Pubdate: Sat, 07 Jan 2017
Source: Beacon Herald, The (CN ON)
Copyright: 2017 Osprey Media Group Inc.
Author: Robin Baranyai
Page: 5


One of the most important and pressing challenges of 2017 will be Canada's
response to opioid addiction. The sheer scale of overdoses from heroin and
other opioids has already led British Columbia to declare a public health
emergency, and the crisis is sweeping east.

Fentanyl has washed over the West Coast like a deadly tsunami. The
synthetic opioid can be up to 100 times more potent than morphine. It's
not just hardened addicts who are dying. Overdose deaths have spiked among
occasional drug users, with fentanyl detected in street drugs ranging from
heroin to marijuana.

Provinces scrambling for an effective response were then hit with
fentanyl's deadlier cousin, carfentanil. Lethal in doses as tiny as a
grain of salt, the drug is 100 times more toxic than fentanyl and
undetectable by smell or taste. For the first time in December,
carfentanil was found in street drugs seized by Ontario police.

Opioids were once a meticulously restricted substance, administered
chiefly for palliative cancer care. In the 1990s, the slow-acting opioid
OxyContin was aggressively - and falsely - marketed as a chronic-pain
reliever with a low risk of dependency and abuse. In Ontario,
prescriptions for OxyContin shot up 900 per cent between 1991 and 2009,
according to the Ministry of Health.

We now know the miracle pain reliever was highly addictive and easy to
abuse. In 2010, manufacturing changes were introduced to make OxyContin
more difficult to crush for snorting or injecting. Fentanyl rushed in to
fill the gap.

It was hoped opioid overdose fatalities would go down when OxyContin was
delisted from the Ontario drug plan in 2012. Instead, the ministry
acknowledges, opioid misuse is the third-leading cause of accidental death
in Ontario. In October the province announced an addiction- and
overdose-prevention strategy with $17 million in annual funding for
chronic pain clinics, and greater access to drug treatments.

Alternative pain management and addiction treatment are two important
elements of a multifaceted problem. But a key pillar of any effective drug
strategy must be harm reduction - helping reduce negative outcomes for
people at all stages of addiction and recovery.

Supervised injection sites such as Vancouver's InSite, which opened in
2003, have proven extremely effective at preventing overdose deaths. They
provide clean needles, helping reduce the spread of HIV and hepatitis C,
as well as access to resources for quitting, when people are ready.
Defying some expectations, neighbourhood crime did not increase around the
safe injection site. In fact it helped move the more overt signs of
illicit drug use, including discarded needles, off the street.

There are encouraging signs this evidence-based response to opioid
addiction will be expanded in the new year. In December, Health Minister
Jane Philpott announced a new national drug strategy treating opioid
addiction as a health issue, not a criminal one. The minister also said
she's creating more resources to help approve new safe consumption sites.

The proposed Bill C-37 is a significant change in direction. The former
federal government fought tooth and nail to close InSite. After losing its
battle with the Supreme Court, it created onerous conditions for the
establishment of safe consumption sites under the Respect for Communities

If approved, C-37 will cut through the red tape, replacing 26 exhaustive
criteria with five simple benchmarks: a demonstrated need for a safe
consumption site; assurance of regulatory systems; appropriate community
consultation; analysis of any projected impact on crime; and proof of
appropriate resources.

The scale of the opioid crisis is devastating - to individuals, families
and communities. We have resisted evidence-based, health-focused drug
policy far too long, at too high a cost. It's time to change that.
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