The composition of the illicit drug supply is of significant concern, as it increases the likelihood of an individual experiencing a fatal overdose. Unless people are offered regulated alternatives, it will be challenging to fully address this public health emergency and to save lives. At VCH, we have been working closely with federal and provincial governments to introduce pharmaceutical alternatives for people at high risk of overdose.

Prescribed alternatives can include powder, tablets, vials or patches containing known qualities of certain prescription-grade opioids, offered in settings with clinical oversight. An example includes SAFER, a VCH pilot program launched in 2021 with funding from Health Canada.



SAFER, located in Vancouver’s downtown eastside, offers fentanyl-containing products to clients using a clinical model and operates as a partnership between the PHS Community Services Society and the B.C. Centre on Substance Use.

Increasing engagement in essential, life-saving health care services

In addition to prescribing pharmaceutical-grade opioids, clients are also connected to treatment, harm reduction and recovery support in the community. Another program that offers pharmaceutical alternatives is Insite, North America’s first supervised consumption site. This site is expanding the availability of prescribed fentanyl products to some of its clients accessing harm reduction services.

Findings from client care at SAFER and Insite will generate evidence on how pharmaceutical alternatives can be offered more broadly to the community. While this work is ongoing, many other VCH sites also offer prescription fentanyl patches to clients who use substances, including community health centres and other VCH-funded sites. Collectively, this work reduces the clients’ need to access the illicit drug supply and decreases their risk of experiencing an overdose. 

These advancements in services are an essential component of the VCH response to the illicit drug toxicity public health emergency, along with prevention, harm reduction, treatment and recovery services. They enable us to meet clients where they are on their recovery journey and increase engagement in essential, life-saving health care services.

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