B.C. introduces new prescribed safer supply policy, a Canadian first

TO help save lives by separating more people from the poisoned illicit drug supply, British Columbia is phasing in a new policy to expand access to prescribed safer supply.

B.C. is the first province in Canada to introduce this public-health measure.

As part of Budget 2021, the Province is directing funding up to $22.6 million to the health authorities over the next three years to lay the foundation for this innovative new approach. The funding will support the planning, phased implementation, monitoring and evaluation of prescribed safer supply services.

“For people who use drugs or who care about someone who does, the risk of death is omnipresent because of the increasingly toxic illicit drug supply,” said Sheila Malcolmson, Minister of Mental Health and Addictions, on Thursday. “At the start of the pandemic, B.C. provided access to some prescribed safer supply medications to save lives from overdose and protect people from COVID-19. Building on what we’ve learned, we’re expanding access to prescribed safer supply to reach more people and save more lives. This is one tool within a comprehensive response to the overdose crisis as we continue to also build up a treatment system so everyone can get the care they need. There is more to do, and we won’t stop working until we turn this crisis around.”

Carefully introducing prescribed safer supply is part of B.C.’s ongoing work to improve services for people with substance use challenges and to end the criminalization of people who use drugs, to reduce stigma and enhance support. Prescribed safer supply is about meeting people where they are at, connecting people to health-care services and reducing harms associated with using illicit drugs.

Once fully implemented, people who use drugs and who are at high risk of dying from the toxic illicit drug supply will be able to access alternatives covered by Pharmacare, including a range of opioids and stimulants as determined by programs and prescribers.

“With more than 7,000 lives lost to toxic illicit drugs, we need new measures to connect people to the supports they need to stay safe,” said Dr. Bonnie Henry, Provincial Health Officer. “Reducing harm for people who use drugs is the right thing to do. Bringing in this new policy to expand prescribed safer supply is a big change for B.C.’s health-care system. It’s about meeting people where they are at, reducing risk of toxic drug death and connecting people to the care they need and deserve.”

The Ministry of Mental Health and Addictions introduces this policy following months of work with partners and stakeholders, including medical doctors, nurses, pharmacists, people with lived and living experience, the First Nations Health Authority and all regional health authorities, and Indigenous-led organizations.

The policy was developed within the limits of the federal Controlled Drugs and Substances Act, which requires controlled substances be provided by prescription.

This new prescribed safer supply policy will roll out through a phased approach, beginning with implementing the policy in existing health-authority funded programs that currently prescribe alternatives to illicit drugs (e.g., opioid agonist treatment, oral and injectable tablet programs) and through newly created programs such as service hubs and outreach teams, supported by Budget 2021. Prescribed safer supply services will also be delivered through the federally funded Safer programs.

The first phase of this new policy is expected to be in place for 18 to 24 months as data is collected to assess this approach. Phased implementation ensures patient and prescriber safety, as well as providing opportunity for rigorous monitoring and evaluation as B.C. builds a body of evidence that will lead to clinical guidance for this policy.

Further phases will expand broader access once the clinical guidance is developed based on findings from the monitoring and evaluation process.

Enhancing B.C.’s response to the overdose emergency is an integral part of A Pathway to Hope, B.C.’s roadmap for building the comprehensive system of mental health and addictions care that British Columbians deserve.

Quick Facts

* British Columbia’s new prescribed safer supply policy is part of a comprehensive package of health-sector interventions designed to stem the tide on B.C.’s overdose emergency. Since 2016, an estimated 6,100 deaths have been averted because of these combined measures. This includes:
– more overdose prevention services/safe consumption sites – from one publicly available site in 2016 to 38 today, and more coming;

– B.C.’s widely available naloxone program – estimated to have averted 3,000 deaths between January 2015 and March 2021;

– expanded access to opioid agonist treatment – more than 24,000 people are currently receiving treatment, more than any time before;

– enabling registered nurses and registered psychiatric nurses to prescribe treatment medications for opioid use disorder – more than 90 nurses have already enrolled and/or completed their first round of training;

– doubling the number of youth treatment beds and adding more than 100 new adult treatment and recovery beds throughout the province; and

– the Province investing $330 million over the next three years in the overdose crisis. Of that, $133 million goes toward treatment and recovery services to help people find their path to wellness. In 2021-22, the total operating expenditures for mental health and addictions services are more than $2.7 billion.