 a major figure contributing to the terrible increase in deaths is that illicit drugs have become so much more contaminated since the start of the pandemic. In the first months of 2020, before the pandemic began, the concentration of fentanyl that the coroner detected in illicit drug deaths was between 4% and 8%. In the last months of 2021, this increased to between 24 and 28% a staggering increase. Between COVID pandemic measures, the poison drug crisis, floods and fires, we've never asked so much from our health authorities and frontline workers and yet we need to do more. We're making historic investments in mental health and addiction supports across the full spectrum of treatment and recovery. British Columbia is tackling this crisis from all angles. We've given nurses the power to prescribe medication assisted treatment. That's a first in Canada. Today, there are 39 overdose prevention and supervised consumption sites in BC, including 13 offering inhalation. That's a particular contributor to loss of life as the coroner has noted. Only one of these sites existed in 2016. We're the first province in Canada to apply to decriminalize people who use drugs. That's an application before the federal government. We've added hundreds of new treatment and recovery beds. We're adding hundreds more. In the last few weeks alone, we've announced a new expansion of free and affordable community counseling across British Columbia. We've added the first of its kind complex care housing program to particularly connect people living with untreated mental health and addictions and sometimes brain injury. The most vulnerable people in British Columbia. Another example is a new primary care clinic in Qualicum Beach that will help those with complex medical and social needs and mental health and addiction challenges. I've been hearing firsthand that what we're doing is making a difference. Last month, Trevor Botkin of Hero Work Victoria told me about his experience with addiction in the construction industry. Men are affected the most by toxic drug deaths as the coroners noted almost 80% of toxic drug deaths and nearly 20% of those who died worked in trades or transport. It's the highest sector identified. That's why we've just funded a million dollars to expand the industry led tailgate toolkit program, bringing overdose prevention and treatment information directly to job sites to connect with people like Trevor. And I've also heard from frontline people and service providers how prescribed safe supply is helping separate people from toxic street drugs. Kate Hodgson, a nurse from the four directions team in the First Nations Health Authority told me this approach is already improving access to life-saving medication. Every coroner's report reaffirms to us why this work is so important. In December, the coroner called on our government to work more closely with prescribers to build their confidence so that they can connect more people with safe supply. And that's exactly what we're doing to support prescribers who are working closely with the BC Center on Substance Use, with doctors of BC, and with nurses and nurse practitioners of BC to provide resources and training to clinicians so that they can confidently prescribe safer supply. And I'm grateful that those last two organizations are here today to speak to the coroner's report. Since we first introduced prescribed safe supply in March 2020, there have been more than 12,000 people helped with this groundbreaking response. This critical medication has been prescribed by more than 3,000 clinicians with a number of prescribers increasing every month. In addition, more than 24,000 people each month receive medication assisted treatment with 1,700 clinicians prescribing medication for opioid use disorder up from 773 in 2017. The second phase of prescribed safer supply is now being implemented in health authorities and in federally funded programs. Our government is making historic investments and systemic changes to our healthcare system to build that comprehensive system of mental health and addiction support for British Columbia, one that did not exist before. Never have so many people worked so hard and stood up so many supports. And clearly these changes can't happen fast enough. We are swimming against a rising tide of need, and so we are determined to do more and continue to build those systems. We need to keep going. We need to keep working together. We will not stop working until we turn this public health crisis around. And I now welcome Dr. Remnick. Dr. Remnick DeSange, the new president of Doctors of BC, to say a few words. Thank you, Dr. DeSange. I'm Elkinson. Good afternoon. It's an honor to attend this event today. However, I'd like to begin by acknowledging that the land on which I'm speaking to you from is the unceded territory of the Coast Salish people, including the territories of the Musqueam, Squamish, and Slewa-Tooth nations. Unfortunately, today, this is a very somber occasion. Lives continue to be lost, and families continue to be devastated in communities all across the province for reasons that could be prevented. The ongoing opioid crisis has had lasting impacts on everyone who comes into contact with it, including health care providers, first responders that are attending on the scene, and our doctors, nurses, and other health care