Renewed calls for opioid dispensing machines as deaths mount
Published Monday, December 10, 2018 8:13AM PST
Last Updated Wednesday, December 19, 2018 5:15PM PST
New strategies to stop people dying in an ongoing overdose crisis by providing a supply of uncontaminated drugs, including a plan to provide replacement drugs through dispensing machines, are in limbo without proper leadership that could resolve the crisis, activists said this week.
More than a thousand people have died in the year since the Overdose Emergency Response Centre was started by the B.C. government, charged Garth Mullins of the B.C. Association of People Who Use Methadone, an opioid substitute medication.
“Government does move slow. But when it’s an emergency, it calls for something more, and we haven’t seen it,” Mullins told reporters at a press conference.
While he acknowledged there are some more harm reduction steps such as more naloxone on the streets to prevent overdoses from becoming deadly, and more overdose prevention sites, he said there’s not enough being done to prevent poisoning from contaminants like fentanyl in the first place.
The problem, he said, is that the OERC can’t come to consensus on clean supply, which is controversial. Pharmacy representatives in the OERC committees are refusing to endorse anything that would open up access to narcotics, and the organization’s structure doesn’t let a leader decide on a path forward.
“We’re really not moving forward and people are dying in large rates and it’s totally unacceptable,” said Charlene Burmeister, a northern peer representative on the Overdose Northern Peer Representative.
Dr. Mark Tyndall, the executive medical director of the B.C. Centre for Disease Control, said he’s been working to convince and educate agencies that a safe, uncontaminated drug supply can prevent deaths.
“We’re still having between 90 to 130 people dying every month. It’s totally urgent. Hard to keep that conversation going because it’s dragged on for so long. It’s extremely important to remind people we’re in the middle of a public health crisis,” Dr. Tyndall said.
Tyndall has been working for a year to bring three Verified Identity Machines that could dispense patients with a prescription a dose of hydromorphone, which could replace an addict’s possibly deadly street supply, which is often contaminated with fentanyl.
The advantages of a machine are that it is secure, it can recognize patients based on fingerprints or passcodes, and it can be placed in an area where the patient frequents such as a housing project or storefront.
One machine will be on display in January at the CDC, but it’s not clear when it will actually be able to dispense, he said. He agreed there are regulatory obstacles but that “everyone is trying to work together and fix these things.”
B.C. College of Pharmacists registrar Bob Nakagawa told CTV News he believes that federal drug control laws, and provincial pharmacy laws, prohibit the machine’s use.
“That would not be within the legislation right now,” he said, pointing to controls on narcotics and regulations on the size of pharmacies.
Mullins said the College needs to do better and recognize how many lives are at stake.
“They were on the committees that we sat on, and I believe they played a rather obstructionist role. I would like to see a change of that kind of role,” he said.
Judy Darcy, B.C.’s minister of mental health and addictions, told CTV News in a statement that the government is working to save lives in the crisis.
“We are dealing with a toxic illegal drug supply, and our government has made an unwavering commitment to the people of British Columbia to address this deadly crisis with everything in our power,” she wrote.
“We will continue to take action with all our partners, including by expanding community-based harm reduction services, increasing the availability of naloxone, addressing the unsafe drug supply and supporting people at risk of overdose from drug use."
Darcy’s statement did not answer CTV News’s questions about a clean supply.