Prescription drug transactions seen outside drugstores in five BC cities

Written By Fran Yanor

Three weeks after the Eby government pushed back against allegations safer supply diversion was a widespread problem, a RCMP surveillance operation revealed trafficking of safer supply pharmaceuticals outside a Prince George drugstore, and a Northern Beat investigation confirmed a similar pattern of behaviour in front of drugstores in four more cities.

“I am confident that it was the trafficking of safe supply for hard drugs,” Prince George RCMP Insp. Darin Rappel told Northern Beat following an investigation that led to the arrest of two people for trafficking safer supply and the seizure of hydromorphone pills on Mar. 23. 

Last month, B.C. Premier David Eby and his ministers of health, addictions and public safety denied, downplayed and dismissed frontline police reports that thousands of suspected safer supply drugs were being trafficked by organized crime.

In the past year, the Prince George and Campbell River detachments have seized at least 18,000 suspected diverted safe supply pharmaceutical tablets combined, including opioids, stimulants and benzodiazapines. A member of the Nanaimo detachment said they had seized “thousands, if not tens of thousands” of suspected hydromorphone pills since B.C.’s program began in March 2020. 

After news of the seizures broke, RCMP “E” Division issued a statement, reiterated by B.C.’s Solicitor General, saying there is no evidence of widespread diversion of safer supply in B.C. or Canada.

More police seizures of suspected safe supply drugs

This week, the PG RCMP have reported another drug seizure found safe supply hydromorphone along with bulk quantities of meth, cocaine, fentanyl and other prescription drugs.

Two people were arrested and released. Police said they intend to recommend charges for trafficking illicit drugs for prescription safer supply. B.C. is one of three jurisdictions in Canada where police only recommend charges, while Crown Counsel decides whether to approve them.

Drugstore surveillance

The March investigation entailed multiple days of surveillance outside a drugstore and a search warrant revealed a quantity of Dilaudid pills, many in their original prescription packaging. 

Dilaudid, or ‘dilly,’ is hydromorphone, a heroin-type opioid prescribed to people with severe drug addictions under the BC NDP government and Health Canada-approved and funded safer supply program.

During surveillance, investigators from two units – problem oriented policing and the downtown safety unit – observed two women conducting drug transactions with people directly after they left an IDA pharmacy, reported the CBC’s Jason Proctor, who obtained a copy of the police warrant that ultimately resulted in two arrests and the seizure of hydromorphone last month.

In all, officers observed 84 drug transactions over 10 days, according to Proctor.

“Individuals are coming out of drugstores and they’re immediately selling [their prescriptions].”

Darin Rappel

Prescription customers were seen selling their safe supply to purchase illicit drugs immediately upon exiting the drug store, Rappel explained in an interview.

“Individuals are coming out of drugstores and they’re immediately selling [their prescriptions]. And then upon the arrest, we confirm it is safe supply,” he said.

Each morning, safe supply patients queued up, crowding the front entranceway before the pharmacy even opened its doors. Then, within minutes of opening, a steady flow of drug transactions took place outside. 

Similar drug transactions in four additional BC cities

An investigation by Northern Beat observed a similar pattern of transactions taking place in front of pharmacies in Victoria, Nanaimo and Duncan. 

And a police source who asked not to be named confirmed the same behaviours around drugstores in a fourth community as well.

In the cities Northern Beat visited, individuals were milling in front of the pharmacies before the doors opened. In all locations, a majority of those who exited the business walked directly to a person loitering in the vicinity or they leaned into the open window of a waiting car or SUV. 

In most cases, an exchange of some sort was seen. Sometimes a prescription pill bottle, a flash of money or a foil-wrapped drug was clearly visible, if not caught on camera. 

Of those who appeared to exchange pharmaceuticals for illicit drugs, many immediately unwrapped what they’d been given, pulled out pipes, and smoked on the spot. Minutes later they slumped to the sidewalk or staggered against the building where they had previously been standing.

Other journalists have reported similar incidents. In the Canada is Dying film, a pharmacist described rampant trafficking of safe supply directly in front of the drug store where she worked. 

Residents, business owners and outreach workers told Northern Beat they’d also personally seen illicit drugs swapped for prescription pharmaceuticals in Victoria, Nanaimo and Duncan.

‘Clearly people are trading their pills’

Soon after Collen Middleton moved to Nanaimo with his wife and two young children, he started finding safe supply labels on his street. He soon discovered the source. Labels littered the sidewalk and parking lot outside the neighbourhood pharmacy.

“I started finding labels every time I’d walk past the pharmacy.”

Collen Middleton

“I started finding labels every time I’d walk past the pharmacy on my way downtown. It was to the point where it looked ridiculous,” said Middleton, who is the founding director and president of the Nanaimo Area Public Safety Association. He stopped collecting labels after about 80.

It’s common for safe supply patients to rip the label off their prescription pill bottle before handing it over to a dealer for illicit fentanyl or other drugs. Other times, they pour the pills into a container held by the dealer and toss the empty bottle on the street.

Discarded opioid prescription bottles and used fentanyl foil outside Outreach Pharmacy in Nanaimo. [Photo Fran Yanor] 

“There was always lots of people hanging around [the pharmacy], lots of cars, and clearly people were trading in their pills, because you could see it. People would go up to the car after coming into the pharmacy. They’d do some kind of exchange.”

Middleton reported the situation to Island Health and never heard back. 

“Just radio silence. The silence actually made me and the people in our group quite agitated. And, we started asking more questions like, who is responsible for all this? Why isn’t anybody looking at this seriously.”

