New order authorizes B.C. nurses to prescribe safe alternatives to toxic street drugs

VICTORIA (NEWS 113) — A new public health order has been issued in B.C., authorizing nurses to prescribe safe alternatives to toxic street drugs and prevent overdose deaths.

The order, from Provincial Health Officer Dr. Bonnie Henry, will allow doctors, as well as registered nurses and registered psychiatric nurse practitioners to prescribe pharmaceutical alternatives and provide opportunities for ongoing care, treatment, and support.

B.C. set a monthly record for overdose deaths in June with 177. The province saw another 175 overdose deaths in July — the third straight month with more than 170.

The overdose crisis was declared a public health emergency in April of 2016.

“We know the pandemic has only made the street drug supply in B.C. more toxic than ever, putting people who use drugs at extremely high risk for overdose,” Henry says in a release.

“Giving physicians and nurse practitioners the ability to prescribe safer pharmaceutical alternatives has been critical to saving lives and linking more people to treatment and other health and social services. I am issuing a provincial health officer order to expand the health professionals who are able to provide safer, accessible alternatives to the toxic street drug supply and help more people find their pathway to hope.”

BC’s top doctor, DBH, has issued a new public health order to help reduce the number of people dying from illicit drugs. The order will allow doctors/nurses to prescribe “pharmaceutical alternatives” to reduce the use of the toxic street supply.

— Sonia Aslam (@SoniaSAslam) September 16, 2020

The order was issued under the Health Professions Act and includes new nursing standards, along with training and education.

“Increasing prescribing access for this high-risk population to allied health-care providers working on the ground makes logistical sense, and we hope that by expanding team-based care to include RNs working in this field, more lives will be saved during the overdose crisis,” says Dr. Kathleen Ross, president, Doctors of BC.

“We support these game-changing treatment options, and hope that as we proceed, a viable partnership among all health care providers working in this environment will help to identify and change any areas that aren’t working. We must be able to meet the needs of patients.”

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The Association of Nurses and Nurse Practitioners of BC is also pleased with the decision.

“In doing this, we have taken an important step in leveraging nursing knowledge by expanding scope in such a way that will have a direct and beneficial impact on harm reduction. Every day British Columbians are losing their lives to a crisis that has only accelerated in the current COVID-19 pandemic. Nurses stand ready at all levels to interact with people who use substances and will utilize supportive harm reduction, coupled with increased prescriptive authority as well as expanded access to referral for ongoing treatment and support to save countless lives,” says Sherri Kensall, with the Nurses and Nurse Practitioners of BC.

In addition to the public health order, the Ministry of Mental Health and Addictions and the Ministry of Health are working with the Office of the Provincial Health Officer to develop an updated policy directive for prescribers and health authorities, which builds on the existing risk mitigation clinical guidance released in March.

Leslie McBain, who lost a son in 2014 to an overdose and now works with the B.C. Center for Substance Use, applauded the new order, However, she said there are a number of outstanding questions.

“I always like to know when the government releases these policies, the question always is, ‘Is this going to happen tomorrow? Is it already in place? Is it going to take six months?'”

The new policy has not yet been finalized, but the province expects it to be released as soon as possible. The policy still emphasizes access to substance-use services, such as harm reduction, treatment, counselling and mental health supports and recovery-oriented services.

“This is what an emergency response looks like,” says Guy Felicella, peer clinical advisor with the Overdose Emergency Response Centre.

“This will provide a lifeline to people who use drugs. It says to them that their lives matter and offers hope to them, their families and their communities. Now the work begins to move forward with building a system of care that connects people to harm reduction, treatment and recovery — a system that meets people where they’re at, wherever they’re at, and offers multiple pathways to care.”

People with substance-use disorder and addictions can currently access safer pharmaceutical alternatives by talking to their doctor, nurse practitioner, community care team or by calling 811.