Seventy-two B.C. doctors have come together to criticize provincial “safer supply” strategies and call for better safety measures and more research into the potential harms of such programs.
One of the B.C. doctors is Dr. Mark Mallet, a hospitalist at Victoria General Hospital, who penned an op-ed piece published in the Times Colonist last month that expressed his concerns with the NDP government’s claims about safer supply. He said the province needs to do a better job of balancing the “risk of harms” with any potential benefits that safer supply programs may offer.
Safer supply programs provide those at high risk of overdose with prescribed drugs as an alternative to purchasing illegal substances off of the street.
His article brought an outpouring of support from the medical community with 71 doctors asking to join his cause.
Dr. Mallet has since penned a letter to Premier David Eby and several provincial and federal ministers calling for change, signed by the 71 doctors backing his stance.
The opinion piece points to a recommendation from B.C. chief medical officer Bonnie Henry to expand the program to include a wider range of prescribed alternatives.
“It is worth highlighting three of her conclusions which should give us pause when considering further expansion, as they clearly indicate that we are jumping the gun,” Dr. Mallet wrote.
Dr. Henry also suggested a scientific and clinical committee be formed to review concerns about safer supply. She said there was not yet enough research to conclude that prescribed safer supply (PSS) was “fully evidence-based.”
Dr. Mallet argued that prescribed safer supply advocates claim their position is based on evidence and opposition to program expansions are nothing more than “fear-mongering.”
The Risks of PSS
He said Dr. Henry herself concluded that PSS comes with a number of potential risks, including the drugs being sold on the streets and an increased opioid access for youth.There have been a number of reports that revealed safe supply customers regularly resell the safer drugs they are given to purchase stronger illicit drugs. The PSS drugs are then available on the streets and are often sold to young people, creating further addiction issues.
Just as worrying, says Dr. Mallet, is the chief medical officer’s admission that research into the potential dangers of safe supply programs is scant and that the extent and impact of drug diversion is unknown.
He called the admission “shocking,” in light of chief coroner Lisa Lapointe’s assertions last year that PSS diversion is an urban myth. At the time, she said the authorities were “closely monitoring, continually, for any and all trends” that could impact the public’s safety.
The RCMP announced earlier this month it had seized more than 10,000 prescription pills—many of them government-funded “safer supply” pills—as part of recent drug busts in Prince George, B.C.
Cpl. Jennifer Cooper said the seizure highlights an “alarming trend” of safe supply drugs being confiscated in police drug busts over the past year.
“Organized crime groups are actively involved in the redistribution of safe supply and prescription drugs, some of which are then moved out of British Columbia and resold,“ she said. ”The reselling of prescription drugs significantly increases the profits realized by organized crime.”
Dr. Henry’s findings should give both the province and advocates of safer supply programs pause, Dr. Mallet said, adding that the expansion of any type of safer supply program is inconceivable when both safety and effectiveness have yet to be proven.
He described research into the efficacy and safety of such programs as essential before any expansion is approved, adding that all PSS should be “tightly controlled, rigorously monitored, and meticulously documented.”
“To demand evidence is not fear mongering, it is not politicizing, and it has nothing to do with moral panic; to demand evidence is, in fact, the very basis of scientific inquiry,” he concluded. “As a physician and a citizen of British Columbia, it is not only my right to demand such evidence; it is my responsibility.”
Auditor General Report
B.C.’s auditor general this week also criticized the government’s prescribed safer supply program, albeit on different grounds. The provincial watchdog said both the safer supply program and B.C.’s overdose prevention and supervised consumption services had “significant deficiencies.”Auditor General Michael Pickup said the ministries failed to “develop or implement strategies to address prominent barriers” to safer supply implementation.
“We recommend the ministries develop an action plan to address barriers to prescribed safer supply implementation that includes working with health authorities to clearly define ministerial and health authority responsibilities for implementation and oversight,” the report stated.
Mr. Pickup’s report also criticized the government for failing to “effectively report publicly” on the performance of prescribed safer supply.
B.C. is the first province to offer safer-supply programs. The initiative was launched by the province’s Ministry of Health and Ministry of Mental Health and Addictions in response to an ongoing overdose emergency that has claimed more than 14,000 lives since 2016.
A B.C. Coroners Service outlined the emergency in a report released earlier this year, noting that at least 198 deaths were caused by the use of “toxic, unregulated drugs” in January alone.
Both federal Conservative Leader Pierre Poilievre and Alberta Premier Danielle Smith have criticized B.C.’s safer supply initiative, saying they believe drugs from the program are being diverted into the rest of Canada.
Ms. Smith, in a March 8 statement, called on British Columbia to stop the flow of safer supply drugs into her province.
“Alberta has been warning for years that diversion of high-potency opioids from these programs could be diverted and trafficked across Canada,” she said. “In Alberta, we have made the provision of ‘safe supply’ illegal to prevent this very thing from happening. Unfortunately, that does not stop organized criminals from bringing it here illegally from other provinces.”