workers in the hospitals and in our communities. We all know and can agree that change is urgently needed, that there is a need to prevent unintentional toxic drug poisoning. The reasons that got us to this place are complex, and the solutions to this particular public health crisis are equally complex. These are tough problems that require equally tough solutions. No one solution is going to work. What we have is a real need for a multi-pronged approach to prevent toxic drug injuries and death, an approach that is based on harm reduction, prevention, treatment, and enforcement. As an initial step, BC doctors support the effort to separate people from the illicit toxic drug supply. People need access to start using safer pharmaceutical alternatives to street drugs. Access to regulated substances, instead of those substances that traditionally have only been available on the illegal market. Doctors of BC recognizes that evidence-based programs offering pharmaceutical alternatives are an important life-saving measure, and careful consideration should be given on how to improve access to these programs while mitigating potential risks. I don't mind telling you that as a doctor, it's not an easy decision to prescribe a narcotic even if it is regulated. There can be all kinds of ramifications for the patient and for the prescriber. Doctors will look at all extenuating circumstances before deciding on this approach. The government's program of prescribed safer supply is a rational option. Options are always good. Options for physicians who wish to participate in the provision of pharmaceutical alternatives and options that explore offering alternatives that do not require physician prescribing. The provision of safer supply and alternatives is again complex, and there is not a one-size-fits-all approach, just as each person's journey to wellness is different. All alternative options need to be examined holistically and considered in the context of longitudinal patient-centered care. What I also want to inform our public, our patients, the families is I don't understand the level of pain that each of you are feeling, and I want you to know that we are committed as the doctors of BC to work with you and work with our partners in collaboration to fix this problem, this pain that we see, it's visible and it's difficult to understand, but we are committed to doing the right thing, and in partnership we will. We will change the way things are, and this can no longer be a crisis in which we are responding to, but like Minister Malcomson said, we are committed to a collective solution, and we are in this together. Thank you. Thank you Dr. DeSanche so much for your partnership and to all the doctors that are out in the field helping connect people with care, the province is grateful, we're honored to be working with you in this difficult time. I'm now pleased that Michael Sandler who is CEO of Nurses and Nurse Practitioners of BC is here to add his voice. Thank you Minister Malcomson. Good afternoon. My name is Michael Sandler and I am the Chief Executive Officer for the Association of Nurses and Nurse Practitioners of BC, or NNPBC. We'd like to start by acknowledging that I'm coming to you from the traditional and unceded territories of the CLX Nation, and that the offices of the Nurses and Nurse Practitioners of BC are located on the traditional and unceded territories of the CLX, Musqueam, Slewa Tooth, and Squamish Peoples. British Columbia is now in its sixth year of the overall crisis, which continues to accelerate despite our current efforts. Each day we lose six people as a result of this crisis. This is simply unacceptable. So I am pleased to be here today to speak with you about the prescribed safe supply model, and the work currently underway to support nurse prescribing of safer alternatives to street drugs. Similar to other advocates who have been focusing on solutions to the overdose crisis, NNPBC supports and applauds prescribed safe supply as an important aspect of a robust harm reduction strategy. Nurses are positioned at the forefront of harm reduction within communities across BC to help address this crisis. As leaders and health advocates within our communities, we have seen firsthand the toll that this crisis has taken. Nursing's reputation is one of the most trusted professions that healthcare is based on our long history of working with vulnerable populations, and we therefore have a responsibility to protect and advocate for harm reduction solutions that continue to enhance on this trend. Safer supply through the expansion of prescriptive authority to registered nurses and registered psychiatric nurses for safer alternatives to street drugs is a welcome, important, and critical enhancement to our harm reduction arsenal. In making this important and necessary change to include RNs and RP and nursing designations to the list of prescribers who can providers who can prescribe safer alternatives to street drugs, the province has taken a major step towards leveraging nursing knowledge and supportive better outcomes for patients. Nurses stand ready at all levels to interact with people who use substances and will utilize supportive harm reduction interventions coupled with increased prescriptive authority, as well as expanded access to referral for ongoing treatment and support to save lives. Working