Pubdate: Tue, 26 Apr 2016
Source: Daily Courier, The (CN BC)
Copyright: 2016 The Okanagan Valley Group of Newspapers
Contact:  http://www.kelownadailycourier.ca
Details: http://www.mapinc.org/media/531
Page: A6

DRUG WAR CONTINUES TO RAGE IN PROVINCE

British Columbia has become the first province in Canada to declare a 
public-health emergency because of fentanyl-related deaths.

Dr. Perry Kendall, the provincial health officer, took this step 
after fatalities associated with the prescription painkiller surged. 
In B.C., 76 people died in January. If these fatality rates remain 
constant, as many as 900 British Columbians could die in 2016.

It's not clear how many of those deaths were due to fentanyl. Some 
varieties are difficult to detect.

But the crisis is real. Fentanyl deaths have spiked countrywide, and 
the trend is sharply upward. The solution is another matter. The drug 
is so powerful, just one grain produces an instant high. Two grains can kill.

And that presents a massive logistical problem. Fentanyl is cheap to 
produce - roughly $70 a gram. But the street value of that amount is 
$20,000 - a drug dealer's dream.

And because it's so potent, small quantities are sufficient to 
sustain a black market.

Most of the packages smuggled into B.C. come from China, and often 
weigh less than 30 grams. How do you interdict illicit shipments that 
arrive in such tiny amounts? And the 30-gram limit is no accident.

Canada Border Service Agency, which polices ports of entry, is not 
allowed to open packages weighing less than that amount without the 
owner's permission. If a suspicious package is found, and that 
permission is not forthcoming, they simply send it back where it came 
from. No doubt the sender tries again.

There is an antidote to fentanyl, called naloxone. But it only works 
if administered quickly. And that is one reason for declaring a 
public-health emergency.

With this provision in place, Kendall is authorized to collect 
drug-overdose data from multiple sources in real time. Emergency 
responders, physicians, hospitals and pharmacies can all be tied into 
a province-wide grid. The hope is that data gathered in this way will 
identify "hot spots" - locations where fentanyl users are grouped.

Naloxone kits can then be distributed in those districts and training 
offered in their use.

So far, between 6,000 and 7,000 people have received the training, 
many of them fentanyl addicts or family members. Several hundred kits 
were used last year, certainly saving lives.

Nevertheless, this is an uphill battle. Fentanyl is the latest in a 
long line of illicit drugs to hit the streets. It was preceded by 
another prescription painkiller, oxycodone, which left a trail of 
fatalities in its wake.

And already there is talk of a next generation. Calgary police have 
warned about a drug called W-18, which is 100 times more powerful 
than fentanyl.

The only long-term solution - not without its difficulties - is to 
offer drug users a safe alternative.

Interior Health is one of many B.C. regions considering safe injection sites.

Yet even if the talks are successful, sites such as these will not 
provide safe drugs. They will only offer a place to consume whatever 
drugs people bring in from the street.

The dilemma is all too obvious. We don't want people dying of dirty 
drugs; however, having government provide cleaner but still 
life-diminishing drugs at supervised sites raises serious moral issues.

Some European countries have been willing to seize this nettle.

Britain and Switzerland, among others, provide heroin to addicts if 
methadone - a less potent alternative - doesn't work for them.

Giving addicts fentanyl at supervised sites would be in keeping with 
this policy, though it would be a gut-wrenching decision.

But that is what the war on drugs has become - gut-wrenching.
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MAP posted-by: Jay Bergstrom