Provincial health officer urges B.C. to expand safer-supply program, despite drug diversion risks

A new report from Dr. Bonnie Henry has called on the B.C. government to broaden the availability and types of drugs that can be prescribed under the province’s controversial safer-supply program.

But the provincial health officer also acknowledged Thursday that the pioneering program carries some societal risks, and urged B.C. to create a scientific and clinical committee to address concerns and evidence arising from it.

B.C. is the first province to have a safer-supply program, which allows medical prescribers to give substance users regulated versions of some opioids.

On Thursday, Henry released her review of the program in a report titled A Review of Prescribed Safer Supply Programs Across British Columbia.

The province had asked Henry to scrutinize any risks and benefits of the initiative and to issue recommendations.

Her report comes amid growing controversy around prescribed safer supply, which B.C. launched in March 2020.

Critics have expressed concerns that some of the regulated drugs may be making their way to unintended substance users without a prescription, known as diversion.

“Emerging evidence indicates diversion of prescribed substance(s) is occurring and may be causing harms,” Henry’s report states.

However, she said there is no evidence that more youth are being diagnosed with opioid use disorder since the province launched its prescribed supply program — in fact, she found the opposite.

But she acknowledged that issues surrounding “diversion and diversion mitigation result in moral distress for some prescribers.”

On the other side, substance users and some health providers have said it is too difficult to access the prescriptions for users at greatest risk of dying from toxic, illicit drugs. 

Henry therefore called on the province to expand its prescription program to include more commonly used drugs including diacetylmorphine — or pharmaceutical heroin — and various forms of fentanyl.

Currently, most of the prescribed supply under the program has been hydromorphone in tablet form, she said.

A bottle labeled dilaudid, a pharmaceutically made version of hydromorphone, is open with white pills in the lid, on a counter.
Dilaudid, a safer supply medication for opioid users, pictured in a Vancouver pharmacy on July 25, 2023. (Maggie MacPherson/CBC)

Last year, a record 2,511 British Columbians died as a result of unregulated drugs, the equivalent of nearly seven deaths a day. That represents a five per cent increase compared with the previous high of 2,383 deaths recorded in 2022. 

On Jan. 24, Chief Coroner Lisa Lapointe renewed her plea for an expansion of safer supply and a “systems change” that treats substance use as a health issue, not a criminal problem.

Following Lapointe’s remarks, B.C. United leader Kevin Falcon said on social media that the grim death toll was an indictment of the B.C. NDP’s policies, including the “reckless decriminalization” of small amounts of certain illicit drugs.  

According to the province, 4,265 people were prescribed an opioid alternative under the $184-million program in November 2023.