with our colleagues at various agencies such as the BC Center for Substance Use and the BC College of Nurses and Midwives, we have been collaborating with respect to how to guide nurses who wish to undertake this education necessary to prescribe these safer alternatives to street drugs for some time. Several hundred nurses have already registered for the training needed to support the scope optimization, and we expect to continue to see these numbers increase. Prescribed safer supply along with harm reduction measures are fundamental in eliminating stigma and bringing adequate attention to BC's overdose and toxic drug crisis. Lives are depending on these interventions and the nurses at BC stand at the ready to support this harm reduction strategy as part of a larger overall push to create meaningful outcome change. NNPBC and the nurses at BC look forward to continuing to provide strategic advice for and support creative solutions to these complex challenges. In closing, NNPBC and the nurses at BC look forward to continuing to work with the ministry, Minister Malcomson and her team on strategies to enhance current interventions and ways to promote additional measures to prevent overdose deaths. Thank you for the opportunity to speak to this important issue. Thank you to doctors at BC and to the Association of Nurses and Nurse Prescribers of BC for standing with the province here today and in this work. And now to the media will take questions. Thank you very much. A reminder to media on the line, please press star one to enter the queue. You'll be limited to one question and one follow-up. Our first question today comes from Marcella Bernardo, CBC. Hi Minister, thank you for taking my question. Just hoping to see, I've been speaking with people here in Kamloops about what is needed most and they're saying that treatment on demand is not available. What efforts are being made outside the lower mainland to provide treatment services for people that can, you know, there's long wait lists of 50 people waiting for it. So what can be done now if somebody is ready to get the help that they want, but they just can't access it. The system of care that British Columbia is building towards and laid out in our plan and pathway to hope is that when people reach out and ask for help on mental health or addictions that they're met with care with dignity and they get access to that help. The same as you would with a physical injury, you know, a broken arm, anything like that. So that's the system that we are working to build from the ground up. This was not a system that was in place when we inherited government in 2017 and our healthcare system fighting two public health emergencies while building that system of care is being pushed to the limit. In the last year, we've opened the new 105 bed addictions specialized addictions in mental health treatment facility at Redfish Healing Centre. That's on the grounds of the former Riverview Hospital, now known as Samiqua Ella. It's also particularly specialized around with people that have behavior or particular aggression issues that have been hard to treat in other areas. We've opened 105 new publicly funded adult treatment beds and 30 youth treatment beds so far across the province in this most recent wave, another 20 youth treatment beds in the previous year, and 10 of those treatment beds were in Kamloops. We recognize absolutely that the wait times to get into treatment and the stages in between treatment are both real gaps in the system that we are continuing to invest in investing at historic levels and not withstanding all the new services that we've stood up over the last three years, last four years, there is still a lot of work ahead of us, but a particular area that that frontline people and people who have who use drugs and have access to treatment have let us know about are the gaps in between. So for example, I'm being able to get into detox right away, then having an intermediary support place so that people don't get discharged back to homelessness or don't get, don't wait to get then into treatment and then post-treatment to have more of a supportive recovery counseling system and particularly orienting people towards housing where they will be supported so that they can lock in what they've learned in treatment. So at all those stages across the continuum implemented by health authorities and often contracted out to experienced frontline groups across the province, including in Kamloops, we're continuing to work hard to build that system of care. We're not there yet, but we're determined to do more. Marcella, do you have a follow-up? I do. I guess it would be how concerned are you that the pandemic along with all of the other shortages that we're experiencing in health care right now is just going to further delay the treatment that people are seeking that they're hoping to get because here in Kamloops, the hospital is already overwhelmed with patients when it comes to COVID and everything else. How can these people expect to get support if there's just not enough people there to help them? This is a question that throughout government we speak about every day. You know, as Michael Sandler said for the Association of Nurses and Nurse Practitioners that we've given registered nurses and registered psychiatric nurses the ability to prescribe medication