Battling a fentanyl crisis, B.C. quietly expands access to clean drugs that addicts can substitute for heroin

published on June 13, 2017 by Travis Lupick in The Georgia Straight

The province plans to make prescription heroin more widely available, not only to treat severe addictions, but also to save people from the fentanyl crisis and overdose deaths

The Portland Hotel Society (PHS) has quietly forged ahead with a lifesaving but controversial tool that could help alleviate Vancouver’s fentanyl crisis.

In December 2016, Dr. Christy Sutherland began prescribing hydromorphone to one patient who for many years struggled with a severe addiction to heroin.

Hydromorphone, which sells under the brand name Dilaudid, is a synthetic opioid very similar to heroin that is routinely used in hospitals across Canada to treat severe pain. Sutherland, a staff physician for PHS, prescribed the drug off-label for the purpose of managing the man’s addiction to opioids.

Every day, two times a day, Sutherland sees that patient at Pier Pharmacy on Main Street and gives him hydromorphone via an injection. As a result, he stopped buying illegal heroin from street dealers. That means he no longer risks his life by injecting unknown substances that likely contain fentanyl, the synthetic opioid that was associated with hundreds of deaths in B.C. last year.

The patient also no longer has to steal to raise enough money to feed his habit, because the program—called injectable-opioid-agonist treatment—is covered by PharmaCare. He has largely left behind the chaos that comes with feeding an addiction illegally.

Since enrolling that first patient (PHS declined to name him for privacy reasons), Sutherland has expanded the Downtown Eastside nonprofit’s hydromorphone program to 19 other people who were diagnosed with an addictions disorder.

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