Pubdate: Thu, 21 Jul 2016
Source: Vancouver Sun (CN BC)
Page: A10
Copyright: 2016 Postmedia Network Inc.
Contact:  http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477

FENTANYL IS NOW A CRISIS

The weekend spike in drug overdoses across Surrey's Whalley area 
would have been a national disaster had the subjects been victims of 
a mass shooting, a wild fire or a plane crash. We seem desensitized 
to events which don't come with the images upon which television news 
and streaming Internet thrive. Nevertheless, Fraser Health medical 
staff faced a disaster-like avalanche of 36 life-threatening cases in 
which people were stricken after ingesting illicit drugs likely laced 
with the deadly synthetic opioid fentanyl.

In this case, emergency workers handled the calamity with competence 
- - and nobody died. For their skill, they deserve thanks. The same is 
true for the health care workers and police officers who then walked 
streets putting up warning notices, handing out pamphlets and talking 
to people about a growing and immediate risk.

How serious is the problem? A report from the provincial coroner's 
service tracking detection of fentanyl in illicit drug overdose 
deaths shows a frightening expansion across both provincial geography 
- - and demography. The number of overdose deaths in which fentanyl was 
detected jumped by 1,346 per cent from 2012 to the mid-point of 2016. 
For users under 19, more frequently users of other recreational 
drugs, the increase is 700 per cent. And the hazard is now 
province-wide. Of the 494 such deaths reported to the end of May, 214 
were on Vancouver Island, in the Interior and across the North.

Synthetics like fentanyl, 50 to 100 times more powerful - and toxic - 
than opiates like morphine or heroin, are increasingly popular with 
those who make and sell illicit drugs because they offer a cheaper 
ingredient which amplifies the potency of what they purvey. But lower 
costs and higher profits for traffickers mean vastly increased risk 
for unsuspecting users of street-purchased drugs. And health 
authorities warn that drugs can be cross-contaminated so even 
non-opiate users can get an overdose from something they think of as 
relatively benign.

Clearly, now is not the time for simplistic moralizing. What's needed 
is immediate harm reduction in the face of an emerging public safety 
crisis as great as any that's faced the province in recent years. 
Fentanyl-implicated overdose deaths, for example, are already about 
10 times the fatalities in the 2009 swine flu epidemic that 
galvanized the province. The response by Fraser Health and Surrey 
RCMP deserves applause. But what next? If fentanyl shows up 
everywhere and in all forms of street drugs, everyone who ingests or 
injects illicit drugs whether veteran addict or naive recreational 
user is now at risk of a lethal overdose.

How to respond? Certainly with a vigorous province-wide educational 
campaign promoting the provincial coroner's urging that those who use 
illicit drugs never use them alone. We should deploy more safe 
injection sites where fast medical assistance is available. And we 
should explore distribution of opioid antidote kits like naxolone 
with instruction in how to use them in the case of an overdose.

This doesn't advocate or condone illicit drug use. But a fulminating 
public health crisis demands robust, pragmatic and imaginative 
response, not sanctimonious self-righteous platitudes that accomplish nothing.
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MAP posted-by: Jay Bergstrom