B.C. authorizes nurses to prescribe safe alternatives to toxic street drugs

B.C. Provincial Health Officer Dr. Bonnie Henry has issued a new public health order making it easier for people to access safe alternatives to toxic street drugs — a move advocates say is desperately needed as deaths from B.C.'s opioid crisis continue to climb. 

The order, issued on Wednesday, authorizes registered nurses and registered psychiatric nurses to prescribe pharmaceutical alternatives to street drugs "to help separate more people from the poisoned street drug supply to save lives and provide opportunities for ongoing care, treatment and support."

Until now, only doctors and nurse practitioners have been able to prescribe drugs, including substitute medications for illicit-drug users as an alternative to potentially deadly substances on the street.

Overdose deaths have spiked in B.C. since the start of the COVID-19 pandemic. B.C. recorded 911 overdose deaths between January and July 2020. Over that same period of time, 195 people died of COVID-19.

More than 5,000 people have fatally overdosed in B.C. since the province declared a public health emergency in 2016. Before the pandemic, the number of fatalities had been on the decline for the first time since 2012.

"Increasing prescribing access for those who are using illicit drugs in B.C. definitely is going to save lives," Kathleen Ross, president of Doctors of BC, told CBC on Thursday.

The new order will also widen the criteria of who is eligible. According to Ross, that means intermittent drug users and people who are likely to use alone will have access and not just chronic, long-term users.

"We know the pandemic has only made the street drug supply in B.C. more toxic than ever, putting people who use drugs at extremely high risk for overdose," Henry said in a statement.

"Giving physicians and nurse practitioners the ability to prescribe safer pharmaceutical alternatives has been critical to saving lives and linking more people to treatment and other health and social services."

"I am issuing a provincial health officer order to expand the health professionals who are able to provide safer, accessible alternatives to the toxic street drug supply and help more people find their pathway to hope."

The new order also expands the types of medications that can be prescribed; and increase access points to allow for dispensing medications from health authorities and community pharmacies.

Henry says new nursing standards will be introduced, along with training, education and access to expert consultation.

Christine Sorensen, president of the B.C. Nurses' Union, said nurses welcome the move by the province, calling it a "natural next step" in treating people with addiction.

"Nurses will welcome this," she said. "As a registered nurse myself, I welcome this new step forward in the care and treatment in this other pandemic that we're working with in this province, which is the opiate crisis. We have done remarkable things in this province to lead how we help people who are struggling with this."

'It'll save lives'

The B.C. Centre for Disease Control estimates that nearly 6,000 deaths have been averted since April 2016 because of supports that have been put in place, including the distribution of the anti-overdose medication naloxone, the creation of more overdose-prevention sites and improved access to medication-assisted treatment.

In March, British Columbia temporarily expanded access to a safer supply of prescription drugs due to concerns about a high number of overdose deaths among isolated drug users during COVID-19.

Sarah Blyth, executive director at Vancouver's Overdose Prevention Society, called the move by the province a "huge step forward."

"We need to make safe drug access as easy as it is to get drugs from a dealer in an alley," she said, saying that shifting supply from the criminal element to the medical profession will allow people with addictions to rebuild their lives.

"It'll save lives.... It couldn't happen any sooner."

Henry has been an advocate for access to a safer supply of drugs, and has called on the federal government to decriminalize possession of small amounts of illicit drugs for personal use.

Canada's Chief Public Health Officer, Dr. Theresa Tam, has also called for access to safer prescription drugs.

Prime Minister Justin Trudeau recently agreed a safer supply is key during the dual public emergencies of a pandemic and the opioid crisis, but he has maintained his stance against decriminalization.