Pubdate: Thu, 01 Mar 2018
Source: Vancouver Sun (CN BC)
Copyright: 2018 Postmedia Network Inc.
Author: Ian Mulgrew
Page: A8


How do we get out of this box? It may be time to follow Portugal in
legalizing drugs

British Columbia has a $250,000-a-day drug habit that is spiralling
out of control - and it's not supported by the Downtown Eastside
street bazaar.

Rather, it's the opioid substitution program.

The province now spends more than $90 million a year on "treatment"
and health services for participants of the drug-maintenance program -
that's more than it provides for legal aid.

The number of patients on methadone or buprenorphine covered by B.C.
Pharmacare doubled to 22,012 last year from 11,377 in 2009-10 - that's
a small municipality like Ladner, Duncan or Parksville.

Imagine 22,012 people getting prescription dope indefinitely to

This is not a "cure" but "treatment" - opioid addicts receive medical
and social support to stabilize and improve their lives while being
encouraged to keep using the pharmaceuticals as long as they help them

The Pharmacare expenditure, which covers "ingredient costs, (pharmacy)
dispensing fees and interaction fees," has increased to $51,465,240 in
2016-17 from $32,170,225 in 2009-10, according to figures provided by
the Ministry of Mental Health and Addictions.

They show the MSP cost, which covers physician fees for "case
management, counselling, and coordination of care," has risen to $17,
508,697 last year from $9,174, 378 in 2009-10. It's about $3,000 a
year per patient.

The government also provides a supplement of up to $500 per year to
assist with the cost of counselling or related services - add nearly
another $3 million for that.

Exacerbating the strain on the health system, these patients visit
hospitals far more than others and cost on average an additional
$1,000 a year each or about $20 million in 2016.

That's in total more than $90 million spent on prescription opioid
addicts compared to the roughly $80 million spent on legal aid.

And those are just some of the ongoing costs associated with the
opioid crisis declared two years ago. There are also the costs of
those supplied by the black market, their health care, first
responders dealing with overdoses, policing, courts ...

In February, a class-action lawsuit settlement also was approved
involving some 11,700 patients on the substitution program who
received disability assistance.

That will cost another $5.7 million to reimburse the money Victoria
wrongly deducted from their cheques.

Count up as well the expense of distributing free nearly 60,000
naloxone kits for counteracting overdoses, eight supervised
consumption sites and 18 overdose prevention sites, increased programs
offering injectable hydromorphone (morphine) and, in April,
hydromorphone tablets.

The new ministry noted it was allocated $322 million in the September
2017 budget update to escalate the province's response and efforts to
get people on "a pathway to treatment and recovery."

Add to that the federal government's plan announced in Tuesday's
budget to address the crisis by investing $231.4 million over five
years, including a $150-million emergency investment to improve access
to treatment programs.

The figures are simply staggering, yet the death toll continues to
rise, some 1,422 in 2017 - "the most tragic year ever," according to
chief coroner Lisa Lapointe - and the epidemic rages on.

To say we need to think out of the box is trite, but that's exactly
why it may be time to consider Portugal's response a generation ago to
legalize all drugs and direct funding away from police and enforcement
and into more effective public health policies.

Since 2001, Portugal's drug overdose deaths have plummeted, drug use
has declined among 15- to 24-year-olds and there has been a decline in
the percentage of the population who have ever used a drug and then
continued to do so.

Federal NDP Leader Jagmeet Singh, a former criminal lawyer, and others
such as recently retired chief medical officer of Health Perry Kendall
have suggested we try the same approach. Perhaps it is time.

But Portugal also expanded the welfare system with a guaranteed
minimum income to improve the lives of the poor and vulnerable most at
risk of addiction. That may have had a big influence.

Still, we definitely need a solution and we need to rethink how all
this money is being spent - too much is flowing into professional
pockets and not enough into services and support for patients and the
needy to reduce addiction.
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MAP posted-by: Matt