Pubdate: Mon, 14 Aug 2017
Source: London Free Press (CN ON)
Copyright: 2017 The London Free Press
Author: Jennifer Bieman
Page: A1


The deadly painkiller fentanyl, thrust under a spotlight by a rare
warning by three health agenices and city police, isn't the only
dangerous street drug raising eyebrows in London.

Heroin is also showing up, in levels-those who work with addicts say
they haven't seen before.

One agency blames the spike on the province tightening the
prescription drugs it covers under a program for people on social
assistance and seniors, which has driven some users to heroin instead.

"I've never known it (heroin) here. Now it is," said Karen Burton,
needle and syringe program coordinator at Regional HIV/AIDS Connection
in London, whose work includes a drug needle exchange program. "Heroin
is here and I don't see it disappearing anytime soon."

Frontline workers at the agency say they're now seeing four or five
heroin users a day, up from two to three people a month last year.

"There's a large amount of heroin now in London and that's a new
situation as of January because of some changes in the way they (the
province) fund drugs," said Blair Henry, harm-reduction case manager
at Regional HIV/AIDS Connection.

The province in January removed certain high-strength prescription
painkillers from coverage under its Ontario Drug Benefit program amid
the opioid drug crisis that's swept the country in recent years,
causing many overdose deaths.

Burton said the move has resulted in fewer high-dose opioid pills
diverted to London streets, driving up the cost of the handful that
remain. She said the government's move, designed to stem prescription
opioid abuse, has paradoxically driven people to illegal drugs
instead. "(High-dose prescription narcotics) are going to become more
difficult to find and if they can get heroin on the street without
looking so hard, then they're going to get heroin." That's a
frightening prospect for Burton and Henry, who know heroin is
sometimes laced with fentanyl, a hyper-potent opioid blamed for a
growing number of deaths in Canada. Police in Sarnia suspect cocaine
laced with fentanyl was responsible for a death last week, one of
three overdoses reported within hours.

Two other people were taken to hospital.

Henry said organized crime likely is bringing heroin to London, seeing
an opening now that high-dose narcotic pills are in short supply.

Addictions and Mental Health Ontario and the Canadian Mental Health
Association were concerned Ontario's move would have unintended
consequences and outlined that position in a joint statement in February.

"Our organizations are concerned that reducing the availability of
high strength opioids will not curb the opioid epidemic overall," they
said. "A well-intentioned policy can lead to an increase in opioid
related harm and further use of risky street drugs."

At Addiction Services of Thames Valley, Ken Lee, who heads a clinic
for recovering drug addicts, said he's already seeing heroin in urine
samples from some recovering drug users he sees.

"I think it's hit the streets in London in the past month or so. Prior
to this, we have not seen any heroin positives in our urine testing,"
he said. "All I am seeing is the tip of the iceberg."

Ontario's move to cut high-dose narcotic pills from its drug benefits
has its defenders.

"These high-dose products normalize a very abnormal and, frankly,
dangerous behaviour," said David Juurlink, head of clinical
pharmacology and toxicology at Sunnybrook Health Sciences Centre in

"It will help doctors not mismanage chronic pain as we've been

The province, spending $224.8 million this year on community
addictions services, said de-listing high-dose opioids will limit the
street supply.

"This supports appropriate access to opioids and encourages
appropriate prescribing while limiting opportunities for the
inappropriate use, abuse, and diversion of high-strength, long-acting
opioids," said Laura Gallant, a spokesperson for Health Minister Eric

Juurlink said smaller-dose opioid drugs still are covered by the
Ontario Drug Benefit Program. And for users who want to seek
treatment, addiction and recovery resources are available too.

While Juurlink agrees not paying for the extra-strength drugs could
force users to try other ones, he said limiting the use of high-dose
prescription opioids is an important and long overdue step.

"In theory you do make it more likely that someone will turn to
something that is more dangerous, but that doesn't mean that it wasn't
the right thing to do in the first place," he said.
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