OPINION: Would a ‘secure’ drug supply end Vancouver’s overdose epidemic?

Opinion: As a harm-reduction measure, Vancouver Coastal Health and others want Ottawa to allow drug clubs to provide free, tested drugs to members.

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Harm reduction’s truism is hard to argue with: You can not help drug users if they are dead.

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In fact, it is usually a conversation stop. But it is also a convenient hug when someone suggests that governments in the midst of the protracted overdose crisis have leaned in a little too hard to reduce damage and not hard enough to tackle the root causes that fuel the drug use epidemic.

So it is with a proposal approved by the Vancouver City Council that calls on Health Canada to allow drug clubs or co-ops to buy heroin, cocaine and methamphetamine, test them, repackage them and give them away to members.

This is pure and simple harm reduction, unbound by healthcare providers and any pretense that it is part of a treatment plan. These would be pharmacies without pharmacists who give users the drugs they feel like in the quantities they want.

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With an average of six British Colombians a day dying from illicit drugs with ever-increasing concentrations of fentanyl, carfentanil and benzodiazepines, there is no doubt that Vancouver and most other BC cities have a deadly problem.

Desperate times, they say, require desperate measures.

But if Health Canada meets the request from the city and Vancouver Coastal Health to exempt the Drug Users Liberation Front (DULF) from the Drugs and Drugs Act, would drug clubs work?

Nobody knows, because it’s never been done before.

“It would not make drug use safe. But it would make it safer than what (users) are doing at the moment,” said Mark Lyshyshyn, the deputy doctor, in an interview.

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“We do not know if it would be a successful program, but I felt it had the potential to reduce the risk of overdose. … The whole point is that they are getting safer drugs.”

He sees DULF’s proposal as an extension of Vancouver Coastal Health’s drug control services and supervised injection sites.

The whole idea of ​​a “secure supply” or even a “secure supply” is a relatively new one that was first used by groups like the Vancouver Area Network of Drugs Users (VANDU) more than ten years ago before the illegal supply was filled with synthetic opioids like fentanyl and before a public health emergency was declared in 2016.

Critics of “secure supply” say there is no such thing, pointing out that the emergence of the emergency was the false and aggressive marketing of OxyContin as non-addictive followed by its over-the-counter.

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Even before that, Vancouver’s drug problem was bad enough that in 2001 the city approved a “four-pillar” approach – prevention, treatment, enforcement and harm reduction. Over the years, the political debate has evolved into harm reduction versus treatment.

“It comes down to a question of philosophy about what the right balance is,” Lyshyshyn said. “And right now people are dying, so the most important pillar is harm reduction, to prevent people from dying.”

He said governments spend “100 times as much on addiction treatment” as on harm reduction, as well as more on enforcement even after a decade of de facto decriminalization in Vancouver.

Police are looking for drug smugglers and illegal drug manufacturers, Lyshyshyn said. And it “only encourages people to create more potent drugs.”

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Still, he hopes more users with a more secure drug supply would seek treatment. Unfortunately, this is not entirely in line with users’ letters attached to the Vancouver Council’s proposal. For them, the treatment does not work.

Greg Fresz receives diacetylmorphine (heroin) twice daily from Crosstown Clinic, which is licensed by Health Canada to supply it. But he wants a supply with home (aka “bearer”) and has been denied it.

“You can’t use crack if you need to have carries. “For me it is not possible, because sometimes I can not get anything else, so I buy pills, diludids, benzoids, something to help me sleep because I am in pain.”

Martin Steward left Crosstown Clinic because it was “too boring.”

“I had to wait for my turn, wait for my medicine, after the medicine I had to sit for 20 minutes before I could walk.”

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A man identified as Steel, who described himself as a “social user”, tried and left the BC government’s “safer supply program” that allows doctors and nurses to prescribe opioids (including fentanyl patches), alcohol, stimulants and benzodiazepines.

“Public supply is weak. It does not satisfy. Yes, it may be free, but it does not do what the drugs are meant to do for many of us. ”

Steel also complained about the drugs that DULF has distributed freely on three occasions in Downtown Eastside: “I found out I needed more.”

Samona Marsh, a “substance navigator for ethical use” at VANDU, wrote: “I do not go to the doctor at the best of times. Why should I go to the doctor to get high? Existing safe delivery programs give you pills. I want to stay high of drugs, not of their pills. ”

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Lorna Bird complained about being on an opioid replacement program that requires daily observed intake of drugs like methadone and suboxone at a pharmacy: “It was a real hassle and disrupted my life a lot.”

Before that, she stopped an injectable heroin program. She did not like to be monitored as she used to.

VANDU “peer navigator” Laura Shaver spends about $ 100 a day on “a variety of street and safe delivery drugs” that include heroin, hydromorphone, Dexedrine, methadole-D, Seroquel and gabapentin.

She has asked for prescription benzodiazepines, but her doctor refused because there were traces of fentanyl in her urine.

“The feeling (on benzo) can be euphoric – and reminds me of the type of high I wanted before I got methadone.”

For more than two decades, the Canadian consensus has been that addiction is a health problem, not a moral failure, and should be treated like any other chronic, recurrent illness.

But the challenge facing Carolyn Bennett, Canada’s new Minister of Mental Health and Addiction, is deciding whether harm reduction includes the right to be high.

[email protected]

Twitter: @bramham_daphne

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