The Province stepped up B.C.’s overdose response even further in 2020-21 due to the dramatic increase in drug toxicity during the COVID-19 pandemic.

As well, Budget 2021 provides a historic investment of $500 million for mental health and substance use over the next three years. This includes $45 million to ensure the stability of all provincial overdose prevention sites, support integrated interdisciplinary outreach teams and increase nursing care. The ministry will share more about specific mental health and substance use investments as part of Budget 2021 in the coming weeks and months.

2020-21 actions:

Enhancing treatment and recovery

New beds for addictions and recovery care
B.C. is doubling the number of youth treatment beds, and more than 100 new adult treatment and recovery beds are being added throughout the province. In August 2020, 20 new youth beds were also added in Chilliwack at the Traverse facility.

Expanded scope of nursing practice
More than 90 registered nurses have enrolled and/or completed their first round of training and to prescribe medication for opioid use disorder. Trained nurses have been prescribing opioid agonist treatment since early 2021. This follows provincial health officer Dr. Bonnie Henry’s order to allow registered nurses and registered psychiatric nurses to prescribe controlled drugs and substances to reach people who have been traditionally underserved.

Expanded opioid agonist treatment
The number of people on opioid agonist treatment (OAT) has grown to more than 24,300 as of March 2021, and the number of clinicians prescribing any form of OAT in a given month increased from 773 in June 2017 to 1,690 in March 2021. 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 are available than ever before – including injectable opioid agonist treatment (iOAT), and low-barrier pharmaceutical alternatives (TiOAT) programs in most health authorities in B.C. In 2019-20, iOAT capacity increased by more than 40%. In November 2019, government approved the expansion of TiOAT into every health authority in the province.

Better, safer care in supportive recovery
New regulations that increased oversight for services, including new mandatory requirements related to staff training, development of a personal safety plan for each resident and supporting people to safety transition and connect to ongoing supports when leaving recovery homes.

COVID-19 funding for treatment and recovery operators
$2.015 million flowed to 53 existing residential treatment and recovery service providers with budgets strained by the COVID-19 pandemic, making sure they can continue delivering quality care for those who need it.

Improving the substance use system of care

New Assertive Community Treatment (ACT) teams
Six teams in Vancouver, Victoria, Maple Ridge/Mission, Kelowna, Nanaimo, and Cowichan Valley/Duncan will be added, bringing the provincial total of ACT teams to 30 to get people connected to services.

New teams to keep people connected to services and treatment
Seven new and nine expanded substance use teams throughout the province have been added to help people stay connected to health-care services, treatment, and recovery.

New and expanded outreach teams
Forty-two new full-time registered nurses, psychiatric nurses, social workers and peer support workers are being added to 14 new and existing interdisciplinary outreach teams throughout the province. This expands access to substance use services to prevent overdose deaths, save lives and connect more people to treatment and recovery.

Significant expansion of mental health and addictions counselling through Community Counselling grants and support to go virtual during COVID-19.

Risk mitigation prescriber guidance
In March 2020, the Province announced new clinical guidance for health-care providers to stem the spread of COVID-19 and respond to the ongoing overdose emergency. Since March, when the Province first announced the new clinical guidance, there has been a 395% increase (from 677 to 3,348) in the number of people dispensed hydromorphone in December 2020 compared to March 2020.

24/7 helpline for prescribers and pharmacists provides live, in-the-moment support to doctors, pharmacists and nurse practitioners while they treat patients with opioid use disorder and consider safe prescription alternatives to the toxic drug supply.

Preventing overdoses

Decriminalization
B.C. is moving forward with an application to the federal government for a Section 56 exemption to the Controlled Drugs and Substances Act. The solicitor general has asked police forces in B.C. to no longer pursue criminal charges for people with personal possession of drugs.

Overdose prevention and supervised consumption services
There are currently 38 overdose prevention and supervised consumption services operating in B.C. under health authority direction. Of these, 12 offer observed inhalation. During COVID-19, all of these sites have been declared essential services. Government has supported the sites to stay open with new COVID-19 safety measures to help give people the confidence that they can continue to use these services safely during the pandemic. Since they were opened, these locations have played a critical role in connecting people to service options. They have had more than 2 million visits, more than 11,000 overdoses responded to and survived, and zero deaths.

Lifeguard App
The free app helps save lives by automatically connecting people who use drugs to first responders if they become unresponsive. Since its launch in late May 2020, the app has been used more than 42,000 times by more than 4,800 app users. In at least 17 instances, the person using the app became non-responsive, and BC Emergency Health Services dispatchers sent paramedics to care for them and take them to hospital. To date, no overdose deaths have been reported through the app. Lifeguard also now provides drug alerts.

Take Home Naloxone Kits
In 2020, more than 270,000 kits were shipped and more than 96,000 have been reported as used to reverse an overdose since the program started (as of April 2021). The kits are available at more than 1,800 locations, including 764 community pharmacies in B.C.

Federal funding for safer supply projects
$15 million in new funding over four years will support three projects in Vancouver and one on Vancouver Island:

• Vancouver Coastal Health Authority Safer Alternative for Emergency Response Initiative ($5 million over four years)
• Providence Health Care Research Institute and BC Centre for Excellence in HIV/AIDS ($3.6 million over three years)
• Kilala Lelum Health Centre/Urban Indigenous Health and Healing Cooperative ($2.8 million over three years)
• AVI Health and Community Services Society Victoria Safer Alternatives for Emergency Response project ($4 million over three years)

These innovative projects will provide pharmaceutical-grade medication as an alternative to the toxic illicit drug supply for people who have not responded to other forms of treatment for opioid use disorder.

Community response

Community Crisis Innovation Fund
This fund supports community-driven, innovative strategies and actions that draw on the expertise of local service providers and people with lived experience.

Grants totalling $1.526 million have been committed to escalate the overdose 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 impacted by the overdose crisis.

Community Action Teams (CAT)
$2.75 million will maintain these services in B.C. communities. The 36 CATs in high-priority communities throughout the province help communities form partnerships and strategies to address the overdose crisis at a local level.

People with lived/living experience
Continued investments will ensure people with lived and living experience are involved in building a provincial 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.

Facility Overdose Response Box (FORB) program provides community organizations with naloxone, supplies and training so staff can recognize and respond to overdose. As of April 2021, there are currently 670 registered sites in the province and 2,029 overdose reversals reported from FORB sites.

Indigenous-led solutions

$20 million provided by B.C. to support the First Nations Health Authority (FNHA) with the renovation and replacement of First Nations-run treatment centres throughout B.C.  

$29 million was provided by B.C. to the FNHA to support the design and expansion of land-based and culturally safe treatment 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.

The Province of B.C., the Government of Canada and the FNHA committed $30 million to support the implementation of a new tripartite partnership for mental health and wellness.  

Provincial overdose emergency response for First Nations communities
$24 million over three years will support the FNHA with the overdose emergency response, with an increased focus on addressing the impact of the emergency on First Nations people living in urban centres. 

Métis-led mental health and wellness initiatives
$1.13 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 anti-stigma campaign.