More than 60 pharmacies have allegedly offered incentives to encourage doctors and patients to use their services to maximize their dispensing fees
A leaked audit that revealed that the diversion of opioids prescribed through the province’s safer supply program is raising concerns among local addiction experts.
“It worries me a great deal that it has gotten so out of control,” said Dr. Caroline Ferris, a frontline addictions physician with more than a decade of experience in Surrey and Victoria.
On Wednesday, a leaked briefing distributed by the opposition B.C. Conservatives revealed the B.C. Ministry of Health has been investigating an alleged scheme involving incentives offered by dozens of pharmacies to patients, doctors and housing providers, and that prescribed drugs were being trafficked provincially, nationally and internationally.
According to the document that was originally prepared for police, more than 60 pharmacies have offered incentives to encourage doctors and patients to use their services as a way to maximize their dispensing fees, which are valued at approximately $11,000 per patient per year. Additionally, some community housing staff have allegedly directed tenants to specific pharmacies.
It shows that from 2022 to 2024, approximately 22.4 million doses of opioids — primarily hydromorphone and oxycodone — were prescribed to about 5,000 clients in B.C.
“A significant portion of the prescribed opioids being freely prescribed by doctors and pharmacists are not being consumed by their intended recipients,” the PowerPoint presentation states.
The next steps will include targeting specific pharmacies by law enforcement, it says.
Asked whether any related investigations had been initiated into individual pharmacists or doctors, both B.C.’s governing College of Pharmacists and the College of Physicians and Surgeons said the information is protected under provincial privacy laws.
Meanwhile, the B.C. Pharmacy Association said in a statement that it condemned the actions of any pharmacist or pharmacy owner involved in illegal activity related to the dispensing of medications used to treat patients with substance-use disorder, including safer supply.
“Giving out incentives or participating in the diversion of any of these medications by pharmacy operators is unacceptable, and the association supports the Ministry and College of Pharmacists taking all actions necessary to ensure patients are protected.”
The statement said training and certification requirements for pharmacies dispensing medications has become more rigorous over the last decade.
While B.C. Health Minister Josie Osborne confirmed the authenticity of the internal briefing on Wednesday, she expressed disappointment over the leak and concern that the ongoing investigation could be compromised.
“I want to acknowledge that we know that this is happening. These allegations are here. There’s absolutely no denial of it. There’s no diminishing of it. … That’s why we’re taking the actions that we are.”
Osborne said only a small number of pharmacies were alleged to be involved in the illicit diversion schemes.
“To put this in scale, you know, we have about 1,400 community pharmacies in British Columbia, and this is a very small proportion of those where those allegations have taken place. But we need to let the investigations play out,” she said.
The leak has raised concerns among critics about the integrity of the safer supply dispensing program, which was launched nearly five years ago in response to B.C.’s opioid overdose crisis declared in 2016. The program provides individuals at high risk of overdose with prescribed medications — either for on-site use or for later use — as a safer alternative to the toxic illegal drug supply.
In response to the investigation, Elenore Sturko, a Conservative MLA and critic of the solicitor-general, has called for a public inquiry into the province’s safer supply program and the appointment of a new public health officer.
In a statement Wednesday, she claimed that Premier David Eby, his ministers, and provincial health officer Dr. Bonnie Henry had long “denied and downplayed” the issue of diversion of prescribed safe supply, saying the leak shows there is “no doubt that the NDP government is responsible for fuelling addiction, deaths, enriching organized crime, and facilitating international drug trafficking.”
Ferris said she believes prescribing these medications should remain at the discretion of addiction specialists.
“It’s the few doctors who prescribe these drugs regularly who make it difficult for the rest of us,” said Ferris, who is also a practice assessor for addiction medicine with the B.C. College of Pharmacists.
Ferris continues to prescribe both hydromorphone and oxycodone to patients for short-term use to alleviate withdrawal symptoms before transitioning them to opioid agonist therapies such as methadone or Suboxone. These therapies require medical supervision during consumption.
“Most of us addiction doctors do everything we can to ensure we don’t prescribe to patients who might misuse or divert the medication, and general physicians wouldn’t even go near prescribing these medications with a 10-foot pole.”
With the recent developments, Ferris suspects funding for B.C.’s prescribed safer supply rollout could be withdrawn.
“It would mean that these prescriptions are no longer covered by Pharmacare,” she said.
— with files from David Carrigg and Canadian Press