Nearly four months since provincial funding for more overdose prevention sites was announced and three months after an ambitious policy calling for increased access to safer supply, people who use substances and workers on the frontlines of B.C.’s overdose crisis have yet to see the promised resources.
But newly appointed Minister of Mental Health and Addictions Sheila Malcolmson said her first priority is removing bottlenecks to get money out the door and kickstart the changes.
Malcolmson, the second minister to hold the post since it was created in 2017, said work on the two harm reduction interventions wasn’t slowed by the snap provincial election.
Staff “assured me the work on implementing Dr. [Bonnie] Henry’s order on expanding prescription options has gone forward full-speed,” Malcolmson said in an interview with The Tyee.
Malcolmson, MLA for Nanaimo, declined to give a timeline for the results to show up on the ground, but said work continued throughout the election. “Nothing has slowed down as a result of not having a minister in place.”
The government announced $10.5 million in funding in August to support 17 new supervised injection sites and 12 new sites for inhaling substances “in communities hit the hardest by the overdose crisis.” Four months later, none are in place.
Vancouver currently has six of the province’s seven permanent overdose prevention sites. There is one in Powell River, and another on the way in Vancouver’s downtown core.
In October, representatives of Vancouver Coastal Health told Vancouver city council that outdoor inhalation capacity was desperately needed. And in other communities, particularly in the Northern Health region that has the highest number of fatal overdoses per capita in B.C., advocates say services need rapid expansion now.
Malcolmson inherits the ministry, the first-of-its-kind in Canada, during what she calls a “double tragedy” as measures taken to prevent the spread of COVID-19 have caused overdose rates to skyrocket. At least 1,362 people in B.C. had died of illicit drug overdoses by the end of October. In 2019, deaths for the full year totalled 982.
The former MP for Nanaimo-Ladysmith, elected to the legislature in a 2019 byelection, said she understands the frustration with the “lag time” between announcements and the rollout of much-needed services.
“I thought when this investment was made in September [for safer supply], that that was the end of it,” she said. “It turns out that if that was it, that would have happened years ago.”
For example, Malcolmson said, working with the colleges that regulate health-care professionals on implementing safe supply is challenging. “This is extremely complex work, and this has never been done anywhere in the world,” she said. “And so, we’ve got no path to follow.”
B.C. will be the first province or territory in Canada to pursue safer supply so aggressively, but countries like Switzerland and the Netherlands have already done so, including a safe supply of pharmaceutical heroin.
Overdose deaths in B.C. were declining until the pandemic began in March, and the BC Centre on Substance Use estimates that actions taken since 2017 have saved more than 6,000 lives.
But Malcolmson is clear that more needs to be done.
She points to the nearly quadrupled prescriptions for hydromorphone, an oral substitute for illicit opioids like heroin, under pandemic prescribing as proof the need is out there.
“That is a very important metric and a direct signal about how much better we can do if we expand access to safer supply,” said Malcolmson.
The ministry has been criticized for being under-resourced, subservient to the Health Ministry and scapegoated for the province’s response to an increasingly fatal overdose crisis.
Malcolmson said she’s prepared to advocate for the resources needed to deal with the mental health and addiction issues in the coming budget. The February budget gave the ministry $10 million, less than the premier’s office.
The Canadian Mental Health Association’s B.C. branch has advocated for $2 billion in investment and joins a number of other organizations calling for a review and overhaul of the Mental Health Act.
Malcolmson also said she is in no hurry to reintroduce Bill 22, controversial legislation that have allowed youths who overdose to be detained against their will.
The bill was introduced in the last session but faced wide opposition from Green MLAs, addiction experts and Indigenous organizations before the NDP paused the legislation and called the election. Premier John Horgan said the failure to pass the legislation was part of his justification for calling the election.
Malcolmson wouldn’t commit to overhauling the legislation, but she did say it won’t be passed in the brief fall legislative session now under way.
She said she wanted to hear more about concerns with the bill.
“People with lived experience have the most to share and the most to teach me, and that is the best way for me to truly be the representative of the people that have sent me to the legislature,” she said.
“I've also got a lot to learn from those who are opposed, and I want to take the time to have those conversations.”