Vancouver explores radical solutions to the fentanyl crisis

Two years ago, I was not familiar with fentanyl, and overdoses just seemed like something you heard about on the news. Drug use and its risks never concerned me as I did not think it related to me.

Then my cousin Tristan died.

It was two summers ago when my twenty-one year old cousin passed away as a result of an accidental fentanyl overdose. Contrary to stereotypical beliefs about addicts, my cousin was a positive, productive, funny, upbeat and happy guy who sadly struggled with a drug addiction since his teen years. With all of our family’s support he had done very well in rehab, and had been clean for many months. He was proud of how well he was doing, as were we. Tragically, Tristan relapsed, and became another victim of the fentanyl crisis.

The Vancouver Sun reported that in early 2019, fentanyl and carfentanil, which get grouped together for reports, were linked to eighty-five percent of fatal overdoses involving heroin, methamphetamine and cocaine. This report confirms that Vancouver’s crisis has not improved much over the past two years. Instead, it has plateaued. This epidemic has affected many lives, killing thousands every year. In 2018, British Columbia set a record for most drug-related fatalities, even though millions of dollars were spent trying to prevent these deaths. The Sun also reported that, an average of four British Columbians died each day, a number so significant that it resulted in a reduced average life expectancy in British Columbia.

Despite the hard work being put into strategies to improve the situation in British Columbia, especially in Vancouver, the crisis remains at a disastrous level. One intervention that has saved countless lives has been making naloxone, the antidote for opioid overdoses, free and readily available to emergency responders and to those at risk. If naloxone can be administered quickly enough, many who would otherwise die from an overdose can be saved. In 2012, the Take Home Naloxone kit project began in British Columbia. 36,608 kits have been used to reverse overdoses since then.

Early this year, the City of Vancouver announced funding to expand a pilot project that will provide pharmaceutical-grade heroin to users on the Downtown Eastside. Since many accidental overdoses occur when users obtain contaminated drugs, or drugs with inconsistent potency, this will greatly enhance the safety for users. In the words of one Downtown Eastside resident interviewed by CBC News, “Users have a hard time distinguishing what drugs they’re consuming… just when we all start to get used to what dose we can take, it changes again.”

There are other new initiatives in place to halt the epidemic such as a pilot project that will allow 50 patients to use to opioid hydromorphone in tablet form while staff monitor them. This will allow users to get the opioids they need while eliminating the risk of fentanyl contamination.

In addition to reducing harm from impure drugs, monitored drug-use sites such as these puts users into contact with health care professionals. It is hoped that better connections between the users and the resources that are available to them will help turn the tide against the overdose crisis.

Tristan’s mother, Kathy, has become an advocate for young people who are struggling with addiction. In an interview with the Vancouver Sun, said she would “like to see more youth-specific services that do a better job of understanding what motivates young people to want to get better, especially in schools,” which she said “must offer more than the hardline don’t-do-drugs message.” She suggested that using activities like sports to make connections between young people and users who are going through recovery might help teens understand the issue and “see the positive side of being healthy.”

Many public health advocates recommend legalizing and standardizing opioid drugs to address the fentanyl crisis in Vancouver, minimizing the associated risks. They argue that nobody who is compelled to, or chooses to, use drugs should be denied access to pharmaceutical grade products. Specialized training for paramedics, education for the addicts, and reducing the discrimination against addicts are also likely to improve the current situation.

Kathy says, “People will not stop dying, and the number will continue to increase until the country wakes up.”

Image: Flickr/Terry Power