Addictions
B.C. poll reveals clash between Indigenous views and drug policy
By Alexandra Keeler
A supermajority of First Nations respondents disagree that criminalizing drug use is racist, challenging public health advocates’ assumptions
A new report shows a majority of British Columbians — and a plurality of all ethnic communities surveyed — disagree with the contention that drug criminalization policies are racist.
The findings challenge assertions made by prominent B.C. policymakers, who have advocated for drug decriminalization and harm-reduction initiatives on the grounds of anti-racism and reconciliation.
The report, published by the policy nonprofit Centre for Responsible Drug Policy and think tank Macdonald-Laurier Institute, draws from a poll of 6,300 B.C. adults that was commissioned by the centre and conducted by Mainstreet Research.
“Chinese and Indigenous leaders keep telling me that their communities are very anti-drug, but public health officials and harm-reduction activists keep saying that legalization is integral to anti-racism and reconciliation,” said Adam Zivo, a journalist and founder of the centre.
“Now we have data to show which side is more accurate.”
When asked whether criminalizing drug use is racist, just 22 per cent of all respondents agreed, while 60 per cent disagreed. Notably, 79 percent of the respondents identified as white.
Disagreement was strongest among First Nations respondents, with just nine per cent of the 172 Indigenous respondents agreeing that criminalization is racist and 67 per cent disagreeing.
Agreement was stronger among Asian communities, with East Asian and South Asian respondents being most likely to say criminalization policies are racist.
In the East Asian cohort, 42 per cent said they disagreed that criminalizing drug use is racist, while 36 per cent strongly agreed. Similarly, 46 per cent of South Asian respondents disagreed and 32 per cent agreed.
Self-determination
The poll challenges views articulated by some prominent B.C. policymakers and public health groups.
In July, B.C.’s provincial health officer, Dr. Bonnie Henry, released a report asserting that drug policies prohibiting the use of hard drugs are rooted in racism and colonialism.
“Prohibitionist drug policies are deeply rooted in colonialism, reflecting and perpetuating systemic racism that disproportionately impacts Indigenous peoples,” Henry’s report says.
“These policies were designed to control marginalized populations and have led to over-incarceration, intergenerational trauma, and significant health disparities within these communities.”
Henry’s report contends that decriminalization policies — such as those implemented by B.C. as part of a three-year trial project that began January 2023 — can help to rectify these injustices by prioritizing health and safety over law enforcement.
Henry’s report was released mere months after B.C. rolled back some of its decriminalization measures in response to growing public concerns over decriminalization’s effects on community safety and order. Henry’s report, which is published by the BC Ministry of Health, urges the province to move in the opposite direction.
“This report’s recommendation is to continue to refine and expand prescribed alternatives to unregulated drugs, and critically, to explore implementation of models that do not require prescription,” Henry writes, referring to harm-reduction initiatives such as safer supply that dispense prescription opioids to drug users.
The report presents decriminalization as a move supported by Indigenous communities, citing the Declaration on the Rights of Indigenous Peoples Act Action Plan. Action 4.12 aims to “address the disproportionate impacts of the overdose public health emergency on Indigenous Peoples by: applying to the Government of Canada to decriminalize simple possession of small amounts of illicit drugs for personal use.”
The Canadian Drug Policy Coalition, a policy advocacy group based out of Simon Fraser University, has similarly contended that drug criminalization is racist.
The coalition’s website says, “the demand by Black communities to decriminalize drugs and to immediately expunge records are a vital necessity for minimizing the racially disproportionate harms of drug criminalization, part of a broader struggle to end the war on Black communities.”
And in December 2023, the Harm Reduction Nurses Association, a national organization that advances harm-reduction nursing, obtained an injunction to prevent the B.C. government from imposing restrictions on public drug consumption.
The association alleged the government’s actions “would put people at greater risk of fatal overdose, make healthcare outreach more challenging, and drive racial discrimination, particularly against Indigenous people.”
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Minority polling challenges
Some Indigenous groups have expressed reservations about blanket decriminalization policies in other contexts.
In January 2024, the First Nations Health Authority, an agency that manages health services for Indigenous communities in B.C., issued a statement acknowledging decriminalization may not be the best approach for all communities.
“FNHA acknowledges and supports the self-determination of each First Nations community when considering implementing this exemption,” the statement reads, referring to the three-year exemption B.C. obtained from federal laws prohibiting the use of hard drugs.
First Nations Health Authority has emphasized the need for culturally informed approaches that prioritize community health and safety and advocated for nuanced strategies tailored to each community’s specific needs.
The Mainstreet Research poll reveals challenges in accurately representing the views of B.C.’s smaller ethnic communities.
While non-white Canadians make up 40 per cent of B.C.’s population, they accounted for only 16 per cent of the poll’s 6,300 respondents.
