BC ends take-home safer supply amid concerns of drug diversion

The province is changing its approach to safer supply management. Effective immediately, new users of the program—which provides safe alternatives to street drugs, such as fentanyl—will be required to consume their prescribed alternative under the supervision of a health-care worker. The province says this will ensure the safer supply prescriptions are consumed by the person they were prescribed to.

Ending the take-home option would “remove the risk of these medications from ending up in the hands of gangs and organized crime,” Health Minister Josie Osborne said.

“In doing this work, we need to know that medications, like prescribed alternatives, are being used by the person they’re intended for,” Osborne said.

The new policy could force those who are prescribed safer supply alternatives to visit these on-site health-care settings multiple times a day for each session of use. Advocacy group Moms Stop the Harm said the new requirement could lead many people to drop out of the safer supply program, opting to return to street drugs which have a much higher rate of death.

Deaths linked to hydromorphone

Hydromorphone is the most commonly prescribed alternative for opioids like fentanyl, which has been a main cause of the province’s ongoing health emergency of toxic drug deaths.

In 2023 and 2024, hydromorphone was linked to only 3% of toxic drug deaths in BC. However, a report from the BC Coroners Service (BCCS) on youth (under age 19) toxic drug deaths found that between 2019-2023, 13% of these deaths were linked to hydromorphone. The BCCS said in its report that it did not believe safer supply “significantly” contributed to youth deaths, since all of the deaths involving hydromorphone involved other substances.

A proposed class-action lawsuit was filed with the BC Supreme Court last summer by the families of two teenage girls who they say became addicted to hydromorphone from the safer supply program—one of the girls died in 2022 at age 14 from hydromorphone use.

Fentanyl was linked to 85% of toxic drug deaths in the province in 2023 and 78% in 2024, making it the leading cause of those deaths. The unpredictable potency of fentanyl is part of what makes it so deadly, as people are unable to gauge dosages. The purpose of the safer supply program is to take out the mystery of potency, ensuring people know what they are consuming.

‍ Provincial health leaders say safer supply should be more accessible

In 2023, The BCCS released a panel report calling for expanded availability of a safer supply, including non-prescription access. The panel argued that only offering the supply to those with a diagnosed opioid disorder was forcing too many people to rely on street drugs, putting an estimated 225K people at risk of dying from toxic drugs. The panel suggested that by opening up access to a regulated supply—particularly in rural areas where drug testing facilities are less common—there would be fewer drug poisonings.

Last summer, Health Officer Dr. Bonnie Henry released a report that argued substances should be more varied within the program. The report said people were potentially selling their prescribed hydromorphone to purchase fentanyl or other high-potency opioids. The method of consumption was also a concern, with many users preferring to smoke or inject rather than take a pill—currently, pills are the only form available through the program. Henry argued that the safer supply program needed to offer a variety of substances to properly address individual patient needs.

Are safer supply drugs being diverted?

Early last year, the province denied the magnitude of safer supply diversion, with Mike Farnworth—solicitor general at the time—and BC’s RCMP deputy commissioner both saying there was no evidence of wide-spread diversion.

However, this month a briefing from the health ministry, leaked by the BC Conservatives, said a "significant portion" of prescribed opioids are being diverted and that prescribed alternatives are being trafficked provincially, nationally, and internationally.

The investigation has found 60+ pharmacies that are suspected of illegally offering incentives to patients to increase their dispensing fees. Some of these pharmacies have been found to have deals with nearby community housing staff, who ​​tell their tenants they must go to certain pharmacies for their prescriptions.

The province will also review the overprescription of opioids. December data show that 97% of people who were prescribed an opioid in BC received it for reasons outside of safer supply purposes, such as pain management. A working group has been established to develop guidelines for reducing overprescription.