By Alexandra Keeler

A B.C. pharmacy scam investigation has led the provincial government to return to a witnessed consumption model for safer supply

More than 60 pharmacies across B.C. are alleged to have participated in a kickback scheme linked to safer supply drugs, according to a provincial report released Feb. 19.

On Feb. 5, the BC Conservatives leaked a report that showed the findings of an internal investigation by the B.C. Ministry of Health. That investigation showed dozens of pharmacies were filling prescriptions patients did not require in order to overbill the government. These safer supply drugs were then diverted onto the black market.

After the report was leaked, the province committed to ending take-home safer supply models, which allow users to take hydromorphone pills home in bottles. Instead, it will require drug users to consume prescribed opioids in a witnessed program, under the oversight of a medical professional.

Gregory Sword, whose 14-year-old daughter Kamilah died in August 2022 after taking a hydromorphone pill that had been diverted from B.C.’s safer supply program, expressed outrage over the report’s findings.

“This is so frustrating to hear that [pharmacies] were making money off this program and causing more drugs [to flood] the street,” Sword told Canadian Affairs on Feb. 20.

The investigation found that pharmacies exploited B.C.’s Frequency of Dispensing policy to maximize billings. To take advantage of dispensing fees, pharmacies incentivized clients to fill prescriptions they did not require by offering them cash or rewards. Some of those clients then sold the drugs on the black market. Pharmacies earned up to $11,000 per patient a year.

“I’m positive that [the B.C. government has] known this for a long time and only made this decision when the public became aware and the scrutiny was high,” said Elenore Sturko, Conservative MLA for Surrey-Cloverdale, who released the leaked report in a statement on Feb. 5.

“As much as I am really disappointed in how long it’s taken for this decision to be made, I am also happy that this has happened,” she said.

The health ministry said it is investigating the implicated pharmacies. Those that are confirmed to have been involved could have their licenses suspended, be referred to law enforcement or become ineligible to participate in PharmaCare, the provincial program that helps residents cover the costs of prescription drugs.

Witnessed dosing

The leaked report says that “a significant portion of the opioids being freely prescribed by doctors and pharmacists are not being consumed by their intended recipients.” It also says “prescribed alternatives are trafficked provincially, nationally and internationally.”

Critics of the safer supply program say it enables addiction, while supporters say it reduces overdoses.

Sword, Kamilah’s father, is suing the provincial and federal governments, arguing B.C.’s safer supply program made it possible for youth such as his daughter to access drugs.

Madison, Kamilah’s best friend, also became addicted to opioids dispensed through safer supply programs. Madison was just 15 when she first encountered “dillies” — hydromorphone pills dispensed through safer supply, but widely available on the streets. She developed a tolerance that led her to fentanyl.

“I do know for sure that some pharmacies and doctors were aware of the diversion,” Madison’s mother Beth told Canadian Affairs on Feb. 20.

“When I first realized what my daughter was taking and how she was getting it, I phoned the pharmacy and the doctor on the label of the pill bottle to inform them that the patient was selling their hydromorphone,” Beth said.

Masha Krupp, an Ottawa mother who has a son enrolled in a safer supply program, has said the safer supply program in her city is similarly flawed. Canadian Affairs previously reported on this program, which is run by Recovery Care’s Ottawa-based harm reduction clinics.

“I read about the B.C. pharmacy scheme and wasn’t surprised,” Krupp told Canadian Affairs on Feb. 20. Krupp lost a daughter to methadone toxicity while she was in an addiction treatment program at Recovery Care.

“Three years [after starting safer supply], my son is still using fentanyl, crack cocaine and methadone, despite being with Dr. [Charles] Breau and with Recovery Care for over three years,” Krupp testified before the House of Commons Standing Committee on Health on Oct. 22, 2024.

Krupp has been vocal about the dangers of dispensing large quantities of opioids without proper oversight, arguing many patients sell their prescriptions to buy stronger street drugs.

“You can’t give addicts 28 pills and say, ‘Oh here you go,’” she said in her testimony. “They sell for three dollars a pop on the street.”

Krupp has also advocated for witnessed consumption of safer supply medications, arguing supervised dosing would prevent diversion and ensure proper oversight of pharmacies.

“I had talked about witnessed dosing for safe supply when I appeared before the parliamentary health committee last October,” she told Canadian Affairs this week.

“I’m grateful that finally … this decision has been made to return to a witness program,” said Sturko, the B.C. MLA.

In 2020, B.C. implemented a witnessed consumption model to ensure safer supply opioids were consumed as prescribed and to reduce diversion. In 2021, the province switched to take-home models. Its stated aim was to expand access, save lives and ease pressure on health-care facilities during the pandemic.

“You’re really fighting against a group of people … working within the bureaucracy of [the B.C. NDP] government … who have been making efforts to work towards the legalization of drugs and, in doing that, have looked only for opportunities to bolster their arguments for their position, instead of examining their approach in a balanced way,” said Sturko.

“These are foreseeable outcomes when you do not put proper safeguards in place and when you completely ignore all indications of negative impacts.”

Sword also believes some drug policies fail to prioritize the safety of vulnerable individuals.

“Greed is the ultimate evil in society and this just proves it,” he said. “We don’t care about these drugs getting into the wrong hands as long as I get my money.”

This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.