Drug user advocates say B.C.’s safe supply program still inaccessible, inadequate

VANCOUVER (NEWS 1130) — Half measures. Incremental. Too little too late. Drug user advocates say B.C.’s expanded safer supply program still leaves too many people out, and puts too much power in the hands of prescribers.

On Thursday, provincial officials announced a plan to spend $22.6 million over three years to expand the existing program that connects people who use drugs to a prescribed supply as an alternative to the toxic, poisoned supply circulating in the province.

In May 2021 alone, there were 160 toxic drug-related deaths. The total number of deaths from illicit drugs from January to May was 851, the most ever reported in the first five months of a calendar year. More than 7,000 people have died in B.C. since a public health emergency was declared in 2016.

RELATED: B.C. expanding access to safer drug supply

Vince Tao, with the Vancouver Area Network of Drug Users, says access to alternatives to dangerous drugs is something the organization has been advocating for, for decades.

“As with all these announcements by the province, it comes to us as a decent step, a decent step. It’s a little too little, too late,” he says.

“We see these as half measures, not the complete steps that are proven from the community, from science. What we need is full safe supply.”

The province announcing today expanding access to supply to combat the #opioidcrisis
Minister for Mental Health & Addiction @s_malcolmson says phase 1 will see prescription access increased in exisiting channels (will be in this stage for 18-24 months). #bcpoli @NEWS1130 pic.twitter.com/z4KzhngVdf

— LizaYuzda (@LizaYuzda) July 15, 2021

The Ministry of Mental Health and Addictions says people who have been clinically assessed will get alternatives including oral opioids, fentanyl patches, fentanyl tablets, as well as injectable and tablet hydromorphone.

But Tao says the requirement for a clinical assessment and prescription means a lot of people who need and would benefit from a safe supply will not be able to get it.

“People know what they want and what they need to feel better. The power to prescribe safe supply, it rests in the hands of the individual prescriber or the pharmacist. For us, that leads to a lot of access barriers,” he explains.

“A doctor or a nurse can prescribe. But then there’s a pharmacist that actually creates all the rules around how you access and consume. There are ways in which it can be managed with the cooperation of a pharmacist if a pharmacist acted less like your dad and more like a counsellor, or a friend or, or a social worker who works with an individual about what their consumption is and how to make sure that they can get the clean supply of what they need.”

RELATED: ‘We cannot do this anymore’: VANDU withdraws from decriminalization talks with city

One issue Tao says VANDU members have raised with other safe supply pilot programs or efforts is that the supply can be cut off.

“There’s no actual thought about what kind of shock that would be to someone’s system, their life, or to the kind of behaviours that it might encourage when people ultimately need to replace that what they were getting with  something less safe on the street,” he says.

“It seemed arbitrary, there was very little logic or rationality behind it at least given to our membership. That’s why we’re hesitant to applaud this model completely because we know what can happen if the power again rests in the hands of the prescriber.”

The phased plan from the province does include a promise of service hubs and outreach teams, and an acknowledgment that people need to be able to access drugs somewhere that they feel comfortable.

Donald MacPherson, executive director of the Canadian Drug Policy Coalition, also welcomes the move but is critical of its scope.

“Many people who are users are quite frustrated because it’s not going to reach a great many people. It will reach people who are already in contact with the health care system, who have the ability to navigate the healthcare system, who have a doctor, or can find a doctor who will prescribe the provincial safe supply substances. There’ll be a lot of people left out,” he explains.

“You have to be diagnosed with a substance use disorder. Many people who use substances aren’t diagnosed and many don’t have a substance use disorder but they may use substances that are compromised with fentanyl. I know people who use drugs are looking for a much broader program that engages organizations like VANDU and others to help get the substances to people.”

BREAKING NOW: @DULFBC @VANDUpeople are handing out free heroin, cocaine and crystal meth in front of the Vancouver Police department offering a safer supply of drugs that were all checked and contain no fentanyl! Real #safersupply #harmreduction pic.twitter.com/FZjUKn8j3c

— guyfelicella (@guyfelicella) July 14, 2021

On Wednesday, VANDU and the Drug User Liberation Front (DULF) handed out heroin, meth, and cocaine that had been tested to ensure they didn’t contain fentanyl or benzodiazepines.

Tao says that effort shows there is a viable alternative to a medical or clinical model of safe supply.

“We wanted to roll out what we thought, a form of community-based safe supply could look like,” he says.

“It was drug users deciding to hand out [safe drugs] to the neighbourhood, to folks in the Downtown Eastside without them having to go do a bunch of tests in front of a doctor, in front of a pharmacist to prove that you need this thing, or prove that you’re able to use this drug properly. This is a model of safe supply that is desperately needed because, ultimately, it brings the power to decide back to the people who are actually using the drugs, and not the so-called medical experts.”

RELATED: Vancouver councillor, advocacy groups distribute drugs to highlight toxic drug supply concerns

MacPherson says the province’s move toward expanding the program, including the requirement for every health authority to set up a program within weeks, is welcome.

But he says the expanded program falls short of taking the kind of action that this devastatingly fatal crisis requires.

“All health authorities are mandated to set up programs and start to initiate offering people safe supply. It’s a real acknowledgement that the toxicity of the drug market is not going to go away. But it’s an incremental step. Usually, when you declare a public health emergency, you move beyond that to a more robust, scaled-up version of trying to address the problem,” he says.

“If there were poisoned food in the in the environment or poisoned water you’d act quickly, decisively, and provide alternative sources of food or water to people. Really, we should be doing the same thing with the toxic drug market.”