Lack of prescribers in Nanaimo limiting access to safer supply

VIU nursing professor Sarah Lovegrove says the lack of prescribers for the safer supply program makes it hard for people in Nanaimo to access alternatives to toxic street drugs. Photo: Mick Sweetman / CHLY 101.7FM

On Thursday, provincial health officer Dr. Bonnie Henry released a review of the province’s prescribed safer supply program, which provides alternatives to the toxic supply of street drugs.

Henry said that the review was done to better understand the impact of BC’s Safer supply program.

“This policy in its intent is an important part of the spectrum of medical care that we are providing and that we need to continue to provide for people who use drugs in this province,” she said.

The review found that just four per cent of the estimated 115,000 people with a diagnosed opioid use disorder in the province have been able to access the safer supply program.

Henry said that one barrier to expanding the prescribed safer supply program is the reluctance of doctors to prescribe it.

“There are still some clinician groups who are opposed to any sort of prescribed safer supply or even OAT and so we need to understand that not all clinicians will be involved in this process,” she said. “In light of that, how do we make a program that meets people's needs, and supports clinicians at the same time.”

Sarah Lovegrove is professor of nursing at Vancouver Island University and a member of the Harm Reduction Nurses Association. She said that accessing safer supply in Nanaimo can be a challenge for people who use drugs.

“Right now, we only have very few providers within Nanaimo that are willing to engage with safe supply prescriptions, and provider programs,” she said. “A few doctors within the community, some addictions doctors within NRGH and AVI Health Services have their enhanced Harm Reduction Program. But those programs are limited because we don't have the number of providers that we need.”

While Henry isn’t advocating a non-prescribed alternative to the safer supply program now, she said it is something that should be explored in the future.

“I do believe we need to continue the discussion and the evidence and the investigation of non-medical models as well,” she said.

Lovgrove thinks that expanding the prescribed safer supply program will be difficult given the lack of buy-in from prescribers.

“I think there's some inherent limitations to the expansion of this model,” she said. “Although it's absolutely necessary that it's expanded and we need to expand to alternative substances beyond hydromorphone, we need to expand to things like stimulants, but I just don't necessarily believe that we have the systems in place to expand these programs.”

Henry addressed concerns around diversion of safer supply, which some critics claim is being sold to youth in order to fund purchases of stronger street drugs.

“The limited data we have right now does not show a linear relationship or any relationship between the start of this policy and what we're seeing in opioid use disorder,” she said.

Henry said that one of her recommendations from the review is to better monitor data of youth substance use and the safer supply program.

“If we start seeing that there's direct relationships between programs, then we need to put in interventions that stop that,” she said.

Instead of being sold to youth, Lovegrove said that what she and her colleagues are seeing in Nanaimo is that safer supply drugs are being used by people to control withdrawal symptoms.

“Oftentimes, what's happening is people who are continuing to access safe or the illicit supply and saving or or sharing that safe supply Dilaudid for times when they are going through withdrawals, when friends or other people in their community are going through withdrawals and utilizing it as a form of community care,” she said.

Funding Note: This story was produced with funding support from the Local Journalism Initiative, administered by the Community Radio Fund of Canada.