Health officials in British Columbia are using language and messaging that casts a favourable light on the province’s safer supply approach to drug addiction. This includes moving away from the controversial “safer supply” wording to instead say the province is offering “prescribed alternatives to the toxic supply.”
This change in wording was among the directions British Columbia’s chief medical officer Bonnie Henry gave in her
report on safer supply programs published Feb. 1. She said the new wording “prescribed alternatives” associates the program more closely with the common clinical practice of prescribing medications for off-label use.
Messaging from provincial officials consistently includes the words “toxic” and “unregulated” before any mention of drugs responsible for overdose or other harms. “Unregulated fentanyl” was to blame for new record-high overdoses announced on Jan. 24, Chief Coroner Lisa Lapointe said in her
report.
This differentiates street fentanyl from safer supply fentanyl—which Dr. Henry’s report said should become more widely available.
The coroner’s report also makes a point of saying safer-supply drugs, such as hydromorphone, are found in only about 3 percent of toxicology reports. This suggests that safer supply is not having a negative impact.
But, as addictions physician
Dr. Michael Lester pointed out, critics of safer supply aren’t saying hydromorphone causes overdose directly. They’re saying that hydromorphone is being diverted—sold on the street—and it starts non-users on the path of opioid addiction that leads to fentanyl-use and, perhaps, overdose.
“[Safer supply] advocates point out that there has not been a spike in hydromorphone-caused overdoses since [safer supply] began,” Dr. Lester said in his communications with journalist Adam Zivo, which Mr. Zivo published in-full online as part of a Feb. 1
article for The Hub.
“Many people who start their opioid addiction using oral opioid medications turn to intravenous use or move up to more potent opioids such as fentanyl in time,” he continued. “It commonly takes many years for someone to eventually die of their opioid dependency. It may be a stronger opioid that eventually causes the their deaths.”
Many of British Columbia’s published materials on safer supply note the lack of evidence that hydromorphone is causing overdoses. Ms. Lapointe also
used such data in a Feb. 1 interview with the CBC to advocate for the expansion of safer supply, including offering it without prescription. Although this information is used to prove lack of harm from safer supply, it doesn’t address the primary concerns raised about safer supply.
Top provincial officials have recently made strong statements in favour of both safer supply and the province’s drug decriminalization pilot, which is another hotly contested policy point.
Moving Forward With Decriminalization
“Our government’s goal is to reduce the fear and shame associated with addiction, so more people can feel comfortable reaching out for help,” she said. The pilot program is set to last another two years, and Ms. Whiteside said it should continue.
Opposition leader, Kevin Falcon of B.C. United, disagreed, saying decriminalization has enabled the proliferation of drugs and open-air drug-use and that it has contributed to the overdose crisis.
“Instead of saving lives, decriminalization has contributed to a record-breaking loss of life in our province. It has done nothing to increase treatment and recovery services or to protect our most vulnerable citizens,” he said in a Jan. 30
statement.
