British Columbia recently mandated that, starting from the end of this month, most “safer supply” drugs must be consumed under medical supervision in an effort to keep them from being diverted to the black market. While this reform is laudable and will help keep dangerous opioids off Canadian streets, it is reprehensible that the province dragged its feet for years here.
Although the BC NDP aggressively championed safer supply throughout the 2010s and 2020s, it eventually backpedalled after media reports showed that many recipients
sell their free hydromorphone to purchase illicit street fentanyl, and that this
floods communities with diverted opioids,
fuelling addiction.
This course-correction was glacial and grudging, though. When the National Post, citing over a dozen addiction doctors across Canada,
first reported on widespread safer supply diversion in mid-2023, the BC NDP
insisted that the program was not contributing to addictions or deaths and that diverted hydromorphone seizures were not increasing.
Later that year, dozens of addiction doctors signed
two public letters warning about safer supply diversion and begging for mandatory witnessed consumption. B.C.’s top doctor, Bonnie Henry, also
produced a report which confirmed, through extensive consultation with the province’s doctors and addicts, that safer supply diversion is a “common occurrence.”
Earlier this month, the province
released new guidelines — which come into effect on Dec. 30 — mandating witnessed consumption for all safer supply patients. These guidelines still allow unwitnessed doses in exceptional circumstances, but qualifying criteria now match those used for traditional addiction medications such as methadone, which means that they are clearer and stricter than before.
While this is an improvement, it is still possible that some clinicians will creatively interpret these criteria to prescribe unwitnessed safer supply opioids to diversion-prone patients. If there is a lesson to be learned from the past few years, it is that many safer supply prescribers cannot be trusted to practice responsibly — many of them
even claim that opioid diversion is a good thing.
Users of 'safer supply' drugs need medical supervision. It shouldn't have taken years for the province to learn that
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