B.C. auditor general finds 'deficiencies' in 2 overdose prevention programs

British Columbia's auditor general says two govern‐ ment programs aimed at curbing the death toll from the toxic-drug crisis were not "effectively imple‐ mented" by the province's Ministry of Mental Health and Addictions and Min‐ istry of Health.

Michael Pickup's office re‐ leased a report Tuesday on the government's overdose prevention and supervised consumption services and the first phase of the pre‐ scribed safer-supply pro‐ gram, launched amid a pub‐ lic-health emergency that has claimed more than 14,000 lives.

"In both of these audits we found significant deficien‐ cies in the provincewide im‐ plementation of these pro‐ grams," Pickup said in a press conference.

The audit found the min‐ istries' guidance didn't in‐ clude minimum service stan‐ dards that ensured consis‐ tent quality and access of services, that it did not ade‐ quately respond to barriers such as local government re‐ sistance, and that a new pro‐ gram evaluation was needed as the health emergency evolved.

B.C. is the first province to have a safer-supply program, which allows medical pre‐ scribers to give substance users regulated versions of some opioids.

The program has gener‐ ated criticism from federal Conservative Leader Pierre Poilievre and Alberta Premier Danielle Smith, who both claimed that drugs from the program were being diverted into the rest of Canada.

Earlier this month, RCMP in Prince George said they seized pills, which included morphine and hydromor‐ phone, two of the drugs in B.C.'s program offering pre‐ scribed alternatives to peo‐ ple at risk of overdose from consuming toxic street drugs.

Elenore Sturko, mental health critic for the Opposi‐ tion B.C. United, has ex‐ pressed concerns that some of the regulated drugs may be making their way to unin‐ tended substance users with‐ out a prescription, known as diversion.

WATCH | No evidence safe-supply drugs being di‐ verted into illegal market, say police:

"We've seen that there [is] the risk of population-level harms with diversion ... there's potential that these drugs are helping fund orga‐ nized crime," Sturko said dur‐ ing an interview with CBC News.

B.C. RCMP assistant com‐ missioner John Brewer said there is "currently no evi‐ dence to support a wide‐ spread diversion" of the legally prescribed substances to the illegal drug market.

Mike Farnworth says he's spoken to the RCMP's com‐ manding officer in B.C. about the drug seizure in Prince George and was told the idea that there is widespread di‐ version is "simply not true."

The auditor general wrote that the ministries' communi‐ cation "about prescribed safer supply, specifically about diversion, has been weak."

Province's lack of trans‐ parency

Pickup says assessing the program's success will re‐ quire "high-quality evaluation data" and more trans‐ parency.

"This is a novel program that requires ... to build trust. However, we found weak‐ nesses in the transparency and said.

The audit states there's no communication plan in place communication," he for the ministries to publicly report the outcomes on as‐ pects such as decreasing the use of unregulated drugs, re‐ ducing illicit drug toxicity in‐ juries and deaths, and miti‐ gating potential harms of prescribed safer supply.

Critics like Sturko argue there isn't any evidence to suggest the safe supply pro‐ gram will help address the drug overdose crisis in B.C.

"If they had evidence that showed it was [working], I think they would be using that to defend their pro‐ grams. They would be using that to tell me to be quiet," she said. "The fact that they haven't tells me that it's probably [not working]."

However, Kora DeBeck, a research scientist with the B.C. Centre on Substance Use, says there is ample evi‐ dence that prohibiting and criminalizing drug possession has been a failure.

"We know that incarcera‐ tion and law enforcement does not work. It does not keep drugs off the street," said DeBeck, who also teaches public policy at Simon Fraser University.

"There's strong scientific evidence demonstrating that [decriminalization] is highly effective in reducing risky be‐ haviour and improving sur‐ rounding communities."

Need for expansion

Pickup's audit found the min‐ istries didn't make "signifi‐ cant progress" in tackling their "most challenging barri‐ ers," such as rural access to the program, health-care providers' hesitancy about prescribing the drugs and whether the drugs being of‐ fered were appropriate.

Last month, a report from Provincial Health Officer Dr. Bonnie Henry called on the B.C. government to broaden the availability and types of drugs that can be prescribed under the province's safersupply program.

The program reached over 4,200 people in Decem‐ ber 2023. According to the province's estimates, over 115,000 people are living with opioid use disorder in B.C.

"In terms of coverage that's just about four per cent," said DeBeck.

She says the safe supply program and supervised con‐ sumption services must be expanded.

"It is a very tiny per‐ centage of the population that is at risk of a fatal over‐ dose that are able to access the service."

There are just under 50 overdose-prevention sites across the province and the B.C. Coroners Service says there has been one death in the province at a site this year.

The auditor general's re‐ port recommends targeting rural and remote communi‐ ties.

Premier David Eby ac‐ knowledged that it's going to be a challenge to expand the programs.

"It's a challenge to deliver health care in rural parts of B.C . ... to make sure we're re‐ sponding to the rapidly evolv‐ ing nature of this crisis," he said during an unrelated press conference Tuesday.

"We'll do all we can to en‐ sure minimum standards of care for all British Columbians."