assisted treatment. That's a first in Canada and a huge step forward. It's been a really impressive increase and we want to continue to expand their scope of practice. At the same time, we recognize that we're asking a lot of nurses. We are encouraged to see places like Interior Health really innovate with some of the outreach work that we've asked them to do. There are integrated treatment teams that work outside of traditional treatment centres or outside of hospitals to go and meet people where they're at. It may be that some people have had difficulty accessing treatment because of transportation challenges or family care responsibilities or shift work. In all those cases, Interior Health's integrated treatment teams are able to get out in the field and connect people with care. We're also the first province in Canada that has adopted a peer curriculum, training curriculum, and peer worker standards of practice. Again, it's been Interior Health that helped us pilot the formalized connection between the health authority and health care with peer workers. But Minister Ebi talks about this within his area of responsibilities, Minister Dix, within his very vital part of that navigation system of the health care system will be peer workers. In addition to the new care workers, the new nurses that we are adding seats under Minister Kang's leadership, but we are making up a lot of lost ground. We as a province have not trained all of the frontline people that we need. We recognize that those who are in the field already are tired. They're looking forward to that next wave of recruits and we just hope that they can hang in there so that they can mentor the new young people that are coming into the field. We're going to continue to take a diversified approach. Next question comes from Syngin Alexander, CTV. Hi, Minister. And actually, all of you, lots of talk about prescriptions. And we're hearing from some people who say prescriptions aren't working, that we need to just, there's too much stigma in asking for a prescription that a lot of people can't get it. And they're suggesting that we just have to get rid of the prescriptions and give those who need the substances directly. Your thoughts there? Well, I'll start by saying connecting people with safe supply is vital, especially given the terribly increased toxicity of the drug supply on the streets. It's a vital harm reduction intervention. And British Columbia being the first place in Canada that has adopted a safe supply system that we're rolling out not just with frontline workers in federally funded clinics, but also through every health authority. We learned from the first phase that we rolled out two years ago that both clinicians and people who use drugs said that they needed to have more types of substances and also more access points. In July, Dr. Bonnie Henry and I announced major expansion of March 2020's safe supply initial roll out and have directed, I've directed every health authority to integrate it into their programs. That expansion is under way now. So fair to say that when you're the first in the country that we are learning as we go and we're continuing to add new medications, for example, fentanyl patches can now be prescribed as a way to separate people from the toxic drug supply. Ventura and other substances are being added and will continue to be added. Already we've been able to expand the number of prescribers and the number of people being reached with safe supply is expanding enormously. We're working within the provincial powers that we have, which is a prescribed system and that's the work that we're doing with partners like nurse prescribers, nurse practitioners and doctors for whom we're grateful. And if either of our other guests would like to add in and describe what you're seeing, that would be great. Michael, do you want to dive in? Go ahead, Michael. I just wanted to reiterate the point that prescriptions are definitely the first step, but we definitely need to ensure that clients have access to as many points of care as possible. And so expanding prescriptive authority for nurses who work at the point of care is an excellent opportunity to continue to promote this first in Canada program. We see this as an opportunity to meet patients where they are at and it also helps to reduce the stigma, which was one of the points that was made by CBC in terms of accessing care and reducing barriers to access that care. At the point of care where the patient is at is extremely important. And so the opportunity to collaborate with the ministry to improve that is welcome. I'll just add Minister Malcomson. I'll just add to that. I think we all can recognize that the government has made great strides in including improved access to the safer pharmaceutical alternatives. But a reminder that dealing with substance use and addiction, we need to improve access to a range of community-based and culturally appropriate evidence-informed substance use prevention, harm reduction, and treatment programs and services. What we are embarking on, as Minister Malcomson has reminded us of, the way that we're moving forward has been exponential. And to recognize that growth and again to make sure that we are meeting our patients at the point of use is absolutely imperative. We have many physicians that are being equipped with the ability