Pubdate: Thu, 03 Aug 2017
Source: Sault Star, The (CN ON)
Copyright: 2017 The Sault Star
Author: Dr. Evan Wood
Page: 6


As the opioid crisis worsens, the more we learn about why people are
dying. One thing is evident: the drug supply is becoming more toxic.
The deadly drug fentanyl is being detected in more than 72 per cent of
all overdose deaths in British Columbia. Two years ago, it was found
in only 29 per cent; two years before that, just 15 per cent.

While untold fatal overdoses have been prevented by first responders,
other health-care providers, and peer groups, the increasingly
poisonous drug supply is clearly undermining the efforts to reduce
overdose deaths.

One problem is much of the focus has been on reducing fatal overdoses
among those using fentanyl, without an equal focus on the reasons
people are overdosing in the first place.

For instance, major successful efforts have been made to expand access
to the overdose reversal drug naloxone whereas efforts to get
individuals off of fentanyl-laced drugs have been slower to implement.

Providing naloxone and other harm-reduction interventions when
overdoses occur can save lives, but we cannot get out of the crisis
solely through these means. We need a new approach involving
strategies to improve the safety of the drug supply and strategies to
get individuals off of fentanyl-laced drugs.

Substantial resources have been expended to reduce the street supply
of synthetic opioids. Not only has this proven unsuccessful, any
expectation that this will be successful fails to acknowledge that the
fentanyl crisis is a consequence of similar prohibition efforts aimed
at reducing the supply of traditional illicit opioids such as heroin.
Indeed, street heroin is a product of the earlier supply reduction
efforts aimed at suppressing the availability of opium.

The simple fact is that drug prohibition has the unintended
consequence of creating a huge illegal market that contributes to
increasingly sophisticated crime groups who ultimately make street
drugs ever more potent and available.

While ending prohibition may not be on the agenda for the provincial
and federal governments, old taboos must be broken. One successful
approach was taken in Portugal, which transitioned its focus from drug
law enforcement to addiction treatment and recovery, ultimately
leading to a severe decline in overdose rates, among the lowest in the
European Union. We must take a similar approach.

Last July, when the B.C. government announced the creation of its
joint task force to respond to the overdose crisis, the announcement
promised to establish a drug testing service to help people find out
if their drugs include adulterants, including fentanyl. This urgently
needed service must be made available as soon as possible.

We also must look to expand a range of addiction treatment and
recovery services aimed at helping persons off of fentanyl-laced
drugs. This includes substitution treatments as well as fully
integrated recovery services to seamlessly help individuals transition
out of all opioid use whenever possible.

As the original principal investigator of Insite, Canada's first
supervised injection site, I've seen the important role that these
programs can have, but also the need to have a functioning addiction
treatment system.

This has become particularly urgent in the era of fentanyl-laced

The next step is to implement all options for protecting people from
the increasingly toxic drug supply. A focus on this strategy is the
only way out of the current overdose crisis.

Evan Wood is director of the British Columbia Centre on Substance Use 
and professor of medicine at the University of British Columbia.
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