BC to Require ‘Safer Supply’ Users to Take Drugs Under Supervision to Curb Opioid Diversion

Heroin and cocaine from a safe supply are handed out to drug users in the Downtown Eastside of Vancouver, on Aug. 31, 2021. THE CANADIAN PRESS/Darryl Dyck

British Columbia has ended its take-home “safer supply” model, now requiring opioid recipients to take their prescriptions under medical supervision to prevent drugs from being diverted to organized crime networks.

B.C. Health Minister Josie Osborne announced the changes in a Feb. 19 press release, saying that by having health professionals witness the consumption of prescribed opioids, the province will ensure they are used by the intended recipient.

“This will remove the risk of these medications from ending up in the hands of gangs and organized crime,” she said.

The move comes after a ministry of health document leaked earlier this month said a “significant” share of the opioids “freely prescribed by doctors and pharmacists” are not being used by their intended recipient, and that government regulated drugs are being trafficked provincially, nationally, and internationally.

The switch to witnessed consumption took effect on Feb. 19 for new patients, said the province, adding that it will work with clinicians to transition existing patients into the new model “as soon as possible.”

Osborne argued prescribed opioids have been “proven to save lives by providing a safer option for people at high risk of overdose,” but that work is needed to ensure the program functions as designed.

B.C.’s government started its “safer supply” program in 2020. The program is a federally funded initiative that provides prescribed opioids to people struggling with addiction as a way to discourage them from getting drugs from the illicit street market. According to the program’s description, this reduces the risk of overdose, poisoning, and death, and helps connect people with health and social services.

Roughly 22,418,000 doses of opioids were prescribed through the program in British Columbia between 2022 and 2024, according to the leaked document.

B.C. Conservative MLA Elenore Sturko described the document as evidence that the safe supply program is “fuelling addiction,” saying the number of opioids prescribed for the program increased to over 20 million from around 500,000 pills in the first 6 months of the program in 2020.

B.C. Opposition Leader John Rustad called the province’s recent decision to require supervised consumption “a major policy victory” scored by his party, in a Feb. 19 social media post. He said he has called for a public inquiry into safer supply diversion in the province.

Program ‘Misuse’

Since last year, the health ministry has been investigating pharmacies dispensing prescribed opioids suspected of engaging in illegal activities, including “misusing” fee-for-service payments to offer “kickbacks to retain and attract new patients,” according to the Feb. 19 press release. So far, the ministry has received allegations against more than 60 pharmacies.

The province said it will adjust the fee structure for pharmacies to better reflect service costs and reduce financial incentives for “bad actors” who try to “take advantage of the system.”

Pharmacies found guilty of wrongdoing will have their licence suspended or cancelled, be made ineligible to bill payments for medications and medical supplies, and referred to law enforcement if necessary, officials said.

The provincial government is also working to address the overprescribing of opioids by health-care providers, noting that 97 percent of the people prescribed opioids last December in the province received them for reasons unrelated to “safer supply,” such as pain management.

The province said it will create a working group with the College of Physicians and Surgeons and the College of Nurses and Midwives to investigate and mitigate the “inappropriate prescribing of opioids.”

Last November, a House of Commons committee heard testimony from London, Ont., police that “safer supply” drugs are being traded for more potent drugs, such as fentanyl. The city of London was the first place in Canada to test the program.

“If they are engaged in the program and receive a supply of Dilaudid, that now acts as currency that they never had previously,” London Police Chief Thai Truong told the House Committee on Health on Nov. 26, 2024.

“And because they’re prescribed a quantity of hydromorphone, they now are able to obtain fentanyl.”

Chandra Philip and Matthew Horwood contributed to this report.