Addictions
Harm-reduction activists could find common ground with critics if they kept an open mind
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By Rahim Mohamed
The recovery-oriented PROSPER Symposium was protested by harm reduction activists.
A star-studded symposium on recovery-oriented drug policy went off without a hitch in Vancouver on Thursday, despite efforts by several prominent harm-reduction activists to sabotage the event.
Harm-reduction activists oppose the enforcement of criminal laws prohibiting public drug use and the prioritization of treatment and recovery-oriented policies.
Yet, if these activists had attended the symposium rather than undermining it, they likely would have found they agreed with many of the speakers’ points.
The PROSPER symposium — which stands for Policy Roundtable on Substance Prevention, Education, and Recovery — was moved to a new venue after organizers caught wind of credible threats to the event’s security. Audio recordings leaked before the symposium depicted activists brainstorming ways to disrupt the proceedings, including by dyeing fountains red, shouting down speakers and honking horns.
The last-minute venue change didn’t stop a handful of protestors affiliated with the group Moms Stop the Harm from picketing the event. Some held photographs of lost loved ones. Others commented to on-location news crews at various points throughout the day.
Fortunately, the event’s logistical challenges didn’t dissuade three high-profile elected officials — Official Opposition leader and leader of BC United Kevin Falcon, BC Conservative Party leader John Rustad and Port Coquitlam Mayor Brad West — from attending the conference.
Even though PROSPER was a success, one can’t help but lament the missed opportunity for the event’s organizers and detractors to come together to find common ground on sensible drug policy.
Speaker after speaker reaffirmed the importance of the 4 Pillars approach to combating drug addiction and dependence. This approach says harm reduction plays an important role in drug policy, but also recognizes the importance of three other pillars: treatment, prevention and enforcement.
No speakers denied the importance of harm reduction; they only said they would like to see a more balanced approach that is recovery-oriented and sees harm reduction as one tool among many.
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One presenter, Dr. Launette Rieb of the University of British Columbia, shared findings from her research on the efficacy of supervised opioid agonist therapy, which involves using medications such as Suboxone to help patients taper their opioid use.
While some harm-reduction activists have been critical of providers of this therapy, many others advocate for its use and want to expand access to it. Why boycott a presentation about this treatment option?
Dr. Pouya Azar, a psychiatrist with Vancouver Coastal Health, had audience members watch snippets from recorded interviews he conducted with opioid-addicted patients. One of the interview subjects told Azar that his mom also used, and noted that taking drugs was one of the few activities they still did together.
These clips underscored the significance of environmental and psychosocial factors in facilitating lasting recovery. This is an idea that harm-reduction activists, at least in theory, also recognize.
The conference placed a strong emphasis on Indigenous perspectives on addiction and recovery. Indigenous leaders shared stories of how addiction had impacted their families and communities.
Harm-reduction activists often emphasize the importance of ensuring Indigenous perspectives are incorporated in treatment approaches. It seems unlikely they would have been offended by these presentations.
“I think many harm-reduction activists are well-intended, hardworking and want the right thing,” said former senior White House drug policy advisor Kevin Sabet and one of the conference’s organizers.
“But they’ve also been led astray by a much smaller group of people who want to dress up radical ideas with sympathetic faces,” he said. “It is in that small band’s group of interest to distort the truth and spread lies about what we are about.”
Sabet and fellow conference organizers have promised to meet with some of the protesters, including parents who lost their children to overdose, at a later point to find areas of agreement.
In the spirit of protecting open discussion, PROSPER also admitted several individuals who work for organizations that were implicated in the leaked audio recordings.
In his closing keynote, Stanford psychology professor Dr. Keith Humphreys expressed cautious optimism about the future of drug policy. He noted that some of the US’ most drug-addled jurisdictions, such as San Francisco and Portland, have recently taken meaningful steps toward sensible drug policies, including ramping up law enforcement in neighbourhoods with high concentrations of drug users.
“I think reality is our friend,” Humphreys said. The past few years have shown that “people who live in an ideological world can recover,” he added, referring to hardline ideological approaches to drug use and other urban issues that have become less popular in recent years.
It’s a shame that some of the people who may have benefited most from Humphreys’ message weren’t in attendance to hear what he had to say. By protesting initiatives like PROSPER, rather than engaging in good-faith dialogue with those who hold different views, these activists are hurting their own cause.
It’s too bad that they’re too blinded by their own ideology to see this.
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Addictions
BC overhauls safer supply program in response to widespread pharmacy scam
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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.
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Addictions
Calls for Public Inquiry Into BC Health Ministry Opioid Dealing Corruption
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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.
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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