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

The place where Chris gets his drugs is bright and airy. The staff is friendly and knowledgeable about the pills he can crush.

An attendant sprayed Covid-cautious spray on his seat before he settled into a booth with a couple of red and yellow pills, a tourniquet, a tiny candle and a lighter.

Chris said that the guarantee was the best thing about this. He no longer spends all of his waking hours trying to scrounge up money to buy something. He won't be arrested and he won't use a drug that isn't what it's advertised as.

Canada's public health system pays for this dispensary.

It is the most radical step in a city that has been at the forefront of experimenting with harm reduction, an approach to reducing deaths and severe illness from illegal drugs by making them safer for people who use them. The concept of harm reduction, even in basic forms such as the distribution of clean needles, is deeply unpopular in the United States.

Less than an hour's drive to the south in the United States, the breadth ofVancouver's services and interventions are almost unthinkable. There are supervised injection sites in the city center, as well as free Narcan kits in every pharmacy, and a safer-use site next to the cafeteria.

Chris, a 30-year-old who wanted to be identified by 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.

The public health emergency that was declared here six years ago due to the overdose epidemic caused by the supply of the drug Fentanyl has led to the creation of a new program to provide a safer alternative.

The program's goal was to keep people from dying and to bring stability to their lives so that they can think about what they want to change, according to Dr.

Chris moved to heroin after starting to use recreational pills. Fentanyl, an opiate that is 50 to 100 times more potent than heroin, has taken over the heroin supply in the city.

British Columbia has seen a surge in overdose deaths since the start of the Covid epidemic. A total of 2,200 people died of overdoses in the province last year, and 115,000 people died of drug overdoses in Canada and the US during that time. The mounting toll has spurred communities to look for new solutions, and this city has tried more of them than any other.

The public health system pays for the experiments in order to save lives and money, and they are supported by the government as well.

The general public and some addiction medicine specialists are concerned. The latest efforts go too far and divert resources from proven treatments to experiments that have not been shown to reduce drug use or save lives. They say that supplying drugs is not a good idea.

Dr. Launette Rieb is an addiction medicine physician who has worked for decades with drug users. Costs go down when access increases.

There is limited evidence of the effectiveness of these interventions.

Providing heroin to patients who had not responded to other forms of treatment helped them reduce their use, stay tied to health care and improve their quality of life, compared with users who were given methadone. A similar benefit was found by another person. The research on the program will track whether it shows the same benefit as the other one.

British Columbia received an exemption from federal drug laws that will allow it to decriminalize possession of up to 2.5 grams of hard drugs. Drug traffickers and production will still be crimes even though the police won't be confiscating small amounts of drugs.

Canada legalized cannabis use in 2018). It should be a first step towards a regulated government supply of all drugs as the best way to respond to growing toxicity, which is the immediate cause of overdose deaths, according to proponents.

Fentanyl has replaced heroin and Dilaudid as the most popular drug in the city. Adderall is a non-opioid prescription medication that is sold on the street as a stimulants. The huge surge in overdoses has been caused by the inability of users to know what they are buying.

The medical director of the Portland Hotel Society is an energetic, fast- talking 41-year-old. Drug use and advocacy by and for drug users have long been a part of the Downtown Eastside. It was home to the first needle exchange in North America.

If she could give people safer drugs instead of responding to overdoses on the sidewalk, she wouldn't be trying to save their lives.

She worked with homeless people. She saw addiction as a disease that she could help people overcome and shifted her thinking on drug use from "drugs are bad and are banned to keep people safe" to "drugs are a disease that she could help people overcome". She believes that all drugs should be regulated by the government and sold in a legal market because there will always be people who use drugs.

Treatment and recovery is not the answer to toxic drugs. She said getting rid of the toxic drug or giving alternatives to the toxic drug supply is something to consider. You can begin to discuss treatment and recovery down the road.

She said that the role of the state should be to keep substances safe and take access out of the hands of organized crime.

Opioid agonist therapy, or medication-assisted treatment, was introduced to patients who were using street drugs. Opiates that are long-acting and do not provide the high are included. Many users were helped by her to stop using all together. The therapy didn't work for some people, so they decided to use safer drugs.

She began to give a replacement for the street drugs, first Dilaudid, then Fentanyl patches, and now the Fentanyl capsule. Her project purchases the Fentanyl from a pharmaceutical manufacturer and puts it in a local pharmacy. The pills are priced to match the street rate.

If a patient can't pay for the drug, the program will cover the cost.

When nurses enroll new participants in the program, they increase the dose over the course of a few days to find out what the patients need. Participants use the drugs under supervision to make sure they have the amount they need to avoid withdrawal so that they don't sell more than they need. They can leave the site to use the drugs.

Chris has been using illegal drugs since he was a teenager. He gets a lot of the drug at the dispensary. Chris needs to feel a quick rush of euphoria and prevent withdrawal after many years of use, but that is much more than would kill a non user. He said he would buy from the program when he got back to work.

Patients such as Chris are not worried about how they will score the next hit to keep the agony of withdrawal at bay.

Lisa James is aware of the benefit of programs. Ms. James used to be addicted to heroin. She would steal from stores in the morning and pass the items to her boyfriend who would resell them and use the money to buy heroin. She was nauseated and twitchy as she waited for him to bring it back.

Ms. James said that doctors all said the same thing: go to meetings. It's like a lifetime away when you're that far down. You can't imagine being through two days.

Ms. James didn't fare well at treatment. She received pure medical-grade heroin from the Crosstown Clinic, which is run by the British Columbia health care system and is free of charge. When she was taken on as a client a decade ago, Ms. James stopped stealing, stopped hustling and was able to set down the constant fear of not being able to buy the next hit. She got a job and the staff at Crosstown helped her find an apartment to live in with her daughter.

She doesn't need to decide if she will stop using heroin now. She said she would be willing to do that even if she had to keep using drugs. I feel fortunate to be here.

Critics of this and other safer-supply initiatives argue that Opioid use disorder is a brain disease that can be successfully treated. The number of children she sees at B.C. Children has reinforced her initial skepticism about safer supply programs.

Drug users prescribed Dilaudid are selling pills to young people and using the money to buy Fentanyl that has contributed to a surge in teen use of the drug.

There is a nine-month waiting list for the main residential women's treatment program. British Columbia allocated $330 million for new treatment and recovery services for substance use, which was an increase, despite the fact that treatment that aims to help people stop using is being shortchanged. Spending on safer supply is less than the total.

The steps in the city don't go far enough. There are 116 people on the Dilaudid program at the Crosstown Clinic. She believes she can provide about 100 people with the drug. Several hundred people are receiving safer drugs through their pharmacy under guidelines that the provincial government loosened in the first days of the Pandemic.

There are daily users on the street, occasional users who don't live near a supervised injection site, and even occasional users who don't live near a supervised injection site.

Donald MacPherson is the director of the Canadian Drug Policy Coalition and a professor at Simon Fraser University.

He said that they needed to do something big. He said that the rate of death requires more sweeping intervention. TheIncremental isn't good. There are no pilot projects anymore.

British Columbia's health officer said there was no choice but to move slowly.

She saidIncrementalism is the only way to go. It has to be evaluated by someone who is not committed to seeing it fail or succeed.

She is part of a community that is trying to figure out what a new, safe, regulated market would look like. She said that people don't deserve to die because of toxicity. How else can we assist?