Safer supply delivery service in northern B.C. aims to help reduce deaths

Jenny McDougall says her life changed when she was prescribed methadone 12 years ago.

Now, she's founded a program that helps others get their prescriptions — a delivery service for prescribed safer supply drugs like hydromorphone tablets, as well as Opiod Agonist Therapy (OAT) or methadone. 

McDougall, 52, works for the non-profit Coalition of Substance Users of the North (CSUN), one of the longest-running peer-led harm reduction organizations in northern B.C., in the small city of Quesnel in B.C.'s central Interior.

She founded the Prescription Alternatives and Peer Advocacy (PAPA) Program, delivering safer supply to those with a prescription but who struggle to make it to the pharmacy daily. 

Prescribed safer supply is a harm reduction strategy that allows certain health-care providers to prescribe regulated versions of some criminalized substances to people at risk of overdose death and other dangerous health outcomes associated with an increasingly toxic and unpredictable illicit drug supply. 

There are many regulated alternatives to the illicit substances available, but McDougall is only able to deliver a few — namely hydromorphone, also known by the brand name Dilaudid, and OAT or methadone. Fentanyl patches still need to be administered by a health-care professional. 

McDougall says the PAPA program started during the COVID-19 pandemic to ensure vulnerable people could stay in isolation. But she fought to continue it after seeing the positive impact of increased access.  

Erica Schoen, a community research associate with the Canadian Drug Policy Coalition, who co-authored a study on the impacts of safe supply as well as the barriers, says flexibility is key to making these programs work.

"There are often very strict and punitive rules [around accessing prescribed safer supply], which doesn't work... For anyone who uses substances and anyone who has problematic substance use, we do need to be flexible." 

For example, McDougall says people who miss a prescription pickup one or two days running can lose their access and have to start from the beginning, sometimes waiting weeks to meet with their health-care provider again. 

For those outside of urban centres, Schoen says there are additional barriers, like finding a health-care provider who will prescribe safer supply. 

From the front seat of her 2001 Chevrolet Venture, McDougall says she's seen first-hand the positive impacts of prescribing safer alternatives to illicit substances can have — in her personal life — and for those around her. 

 "I've maintained housing for the last 10 years in the same place. I work every day now, and I'm back in contact with my family… I'm a very active grandma," she says.

"And it's all because of methadone and harm reduction."

McDougall says this is the case, even though many people continue to use illicit substances at the same time as their prescriptions. She says the doses prescribed tend to be lower than what people need to fend off withdrawal symptoms or "get un-sick."

"They still have to use [illicit substances] because the meds aren't enough … [The street supply] is just so much stronger. People can get up to 14 Dilaudid's [hydromorphone pills] a day, and they take them all at once, and it doesn't even get them "un-sick."

But she says it's still helping people stabilize and care for themselves better. 

"The benefits are being able to stay home, sleep and eat before you're out trying to get "un-sick" ... they're able to go out and visit their kids" without taking a dose of unknown potency first. 

'Less need to take risk'

Stephanie Driediger, one of the people McDougall delivers medications to, says she fled an abusive partner two years ago, leaving behind a four-bedroom house on a corner lot, two jobs and a family. 

"I was no different than any other person ... I was left with nothing. Absolutely nothing." 

Dealing with trauma and PTSD from the relationship and living on the streets, she says she became dependent on illicit substances. In the spring, she was able to move into a motel through a B.C. Housing program, though that program is at risk of ending in the fall. 

Schoen says people who use drugs report a wide range of benefits, including "improved health and a reduction in infection and really just less need to take risks." 

She says a regulated supply reduces the risk of overdose for those who can access it.

"We know that's safer than not knowing what you're putting in your body."

McDougall says for some people she delivers to, a safe supply has meant they are no longer overdosing daily or multiple times a day. 

For Driediger, she says safer supply has helped her stabilize and access counselling for post-traumatic stress disorder (PTSD) for the first time. 

"You can actually feel like a normal person— wake up and go to sleep at regular hours — [it's] been just long enough for me to get appointments in place. My family can contact me again."

"It's been really nice."