Substance Use News: Directions for 2019

BC remains at the forefront of the Canada’s opioid crisis. What directions might the response take in 2019? Here are some recent pieces marking developments in approaches and continued harm reduction.

Public Health and Advocacy

City of Vancouver Opioid Emergency Task Force
The City of Vancouver launched an Opioid Emergency Task Force in mid-November 2018, and within a month, the Task Force released Mayor’s Overdose Emergency Task Force – Recommendations for Immediate Action on the Overdose Crisis.  The report begins:

Despite concerted efforts by government and community partners, Vancouver continues to be severely impacted by the convergence of a long-standing mental health and addictions crisis and increasingly potent and toxic drug supply, creating a sustained overdose crisis. Bold actions need to be taken … to change the course of the crisis that has devastated thousands of Vancouverites who have lost family members and friends. All of our residents have the right to thrive to the best of their ability, let alone survive.

Minutes from the Special Meeting of the City Council on December 20 document the discussion and decisions resulting from the Report and what those living in Vancouver can expect.

 

Fighting overdose with access to safe pharmaceutical opioids

In an interview with Margaret Gallagher posted on December 29, Provincial Health Officer Dr. Bonnie Henry admitted BC’s current status  is “incredibly discouraging.” She noted the big driver of overdose is the toxic drug supply, and the province is looking at how best to provide a safe supply to people who are dependent on opioids. She also talked about the important role of decriminalization. Andrea Woo, who has long called national attention to the issues in BC, highlighted a pilot program offering a safe supply that will be to be available in Vancouver.
Canadians in small towns face alarmingly higher risk of opioid overdoses

The crisis isn’t situated only in Vancouver. According to information from the Canadian Institute for Health Information (CIHI), people in Prince George, Nanaimo and Kamloops are “among the communities with the highest hospitalization rate for opioid poisonings. The rate of hospitalizations for opioid overdoses was two and a half times higher in smaller cities with populations of 50,000 to 99,999 than in large urban centres, according to the CIHI data.”

The presence of services is a vital issue: Your chance of surviving an overdose may depend on where you live. Notes this piece:

There are eight approved supervised consumption sites in British Columbia, nine in Ontario, six in Alberta, four in Quebec, and none elsewhere, according to Health Canada. Jordan Westfall, executive director for the Canadian Association of People Who Use Drugs, said rural and remote areas are particularly underserved. A lack of education and political will have been the biggest challenges to preventing overdose deaths, he said. Unlike other health-care decisions that are based on data, the question of allowing services like supervised consumption sites is often put before the public, he said.

 

Lawsuits Against Opioid Manufacturers 

Thousands of state and local governments in the US, including cities and tribal governments, are demanding that companies like Purdue Pharma, Walmart and Rite-Aid compensate them for the costs of responding to the opioid crisis. They’re also pushing companies to reveal far more internal documents, detailing what they knew about the risks of prescription pain medications. BC was the first province in Canada to launch a lawsuit against over 40 opioid manufacturers last year, and Purdue, one of the manufacturers named, responded to BC’s suit, saying the company “followed all of Health Canada’s regulations, including those governing marketing.” Alberta is considering following BC’s lead.

Lawsuits against opioid manufacturers will be costly, says American Barry Meier, author of “Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic.” Meier cautions that when governments settle with pharmaceutical companies to minimize huge legal costs, vital information about the extent of opioids’ impact on public health can be lost.

 

Treatment and Support

Study Confirms One Hour Discharge Rule is Safe after Naloxone

It’s safe for hospital emergency departments to discharge opioid overdose patients as early as one hour after receiving naloxone, a new study shows. This study looked at St. Paul’s Hospital criteria for discharge, which was developed in 2000 to see how they held up given the changes in opioid use emergencies.

 

Her husband invented naloxone and her son died from overdose. Joyce Fishman advocates for harm reduction

Naloxone was created to help patients suffering from constipation caused by opioids used in pain management. Joyce Fishman’s husband Jack was one of the co-creators; Joyce and Jack’s son died of an overdose in 2003, before naloxone was standard practice to reverse overdose. Joyce backs harm reduction and naloxone training for all.

 

 

Questions? Feedback? Get in touch! Janet Madsen, Capacity Building  and Knowledge Translation Coordinator, [email protected]

 

 

 

 

 

Image: Focus by Andrew, Flickr (Creative Commons)