC NDP, and those who implement their bidding, cut access to regulated opioids – they are also working to expand forms of temporary forced abstinence through new forms of criminalization and involuntary treatment. This is despite the acute risk of overdose among people enduring incarceration post-release, as well as people released from involuntary treatment sites.
The move by the BC NDP to restrict access to prescribed safer alternatives further exemplifies the targeting of populations already made marginal by punitive and carceral policies that eliminate individual autonomy, choice and restricts movement and mobility.
Statement endorsed by:
Vancouver Area Network of Drug Users (VANDU)
Care Not Cops
Crackdown Podcast
Pivot Legal Society
Coalition of Peers Dismantling the Drug War
Doctors For Safer Drug Policy
Police Oversight with Evidence and Research (P.O.W.E.R)
Canadian Students for Sensible Drug Policy – Vancouver Chapter