Pubdate: Sat, 15 Apr 2017
Source: Vancouver Sun (CN BC)
Copyright: 2017 Postmedia Network Inc.
Author: Camille Bains
Page: A4


A tag hanging from a dead man's left toe says the cause of death was
an overdose of fentanyl, "unknowingly taken with other drugs."

The cadaver draped in a white sheet is displayed in transit ads funded
by the Vancouver Police Foundation and represents 922 people who died
in British Columbia from drug overdoses last year alone.

A spiralling number of deaths, often involving the painkiller
fentanyl, prompted the provincial government to declare a public
health emergency on April 14, 2016, and to launch its own awareness
campaign on TV, radio, Facebook, transit and at bars and

The province rolled out its latest campaign this week, featuring
Facebook ads about a mother whose son died of an overdose, users who
say they struggled with the shame of addiction until they got
treatment, and the importance of carrying naloxone, a medication used
to reverse overdoses.

The state of emergency remains in effect after a year, but fatalities
have continued, with a monthly high of 142 deaths in December reported
by the B.C. Coroners Service.

It said the number of deaths in February was down slightly from 117 in
January but 219 people died in the first two months of this year, up
from 143 fatalities during the same period last year.

Many of the dead had no idea that fentanyl was cut into their drugs of
choice, including heroin, cocaine, crack, ecstasy and meth, and that
merely a speck of the powerful opioid can kill.

Provincial health officer Perry Kendall said that after a decline in
overdoses between March and September last year, another even more
potent drug, carfentanil, was responsible for an increase in deaths
starting in November.

"That was just a sickening feeling," Kendall said.

He said the don't-use-alone message is still not getting out to people
who use illicit drugs despite measures that have been taken, such as
more distribution of naloxone, lifting restrictions on doctors
prescribing the treatment drug suboxone, and the opening of overdose
prevention sites where people can ingest drugs under

In November, the federal government banned the importation of six
precursor chemicals used to make fentanyl, and Kendall said the
province is pushing for legislation that would allow Canada Border
Services Agency officials to open mail under 30 grams because it could
contain small amounts of fentanyl shipped from countries including

A bill is before the House of Commons.

Addressing the public's stigma around health-care spending on drug
addiction has also been a challenge, Kendall said.

"It's like all these emergency rooms full of people who are dying from
overdoses are creating waiting problems for real health issues. Either
you see addiction as a health issue, which it is, or you see it as
people doing bad things and they don't deserve our compassion and
resources," he said.

"I do think we're now seeing addiction as a health issue and not just
a moral issue or a criminal issue."

Kendall said the next step for the province will be to provide
treatment with opioid substances, such as the painkiller hydromorphone
and injectable heroin.

Patients take those two drugs under supervision at the Crosstown
clinic in Vancouver, the only such facility in North America, but lead
physician Dr. Scott MacDonald said so many people who haven't
responded to other treatment could benefit if the program were expanded.

The B.C. Centre on Substance Use is developing guidelines regarding
that move on behalf of the Health Ministry, said Cheyenne Johnson, a
nurse and clinical director at the centre.

She said training family doctors to screen and diagnose opioid
addiction will be key to addressing the high number of overdose deaths
in British Columbia, and that the centre has taken on that task.

Since last October, nearly 1,100 doctors have been educated at 25
locations around the province to recognize addiction and refer
patients for treatment, Johnson said.

The College of Physicians and Surgeons of British Columbia has so far
offered basic addiction training, but as of June 5 the centre will
fully take over the effort through an online course in hopes of
reaching as many doctors as possible, she said.

Johnson said some doctors who have taken the training shared that they
were "scared" to deal with patients hooked on opioids because they
lacked adequate medical expertise.

"The overdose epidemic has really shone a light on how much untreated
addiction we have in the province of British Columbia, so not only
people who have substance use disorders but people who might use
recreationally," she said.

"When you go into private treatment recovery centres, what you see is
RCMP officers, you see firefighters, you see people who work in oil
and gas, teachers, and you see nurses. You see everybody."
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