Prior to COVID-19, overdose deaths in B.C. had decreased 36% year-over-year, showing collective efforts were making a difference. However, the drug supply has become more toxic than ever before, with tragic consequences. In May 2020, the average number of drug alerts issued per week more than doubled compared to earlier this year. Alerts were issued in 24 communities, more than in the first three months of the year combined.

Under the pressure of two public health emergencies, the Province is adapting and changing as it continues to focus on scaling up what the evidence shows is working to save lives, while connecting more people to treatment and recovery services and supports.

Responding to an even more toxic drug supply:

• New prescriber guidance: in March 2020, new guidance for prescribers and pharmacists was released to keep people with substance use disorder separated from the toxic drug supply and protect them from withdrawal and other harms during COVID-19. The program has trained more doctors, nurse practitioners and pharmacists on how to prescribe pharmaceutical alternatives to a toxic drug supply, and 3,000 have attended webinars for prescribers on how to use the new guidance to support people.
• There has been a 149% increase (from 677 to 1,686) in the number of people dispensed hydromorphone in May 2020 compared to March 2020. Dispensations have occurred in every health authority region in the province. Pharmaceutical options give patients the opportunity to stabilize and take the steps necessary to find a pathway to treatment and avoid accessing the unpredictable and highly toxic drug supply.
• A new 24/7 helpline for prescribers and pharmacists, launching on Monday, June 15, 2020, will provide live, in-the-moment support to doctors, pharmacists and nurse practitioners while they are treating patients with opioid use disorder and considering prescribing safe prescription alternatives to the toxic drug supply.

Keeping people safe as they stay home:

• New Lifeguard app: the recently launched, free app helps to save lives by connecting people who use substances automatically to first responders if they become unresponsive. Since its launch in late May, 423 people have used the app and it has already called first responders to save lives.
• Overdose prevention and supervised consumption services: during COVID-19, these sites have been declared essential services. Government has supported the sites to stay open with new COVID-19 measures to help give people confidence that they can continue to use these services safely during the pandemic. Since their inception, these 32 locations have played a critical role in connecting people to treatment and have had more than one million visits, more than 3,000 overdoses survived and zero deaths.
• Take Home Naloxone Kits are available at 1,723 locations, including more than 731 pharmacies in British Columbia. In 2019, 232,312 kits were shipped and 61,374 have been reported as used to reverse an overdose.

Enhancing treatment:

• Expanded opioid agonist treatment (OAT): the number of patients dispensed OAT has grown to 23,199 as of May 2020, and the number of clinicians prescribing any form of OAT in a given month increased from 773 in June 2017 to 1,495 in April 2020.
• B.C. has also significantly expanded access through Rapid Access to Addictions Care clinics in all health regions (42 new patients per week, with 2,500 referred to community for ongoing care) so that more people can access the care they need, where and when they need it.
• More flexible treatment options: B.C. has more options than ever, including injectable opioid agonist treatment (across eight sites) and low barrier pharmaceutical alternative programs. These programs are increasingly available at some supervised consumption services, so people can get directly connected to treatment. They will be expanding to 335 patients in Vancouver, the Interior and Fraser Health.

Improving the substance use system of care:

• Emergency room connections: improving access to evidence-informed care, including access to suboxone.
• Emergency health services pilot project: through a partnership with BC Emergency Health Services, more people who are not already connected to care are being provided with referrals and ongoing support if they decline transport to hospital following an overdose.
• Better, safer care in supportive recovery: including more government oversight, expanded training for staff and higher per-diem rates for people on income assistance in supportive recovery.
• Significant expansion of mental health and addictions counselling through Community Counselling grants.

Community response:

• Grants totalling $1.6 million will be provided to escalate the overdose response in rural and Indigenous communities and to provide supports including groups for grief and loss, family services, and networks for people and families impacted by the overdose crisis.
• People with lived/living experience: continued investments to ensure people with lived and living experience are involved in service delivery, policy and program development.
• Facility Overdose Response Box program: provides community organizations with naloxone, supplies and training so staff can recognize and respond to overdose. There are currently 625 registered sites in the province.

Indigenous-led solutions:

• $40 million provided to upgrade First Nations-run treatment centres throughout B.C. will link more people to treatment and recovery. Plans call for eight projects: two new facilities and six replacement facilities in coming years.
• Land-based healing: $23 million for critical, land-based, cultural programs that support healing from trauma and strengthen resiliency.
• $44 million to the First Nations Health Authority to support the overdose emergency response as it relates to First Nations communities.