Deborah Phair, a Prince George naturopathic doctor, says the shortage of doctors, registered nurses, psychiatric nurses and nurse practitioners who have the authority to prescribe life-saving alternatives is contributing to the opioid death toll.
She is calling on the provincial government to expand the scope of practice for B.C.’s naturopathic doctors to allow them to prescribe immediate-release safer supply substances and also prescribe opiate agonist therapies (OAT) which take away their cravings for hard drugs. OAT allows people with opioid use disorder to hold down jobs and function in society throughout the day.
“We’ve got a public health emergency and we need somebody to take the ball and get this happening,” said Phair. “We have more patients who need the care than we have health providers. The reason naturopathic doctors want access is there’s a documented shortage of primary-care providers; there are not enough people to prescribe for this region.”
Every day, on average, nearly six people in British Columbia die from unregulated drug overdoses. That’s 41 deaths each week. At that rate, 2,165 people will die this year.
On Nov. 1, a report from the BC Coroners Service death review panel recommended that the fastest way to reduce opioid-related deaths is to reduce dependence on supplies of toxic street drugs. That means giving access to a quality-controlled and regulated supply of drugs to the 100,000 British Columbians diagnosed with opioid use disorder who are at risk of dying.
Fewer than 5,000 people now receive safer supply prescriptions in B.C.
Of the more than 700 naturopathic doctors in B.C., most of them are already prescribing prescription drugs. Phair says for naturopathic doctors to have an impact on reducing drug-related deaths by prescribing safer supply and OAT they also would also have to be able to bill the medical system for seeing those patients. She said they should have access to medical labs and diagnostics and specialist referral authority.
“Essentially we’re functioning as primary care providers like nurse practitioners and general practitioners,” she said. “We don’t need to go to other countries to recruit health care workers and to train and licence because there’s 633 (prescribing) naturopathic doctors already in the communities in B.C. that are disproportionally affected.”
The Canada Health Act does not oblige provinces and territories to pay for naturopathic medicine and B.C. does not fully fund its naturopathic doctors. They operate outside of the Medical Services Plan, much like dentists, and many patients pay for their services out of pocket.
“Until naturopathic services are funded equivalently there’s still going to be barriers for people who are unhoused and dependent on social services. The only people who are needing these medications who can afford us right now are gainfully employed.”
In September 2020, a letter from federal health minister Patty Hajdu was sent to provincial health ministers urging immediate action from all levels of government and health care professions to do all they could to help provide people who use drugs with a full spectrum of options for accessing pharmaceutical-grade alternatives to the toxic street supply. Three years after that letter was sent, those barriers still exist.
BC’s Naturopathic Doctors Association initiated a campaign in 2018 to provide enhanced primary care services to British Columbians, asking the province for access to federally-controlled substances and also the ability to refer patients directly to specialists. The petition garnered thousands of signatures in support, but Phair said Health Minister Adrian Dix chose not to act on the group’s recommendations.
“Most patients just want access for primary care,” said Phair. “Naturopathic doctors are an opportunity to improve primary care in this province and the government is not acting on that opportunity. It’s just a no-brainer.”
Phair says it will take forward-thinking policies to fix the opioid crisis and society cannot afford to turn its back on the problem. She said the cost of programs which supply drug alternatives that keep people alive and functioning is justified if it reduces overdose deaths and cuts property crime which stems from drug addictions.
“We have people who are ill and some resort to crime to fund their addiction so there’s a whole cost to the community from people being in that drug-seeking spiral,” said Phair.
“I just think the social cost of addiction is something people don’t think about,” she said. “If people were stable then hopefully that would break the cycle of needing to seek relief from a toxic drug supply. Naturopathic doctors would love to be part of the team treating this vulnerable population and be part of the solution.”