Responses by Black, Middle Eastern and Southeast Asian respondents were excluded from the current analysis because sample sizes were too small, numbering below 100. The English-only and automated telephone polling format may also increase uncertainty.
As the poll focused primarily on B.C. and broad drug policy questions, its findings underscore the need for a deeper understanding of community beliefs to inform drug policies.
The Centre for Responsible Drug Policy is releasing the polling data and its report on a “preliminary” basis so it can inform drug policy discussions ahead of provincial elections, which are taking place this October in B.C., Saskatchewan and New Brunswick.
But Mainstreet Research is continuing to gather data, aiming for a final survey size of more than 12,000 respondents. Once completed, the survey will be one of the largest polls on harm reduction ever conducted in Canada.
“The final report, set to be released later this year, will include larger samples from B.C.’s diverse ethnic communities, providing further clarity on their beliefs,” Zivo said.
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.
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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.
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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.
Our content is always free – but if you want to help us commission more high-quality journalism, consider getting a voluntary paid subscription.
The leaked audit shows from 2022 to 2024, a staggering 22,418,000 doses of opioids were prescribed by doctors and pharmacists to approximately 5,000 clients in B.C., including fentanyl patches.
A confidential investigation by British Columbia’s Ministry of Health, Financial Operations and Audit Branch has uncovered explosive allegations of fraud, abuse, and organized crime infiltration within PharmaCare’s prescribed opioid alternatives program. Internal audit findings, obtained by The Bureau, suggest that millions of taxpayer dollars are being diverted into illicit drug trafficking networks rather than serving harm reduction efforts.
The leaked documents include photographs from vehicle searches that show collections of fentanyl patches and Dilaudid (hydromorphone) apparently packaged for resale after being stolen from the taxpayer-funded “safer supply” program. This program expanded dramatically following a federal law change implemented by Prime Minister Justin Trudeau’s government in 2020, which broadened circumstances in which pharmacy staff could dispense opioids, according to the document’s evidence.
“Prior to March 17, 2020, only pharmacists in BC were permitted to deliver [addiction therapy treatment] drugs,” the audit says.
B.C.’s safer supply program was launched in March 2020 as a response to the opioid overdose crisis, declared in 2016. It allows people with opioid-use disorder to receive prescribed drugs to be used on-site or taken away for later use.
The Special Investigations Unit and PharmaCare Audit Intelligence team identified a disturbing link between doctors, pharmacists, assisted living residences, and organized crime, where prescription opioids meant to replace illicit drugs are instead being diverted, sold, and trafficked at scale.
“A significant portion of the opioids being freely prescribed by doctors and pharmacists are not being consumed by their intended recipients,” the document states.
It suggests that financial incentives have created a business model for organized crime, asserting that “prescribed alternatives (safe supply opioids) are trafficked provincially, nationally, and internationally,” and that “proceeds of fraud” are being used to pay incentives to doctors, pharmacists, and intermediaries.
BC Conservative critic Elenore Sturko, a former RCMP officer, began raising concerns about the program two years ago after hearing anecdotes about prescribed opioids being trafficked. She asserts that the program is a failure in public policy and insists that Provincial Health Officer Dr. Bonnie Henry be dismissed for having “denied and downplayed” problems as they emerged. Sturko also argues that B.C. must change its drug policy in light of U.S. President Donald Trump’s stance linking the trafficking of fentanyl and other opioids to potential trade sanctions against Canada.
The document shows that PharmaCare’s dispensing fee loophole has incentivized pharmacies to maximize billings per patient, with some locations charging up to $11,000 per patient per year—compared to just $120 in normal cases.
Perhaps most alarming is the deep infiltration of B.C.’s safer supply program by criminal networks. The Ministry of Health report lists “Gang Members/Organized Crime” as key players in the prescription drug pipeline, which includes “Doctors, pharmacies, and assisted living residences.”
This revelation confirms long-standing fears that B.C.’s “safe supply” policy—originally designed to prevent deaths from contaminated street drugs—is instead sometimes supplying criminal organizations with pharmaceutical-grade opioids.
The leaked audit shows from 2022 to 2024, a staggering 22,418,000 doses of opioids were prescribed by doctors and pharmacists to approximately 5,000 clients in B.C., including fentanyl patches.
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Beyond organized crime’s direct involvement, pharmacies themselves have exploited regulatory gaps to generate massive profits from PharmaCare’s policies:
- Pharmacies offer kickbacks to doctors, housing staff, and medical professionals to steer patients toward specific locations.
- Financial incentives fuel fraud, with multiple investigations identifying 60+ pharmacies offering incentives to clients.
- Non-health professionals, including housing staff, are witnessing OAT (opioid agonist treatment) dosing, violating patient safety protocols.
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