‘Safer supply’ in BC tied to increase in poisonings, but not deaths

Abstract

A cohort study that looked at Canadian province British Columbia's Safer Opioid Supply policy, instituted two years ago, found that there was a moderate increase in the number of individuals with at least one opioid prescription, a large increase in the number of opioid prescriptions dispensed, and a substantial increase in hospitalizations related to opioid poisoning. According to the study, “British Columbia's Safer Opioid Supply Policy and Opioid Outcomes” published online in JAMA Internal Medicine on Jan. 16, there were no statistically significant changes in deaths from opioid overdoses and no significant change in the number of prescribers. Rather, those prescribers who were there before prescribed a significantly greater amount of opioids. And the opioid‐related poisoning hospitalization rate increased by 3.2 per 100,000 population. The study, by Hai V. Nguyen, Ph.D. and colleagues, was funded by the Canadian Institutes of Health Research. The study used quarterly data from 2016 to 2022 from British Columbia, where the Safer Opioid Supply policy was implemented, then compared that data to Canada's Manitoba and Saskatchewan provinces where the policy was not implemented. The main outcomes were rates of prescriptions, claimants, and prescribers of opioids targeted by the Safer Opioid Supply policy (hydromorphone, morphine, oxycodone, and fentanyl); opioid‐related poisoning hospitalizations; and deaths from apparent opioid toxicity. The researchers concluded that while the Safer Opioid Supply policy was associated with higher rates of safer (prescription) supply, it was also associated with a significant increase in opioid‐related poisoning hospitalizations. “These findings will help inform ongoing debates about this policy not only in British Columbia, but also in other jurisdictions that are contemplating it,” the researchers concluded.