B.C.’s suspension of work on Vancouver Island hospital overdose prevention sites under scrutiny
Leaked internal planning documents from Island Health show that the health authority had planned to open overdose prevention centres (OPC) at three Vancouver Island hospitals — with one site to be implemented in the summer of 2024 and the others soon after.
But all work stopped in April “on government direction,” the documents say.
It came at the same time that B.C. announced it was rolling back its decriminalization pilot in the wake of concerns, including among health-care workers, about illicit drug use in spaces such as hospitals.
A group of Vancouver Island doctors and other health-care professionals say they’re frustrated with the decision to halt the overdose prevention sites, which they say they saw as a significant step toward addressing the toxic drug crisis now nearing the end of eight years as a public health emergency.
“When you’re a physician, you’re trained to provide care based on objective evidence,” said family and addictions medicine doctor Jess Wilder, who is part of the group Doctors for Safer Drug Policy.
“It creates a lot of moral distress when we have politicians who have no idea about this work and no idea what it is like to work on the frontlines of this, creating barriers to me providing the care that I need to save lives.”
An overdose prevention site aims to create a safe space for those who use drugs, with peer workers on hand to provide care and attend to any health emergencies as necessary.
Doctors temporarily set up unsanctioned sites
Her comments come in the wake of a protest outside of Nanaimo and Victoria hospitals last week by the group of Island-based physicians who set up unsanctioned overdose prevention sites in tents for three days to provide what it said is a vital service that needs to be included in the care provided by hospitals.
The Island Health planning documents, first reported by Filter Magazine, detail work that began on the three OPCs in September 2023, following a “directive to move forward” from Kathy MacNeil, the president and CEO of the Vancouver Island Health Authority.
A steering committee was created that month, with working groups initiated in November.
Plans laid out in the documents outline how the health authority had selected Nanaimo Regional General Hospital, Royal Jubilee Hospital in Victoria, and Campbell River General Hospital as sites for OPCs originally anticipated to roll out in 2024.
The Nanaimo OPC, which the documents say was scheduled to start hiring for implementation in the summer of 2024, would operate every day from 11:30 am to 6:30 pm through a tent and van set up on the grass beside the hospital’s rehabilitation facility.
“Organization-Wide Framework is 75% complete and available for review,” the documents say.
Health Ministry non-committal
Island Health refused to answer questions from the CBC for this story, directing all requests to the Ministry of Health.
Tracy Fan, a spokesperson for the ministry, would not answer specific questions from the CBC and said Health Minister Josie Osborne was unavailable for an interview.
Instead, Fan said in a statement that the province suspended planning on new OPC sites in April 2024, including the ones in Island Health, so it could establish “minimum service standards” that would be an operational baseline for these facilities.
“This work is complex and is still underway,” wrote Fan.
Fan said the ministry’s focus is on “continuing to expand access to addiction treatment services” such as detox, treatment and aftercare.
The ministry refused to say whether the three Vancouver Island hospital-based OPCs are still a possibility.
Wilder pushed back on the ministry’s assertion that more work is needed to establish minimum standards for OPC services, pointing to guidelines from the B.C. Centre for Disease Control, the B..C Centre for Substance Use, and other health authorities that she says already exist.
“No other operational tool has been held to this standard that they’re now claiming is the reason that this has taken so long,” she said.
St. Paul’s Hospital
Vancouver Island hospitals would not be the first to have an OPC. St. Paul’s Hospital in Vancouver already has one, and Wilder says its success could be a model for potential Island sites.
She says that in 95 per cent of the cases where staff have had to medically intervene, such as in the case of an overdose, they’ve been able to do it without taking up emergency or other hospital services.
Patients who use this service, Wilder said, are also able to stay in the hospital and receive the full course of their care because of it, when they may otherwise have had to leave earlier.
Some are critical of any move to bring harm reduction services into Island hospitals.
B.C Premier David Eby is ordering a review into a program that put three harm reduction kiosks at Vancouver Island hospitals. The review comes after a B.C. Conservative candidate raised concerns.
B.C. Conservative health critic Anna Kindy, a physician who has worked in addictions medicine, told CBC’s On The Island in response to the Doctors for Safer Drug Policy protest that she is against OPCs in hospitals and feels they do not make hospitals safe spaces for patients or staff.
“To enable people to use something that’s actually killing them or injuring their brain is, to me, unethical,” she said.
Kindy’s appointment as health critic has drawn criticism due to her opposition to COVID-19 vaccine mandates, and Doctors for Safer Drug Policy said she was removed from an island addiction medicine forum due to “unscientific and frankly stigmatizing” comments.
Corey Ranger, the president of the Harm Reduction Nurses Association and a registered nurse, said that people who use drugs will use them regardless — so he feels it’s best when there’s a safe place for that. He was disappointed that the province stopped the OPCs, but is hopeful Minister Osborne will consider revisiting the plans.
“[It] means less people dying alone, and less people experiencing harms like injection-related harms, but also less moral distress for staff because they’re not finding people overdosed in bathrooms, less occupational health and safety risk for staff because there’s less likelihood of opening a door and walking through some smoke from illicit drug use,” he said.
“These solutions benefit everybody.”
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