February 19, 2025: The Province of BC has announced changes to the prescribed alternatives policy, which will now require all prescribed alternatives to be witnessed by health professionals. This requirement goes into effect immediately for all new clients only. This supersedes the guidance contained in this document.
The BCCSU will release clinical resources to support the safe transition of existing clients from non-witnessed to witnessed doses. Until that time, clinicians should continue to use their clinical discretion for clients currently receiving and benefiting from non-witnessed doses, as described in the below clinical resources.
In July 2021, the Ministry of Mental Health and Addictions, Ministry of Health, and Office of the Provincial Health Officer released Access to Prescribed Safer Supply in British Columbia: Policy Direction, which enables individuals to access a range of medications through prescription to reduce the risk of drug toxicity death due to accessing the illicit drug supply.
The first phase of implementation of this policy allows for the prescribing of certain opioids through regional health authority-run programs and federally funded programs (e.g., SAFER).
Prescribed pharmaceutical alternatives is not intended for treatment of substance use disorders but is primarily a harm reduction approach as one strategy for reducing the risks of illicit drug toxicity events and deaths.
The new prescribed safer supply protocols are being developed and released in a phased approach to support the implementation of emerging approaches for prescribed safer supply in BC. They are targeted for Health Authorities looking to implement in their regions.
Monitoring, evaluation, and data collection of prescribed safer supply is ongoing. Protocols include direction for prescribers to include “SA” in prescriptions, which tells the dispensing pharmacist to tag the prescription with a (non-public) identifying code, for program evaluation purposes, in PharmaNet.
These protocols will be updated as evidence is collected and practices are evaluated.
Prescribed Safer Supply Protocols: