Pubdate: Thu, 29 Dec 2016
Source: Province, The (CN BC)
Copyright: 2016 Postmedia Network Inc.
Contact:  http://www.theprovince.com/
Details: http://www.mapinc.org/media/476
Author: Larry Campbell (Larry Campbell is a Canadian senator and former
mayor of Vancouver.)
Page: 14

FENTANYL CRISIS DEMANDS BOLD SHIFT IN TREATING DRUG ADDICTION

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.
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