Via The Globe and Mail: COVID-19 pandemic pushes B.C. to move forward on safe take-home drug supply strategy. This makes such good sense, it's surprising it's not universal health policy. Excerpt:
British Columbia is moving to provide drug users with a take-home supply of regulated substances as part of its COVID-19 pandemic response strategy for vulnerable populations.
The City of Vancouver and drug policy experts have called for “safe supply” for some time, but reluctance from regulatory bodies and the province restricted the provision of drugs such as hydromorphone and methadone to clinical settings that require witnessed daily ingestion.
As the new coronavirus swept the globe, health officials issued directives for people to restrict their movements, stay home and self-isolate when necessary, presenting a major obstacle to people with chronic substance use disorders who are unable to stockpile their prescription medications.
In B.C., the extraordinary circumstance of having two active public health emergencies – COVID-19 and an overdose crisis caused by a toxic supply of drugs – made safe supply a reality.
Provincial Health Officer Bonnie Henry said the move is particularly aimed at supporting people in places such as Vancouver’s Downtown Eastside.
“These guidelines enable us to provide a safe supply for people and to ensure that they’re able to comply with our public health advice around isolation or quarantine, should that be required," she said.
The move is made possible by recent changes to the federal Controlled Drugs and Substances Act and provincial prescribing guidelines. Together, they allow prescribers and pharmacists to prescribe individualized take-home supplies of drugs, colloquially called “carries,” and pharmacists to deliver medications and extend or refill prescriptions over the phone.
Eligible patients must be at risk of COVID-19 infection or confirmed positive, have a history of ongoing active substance use, and be deemed at high risk of withdrawal or overdose.
While opioids are the main driver of B.C.’s overdose crisis, the new guidelines extend to other substances, such as stimulants, benzodiazepines, tobacco and alcohol.
Prescribed stimulants include dextroamphetamine (trade name Dexedrine), while benzodiazepines include clonazepam. Those with tobacco use disorder can be provided with nicotine replacement therapies such as the patch or gum, while medications used to manage alcohol withdrawal include gabapentin and clonidine.
Donald MacPherson, executive director of the Canadian Drug Policy Coalition, said Thursday he was simultaneously delighted and astounded by the development.
“This is potentially a life line for so many in a very strange time," he said. “But the same conditions existed four months ago, eight months ago, two years ago, five years ago. All the calls for safe supply during the last several years of the drug toxicity crisis, and it took a global pandemic to move the dial."
