B.C.'s prescribed safer drug supply saved lives, landmark study finds

Providing prescription opioids to B.C. residents addicted to street drugs during the COVID-19 pandemic "significantly" reduced their likelihood of dying, according to a landmark study.

The research, which was published this week in the British Medical Journal, compared drug users who accessed prescribed safer supply between March 2020 and August 2021 with those who did not, and found a dramatic difference in health outcomes between the two groups.

Individuals who received as little as one day's supply of pharmaceutical opioids were 55 per cent less likely to suffer a fatal overdose the following week than their counterparts without a prescription, according to the findings.

The odds of survival were even better for those who received at least four days' worth of prescribed drugs. Those individuals were found to be 89 per cent less likely to die from an overdose the following week than the comparison group.

While experts and advocates have long argued that safer supply significantly reduces overdose risks, study co-author Dr. Amanda Slaunwhite said the benefits researchers uncovered exceeded their expectations.

"The magnitude of the reduction in mortality was surprising to us – and I think really speaks to how toxic the (illicit) drug supply is," said Slaunwhite, a senior scientist with the B.C. Centre for Disease Control.

The research is believed to be the first population-based cohort study to measure the impacts of prescription opioids on people with substance use disorder.

Slaunwhite noted that the findings come in the wake of more than 13,300 deaths from illicit drugs in B.C. alone since 2016, the majority of which have been blamed on fentanyl. 

"Our hope is that this research is used to inform evidence-based practice and policy," she said. "We need to identify and evaluate interventions that keep people alive."

CTV News reached out to Jennifer Whiteside, B.C.'s minister of addictions and mental health, to ask whether the province had plans to expand access to prescription opioids for drug users, but was told she was unavailable to answer questions Thursday.

In a statement, Whiteside's ministry said the government is continuously developing its approach to prescribed safer supply, and that provincial health officer Dr. Bonnie Henry has been reviewing the current implementation of the policy "over the past several months."

"She has been seeking valuable input from clinicians and other partners," the statement said. "It is anticipated that Dr. Henry will share the results of her review in the near future."

Slaunwhite acknowledged that prescribed safer supply, as a relatively new approach, has been met with some controversy, and said ongoing research is needed to monitor the impacts, including unintended consequences such as diversion, or the re-selling of prescription opioids for a profit.

A panel of experts convened by the B.C. Coroners Service has pushed for a more radical policy, recommending the government "urgently" begin providing non-prescription safer supply in order to combat the persistent problem of overdose deaths, of which there have been an average of about seven per day in the province in recent years.

The panel, which was made up of more than a dozen doctors, the chief of the Abbotsford Police Department, and others with expertise in health and public safety, suggested that diversion could be addressed by selling non-prescription safe supply for the same price as street drugs, removing the incentive to re-sell them.

Users unable to afford the drugs would be allowed to consume them for free at designated sites.

Whiteside quickly rejected the recommendation of a non-prescription supply when the panel delivered it back in November. Her ministry did not respond to a question about whether officials were re-thinking that decision in light of the research published this week.