Fentanyl crisis demands bold shift in treating drug

It is time to face reality. We must actively seek new solutions to address the fentanyl crisis and be more proactive on an emergent basis. The existing strategies to treat the disease called drug addiction are not working — over 800 people will die in B.C. this year. We expect this number to continue to grow as more and varied compounds are introduced both domestically and from overseas. Think of the steps that were implemented immediately to prevent and treat SARS and the Zika virus. And yet we refuse to move quickly and decisively on what is described in B.C. as a public health emergency. Why has this not been declared a public health emergency in the rest of Canada?

Last week, the federal government introduced Bill C-37. This will undo the draconian measures of the previous government, which were based on fear not science. Within this bill are measures to allow for borders agents to open letter mail that is suspected of containing powder and a ban on pill presses used to manufacture fake opiate pills. All of these measures certainly will assist in keeping fentanyl and other opiates from coming into the country. But we need to be more proactive on an emergent basis.

Drugs will continue to enter and be made in this country. Even if we could stop fentanyl, there will always be other drugs manufactured and sold on the street. We need to treat the disease of drug addiction rather than continuing to depend on interdiction and law enforcement.

All levels of government need to support prescription opiate replacement therapy like suboxone, methadone, and stronger drugs like hydromorphone (dilaudid) and diacetylmorphine (heroin). Replacement therapies treat withdrawal symptoms with opiates that are pharmaceutical and not contaminated.

Peer-reviewed articles of both NAOMI and the SALOME projects (which provided prescription heroin and dilaudid in Providence Health Care’s Crosstown Clinic in Vancouver to long-term heroin users) demonstrate that dilaudid and heroin are more effective than methadone at treating the painful withdrawal symptoms of addiction for participants in the studies. Those who are enrolled in the projects continue to live, get healthy, and receive treatment. Both projects, like the supervised injection site Insite, reduced public disorder, reduced crime, and connected drug users to health care for their other chronic medical conditions.

We know that supervised injection sites work to prevent death and address the issues relating to public disorder — we should also be offering opiate-replacement therapy through supervised injection sites. Those suffering from addictions should be seen by a doctor. The doctor can then make decisions on what therapy would work best. Prescriptions would be issued that can only be filled at a supervised injection site or other similar medical facility. The medicine would be administered at the site, with no drugs leaving.

Beyond quietly overturning a highly politicized restriction on access to prescription heroin for a small group of patients who were in the SALOME study in the Downtown Eastside, elected officials need to find the courage to implement these solutions. More importantly, we as citizens must hold our politicians to account. Do we have to wait until this public health emergency reaches Ontario and Quebec before the federal government reacts? How many more people have to die? How many families need to suffer? Rise up. Demand action. The next person who dies a preventable death may be your family member or friend.