Fentanyl From the Government? A Vancouver Experiment Aims to Stop Overdoses

[Chip (OP)]

source: https://www.nytimes.com/2022/07/26/health/fentanyl-vancouver-drugs.html

note: these are only excerpts - to see the whole article, follow the source link above

Fentanyl From the Government? A Vancouver Experiment Aims to Stop Overdoses

July 26, 2022

A city on the forefront of harm reduction has taken the concept to a new level in an effort to address the growing toxicity of street drugs.


A nurse at the Crosstown Clinic, a supervised injection site in Vancouver, British Columbia, handed out a syringe of medical-grade heroin to a patient in May.

VANCOUVER, British Columbia — The place where Chris gets his fentanyl is bright and airy, all blond wood and exposed brick. The staff is friendly and knowledgeable about the potency of the pills he can crush, cook and inject.

Soft pop music played, and an attendant spritzed a bit of Covid-cautious spray on his seat before he settled into a booth on a recent afternoon with a couple of red-and-yellow pills, a tourniquet, a tiny candle and a lighter.

“The best thing about this is the guarantee: I can come in here four times a day and get it,” Chris said. He no longer spends all of his waking hours in a frantic scrabble of panhandling and “other stuff” to scrape up the cash to pay a dealer. He won’t get arrested — and he won’t overdose and die using a drug that is not what it is sold as.

This fentanyl dispensary is legal, and Canada’s public health system finances it.

It is the latest and perhaps most radical step in a city that has consistently been at the leading edge of experiments in “harm reduction,” an approach to reducing deaths and severe illness from illicit drugs by making the drugs safer for people who use them. Harm reduction, even in basic forms such as the distribution of clean needles, remains deeply controversial in the United States, although the concept has been gaining fitful support as overdoses rise, including from the Biden administration.

But the breadth of Vancouver’s services and interventions is almost unimaginable in the United States, less than an hour’s drive to the south. Supervised injection sites and biometric machines that dispense prescription hydromorphone dot the city center; naloxone kits, which reverse overdoses, are available free in every pharmacy; last year, a big downtown hospital opened a safer-use site next to the cafeteria, to keep patients who are drug users from leaving in order to stave off withdrawal.

And since April, Chris, a wiry, soft-spoken 30-year-old who wanted to be identified by only his first name to protect his privacy, has received pharmaceutical-grade fentanyl through the dispensary, which sells to those who can pay and provides free drugs through the program’s operational budget to those who cannot.

The new program aims to provide a safer alternative to the fentanyl available on the streets, where the supply is increasingly lethal and is responsible for most of the overdose epidemic that was declared a public health emergency here six years ago.

Dr. Christy Sutherland, a board-certified addiction medicine specialist who set up the program, said its goal was, first, to keep people from dying, and, second, to help bring stability to their lives so that they may think about what they might want to change.

Chris started using pills recreationally in his teens, then moved to heroin. But the heroin supply in Vancouver was taken over about a decade ago by fentanyl, an opioid that is 50 to 100 times as potent and thus far more profitable for the cartels that sell it.


Chris has been using illicit drugs since he was a teenager. “The best thing about this is the guarantee: I can come in here four times a day and get it,” he said.

Chris has been a daily user of illicit drugs since he was a teenager. He receives 30,000 micrograms of fentanyl at the dispensary each day. That is vastly more than would kill a nonuser — a doctor would typically prescribe about 50 micrograms temporarily to manage pain — but, after years of use, it is what Chris needs to feel a quick rush of euphoria and prevent withdrawal. He said he hoped to return to working soon and then would start buying from the program, the way he would patronize a liquor store.


Wistaria Burdge, right, a nurse, helped Ken Elliott apply a bandage after injecting heroin at the Crosstown Clinic.

Fentanyl has largely displaced heroin and the opioid painkillers Dilaudid and OxyContin as the illicit drug most used in Vancouver, a shift underway throughout North America. It is also often cut into other drugs, including non-opioid prescription medications such as the attention deficit disorder medicine Adderall, which is sold on the street as a stimulant. Its potency and users’ inability to know what they are buying or how strong it will be have led to the huge surge in overdoses.

Dr. Sutherland, an effervescent, fast-talking 41-year-old, is the medical director of a social service agency called the PHS Community Services Society.  It serves the Downtown Eastside, a neighborhood that has long been the site of intense drug use and advocacy by and for drug users. It was home to North America’s first needle exchange, first supervised injection site and first prescription heroin program.

Dr. Sutherland said she was tired of responding to overdoses on the sidewalk outside her clinic, knowing that if she could go back in time 10 minutes and give people safer drugs, she wouldn’t be trying to save their lives.

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[Skeetermcbeaver]

I think the whole safe supply idea is a great start and something I wish the USA would adopt as a policy vs locking people up or exposing them to prison and really difficult rehab facilities that are very doubtful to be effective. Great post! Thank you!