to manage this crisis, but it needs wraparound and full patient-centered care. So also addressing the social determinants of health, which the minister has alluded to, these are the things that are going to help in the community to decrease the urgent crisis. And I think we need to approach this in a collective and collaborative manner, but again, ensuring that we're responsive to the needs of our patients. Sinjin, do you have a follow-up? Yeah, and thank you. And I'll stick to this because it is, I think, important. I know Dr. you said it very well that it's very difficult at times to decide whether someone should be prescribed something. I'm assuming that people do get turned away and do we know what happens when those people are turned away? Or should you want to take that? I don't know exact circumstance of what happens in the particulars of that situation, but what I can say, what I see in the emergency department, both working as a frontline physician in the hospital and the community, someone that has been committed to both the Child Youth Mental Health and Substance Use Collaborative Efforts for some time, I can say to you that we need to do better. And in informing the decisions, we need to understand addiction and the substance use and concurrent disorders that have patients in these predicaments. And what I can assure you is that everyone in the frontline and the increase in the services that have been provided, both where nursing profession and our physician colleagues on the ground, as well as all of the ministry's efforts have substantially reduced that. And we are working collectively, but it's going to take all of us, the public as well, to decrease the stigma around addictions and those that are seeking care. They need to be recognized for even seeking help and that we change their attitudes collectively as public and bring this into awareness. These people are in pain. Addiction is pain and we need to address this from a collective, multifaceted, prong approach that makes sure that we are ensuring to look at connection and that sense of belonging again, where we bring people back into wraparound team-based care in which we can have multi- providers provide for that patient's complex needs. Addictions are very complex and we need to understand to be available on every aspect to help those patients in need. And this is exactly the direction that we are headed in. Next question comes from Les Lane, Times Colonist. Well, thank you. To anyone, I guess. I was just curious, based on the coroner's report this morning, looking at the some federal statistics fairly briefly, I have to admit that why is BC's rate of fatality rate, and I think most of the other metrics as well, why is it so disproportionately high compared to other provinces? The federal report I saw 90% of the fatalities are in three provinces, Ontario, Alberta and BC. BC and Alberta are roughly comparable. The BC's fatality rate is, like, I think it's almost double Ontario. So why is this basically a Western Canadian problem? And if you agree with that, why? Yeah, thank you, Les. British Columbia has been contending with the overdose crisis for longer than anywhere in Canada. I know my own community, Nanaimo, got hit early and hard by the overdose crisis. We were experiencing real terrible and disproportionate loss of life. Our medical health officer speculated that there might have even been some, you know, and no dealers, you know, testing stronger supply, you know, with tragic, terrible results. I'm particularly encouraged that now we have, the federal government has mirrored British Columbia's move, the Premier's decision in 2017 to create a dedicated ministry of mental health and addictions. Well, we've got our heads down fighting this crisis in BC very hard. I'm very pleased that I now have a federal counterpart and in Carolyn Bennett, in fact, a medical doctor. So I am going to be drawing on her reflections and analysis about how we're doing across the country. But she continues to say, as did her predecessor, the federal minister of health, Patty, I do say that they, the rest of the country is learning from how what British Columbia has learned because we've had to innovate. And it's a huge credit to the practitioners and people on the front line. The province is informed every day by what they're seeing and learning. And we're very grateful for their service and how they inform our work. Les, do you have a follow up? One other thing, I'm not clear on just the fatality rate based on the coroner's report, obviously. The rate has been so high it's been cited previously that it's actually impacting the life expectancy in this province. And you'd think that this horrible attrition rate, I think 8,600 deaths over the last year that in that relatively small pool of drug users, just that attrition rate would lower the rate of fatalities. But it seems to be the numbers and the rate seems to be increasing. Is there something going on that like there are more and more people starting to use these drugs despite 10 years worth of warnings about how dangerous it is? Or where are these users? Are there more users, I guess, basically? That's a question. We're in such a terrible time where the people that are reaching out for help with us standing up more and more clinics, more treatment beds, more supervised consumption