Pubdate: Fri, 03 Mar 2017
Source: Metro (Vancouver, CN BC)
Copyright: 2017 Metro Canada
Author: David P. Ball
Page: 4


Disease control director says more should be prescribed

One of British Columbia's top experts on diseases has slammed
longstanding "drug policies that criminalize drug users," in an op-ed
in the B.C. Medical Journal's new issue, and pushed for the expansion
of government-prescribed opioids.

Dr. Mark Tyndall, provincial medical director of the B.C. Centre for
Disease Control, wrote about the province's opioid overdose epidemic,
which has killed almost 1,000 people in the last year "despite a
public-health emergency announcement in April 2016."

"Harm reduction interventions along with basic social supports are
necessary to reduce suffering and prevent deaths," Tyndall wrote.
"Proven harm reduction interventions must be scaled up, including
supervised injection sites, low-barrier supportive housing, better
access to primary-care based opiate agonist therapy (OAT), and an
expansion of prescription opioid programs."

However, prescription heroin - despite successful results from two
landmark Vancouver studies, SALOME and NAOMI at the Crosstown Clinic -
has not yet been allowed beyond the roughly 130 hard-to-treat alumni
of those pilot studies.

Last week, health minister Terry Lake said he was "open" to the
possibility of expanding prescription heroin and hydromorphone - but
only on the advice of an expert substance-use committee, the B.C.
Centre for Substance Use, and only in certain "appropriate" regions,
citing overdose epicentres in the Downtown Eastside, Victoria and Surrey.

However, in January he said "we need the evidence first," and in a
later interview that prescription heroin was too publicly
controversial to roll out. Last week, on a national day of action on
overdoses, Vancouver Area Network of Drug Users (VANDU) board member
Karen Ward told Metro that it wasn't a lack of evidence stopping B.C.
from making prescription heroin available - but a lack of "political
bravery" by the government.

Tyndall called on the province's physicians to play a stronger
advocacy roll in supporting harm reduction approaches to treating
addiction, as well as ensuring substance users get access to such
treatments. He said opioid use is primarily "driven by a desire to
self-medicate," meaning that drug use "will continue no matter how
high the risk."

"There are myriad reasons and events that launch people into habitual
drug use -trauma, personal tragedy, injuries, sexual abuse, racism,
and mental illness to name a few," he wrote. "But one thing is
consistent - no one started using drugs to become isolated,
stigmatized, destitute, and criminalized.

"These devastating consequences of drug addiction are directly related
to entrenched drug policies that criminalize drug users and a societal
indifference to the pain, suffering, and even death of people who buy
drugs from the illicit market."
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