Pubdate: Wed, 18 Oct 2017
Source: Montreal Gazette (CN QU)
Copyright: 2017 Postmedia Network Inc.
Author: Charlie Fidelman
Page: A1


With just enough methadone to last the trip home to Montreal, Melodie
was in a panic that she'd missed her flight. She was in Paris, and her
supply of prescription methadone, a medicine that helps lower cravings
and withdrawal symptoms caused by opiate use, was about to run out.
Without it, she worried about a relapse, going into the street in
desperation, and doing something dangerous for a fix.

But an online search brought her to a Parisian mobile health clinic.
And they welcomed her. They gave her the methadone that she needed to
stay sober. There was no bureaucracy, no delay, and no prescription
signed by someone in authority - just instant help.

That's what Quebec needs now, more resources - and more money -
invested in public health techniques that have proven their worth,
Melodie, who heads L'Injecteur, a magazine by and for people who use
drugs, said Tuesday. With deaths soaring from illicit drugs
contaminated with fentanyl, a coalition of community groups, crisis
workers, activists and drug users called on the Quebec Health
Department and the City of Montreal to improve health prevention
services for a population at risk of dying of overdoses.

Why not invest immediately in harm-reduction methods that are known to
work? demanded Jean Francois Mary.

"Are (political and health) authorities waiting for a magic number of
dead - an acceptable quota?" said the director of a provincial
association for the promotion of drug users' health, the Association
quebecoise pour la promotion de la sante des personnes utilisatrices
de drogues (AQPSUD). "Let's not repeat the same mistakes made in
Vancouver," where more than 1,100 people have died this year alone
because of fentanyl-related intoxication.

Mary, whose group is a member of the Montreal Harm Reduction
Coalition, lashed out Tuesday against what he called systemic barriers
to health, hours after the provincial ambulance service,
Urgences-Sante, reported a sharp uptick in deadly overdose cases this

According to the most recent data, 60 people died of overdoses between
Aug. 18 and Oct. 16 in Montreal. Most of the deaths, 41 cases,
occurred in the downtown Centre Sud area.

Nearly 60,000 people died of fentanyl-related drug overdoses in the
U.S. last year, while Canada had more than 2,800 cases.

Whether it's called an escalating public health crisis, or a looming
crisis, it's all just semantics, Mary said. "For us, it's people we
know. I can put faces to this crisis," he said. "We are seeing people
dying. We have the means to act as a society - and it's unacceptable
that we're not.

"The first solution is naloxone - and we don't understand why that
isn't already in place," Mary said of the powerful antidote currently
available in four Montreal pharmacies. Provincial health officials
announced in mid-September that Quebecers would be able to obtain
naloxone free of charge in all pharmacies. First responders, including
police, will be also able to carry the kits and administer the antidote.

But community groups and crisis intervention workers immediately
responded by calling for wide distribution at safe injection sites as
well as organizations that work with users. More than 75 per cent of
Montreal's drug users get their paraphernalia at safe injection sites
and needle exchanges. That's where the naloxone should be, workers

When a community's water supply is contaminated, officials move in
with clean bottled water, Mary said. "But when we have contaminated
drugs, we let people die and we do nothing," he said, even though
pharmacies are filled with clean opioids.

The coalition is calling for better drug treatments for users;
extended hours for safe injections sites, up to 24 hours a day;
funding for methadone substitution programs, which currently have wait
lists, and testing kits so drug users can be sure what they are taking
really is safe.
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