Middleton complained to the pharmacist, who now also owns the whole building block, including a portion leased to AVI Health Clinic where patients are prescribed safe supply, including witnessed fentanyl patches, sufentanil injections and fentanyl tablet ingestion, said Middleton. 

“I said you’ve got these people that are discarding labels. They might be selling these drugs.” 

He said the pharmacist shrugged it off, saying people were on drugs and didn’t know what they were doing.

So Middleton complained to the college of pharmacists. 

With no effect. 

In response to questions in March about whether pharmacists had voiced concerns about diversion of safer supply with the College of Pharmacists of BC, president Colin Wong said, “Diversion isn’t something that that we can do anything about. As far as I understand, we haven’t received a complaint from a registered pharmacist about this at all.”

When asked by Northern Beat if members of the BC Pharmacy Association, an industry group representing community pharmacy owners, had voiced any concerns about diversion near their businesses, spokesperson Angie Gaddy likewise noted in an emailed response, “We have no direct knowledge of any specific instances where this might be happening.” Questions about safe supply should be directed to prescribers and those overseeing the program, she added. 

Canada is only country allowing unwitnessed safer supply

Introduced in March 2020 as a pandemic measure for people using drugs in isolation, the safer supply program was intended to replace people’s reliance on illicit drugs, namely fentanyl, and reduce overdoses. While some studies have purported a variety of benefits, there is no scientific evidence it has achieved either goal.

Canada is the only place in the world offering these drugs in this unwitnessed manner. 

Despite recognizing diversion is commonplace and acknowledging the province has limited data or knowledge about where the drugs are ending up, B.C.’s Provincial Health Officer Dr. Bonnie Henry wants the program to keep growing.

In February, Henry recommended the program be expanded to include more drugs, at higher potencies, in more locations, in additional formulations that can be smoked and injected. 

Addictions physicians have long warned that some of the millions of pills prescribed under the program are being diverted, creating new opioid users. They’ve called on governments to halt the program or at least ensure the drugs be consumed supervised by a health professional, so they can’t be diverted to people for whom they’re not prescribed.

Premier Eby and his government have so far resisted doing either. Although Eby said his government’s goal is to achieve “zero diverson,” he has offered no plan of action to achieve it. 

Worried for their kids’ future

The free flow of opioids in the community has Middleton and wife worried for the future of their children. Will battling through an opioid addiction become a right of passage for young people, Middleton asked.

Nanaimo fire crew revive someone across the street from a safe consumption site. [Photo Fran Yanor]

In the meantime, safe supply diversion has made their community unsafe. 

“You never know who you’re dealing with when you walk up that street. There’s some pretty dangerous people that run drugs out of that part of the block,” he said.

Safe supply drugs, predominantly hydromorphone, morphine, oxycodone, and some stimulants and benzodiazepines are a high value product in illicit markets, bringing increasingly higher profits to dealers the further the drugs are sold from B.C.

‘Prescription pills… are funding organized crime’

Safe supply patients sell the pills for as little as $1 each and dealers can turn around and resell it elsewhere in the province for upwards of $5 each, or for as much as $10 to $20 a tablet in Alberta.

“Our investigative theory is that these drugs are being all bulk-collected and then actually shipped out-of-province because there’s no reason for these pills to be hoarded in that quantity,” Prince George RCMP senior investigator, Scott Cundy, said of his detachment’s seizures in an earlier interview. Cundy works in the street crew unit, which investigates gang activity and the mid-level organized drug trade. 

The Prince George police have seen an increase in organized crime activity, Cundy said. The groups are highly mobile between cities and provinces and his team has tracked them moving from B.C. to Alberta, Saskatchewan and Manitoba. 

“Prescription pills – call them safe supply or whatever you want – are funding organized crime, there’s no doubt about it,” he said.

“What it really amounts to is fraud of taxpayer dollars.”

Collen Middleton

“This is a significant source of profit for organized crime groups,” said Middleton. “Because you can do the math, see how many people are accessing hydromorphone and OxyContin and Kadian and all these drugs. It adds up pretty quick.

“What it really amounts to is fraud of taxpayer dollars. And if people are staying sick and not getting access to treatment or recovery, it’s just a waste of money.”

’Free’ drugs are a commodity, like stolen goods’

On the streets of Prince George, dillies or Dilaudid/hydromorphone are a quick trade for the fentanyl or meth the safe supply patients really want. A bottle of hydromorphone pills goes for about $20 cash or ‘a point’ (.01 g) of fentanyl, according to police.

Victoria outreach worker Derrick Forsythe said people use hydromorphone and other ‘free’ drugs as a commodity, like stolen goods, he said. 

“If you want to keep them alive and communities safe, it’s jail or institutions. Or else death,” says outreach worker Derrick Forsethe, who has been off hard drugs for more than 11 years. [Photo Chad Hipolito]

“Some people owe money to their dealer and that’s how they pay. Their dealer probably fronted them the night before, so now the pharmacy is open and he must pay up.” 

“When he pays, he may get another front. And round and round we go.”

“Some people owe money to their dealer and that’s how they pay.”

Derrick Forsythe

Forsythe has been sober for more than 11 years and now works helping others navigating their own recovery in the city’s ground zero neighborhood for homelessness, addiction and mental illness – Pandora Avenue.

Diversion has always been happening, “It’s just gotten more dangerous with fentanyl and morphine being prescribed,” he said.

He compares safe supply to the Rat Park mouse experiment where scientist Dr. Bruce Alexander ran an experiment, giving two groups of mice access to plain water or heroin or cocaine-laced water. Essentially one mouse group had social interaction, the other didn’t. The mice without a community kept drinking the drugs, where the other group didn’t.

“The mouse didn’t eat or play, it just took the free drug until it died. That’s what we’re doing to those people.”