Good morning,
Wendy Cox in Vancouver today.
This week, B.C.’s Health Minister has found himself having to assure nurses and anyone else visiting a hospital that his government will ensure there is a consistent policy on how to manage illicit drug use in a health care setting.
The question Adrian Dix’s ministry is having to hastily address isn’t just if illicit substances can be consumed by patients in hospitals, but also when and where.
It’s another entanglement the NDP government has had to confront in the 15 months since B.C. became the first jurisdiction in Canada to decriminalize small amounts of some street drugs, an effort to reduce stigma of drug users and encourage them into treatment.
The issue exploded last week after the opposition BC United party raised a memo written last July and issued to workers at GR Baker Memorial Hospital in Quesnel, B.C. The memo stated that it is illegal for staff to go through a patient’s personal belongings and that staff must not confiscate personal items, even if they include illegal drugs.
But the memo went on to say that “patients can use substances while in hospital in their rooms.”
Shadow minister for health Shirley Bond blamed the matter on the B.C. NDP’s “dangerous decriminalization experiment.”
Bond told the legislature that nurses are telling the opposition that drug use is “allowed, permitted and endorsed” in hospitals.
Dix told the legislature that the safety of health care workers, doctors and nurses is a “singular priority” and noted that the province has hired 320 security officers in 26 acute care hospitals to address previous concerns about staff safety.
To which Bond responded that the security guards aren’t any help if the policy is to allow patients in hospitals to use illicit substances.
Dix’s office later clarified that the Quesnel hospital memo was, while well-intentioned, badly written. The official policy in the Northern Health Authority is that while patients are permitted to bring small amounts of controlled drugs into certain areas of health care settings, there are rules around where those substances can be stored or used.
Bond noted Victoria General Hospital has installed alarms in the maternity ward to detect fentanyl smoke. Another nurse at Shuswap Lake Hospital went to help a patient in a bathroom and was met with a cloud of fentanyl smoke. Bond asked Dix if his office would issue a directive to all the province’s health authorities that illicit drug use is not permitted.
But even nurses agree it’s not that simple.
Adriane Gear, president of the B.C. Nurses’ Union, said while nurses in general support harm reduction, decriminalization has complicated the situation in many hospitals, especially in the north, on Vancouver Island and in the Interior.
“I think there’s confusion around decriminalization,” Ms. Gear told reporter Andrea Woo.
“Substance use isn’t a criminal matter; it is a health matter. But that doesn’t mean then that people can just consume anytime, anywhere. If there have been clear policies, they have not been followed.”
She noted there has always been some use of illicit drugs on hospital grounds.
A June 2023 WorkSafeBC inspection found the Vancouver Island Health Authority did not train its employees on how to mitigate the risk of exposure to illicit substances, leading to exposure for workers. The agency ordered the health authority to come up with a plan to allow patients to use safely. Without such a plan, some patients would use substances in unapproved areas or areas where they would be at more risk.
In a statement to Andrea, Island Health said it has now trained more than 90 per cent of its workers on mitigating their exposure to illicit substances and how to deliver harm reduction care for those patients.
Dix did not accede to the Opposition’s demand that illicit drug use be banned in hospitals.
Instead, he announced a task force to come up with standardized rules across health authorities “in the next short while,” a tall task given the variety of facilities across the province. Some hospitals have harm reduction facilities like Vancouver’s St. Paul’s overdose prevention site. Others don’t.
“The reality is, we have, on any given day, hundreds of people in our hospitals who face severe addiction issues,” Dix told reporters on Monday. “As a practical matter, we want to ensure everyone knows what the rules are everywhere.”
This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief Mark Iype. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.
Wendy Cox