The Province continues to enhance B.C.’s response to the toxic drug crisis, investing $1 billion through Budget 2023 over the next three years.
Visit the BC Centre for Disease Control's (BCCDC) website for more data on the drug poisoning response:
http://www.bccdc.ca/health-professionals/data-reports/overdose-response-indicators
Take Home Naloxone Program: https://towardtheheart.com/thn-in-bc-infograph
Data on prescribed safe supply is available from the BCCDC:
http://www.bccdc.ca/resource-gallery/Documents/Statistics%20and%20Research/Statistics%20and%20Reports/Overdose/2022.02.22_BCCDC%20Infographic_RMG.PDF
Recent actions:
Preventing drug poisoning through harm reduction
Access to prescribed safer supply, a Canadian first
B.C. is the first province to offer prescribed safer supply.
People have been accessing prescribed safer supply since March 2020, when the Province introduced the first phase of the program. In the month of March 2023, approximately 5,044 people were prescribed safer supply opioid medications.
Through Budget 2023, government is investing an additional $184 million over three years to support safer substance use for those living with mental health issues and addictions. This includes providing safe prescription alternatives, such as diacetylmorphine, to help reduce the harmful effects of the toxic drug supply and to connect people with supports and treatment.
Decriminalization
B.C. is the first province to receive a three-year exemption from the federal government to remove criminal penalties for people who possess small amounts of illicit drugs for personal use. Decriminalization of people who use drugs will reduce the fear and shame that keeps people silent and leads so many to hide their drug use and avoid treatment and support. Reducing the stigma of drug use is a vital part of B.C.’s work to build a comprehensive system of mental-health and substance-use care. Decriminalization became effective Jan. 31, 2023, and the Province is working with a broad cross-section of partners to make sure police are trained and health authorities are prepared for this change.
Overdose prevention and supervised consumption services
B.C. is expanding access to overdose prevention services that offer observed inhalation services in communities hardest hit by the drug-poisoning crisis. From January 2017 until the end of March 2023, there were more than 3.8 million visits to overdose prevention services and supervised consumption site (OPS/SCS), 24,793 overdoses responded to and survived, and two deaths. The number of OPS sites has significantly increased – from one site in 2016 to 45, as of March 2023, including 16 sites offering inhalation services. In March 2023, there were 68,507 visits to overdose prevention services and supervised consumption sites, and 34,626 visits to inhalation overdose prevention and supervised consumption services.
Drug-checking services
There are a number of drug-checking services throughout the province to help people learn what is detected in the substances they are taking to reduce the risk of drug poisoning and connect them to supportive services.
More than 104 distributed drug-checking sites have opened around the province: 26 in Fraser Health, 35 in Interior Health, 30 in Island Health, two in Vancouver Coastal Health, and 11 in Northern Health. These sites reduce rural inequities and improve access to drug checking services for more British Columbians.
There are 27 Fourier Transform Infrared (FTIR) spectrometres for drug checking in B.C.: Fraser Health (three); Interior Health (eight); Northern Health (two); Island Health (seven); Vancouver Coastal Health (four); and three additional instruments owned by the BC Centre on Substance Use.
In addition, government has invested in HarmCheck, a cutting-edge enhanced drug-checking technology developed by Vancouver Island University that helps people have more accurate information about what substances they are taking, further helping to reduce the risk of drug poisoning.
Lifeguard App
The free app helps save lives by automatically connecting people who use drugs to first responders if the user becomes unresponsive. From May 2020 until the end of March 2023, the app had been used more than 118,669 times by 19,504 app users. To date, no drug-poisoning deaths have been reported through the app. Lifeguard also provides drug alerts.
Take-home naloxone kits
As of March 2023, more than 1.8 million kits have been shipped and 152,955 have been reported as used to reverse a drug poisoning. The kits are available at more than 2,159 locations, including 833 community pharmacies in B.C.
The Facility Overdose Response Box (FORB) program provides community organizations with naloxone, supplies and training so staff can recognize and respond to drug poisonings. There are 772 active sites in the province and 3,191 drug-poisoning reversals reported from FORB sites as of March 2023.
Enhancing treatment and recovery
New beds for addictions and recovery care
The B.C. government has prioritized making new treatment and recovery beds available in 2021 to those who need them.
Budget 2023 invests $586 million across the spectrum of services and supports for people struggling with substance use disorder. This will focus on expansion of treatment and recovery beds, the development of new recovery communities to support the long-term recovery of those who have gone through treatment, Indigenous treatment centres, and wraparound services for youth.
Government will also develop and roll out a new model of seamless care to support people through their entire recovery journey from detox to treatment to aftercare.
As of September 2022, there were 3,260 publicly funded adult and youth community substance-use beds. Data about beds is updated four times annually.
Expanded scope of nursing practice, a Canadian first
To increase the number of clinicians who can prescribe medications for opioid-use disorder – particularly in rural and remote parts of the province – registered nurses (RNs) and registered psychiatric nurses (RPNs) can now complete training to begin prescribing opioid agonist treatment. In October 2022, the British Columbia Centre on Substance Use (BCCSU) launched education and training to enable RN/RPN prescribers to offer methadone and slow-release-oral-morphine (Kadian), in a phased approach, in addition to existing education and training focused on buprenorphine/naloxone.
