Pubdate: Fri, 26 May 2017
Source: Province, The (CN BC)
Copyright: 2017 Postmedia Network Inc.
Authors: Eugenia Oviedo-Joekes and Martin T. Schecter
Page: 23


"Yes, and how many deaths will it take till he knows, That too many
people have died?" - Bob Dylan, Blowin' in the Wind

Beginning in 1993, Justice Horace Krever led a Royal Commission of
Inquiry into the tainted-blood scandal in Canada. Inquiries were held
in other countries. One of the key questions was why people with
hemophilia were forced to continue to inject blood products that were
not screened for HIV, when newer and safer products were already available.

Criminal charges were laid in a number of settings. The Canadian Red
Cross pleaded guilty to the crime of distributing a contaminated drug
and made a large donation in exchange for six criminal charges being

Edward Herve, the French minister of health during the scandal, was
convicted of manslaughter. Two top officials in the French blood
system were also convicted and sentenced to prison.

Why these prosecutions? Because these people and organizations
knowingly allowed people to continue to inject potentially lethal
substances when they had the means to stop it. That sounds like a
crime, doesn't it?

Let's turn from blood products to opioids. The illicit drug supply
accessed by people with opioid addiction has always been unsafe.
Because of, and only because of criminalization, peoples' lives are at
risk from injecting unknown doses of contaminated street opioids in
unsafe conditions.

While people from all walks of life are affected, it's always the very
vulnerable who suffer most. In a system that fails to provide safety,
they are left to fend for themselves in dangerous times, while gangs
and cartels that supply black-market drugs are enriched and emboldened
to wreak violence on people and communities around the world.

Fast-forward to 2017. As if even possible, it's infinitely worse now.
The illicit drug supply is now catastrophically and irrevocably
lethal. The addition of fentanyl, carfentanil and their analogs - many
of which are thousands of times more potent than heroin and morphine -
has transformed each illicit opioid injection from a risky activity
into Russian roulette. If this seems unfamiliar to you, come to
Vancouver and listen to the wail of ambulance sirens pierce the air
every night.

On Friday in Vancouver, an international panel of experts from
Switzerland, Holland, Germany, Denmark and the U.K. are presenting the
experiences in their countries where pharmaceutical heroin is being
prescribed successfully to people most adversely affected by opioid

In Portugal, possession of drugs from marijuana to heroin has been
decriminalized for 16 years. As far as we know, in none of these
European countries has the sky fallen in.

In Portugal, the overdose death rate is about three per million; in
Canada, it's more than 20 times higher. In Germany, there are 24
safe-consumption sites; in Canada, there are two. In Switzerland,
there are 23 clinics offering medically prescribed heroin to those who
require it; in Canada, there is one.

What makes these differences even more egregious? Because, to
paraphrase our prime minister, "it's 2017." Canada should know better.

In the tainted-blood scandal, individuals were convicted of crimes for
knowingly allowing people to continue to inject potentially lethal
substances when they could have saved them. It was a crime.

But think for a moment. Are we now not all guilty of the same thing?
Whether we are politicians, decision-makers, health professionals,
legislators, researchers or members of the public - are we all not
culpable in the overdose crisis? We have overwhelming evidence on what
to do and yet we fail to act. What will the decision-makers of today
say if called to stand before a future Royal Commission about opioids?

Dylan prompts us to ask how many deaths it will take until we know.
Are we all brave enough to admit that what we are doing isn't working
and that we must change?

Can we not summon within ourselves and our society the compassion, the
courage, the wisdom and the will to do the right thing - right now? We
believe we can. Let us all make certain the answer doesn't stay
blowin' in the wind.

Dr. Eugenia Oviedo-Joekes and Dr. Martin T. Schechter, faculty members 
in the School of Population and Public Health at the U.B.C., were lead 
investigators of the NAOMI and SALOME clinical trials of medically 
prescribed heroin and hydromorphone.
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