The Province stepped up B.C.'s response to the toxic drug crisis in 2020-21 in response to the increase in the toxicity of illicit drug supply 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 overdose prevention services around the province, support integrated interdisciplinary outreach teams, and increase nursing care. The ministry will have more to share about specific mental health and substance-use investments as part of Budget 2021 in the coming weeks.
Enhancing treatment and recovery
New beds for addictions and recovery care
B.C. is creating 123 new youth substance-use treatment beds, and more than 100 new adult treatment and recovery beds are being added throughout the province. To date, 95 have been implemented. In August 2020, 20 new youth beds were added in Chilliwack at the Traverse facility.
Expanded scope of nursing practice, a Canadian first
To increase the number of clinicians who can prescribe medications for opioid-use disorder, registered nurses (RNs) and registered psychiatric nurses (RPNs) can now complete training to begin prescribing opioid agonist treatment. Through August 2021, 101 RNs and RPNs from all health authorities have enrolled, and 47 have fully completed their training. Work is underway to train as many as 450 new nurse prescribers by March 2023.
Expanded opioid agonist treatment
The number of people dispensed opioid agonist treatment (OAT) in a given month is nearly 24,000. The number of clinicians prescribing any form of OAT in a given month increased from 773 in June 2017 to 1,723 in July 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 like tablet iOAT (TiOAT) programs in most health authorities in B.C. In November 2019, government approved the expansion of TiOAT into every health authority in the province. Once all planned programs are operational, iOAT capacity will increase by about 34% from 304 in 2019 to 406 and the number of sites will double from six to 12.
COVID-19 funding for treatment and recovery operators
More than $2 million has 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 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
New full-time registered nurses, psychiatric nurses, social workers and peer support workers are being added to new and existing interdisciplinary outreach teams throughout the province. This expands access to substance-use services to prevent drug poisoning deaths, save lives and connect more people to treatment and recovery.
24/7 helpline for prescribers and pharmacists
This helpline 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 safe prescription alternatives to the toxic drug supply.
Preventing drug poisoning
B.C. is working with partners on an application to the federal government for a Section 56 exemption to the Controlled Drugs and Substances Act. The solicitor general sent a letter to police chiefs asking police to focus on more serious crimes and align with more harm-reduction principles.
Access to prescribed safer supply, a Canadian first
In July 2021, the Province announced a policy to increase access to pharmaceutical alternatives to the illicit drug supply to reduce drug poisoning events and deaths. B.C.'s Prescribed Safer Supply will enable regional health authorities to begin offering a wider range of medications, including fentanyl products and stimulants, as safer alternatives to toxic street drugs. As this is a novel and innovative prescribing practice, implementation will begin with enhancing existing health authority programs that prescribe alternatives to illicit drugs (i.e., OAT, iOAT, and TiOAT clinics) to offer additional medications, initially focusing on a priority list of opioids.
Government is investing $22.6 million over the next three years to support health authorities in implementing this policy. Funding will support expansion of existing and creation of new programs, increasing staffing capacity through hiring new FTEs, and robust monitoring and evaluation of this never-been-done-before policy.
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 drug poisoning emergency. Since March 2021, when the Province first announced the new clinical guidance, there has been a 475% increase (from 677 to 3,899 people) in the number of people dispensed hydromorphone in May 2021 compared to March 2020.
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. 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 crucial role in connecting people to service options. They have had more than two million visits, more than 11,000 overdoses responded to and survived, and zero deaths.
The free app helps to 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 63,000 times by more than 6,300 app users. To date, no drug poisoning deaths have been reported through the app. Lifeguard now also provides drug alerts.
Take-home naloxone kits
Since the program started, more than one million kits have been shipped and more than 100,000 have been reported as being used to reverse a drug poisoning since the program started. The kits are available at more than 1,890 locations, including 765 community pharmacies in B.C.
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 675 registered sites in the province and 2,204 drug poisoning reversals reported from FORB sites (as of September 2021).
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)
$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 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.
$20 million provided by B.C. to support the First Nations Health Authority with the renovation and replacement of First Nation-run treatment centres throughout B.C.
$30 million was provided by the B.C. government to the First Nations Health Authority (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. and the FNHA committed $10 million each to support the implementation of a new partnership for mental health and wellness.
Provincial drug poisoning emergency response for First Nations communities
$24 million over three years will support the FNHA with the drug poisoning emergency response, with an increased focus on addressing the impact of the emergency on First Nations people.
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 stigma-reduction campaign.