As of May 2023, 252 RNs and RPNs from all health authorities have enrolled and 121 have completed their training. In January 2023, 253 patients had a dispensation of buprenorphine/naloxone, methadone or slow-release oral morphine at community pharmacies within B.C. prescribed by 29 RN or RPN prescribers. Nurses prescribing for opioid-use disorder is being implemented in collaboration with First Nations communities, and training is underway.
Medication-assisted treatment
In March 2023, 24,947 people were dispensed opioid agonist treatment (OAT) medications. The number of clinicians prescribing any form of OAT increased from 773 in June 2017 to 2,106 in March 2023. Access has also been significantly expanded through Rapid Access to Addictions Care Clinics in all health regions, so more people can access the care they need, where and when they need it.
More flexible treatment options
More options for medication-assisted treatment are available than ever before – including injectable opioid agonist treatment (iOAT) and low-barrier pharmaceutical alternatives like tablet iOAT (TiOAT) programs in most health authorities in B.C. In November 2019, government approved the expansion of TiOAT in every health authority in the province. Currently, iOAT is available in high-need communities as determined by overdose surveillance data, including Surrey, Abbotsford, Kelowna, Victoria and multiple Vancouver locations. In December 2020, the Province approved plans for Northern Health’s first integrated iOAT and TiOAT program in Prince George. The Ministry of Health and the Ministry of Mental Health and Addictions, as well as health authorities, are continuing to work to expand programs where needed.
Improving the substance-use system of care
New teams to keep people connected to services and treatment
Sixteen substance-use teams throughout the province help people stay connected to health-care services, treatment and recovery. Services are tailored to each community, provided by a range of professionals including nurses, counsellors, social workers and peers. Teams support adults, including young adults, in communities throughout B.C., including Vancouver, Abbotsford, Kelowna, Prince George and Nanaimo.
24/7 support for people living with serious mental-health challenges
People living with severe mental-health challenges have access to 29 Assertive Community Treatment teams throughout B.C. that provide 24/7 supports. Teams are in every health authority in B.C, including in Kelowna, Kamloops, Vancouver, Surrey, Victoria, Nanaimo and Prince George. Services include crisis assessment and intervention, psychiatric or psychological treatment, and medication management.
24/7 helpline for prescribers and pharmacists
The helpine provides live, in-the-moment support to doctors, pharmacists, registered nurses, registered psychiatric nurses, midwives and nurse practitioners as they treat patients with opioid-use disorder and consider prescription alternatives to the toxic drug supply.
Enhancing mental-health crisis lines
Planned enhancements to crisis-line services include additional responders to increase crisis-line capacity to answer calls, improved recruitment and retention strategies, upgraded and improved technology, and standardized training for call responders.
Community response
Community Crisis Innovation Fund
Supports community-driven, innovative strategies and actions that draw on the expertise of local service providers and people with lived experience.
Grants totalling more than $1.5 million have been committed to escalate the drug-poisoning response in rural, remote and Indigenous communities. The grants will also provide supports, including groups for grief and loss, family services and networks for people and families affected by the drug-poisoning crisis.
Community action teams (CAT)
Approximately $2.75 million supports these teams in B.C. communities. The 36 CATs in high-priority communities throughout the province help communities form partnerships and strategies to address the drug-poisoning emergency at a local level.
People with lived/living experience
People with lived and living experience are supported by investments to be involved in building a provincewide network of people who use drugs to share that experience and expertise, as well as funding for peer and family support networks. Moms Stop the Harm - B.C. is leading Stronger Together, a provincial family support and development project.
Indigenous-led solutions
First Nation-run treatment and healing centres
Ten First Nations treatment and healing centres operate throughout B.C., six are being renovated and two new facilities are being planned – one in the Vancouver Coastal region and the other in the Fraser Salish region.
These facilities are supported by $20 million from the Government of B.C., matched by $20 million from each the federal government and the First Nations Health Authority (FNHA) to support the renovation and replacement of First Nations-run treatment centres throughout B.C.
The Province is providing additional one-time funding of $35 million to the First Nations Health Authority to support the completion of the eight community-based First Nations treatment centre projects.
Approximately $49 million has been provided to the FNHA to support the design and expansion of land-based and culturally safe services. As part of this initiative, the FNHA has provided funding to First Nations to increase the number of treatment options available to First Nations clients with a focus on land-based, family-based or group-based treatment services.
Provincial drug-poisoning emergency response for First Nations communities
Budget 2023 continues funding to support Indigenous-led approaches to prevention and harm reduction, as well as culturally safe substance-use care and treatment services.
As part of $586 million across the spectrum of services and supports for people struggling with addiction, Budget 2023 invests $171 million over three years for Indigenous-led recovery and aftercare services and supports founded on the strengths of culture, language and identity to build resiliency and overcome unresolved trauma.
Métis-led mental health and wellness initiatives
Approximately $1.9 million has been provided to the Métis Nation BC to support Métis-led mental-health and wellness initiatives, including the development of a cultural safety and wellness curriculum and a harm-reduction and stigma-reduction campaign.
Gwa'sala-'nakwaxda'xw partnership
Extension of the Indigenous-led program for alcohol treatment and recovery in Port Hardy.