The Province is taking action to prevent the diversion of prescribed opioids and hold bad actors accountable for putting people and communities at risk.

The Prescribed Alternatives Program helps save lives by separating people at the highest risk of overdose from toxic street drugs and predatory drug dealers. It is one part of the Province’s work to address the toxic drug crisis, in addition to the expansion of treatment and recovery services, early intervention and prevention, supportive housing and more.

“We are committed to saving lives and getting the people who are suffering from addiction the treatment they need,” said Josie Osborne, Minister of Health. “In doing this work, we need to know that medications, like prescribed alternatives, are being used by the person they’re intended for. Prescribed alternatives have been proven to save lives by providing a safer option for people at high risk of overdose. We are requiring that the use of prescribed alternatives must be witnessed by a health professional. This will remove the risk of these medications from ending up in the hands of gangs and organized crime.” 

The Province is revising the Prescribed Alternatives Program to require that the consumption of all prescribed alternatives must be witnessed by health professionals, ensuring they are consumed by their intended recipient. This requirement will be implemented immediately for new patients. The Province will work with clinicians to transition existing patients to witnessed consumption as soon as possible, while ensuring continuity of care.

Since 2024, the Ministry of Health’s Special Investigative Unit, in collaboration with the College of Pharmacists of BC and law enforcement, has been investigating pharmacies suspected of engaging in illegal activities, including misusing fee-for-service payments to offer incentives to attract patients. So far, the Ministry of Health has received allegations against more than 60 pharmacies. In cases where wrongdoing is confirmed, the Ministry of Health will, in co-ordination with the College of Pharmacists of BC, ensure that a pharmacy’s licence is suspended or cancelled, made ineligible to bill PharmaCare and referred to law enforcement as appropriate.

The Province will make changes to fix the fee structure for pharmacies that provide prescribed alternatives. Fees will be restructured for daily dispensing to better align with the cost of providing service and avoid financial incentive for bad actors to offer kickbacks to retain and attract new patients, and to try to take advantage of the system.

The Province is also working with partners to take action to reduce the over-prescribing of opioids generally by health-care providers. In December 2024, 97% of the people who were prescribed an opioid medication in B.C. received it for reasons unrelated to prescribed alternatives, such as pain management. The Province will establish a working group with the College of Physicians and Surgeons and the College of Nurses and Midwives to investigate the inappropriate prescribing of opioids and take action to reduce overprescribing, including enhanced monitoring and additional guidance.

“The overwhelming majority of pharmacies and prescribers follow the rules, but it is unacceptable that bad actors are exploiting the health-care system and putting communities at risk,” Osborne said. “We are working with law enforcement to stop illegal activity and ensure pharmacies operate in the best interests of patients and public safety.”

This announcement builds on work underway to build a seamless system of mental-health and addiction care to better meet people where they are at and provide them with supports at every stage of journey. That is why the Province is taking actions, such as enhancing overdose-prevention services, supervised consumption sites and drug checking. These services keep people alive, giving them a chance to connect to care and find a path forward.

Learn More:

Learn about mental-health and substance-use supports in B.C.: https://helpstartshere.gov.bc.ca/

To learn how B.C. is building better mental-health and addictions care, visit: https://gov.bc.ca/BetterCare

A backgrounder follows.