Harm-reduction advocates say they are bracing for a possible increase in overdose deaths and more stress on the health-care system if the incoming B.C. Conservative government follows through on its pledge to end safer supply in the province.
Leslie McBain, co-founder of Moms Stop The Harm and a caregiver lead at the B.C. Centre on Substance Use, says she was “horrified” after seeing the Conservatives win a majority in the Oct. 24 election.
“With the NDP, we were feeling like we were taking no steps forward and all the time taking two or three steps back, and I feel like right now we’re backing up to the edge of a cliff,” said McBain.
The Conservative platform promises to end the existing safer supply approach, saying the overdose crisis is being managed with “free hard drugs” instead of treatment.
It says “drug-friendly facilities,” such as supervised consumption and overdose prevention sites, have been forced on communities that did not want them.
The party says the focus will instead be on “drug prevention, treatment, and recovery.”
McBain said, while the details of the Conservatives’ plans are still uncertain, she is concerned that more people will die or suffer permanent brain injuries from toxic drugs if current safer supply initiatives are eliminated or reduced.
The B.C. Coroners Service says more than 19,000 people have died because of unregulated drugs since 2016, when the province declared the toxic drug crisis a public health emergency.
Safer supply initiatives have spread across Canada since 2016 and expanded rapidly during the COVID-19 pandemic to respond to soaring overdose deaths.
The approach provides patients with access to drugs that have a known potency and composition, often referred to as “prescribed alternatives,” allowing drug users to avoid unregulated and potentially toxic substances.
The previous B.C. NDP government introduced a prescribed alternative policy directive for health-care professionals in 2021, but it put more limits on the program last year. All patients taking certain prescribed alternatives are now required to do so under the supervision of a health professional, such as a pharmacist or nurse.
The changes are intended to ensure medications are not being sold or otherwise diverted to individuals without a prescription, which is a concern the B.C. Conservatives cited during their campaign.
In February 2025, a leaked Ministry of Health briefing intended for police said a “significant portion” of prescribed opioids in the province were being diverted or sold, and in some cases were being trafficked nationally and internationally.
The ministry noted in a release that the vast majority of opioid prescriptions in B.C. were unrelated to the prescribed alternative program.
Prescriptions have also been declining in recent years. The province said there were just 2,200 patients receiving the commonly prescribed alternative hydromorphone in July 2025, down from a peak of nearly 5,000 in March 2023.
Critics say the requirements for “witnessed dosing” put up more barriers to accessing the program.
“This puts an incredible burden on our patients’ lives,” said Dr. Ryan Herriot, a Victoria-based addiction medicine specialist and co-founder of Doctors for Safer Drug Policy. “Imagine having to go three times a day to the pharmacy.”
Herriot said he had several patients with addictions who were relatively stable in their lives, but were showing up more frequently in the emergency department after restrictions on safer supply were put in place.
“Having people showing up in crowded emergency departments with overdoses that don’t need to be occurring at all, of course, impacts healthcare response times for everybody,” said Herriot.
Corey Ranger, president of the Harm Reduction Nurses Association, said the benefits of safer programs outweigh concerns about possible diversion of drugs.
“It helps connect people to health and social services. It reduces individual risk of toxic drug poisoning. It reduces risk of non-fatal toxic drug poisoning, which is a huge risk for hypoxic/anoxic brain injury. And so it’s a real shame that we’ve seen such stoking of people’s fears,” he said.
Ranger said he is worried the incoming government could pull funding for community-based programs that provide access to safer supply drugs.
“Those are well studied, highly overseen programs that work with people who are at the most risk of irreparable harm and death at the hands of the toxic drug supply. So there are a multitude of people who don’t have any other options if those programs get taken away,” he said.
Ranger said it’s less certain whether the province will be able to put restrictions on individual prescribers, though he pointed to other provinces that have done so, including Alberta and Ontario.
Alberta effectively banned safer supply in the province by introducing stringent regulations in 2022, limiting prescribing to a small number of specialized clinics and required witnessed dosing.
Officials with the Substance Use Health Network said in a case study that about 350 Albertans were affected by the changes, but it’s difficult to gauge the outcomes of the policy changes because the province did not track it.
Herriot said such restrictions also raise questions about physician autonomy and political interference in medicine.
“We don’t want the government directly interfering in what kinds of medical care your doctor can or can’t provide to you as long as they are keeping with the standards of their profession,” he said.
Claire Rattée, who was re-elected as MLA for Skeena and previously served as Conservative critic for mental health and addictions, said the province’s current approach isn’t working.
“I think people in British Columbia are ready for a chance to try a different option. That’s clearly what they voted for,” said Rattée.
She said the incoming government plans to work with clinicians and experts on implementing the proposed changes to safer supply.
“I take those doctors and different clinicians’ concerns very seriously,” said Rattée. “I think that every overdose death is a tragedy and decisions affecting people with substance use disorders have to account for the risks of changing their care.”
Rattée has spoken publicly about her own past struggle with addiction.
“If the government had made it easier for me to continue down a destructive path in the lifestyle that I was living, if they had encouraged it and made it easier, I’m not sure that I would still be here right now,” she said. “We need to be providing pathways into recovery.”