sites, mobile testing, standing up new services and new ways to connect with people. We also note that as the coroner says, the majority of people that are dying of overdose are in their own private homes. This is not street use that is particularly taking people down. And I hear from firefighters in my own community and from the coroner also that a great number of people who are dying are dying alone. And I hear from their families and friends sometimes they have no idea that the person was battling with addiction. So those people are not likely to have a conversation with their primary care provider about a medical intervention. And so it's a fair criticism of our prescribed safe supply program. That is good for people with opioid use disorder and people that are chronic users. But there may well be someone that experiments. It might even be something that they do not think has any threat to their life. So this takes us in a couple of directions. One, the work that we're doing on drug testing and we're trying to expand and innovate on that so that people are able to, whether they walk into a center or whether they mail in samples, they can get that feedback about whether the drug that they're contemplating using is going to be life threatening. But also our decriminalization application to the federal government, where we use that to assert that drug use is a health care issue and not a criminal justice issue, we really need to remove the stigma so that if somebody is thinking about using drugs, we really do not want them to use a loan. If they are going to use a loan, use the lifeguard app. You can download that. This is a new program of our government. And particularly, if you think you're in trouble, please do talk to somebody in the health care field. They can connect you with the supports that you need. Using a loan often means dying alone with the terrible increases in toxicity. That's the biggest contributor that the coroner has pointed for us to have. Remember in 2019, drug deaths, drug overdose deaths, did fall. And then in that continued for the first two months before the pandemic was declared. We hit March 2020 and the terrible increase in toxicity was completely aligned with that increase in deaths. And I think that's where the coroner is going around looking at the trend lines and how this continues to take so many lives. Next question goes to Andrea Wu, Globe and Mail. Hi, thanks for taking my question. Several clinicians have said that they were audited by the College of Physicians and Surgeons of DC for prescribing safer supply. And it has seemed that the college does not support the initiative. Can you tell me about the discussions that there have been if any with the college? Thank you, Andrea. Because we're so reliant on doctors and nurse practitioners doing this vital work of connecting people who use drugs with prescribed safe supply, we want very much as a government to remove barriers to their success. We're doing that in a number of ways, providing some of the clinical support, working with the BC Centre on Substance Use and working collaboratively with the associations that you see with us today, developing that guidance and education and the kind of specialized backup support. And there's a helpline prescriber who's thinking of connecting a patient with prescribed safe supply can get that support. But we have heard about the effects of a chilling effect that the actions of the colleges can have. We are working with them to provide that guidance, trying to get at what's at the heart of the college with its multiple responsibilities about whether there is a system of prescribing that might be leading to actual abuses versus what is now recognized as a very mainstream practice certainly within our government. I know that the coroner and Dr. Henry have met directly with the college just in recent weeks to express these concerns and see what we can do to remove them. And we continue as a government to work with all the colleges of pharmacy and physicians and surgeons to resolve any concerns that they have around prescribed safe supply and remove from any barriers that prescribers might feel to connect people with this life-saving support. Andrea, do you have a follow-up? Yes, thank you for that. This is not something that you necessarily have authority over, but with more than 2,200 British Columbians dead last year, nearly 10,000 since 2016, I'm curious why, in your opinion, we have not seen a coordinated province-wide emergency response proportionate to the magnitude of this death toll. The work that we are doing province-wide to respond to the first public health emergency declared in 2016 and now COVID has absolutely stretched the healthcare system that when we formed government in 2017 that there was not a system of care for mental health and addictions, no continuum of care that had that seamless path through all the stages of addictions treatment and recovery. And then with the increasing terrible loss of life and the terrible increase in toxicity of the drugs, it has meant that we are building a system and fighting two health emergencies at the same time. But I'll say, notwithstanding, that clearly this isn't enough because we are still losing so many lives, our province is now spending every year $2.7 billion across multiple ministries to respond to the overdose crisis