The Province is completing the transition to new witnessed dosing requirements to address the diversion of prescribed alternatives, while maintaining access to the program for people who need it.

As of Dec. 30, 2025, all patients who have prescriptions for prescribed alternatives will be required to take their prescribed medication under the supervision of a health professional, such as a pharmacist or nurse, when the medication is dispensed at the pharmacy. This policy completes the transition, which started this year, to move patients to witnessed dosing.

“Prescribed alternatives save lives by separating people at highest risk of overdose from toxic street drugs and predatory drug dealers, and give people a chance to get into treatment,” said Josie Osborne, Minister of Health. “To ensure these medications are used as intended, we are moving to witnessed dosing for all patients, and we are supporting pharmacists and prescribers as they implement this change. We will continue to closely monitor the situation to make sure people struggling with addiction can access the care and treatment they need, while also ensuring that medications are being taken by the people they are prescribed for.”

To further ensure that the prescribed alternatives are being consumed by the intended patient, government policy and clinical guidance continue to emphasize the clinical tools prescribers should use to monitor for diversion, such as regular testing urine for drugs, for patients who qualify for an exemption to witnessed dosing.

Limited exemptions to witnessed dosing are in place for patients in exceptional circumstances. Regular clinical assessments are required as part of ongoing patient exemptions to confirm medication adherence for any doses that are not witnessed by a health professional.

Evidence shows that prescribed alternatives are helping keep people who are at the highest risk of drug poisoning alive so they can stabilize their lives and connect with care and treatment. A peer-reviewed study published in the British Medical Journal found that prescribed alternative opioid dispensations were associated with a 61% reduction in death, and a dispensation for four or more days was associated with a 91% reduction in death during the following week.

Prescriptions of hydromorphone through the Prescribed Alternatives program, which is the medication most at risk of diversion, have declined more than 50% from its peak of more than 4,500 clients in March 2023 to approximately 2,200 clients in July 2025.

The Prescribed Alternatives program helps save lives by separating people at the highest risk of overdose from toxic street drugs and predatory drug dealers. This is one part of government’s work to address the toxic-drug crisis and build a full continuum of mental-health and addictions care that works for everyone, including early intervention and prevention, treatment and recovery services, supportive and complex-care housing.

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

To learn more about the new witness fee payment system for pharmacies, visit:
https://www2.gov.bc.ca/gov/content?id=9F6C94D240F646C8BA09EEC487426DE8 

To read the peer-reviewed study from the British Medical Journal, visit:
https://www.bmj.com/content/384/bmj-2023-076336