From BCPhA submission to B.C.'s select standing committee on health
In early July, the BC Pharmacy Association provided a written submission to B.C. government’s Select Standing Committee on Health on the topic of B.C.’s safer supply pilot projects. Safer supply is part of the provincial government’s work to reduce harm associated with using illicit drugs.
The Select Standing Committee, which received the submission, is one of nine permanent all-party committees of the Legislative Assembly of British Columbia. It works to identify potential strategies to maintain a sustainable health care system for British Columbians; and consider health capital funding options.
As part of Budget 2021, the provincial government directed funding of up to $22.6 million to support the planning, phased implementation, monitoring and evaluation of prescribed safer supply services. Once implemented, it is expected that people at high risk of dying from the toxic illicit drug crisis will be able to access alternatives covered by Pharmacare, including a range of opioids and stimulants.
The Association, in its written submission to the Committee, communicated its belief that considerable work needs to be done to create a treatment protocol and clinical guidelines that can be understood and implemented by prescribers and pharmacists and their patients. Regulatory bodies and organizations representing practitioners must be involved.
The BCPhA’s position is that current guidelines for dispensing safer supply are inadequate and leave pharmacists in a position where they are vulnerable to regulatory and PharmaCare audit exposure. While the development of guidelines needs to be done immediately, there also must be plans for proper evaluation on safer supply. Clear evaluation methods should be developed that include proper clinical support, which include assessments and follow-ups, not simply a witnessed ingestion or a dispense of this medication from pharmacists. We understand the launch of B.C.’s safer supply pilot projects were predicated on an evaluation process that would provide important learnings about the role risk mitigation strategies like safer supply can and should play in the battle against opioid deaths.
We believe a wraparound approach is key when delivering safer supply. What will be key is addressing the challenge of consistency in access to prescriptions for safer supply. Not all practitioners will prescribe for this. In fact, we have seen not enough clinicians prescribing for opioid agonist treatment throughout the province. It is imperative that individuals understand that without a prescription, pharmacists can’t dispense, regardless of their interest in doing so.
Pharmacists as health care practitioners will never abandon their duty to care. While there is an understanding that safe supply is harm reduction, not clinical treatment, it must be understood that health care providers will always need to ensure that nothing they do will cause harm to a patient.
In the submission, the BC Pharmacy Association asks that we are part of the discussion and planning of well-developed clinical guidelines and evaluations to ensure that all issues are being considered when delivering important care to patients. We want to be at the table when discussions begin to bring our experience and expertise in delivering care for patients with opioid use disorder.
The full submission to B.C. government can be found at bcpharmacy.ca/advocacy/submissions