British Columbia's former chief coroner says she's disappointed by the province's overhaul of its program that provides prescription alternatives to toxic street drugs, a shift she says "feels like a really impulsive political decision."
Lisa Lapointe said the move to a "witnessed-only" model in which people are supervised while consuming their prescription drugs appeared to ignore scientific evidence.
"(Driving) people away from the illicit black market by providing them access to a regulated supply of the drug that they're dependent on keeps people safe," said Lapointe, who retired from the chief coroner's post in February 2024.
"It's really disturbing that our politicians who we rely on to keep us safe are more likely to respond to ideological arguments than science."
Health Minister Josie Osborne announced the change on Wednesday, saying it was aimed at preventing the diversion of take-home prescription opioids onto the street.
The issue of opioid diversion from the prescribed alternatives program, also known as safer supply, has dogged the NDP government of Premier David Eby.
Last March, both the RCMP's commanding officer in B.C. and then-solicitor general Mike Farnworth said there was no evidence of "widespread" diversion.
But this month, a leaked Health Ministry briefing for police said a "significant portion" of opioids prescribed in B.C. were being diverted.
Opposition leader John Rustad of the B.C. Conservatives portrayed the policy shift as a "major policy victory" for his party.
"Eby’s NDP has caved on one of Eby’s signature policy proposals and made a major about-face on their failed radical left-wing safe supply policy," he said on social media.
Lapointe said she had "so many questions" about the information on which B.C. officials based their decision to overhaul the program.
"What harms have we seen? If diversion is happening on the scale that allegedly it has been, why? You know, who's looking at the pharmacy and the pharmacists and that's the job of the College of Pharmacists," she said in an interview.
"If widespread diversion is happening, is it because people aren't getting the drug they need, and are these actually diverted prescribed medications? Or is this Dilaudid that's been manufactured by organized crime to look like prescribed medications?" she said, referring to the brand name for hydromorphone, a commonly prescribed safer-supply drug.
Lapointe — who sometimes clashed with the government over drug policy and presented a report in 2023 that recommended expanding safer supply to people without prescriptions — said the province should share the evidence behind the witnessed-consumption-only strategy.
"If they feel confident in their finding, then release the data."
Lapointe said the change would curtail access to prescription alternatives, making it "really onerous," especially for those who require multiple doses each day.
DJ Larkin, executive director of the Canadian Drug Policy Coalition based at Simon Fraser University, agreed and said people cannot go to a health provider's office potentially multiple times each day in order to access prescription alternatives.
"Taken at face value, if this program is now to require people to attend every dose, it means the program will effectively disappear," Larkin said in an interview Thursday.
"If you live in the Northern Health Region, the idea of travelling for daily dispensing and witness dispensing is impossible."
Larkin said the new policy was "based on politics and not on evidence."
Leslie McBain with the advocacy group Moms Stop the Harm said she was "blindsided" by what she also called a political move.
She said people who have stabilized their lives by participating in the program were being "put in an ugly position."
"Instead of going to the pharmacy four times a day or three times a day to be witnessed, they will just go back to the black market, which is much easier, and then there will be more toxic overdoses and more fatalities," she said.
B.C.'s new policy reflects recent recommendations by Addiction Medicine Canada, a group of addictions clinicians, who urged the province to adopt a supervised model.
Group member Dr. Robert Cooper, an addictions doctor and family physician in Toronto, said last month that "widespread" anecdotal reports alleging inappropriate use of prescribed opiates required such a policy shift.
"The concern here is where the programs are giving medications to patients who … are either using them inappropriately, so injecting or crushing and snorting and/or selling (them) or giving them to others, and using the proceeds to buy fentanyl."
But Larkin said diversion has been happening for as long as prescriptions have existed, and it's important to look at why it may be occurring in B.C.
"One answer is the drug supply is really scary for people right now, and so diversion to friends and family can be a way to keep loved ones safe by sharing your prescription with someone else," Larkin said.
Dr. Ryan Herriot, an addictions medicine doctor and family physician on Vancouver Island, said he worried about politicization of care for those with substance-use disorders.
"I'm not saying this government would do that, but I worry that they are, maybe unbeknownst themselves, they're actually making it easier for someone else in the future to further politicize other areas of medicine," said Herriot, who is a member of the group Doctors for Safer Drug Policy.
Angie Gaddy, spokeswoman for the BC Pharmacy Association, said in an email the group was waiting for more details but "we do support the government's decision as an element in addressing the diversion of prescribed alternatives."
More than 16,000 people have died in B.C. since the toxic drug crisis was declared a public health emergency in April 2016.
