A doctor in Nelson, B.C., says after four years of trying to establish a safe supply program through conversations with the local health authority, he is making his frustrations public with hopes it will pressure officials into action.
Michael Vance, a family physician who focuses on addictions, says he’s had multiple meetings about safe supply with Interior Health over the span of four years.
However, the health authority has never committed to providing him with the funding for a nurse, which would allow Vance to adhere to professional recommendations around prescribing safe supply in a team-based setting.
Vance would like to be able to prescribe drugs such as fentanyl, sufentanil, and morphine, which are allowed under B.C.’s safe supply program. He says the prescribed drugs would help people get off an increasingly toxic street supply, which has already resulted in a number of fatal overdoses in Nelson and the West Kootenay region this year.
“How many more deaths need to happen before we actually put our money where our mouths are and get this treatment going?” he said.
“Every time I go to these meetings, I get more and more frustrated that there’s people dying and we’re not doing anything. I just can’t understand how we can continue.”
Vance said he’s already able to prescribe drugs like hydromorphone without the aid of support staff, as part of programs that are in place across the province. These are also used for opioid agonist therapy (OAT), which provides opioid users with longer-acting drugs to reduce dependency.
However, the B.C. College of Physicians and Surgeons says doctors looking to prescribe safe supply drugs should do so “preferably in a team-based setting,” and there should be safeguards in place. Vance says prescribed safe supply programs are set up with multidisciplinary teams to ensure smoother administration.
CBC News has requested comment from Interior Health on the specifics of Vance’s request.
However, the health authority confirmed in an email that there are no safe supply programs they are aware of in Nelson. Health authorities are responsible for dispensing funding for safe supply programs.
“Interior Health has implemented, or is in the process of implementing, services that offer prescribed safer supply in Kelowna, Vernon, Kamloops and Penticton,” a spokesperson said. “Planning for other communities is underway.”
Vance says he’s able to prescribe drugs like hydromorphone already. However, to prescribe stronger substances like fentanyl (pictured here), he needs the help of a nurse. (CBC)
Safe supply not reaching rural communities
Vance said dozens of his clients would benefit from a prescribed safe supply, and that they aren’t able to travel to Vancouver or the province’s bigger urban centres to do so.
He says the lack of funding for safe supply in rural areas of B.C. is negatively impacting drug users there, with some communities seeing extremely high rates of death.
Holly Trider, a peer worker with Kootenay-based harm reduction organization ANKORS, says it is “hard not to feel abandoned” by Interior Health’s slow progress on the issue.
“Living rurally adds an extra barrier to how safe supply rolls out here. Many folks live an hour or more from their OAT clinic, relying on a public transit system that, well, isn’t reliable,” she said. “If they cannot get at least weekly [prescriptions], then safe supply just isn’t feasible for them.”
In addition, Trider criticized hydromorphone and other drugs used for OAT as not being close enough to the drugs people are using daily.
“Safe supply does not work if it’s done halfway like this. So yes, this means fentanyl and proper stimulants’ availability,” she said. “It is my understanding that we do not have these options for our folks because there is no one to run the program.
“It is devastating and infuriating to see all this loss, pain and struggle — when we know the answer, and our health authority holds the power to make it happen.”
Compassion clubs another option
Dylan Griffith, the founder of the Kootenay Insurrection for Safe Supply, says prescribed safe supply programs are beneficial for drug users because they get connected to health care as a result, and it offers stability.
However, he says that in the context of a primary health-care crisis and stigma against drug users on the part of some doctors, the prescriber model alone would not be enough to solve the toxic drug emergency.
Griffith is advocating for a compassion club model in the Kootenays, which sees drug user groups hand out tested drugs at cost to participants in a program.
“We’re sick of watching our friends and neighbours die,” he told CBC News. “If [the government] is not going to implement those solutions then we will.”
Dylan Griffith, the founder of the Kootenay Insurrection for Safe Supply, says the prescribed model for safer supply is useful, but its current implementation doesn’t come close to meeting the needs of drug users across B.C. (Submitted by Dylan Griffith)
Griffith said he is aware of four people who died of a fatal overdose in Nelson over the past three weeks, and he would be working with drug user groups to get his program off the ground.
“For some people, those substances are necessary for them to function in daily life,” he said. “We believe that denying them access to a clean supply of those drugs is a violation of their rights.”
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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