Diversion of 'safer provide': A rising downside or city fantasy?

Officers in Vancouver say they’re monitoring carefully, however do not consider diversion is a major downside. Specialists, nonetheless, say extra safeguards are wanted

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“A nightmare every single day” is how Greg Sword describes the agony of shedding his 14-year-old daughter Kamilah to a drug overdose final August.

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“She took a tablet in the course of the evening and by no means wakened.”

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The B.C. Coroners Service informed the grieving father that Kamilah had three medication in her system: cocaine, MDMA and hydromorphone, also called Dilaudid or “dillys.”

“I had by no means heard of hydromorphone,” mentioned Sword.

Now he can’t take into consideration the rest.

Kamilah had all the time been fun-loving and outgoing, however throughout COVID-19, the isolation hit her exhausting. She started dabbling with medication.

Sword mentioned somebody his daughter knew had bought the hydromorphone for her in Vancouver’s Downtown Eastside, the place “dillys” go for a greenback or two.

Though he has no method of realizing for certain, he believes the hydromorphone tablet his daughter ingested may have been diverted from Vancouver’s so-called safer provide.

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Whereas his concept about safer-supply medication being diverted has been raised by others for the reason that inception of this system, it’s troublesome to show the place the drug in his daughter’s system originated.

Pharmaceutical-grade hydromorphone is certainly one of a spread of medicines prescribed as a part of the safer-supply program, designed to offer a safer different to the poisonous unlawful drug provide that places customers at excessive threat of demise by overdose.

In April, B.C. Chief Coroner Lisa Lapointe mentioned the concept sufferers are promoting their safer-supply medication to youth, creating new addicts and inflicting demise, is an city fantasy.

“It’s not true,” mentioned Lapointe in her keynote deal with on the B.C. Centre on Substance Use convention. “We’re monitoring clearly very, very carefully the outcomes of those that die of the poisonous drug provide. Youth are usually not dying from diverted provide.”

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In line with a spokesperson for the coroner’s service, the latest reporting by drug kind reveals that hydromorphone was current in simply 5 per cent of drug toxicity deaths between July 2020 and December 2022. The report additionally confirmed that fentanyl was current in 88 per cent of drug toxicity deaths throughout that point. Almost all deaths within the province are the results of mixed-drug toxicity.

Jennifer Whiteside, B.C.’s minister of psychological well being and addictions, mentioned she takes the difficulty of diversion of safer provide “very severely,” and is ready for the outcomes of the coroner’s investigation into Kamilah’s demise “to grasp the circumstances and inform our ongoing work to stop such deaths from taking place.”

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Eighty-four per cent of hydromorphone prescribed in B.C. is for ache reduction, whereas 16 per cent is distributed via prescribed safer provide.

In March 2023, 5,044 folks in B.C. have been prescribed pharmaceutical opioids — together with hydromorphone — underneath this system.

“Oversight, monitoring, threat administration and mitigation methods” are in place and constantly adjusted, in accordance with the Psychological Well being and Addictions Ministry. This consists of monitoring for “unintended penalties of prescribed secure provide, together with diversion.”

Elenore Sturko, a Surrey South MLA with the B.C. United celebration, informed Postmedia Information she doesn’t consider satisfactory safeguards or monitoring are in place.

Sturko desires a evaluate of this system, and for the provincial authorities to contemplate imposing stricter controls, together with “witnessed” provide. For instance, methadone, an opioid agonist that’s used to deal with opioid use dysfunction, is normally distributed at a pharmacy underneath the watch of a pharmacist.

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“These eight-milligram tablets which are diverted from secure provide are broadly obtainable on the road,” mentioned Dr. Alan Brookstone, a Surrey addictions medicines’ specialist.

Brookstone is at present treating a number of opioid-addicted sufferers who report that their suppliers offered them with hydromorphone tablets obtained via a B.C. safer-supply prescription.

One couple he’s treating, of their mid-50s, had no historical past of substance abuse. In 2021, pals instructed they struggle the tablets at a social gathering.

“They each ended up attempting a hydromorphone eight-milligram pill that evening,” Brookstone mentioned.

The couple shortly turned dependent, utilizing five-to-10, eight-milligram tablets a day every, and spending about $700 each two weeks on the tablets.

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“My sense of that is that we’re seeing an acceleration of people who’re changing into hooked on drugs coming from secure provide,” mentioned Brookstone. “This system ought to be considerably lowered, or managed and reduce.”

Mark Tyndall, College of B.C. professor and a founding father of MySafe, a program that dispenses hydromorphone tablets to customers at excessive threat of overdose via biometrics-controlled merchandising machines, mentioned their monitoring reveals that almost all of drugs stick with the person.

“We get the odd one that has offered or given them to folks,” mentioned Tyndall. “I don’t assume it’s a standard factor.”

Nevertheless, Tyndall mentioned hydromorphone diverted from ache prescriptions has all the time been obtainable on the black market, and faux hydromorphone, which can comprise harmful components like fentanyl, can also be broadly obtainable on the streets.

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“We’re attempting to stop folks from dying,” mentioned Tyndall. “We’ve got another safer provide, and it’s the one moral response that we have now.”

A latest evaluate of this system within the Canadian Medical Affiliation Journal reveals that MySafe individuals report much less use of illicit medication, much less dependence on crime, panhandling and intercourse work, and larger deal with constructing a more healthy way of life.

A complete of 596 folks died because of illicit medication within the first three months of 2023. Illicit drug deaths proceed to be the main reason behind non-natural deaths within the province.

Sword remains to be in search of solutions: “I’m talking out so nobody else has to undergo this.”


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