More than six years ago, a public health emergency related to opioid overdose deaths was declared by the provincial health officer. Currently six people per day are dying of drug overdoses, which are most often linked to fentanyl in the illicit drug supply. The acknowledges with sadness the devastating toll that illicit drug toxicity has had on members of our communities, and their families and friends.
The BC Ministry of Health (MoH) and Ministry of Mental Health and Addiction (MMHA) have taken bold action to encourage prescribing of safer pharmaceutical alternatives/prescribed safer supply to combat this crisis. In July of 2021, they published . Each health authority was directed to enhance or establish programs to support prescribing hydromorphone products, fentanyl products, and other pharmaceutical products as a safer alternative to the toxic street supply.
The has published articles on safer supply in the Connector in September 2021 and March 2022. In both articles it was acknowledged that providing pharmaceutical-grade alternatives to the toxic street supply, both in the context of a comprehensive treatment plan or as a standalone harm reduction strategy, may allow registrants to better support patients with substance use disorder, and may reduce their risk of overdose and death.
With appropriate safeguards in place, including practising within the limits of their clinical competence and preferably in a team-based setting, registrants are encouraged to use their professional judgement to determine the best treatment plan for their patients. In 2022, of the ’s 14,269 registrants, 2,338 (16%) self-reported on the Annual Licence Renewal Form that they provide opioid agonist treatment for opioid use disorder. Moreover, 1,607 (11% of all registrants) reported that they provide prescribed safer supply.
The is not in a position to endorse one clinical intervention over another, nor does it write clinical practice guidelines on the management of opioid use disorder or any other clinical condition. However, the strongly supports sound scientific research and data collection that will define best practices, and guide improvements to health-care programs.
Since January 2022, all prescribers have been asked to write “SA” (safer alternative) in the “Directions for Use” section when they are filling out the duplicate (Controlled Prescription Program) prescription form. However, many registrants are still neglecting this simple but critical step when providing safe supply for their patients.
Writing this code enables the pharmacist to enter this information into the PharmaNet database. This is the only way the MoH, MMHA, and partners such as the BC Centre on Substance Use and the BC Centre for Disease Control can conduct research to gauge the effects of safer supply, modify treatment programs, assess resource allocation needs, and to construct sound clinical practice guidelines. Prescribed safer supply is an evolving practice, and registrants are encouraged to do all they can to ensure that it is better understood. Completing the form correctly by writing “SA” is the first step in that endeavour.