B.C.鈥檚 auditor general says two key provincial programs intended to help the toxic-drug crisis that has resulted in at least 14,000 deaths since 2016 were not 鈥渆ffectively implemented.鈥�

Auditor-General Michael Pickup鈥檚 review, released Tuesday (March 19), looked at provincial overdose prevention and supervised consumption sites, as well as the prescribed safer supply program.

鈥淎 prominent theme runs through both of these audits and that is that the Ministry of Mental Health and Addictions and the the Ministry of Health have not effectively addressed the many challenges and barriers facing each program,鈥� Pickup said in a news release.

The audit found the ministries鈥� guidance didn鈥檛 include minimum service standards that ensured consistent quality and access of services, that it did not adequately respond to barriers such as local government resistance and that a new program evaluation was needed as the health emergency evolved.

Pickup鈥檚 audit of safer supply found the ministries didn鈥檛 make 鈥渟ignificant progress鈥� in tackling its 鈥渕ost challenging barriers,鈥� such as rural access to the program, health-care providers鈥� hesitancy about prescribing the drugs and whether the drugs being offered were appropriate.

Both ministries have accepted all seven recommendations from the reports, including improving minimum service standards, increasing public reporting and addressing a lack of doctors who prescribe safer supply drugs.

The audit also pointed to what Pickup described as the province鈥檚 failure to overcome significant municipal resistance to overdose prevention sites. Municipalities have used bylaws, zoning and permitting to prevent the establishment of such sites.

Overdose prevention sites monitor people at risk of toxic drug poisonings and provide drug testing kits, as well as readily-available Narcan in the event of an overdose. Supervised consumption sites allow people to use drugs under the supervision of trained staff without the risk of arrest for drug possession.

As of June 2023, there were 47 overdose prevention and safe consumption sites in B.C., according to the report.

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Pickup鈥檚 report says that government鈥檚 failure to overcome municipal resistance and other roadblocks, such as staff retention at these facilities and infrastructure, has heightened various risks 鈥� the most serious being increases in death and injuries due to the circulating toxic drugs.

鈥淢any thousands of people in B.C. are grieving the losses of family and friends from the toxic-drug supply,鈥� Pickup said. 鈥淭he crisis is also an immense challenge for those working to provide care and support for people who use substances. My team and I have a deep sense of empathy for everyone who has been touched by this continuing tragedy.鈥�

The audit also highlighted several obstacles found within the implimentation of the safe supply program, which the province has rebranded as 鈥減rescribed alternatives.鈥�

That program allows physicians or nurse practitioners to prescribe pharmaceutical-grade alternatives for people at risk of harm or death from the toxic drug supply.

Critisism by the auditor general include the unavailability of drugs in a form that can be smoked, as well as the perceived low potency of hydromorphone, and the lack of access in rural communities.

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Other aspects the report highlights includes a lack of reliable and publicly available data about the program鈥檚 effectiveness and geographic reach. Pickup鈥檚 report also takes aim at the province鈥檚 communication around expansion of the program and the types of drug alternatives available to those in need.

鈥淲e found that health-system partners and some health authorities believe that communication by the ministries about prescribed safer supply, specifically about diversion, has been weak,鈥� the report reads.

Addictions Minister Jennifer Whiteside declined an interview Tuesday, but said in a statement that the government is building a continuum of care 鈥渢hat includes prevention, harm reduction, treatment and recovery.鈥�

鈥淲hile we have rapidly expanded access to overdose prevention sites as a critical tool to keep people alive, we acknowledge there are some persistent barriers impacting implementation and service standards,鈥� she said. 鈥淚n the same way, while monitoring is in place for our prescribed alternatives program, we continue to work directly with prescribers to support implementation.鈥�

She said the ministry is already working to address many of the items cited in Pickup鈥檚 reports.

At an unrelated news conference on Tuesday, Premier David Eby acknowledged the reports鈥� findings of barriers to accessing those prevention services, especially in remote parts of B.C.

鈥淭here are big challenges for us in delivering rural health care, period, and including in the areas where people are struggling with addiction at risk of overdose,鈥� he said. 鈥淚t鈥檚 important to note (Pickup鈥檚) not saying stop the program, he鈥檚 not saying the program doesn鈥檛 work, he says he wants more of it in every part of the province. This is a challenge for us.鈥�

The auditor鈥檚 report said overdose-prevention and safe-consumption sites provide safer environments for people to use drugs under the supervision of a health-care professional or harm-reduction worker to monitor for signs of drug toxicity.