B.C.㽶Ƶֱs auditor general says two key provincial programs intended to help the toxic-drug crisis that has resulted in at least 14,000 deaths since 2016 were not 㽶Ƶֱeffectively implemented.㽶Ƶֱ
Auditor-General Michael Pickup㽶Ƶֱs review, released Tuesday (March 19), looked at provincial overdose prevention and supervised consumption sites, as well as the prescribed safer supply program.
㽶ƵֱA prominent theme runs through both of these audits and that is that the Ministry of Mental Health and Addictions and the the Ministry of Health have not effectively addressed the many challenges and barriers facing each program,㽶Ƶֱ Pickup said in a news release.
The audit found the ministries㽶Ƶֱ guidance didn㽶Ƶֱt include minimum service standards that ensured consistent quality and access of services, that it did not adequately respond to barriers such as local government resistance and that a new program evaluation was needed as the health emergency evolved.
Pickup㽶Ƶֱs audit of safer supply found the ministries didn㽶Ƶֱt make 㽶Ƶֱsignificant progress㽶Ƶֱ in tackling its 㽶Ƶֱmost challenging barriers,㽶Ƶֱ such as rural access to the program, health-care providers㽶Ƶֱ hesitancy about prescribing the drugs and whether the drugs being offered were appropriate.
Both ministries have accepted all seven recommendations from the reports, including improving minimum service standards, increasing public reporting and addressing a lack of doctors who prescribe safer supply drugs.
The audit also pointed to what Pickup described as the province㽶Ƶֱs failure to overcome significant municipal resistance to overdose prevention sites. Municipalities have used bylaws, zoning and permitting to prevent the establishment of such sites.
Overdose prevention sites monitor people at risk of toxic drug poisonings and provide drug testing kits, as well as readily-available Narcan in the event of an overdose. Supervised consumption sites allow people to use drugs under the supervision of trained staff without the risk of arrest for drug possession.
As of June 2023, there were 47 overdose prevention and safe consumption sites in B.C., according to the report.
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Pickup㽶Ƶֱs report says that government㽶Ƶֱs failure to overcome municipal resistance and other roadblocks, such as staff retention at these facilities and infrastructure, has heightened various risks 㽶Ƶֱ the most serious being increases in death and injuries due to the circulating toxic drugs.
㽶ƵֱMany thousands of people in B.C. are grieving the losses of family and friends from the toxic-drug supply,㽶Ƶֱ Pickup said. 㽶ƵֱThe crisis is also an immense challenge for those working to provide care and support for people who use substances. My team and I have a deep sense of empathy for everyone who has been touched by this continuing tragedy.㽶Ƶֱ
The audit also highlighted several obstacles found within the implimentation of the safe supply program, which the province has rebranded as 㽶Ƶֱprescribed alternatives.㽶Ƶֱ
That program allows physicians or nurse practitioners to prescribe pharmaceutical-grade alternatives for people at risk of harm or death from the toxic drug supply.
Critisism by the auditor general include the unavailability of drugs in a form that can be smoked, as well as the perceived low potency of hydromorphone, and the lack of access in rural communities.
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Other aspects the report highlights includes a lack of reliable and publicly available data about the program㽶Ƶֱs effectiveness and geographic reach. Pickup㽶Ƶֱs report also takes aim at the province㽶Ƶֱs communication around expansion of the program and the types of drug alternatives available to those in need.
㽶ƵֱWe found that health-system partners and some health authorities believe that communication by the ministries about prescribed safer supply, specifically about diversion, has been weak,㽶Ƶֱ the report reads.
Addictions Minister Jennifer Whiteside declined an interview Tuesday, but said in a statement that the government is building a continuum of care 㽶Ƶֱthat includes prevention, harm reduction, treatment and recovery.㽶Ƶֱ
㽶ƵֱWhile we have rapidly expanded access to overdose prevention sites as a critical tool to keep people alive, we acknowledge there are some persistent barriers impacting implementation and service standards,㽶Ƶֱ she said. 㽶ƵֱIn the same way, while monitoring is in place for our prescribed alternatives program, we continue to work directly with prescribers to support implementation.㽶Ƶֱ
She said the ministry is already working to address many of the items cited in Pickup㽶Ƶֱs reports.
At an unrelated news conference on Tuesday, Premier David Eby acknowledged the reports㽶Ƶֱ findings of barriers to accessing those prevention services, especially in remote parts of B.C.
㽶ƵֱThere are big challenges for us in delivering rural health care, period, and including in the areas where people are struggling with addiction at risk of overdose,㽶Ƶֱ he said. 㽶ƵֱIt㽶Ƶֱs important to note (Pickup㽶Ƶֱs) not saying stop the program, he㽶Ƶֱs not saying the program doesn㽶Ƶֱt work, he says he wants more of it in every part of the province. This is a challenge for us.㽶Ƶֱ
The auditor㽶Ƶֱs report said overdose-prevention and safe-consumption sites provide safer environments for people to use drugs under the supervision of a health-care professional or harm-reduction worker to monitor for signs of drug toxicity.