Despite increased work to combat B.C.’s public-health emergency, more people died of an overdose in 2018 than any other year on record, leading to calls to make heroin and alternatives available at the doctor’s office.
The B.C. Coroners Service said Thursday that 1,489 people died of a suspected illicit-drug overdose in B.C. last year, up from 1,487 in 2017. Most who died were men (80 per cent) aged 30-59 (71 per cent), and most died indoors (86 per cent). Fentanyl, an opioid being cut into heroin and other drugs, was detected in about 85 per cent of the deaths, up from 82 per cent in 2017.
People running overdose prevention sites and expanding access to Suboxone treatment and the overdose-reversing drug naloxone have been credited with keeping the crisis from getting worse.
But to actually reduce the death toll in 2019, provincial health officer Dr. Bonnie Henry said B.C. needs to introduce a safer supply of drugs to replace the toxic street-drug supply.
Henry said it’s important to first have low-barrier access to opioid-agnoist treatments like Suboxone and methadone for people on a path to recovery. But for some people, swapping out their fentanyl-poisoned street drugs with pharmaceutical ones needs to be a first step.
“For people who, right now, have an addiction to opioids … and are relying on this contaminated street-drug supply on a daily basis, and they’re not in a place in their lives where they’re willing or able to enter the treatment side of the spectrum, we need to have options to provide them with a safer supply than what they’re getting on the street so that they stay alive during this period of time,” she said.
“They’re at such high risk of death right now.”
Dr. Jane Buxton of the B.C. Centre for Disease Control said people should be able to seek access to a regulated, safer supply of opioids through a physician.
“Depending on who it is, we still know that going through treatment, that suits some people,” she said. “Other people, especially (those) on Suboxone, that can be life-changing. But that doesn’t suit everybody, so we have to have that variety of options.”
She pointed to a program run by the Portland Hotel Society’s Dr. Christy Sutherland, who has started 300 people on liquid hydromorphone and who last month added 50 more spots for people to crush hydromorphone pills and inject them.
When certain people who use drugs are engaged with the health system in this way, they can go on to seek treatment, food, housing and other supports, Buxton said.
“What we’ve seen in the past is that when people have a stable supply, then their life becomes more stable, then they’re able to potentially think about other treatment and being on other opioid-agnoist therapies,” she said.
“Most people are seeking drugs in the illicit market, which are dangerous, and it’s hard to be stable when that’s part of your life and things are so toxic.”
Jordan Westfall, president of the Canadian Association of People Who Use Drugs, said he found hope in the chief health officer’s comments about a safer supply.
“I think the barriers need to be reduced,” Westfall said.
He said programs like the Crosstown Clinic, which provides medical-grade heroin and hydromorphone, are crucial, but for some people the requirement that they visit clinics or nurses several times a day is too high a barrier.
Westfall added that not all people who use drugs seek recovery, and some will continue to seek street drugs to treat their own pain or feel the euphoric effects.
“We need to make sure our programs are as accessible as the street-drug supply which, for many people, is very accessible,” he said.
“You should be able to go to a physician and get a prescription for a drug, if the alternative is you buying that drug on the street and dying.”
Mental Health and Addictions Minister Judy Darcy said her ministry is working on a wide variety of evidence-based solutions to the public health emergency.
“We are going to use every tool in the toolbox,” she said. “We are not going to leave any stone unturned when it comes to safe alternatives for people to the poison-drug supply.”
Darcy said her ministry is working with the B.C. Centre on Substance Use to train more physicians in addiction and 2,100 have enrolled in a program since July.
But Darcy’s ministry must work with federal legislation that prohibits the use of controlled substances, which prevents her ministry from simply allowing doctors to prescribe heroin and substitutes at clinics, she said.
“We’re pushing the envelope within that federal context,” she said.
Jane Thornthwaite, B.C. Liberal opposition critic for mental health and addictions, said she supports making a safer drug supply available to immediately save lives, but said it must be paired with a pathway to treatment and recovery options for anyone who uses it.
“You need to have the support systems in place for these people to actually move forward,” Thornthwaite said. “If we’re not going to get to the root of the problem, then this crisis is not going to get any better. We’ll just have new people getting into the system and it could grow and grow.”
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