and to attend to people's mental health and substance use issues. That is being spent through health authorities, through the education ministry, through Ministry of Children and Family Development. Public safety is working very hard on the criminal justice aspects of this, pursuing drug dealers and drug trafficking with serious focus. We're building up the healthcare elements, working to combat stigma, working on treatment and recovery, and in an unprecedented way bringing out substance use treatment teams, community act teams, very street based, really hitting this with every element. And through government we've got a newly established cabinet committee that brings all the relevant ministries together. And also if you look at the mandate letters of government, this overdose crisis is pointed to multiple ministries. So we are coordinating our response, but I'll say again that fighting an overdose emergency, fighting a public health emergency and building a system of care at the same time just means we have double the work and it's more important and urgent than ever. We have time for one more question and we will go to Dustin Godfrey, Burnaby Beacon. Hi, thanks for the opportunity here. Quite frankly, we've seen a very slow pace of increasing access to safe supply over the last several years. You said in the past that this is to ensure that the government gets it right. I guess what I want to know is how you can justify that? I can justify airing on the side of underutilization when it's clear that thousands of people are dying while they wait, and especially when BC government was able to turn on a dime to respond to COVID. Yeah, thank you for the question. Fighting COVID on the foundation of an intact healthcare system is very different from fighting the overdose public health emergency while building a system of care at the same time. And British Columbia being the first province in the country to apply for decriminalization, the first province to give registered nurses the power to prescribe medication assisted treatment. We have had 24,000 people on medication assisted treatment. That's a big uptake in the province for us to be having added hundreds of treatment beds. We're going to add hundreds more to go from one supervised consumption site to 39. Again and again throughout the province, the expansion of services and supports is historic and it's not enough. On prescribed safe supply, again the first place in Canada to do this, so we didn't have within the federated system and the overall responsibility coming from on illicit drugs and regulation of controlled drugs and substances coming from the federal government. The only province that has prescribed safe supply, but 15,000 people over the last two years have been prescribed a safe supply. So and it's not enough. We're determined to do more and do that in partnership but we have unrolled. We have implemented an unprecedented program and the expansion of that program is happening right now with new substances being added. There's nowhere else in Canada that you can be prescribed a fentanyl patch for the purpose of separating people from the toxic drug supply. Ventura and other substances being added right now. Thanks to the addiction medicine doctors and people working on the front line who have innovated and tried things in new ways and as a province we've been able to come behind them. We all feel the urgency of this and we are determined to do more. My resolve on a day like this has never been stronger. Dustin, do you have a follow up? Yeah, so we've heard months after months that you know the government has a heavy heart over the crisis. I guess I kind of wonder how people can be expected to believe that when movement on this has been so slow. Well again I'll say Dustin the the loss of life tells us continued and terrible and unacceptable loss of life tells us that we need to do more and there's nowhere in the country that we have added new surfaces and supports at a greater rate than what British Columbia is and we have a lot more to do and we've already committed to doing that. It's already last year's budget had a half billion dollars for expanded treatment support overdose response. We're working with First Nations Health Authority building treatment centers in the north. We're continuing to innovate on on drug testing and and continuing to add and expand prescribed safe supply of 15,000 people on prescribed safe supply is is not nothing bringing new practitioners and training new practitioners supporting them. That's not nothing and it's not enough and we're determined to do more and and the pathway to hope our plan adopted by my friend and predecessor Judy Darcy the first Minister of Mental Health and Addictions in the country in 2018 is our roadmap and one that we're continuing to fund and implement with in partnership with prescribers and again thanks to both doctors of BC and the Association of Nurses and Nurse Prescribers for standing with me on this very hard day showing our our solidarity and our our united front determined to connect more people with this form of of life-saving response to the overdose crisis. Thank you very much everybody that concludes today's availability. Thank you for being here and thank you so much to our our partners Dr. DeSage and Michael Sandler. Thanks for being here. All the best keep safe.