New safe supply rules take effect in B.C., with mixed reactions

New restrictions to British Columbia’s safe supply program are now in effect.

Some addictions specialists worry the changes will push people back to toxic street drugs, while others say the changes were long overdue.

“A majority of our clients haven’t had an issue with the changes,” said Jake Flood, operations manager at the Umbrella Society, a Victoria-based non-profit that connects people to treatment and recovery services.

Those changes – to further restrict access to the province’s prescription opioid program or safe supply – rolled out Dec. 30.

Now, most patients who take prescription opioids such as hydromorphone or fentanyl patches will have to do so under the supervision of a pharmacist or health professional.

Flood says moving to witnessed safe supply strikes the right balance.

“It’s the people that are not taking safe supply as prescribed and selling it on the street that are having an issue with it,” he said.

The move to end take-home safe supply came after leaked internal RCMP slides revealed a “significant proportion” of prescribed opioids were being diverted and trafficked in B.C.

Flood says some of those diverted hydromorphone pills, known on the street as “dillies,” would sell for as little as a few dollars each. Flood, who struggled with addiction for five years before seeking treatment, says he and fellow outreach workers were seeing those cheap pills end up in the hands of teens.

“That was their kind of first taste of using substances. And unfortunately some of those folks end up going on to using more dangerous illicit substances like fentanyl.”

But Dr. Jess Wilder, a Nanaimo-based addictions doctor, says the changes create barriers for her patients, many of whom are unhoused.

“I’m seeing patients destabilize as a result of not being able to access these medications,” said Wilder, who co-founded the advocacy group Doctors for Safer Drug Policy.

WATCH | Safe supply user frustrated with those abusing the program:

Safe supply user frustrated with those abusing the program

Shauna Adams says many people depend on the safe supply program, and it bothers her to see it being abused at the expense of those who need it.

Wilder says she’s also heard from pharmacists in Nanaimo and Campbell River who say they don’t have the staff to supervise dosing and could pull out of the safe supply program all together.

“It’s a massive strain on our pharmacists,” she said. “We’re in a health-care crisis right now and that extends to our pharmacy colleagues. So due to capacity, some pharmacies have not been able to support patients in the ways that the government is requesting that we do.”

There are key exceptions to the new rules, including for some in rural communities and people who can show their work schedule does not allow them to go to a pharmacy several times a day.

The witnessed dosing does not apply to people who take prescription opioids for pain management, palliative care or other non-addictions related medical issues.

Some pharmacies will deliver prescription opioids to those managing their addiction.

But Wilder says that still leaves patients who live on the street at risk of falling through the cracks.

“I fear that our most vulnerable patients and the ones who are most at risk of dying from the toxic drug crisis are the ones who are going to be left out of these extra supports.”

At its height, 5,000 people were enrolled in B.C.’s safe supply program. Now there’s about 1,900, according to the Health Ministry.

B.C. Conservative addictions and mental health critic Claire Rattée says the safe supply program had problems from the start and she says there’s no evidence that the program has reduced overdose deaths.

She said the fact that the number of people using the program has declined so sharply with the announcement of witnessed dosing “leads me to believe that many people were using it for the purposes of diversion.”

B.C. Health Minister Josie Osborne was not available for an interview. Her ministry says in a statement, the new rules are aimed at keeping people alive while connecting them to treatment services.

But Flood says the province has a long way to go in providing the required treatment beds as many of their clients continue to face months-long waits for detox and stabilization.

“The need is is so great. There’s so much demand for it and and we’re just not meeting it.”