Long Read: This Doctor Might Have the Answer to the Fentanyl Crisis

published on November 14, 2017 by Bruce Grierson in Vancouver

Dr. Evan Wood has a controversial idea for treating the fentanyl crisis—fight drugs with drugs. Are we ready for his radical plan?

“I’m going to be the least compelling speaker you’ll hear tonight,” Dr. Evan Wood tells me as we pull up in front of the Anvil Centre auditorium in New Westminster. People are already trickling in for tonight’s event, Recovery Speaks, featuring inspiring personal tales of sobriety on the other side of hellish addiction.

Wood holds a fistful of titles—including professor of medicine at UBC, Canada Research Chair in Inner-City Medicine and head of the province’s newly established response to the opioid crisis, the British Columbia Centre for Substance Use (BCCSU). He’s giving the keynote address tonight—and he’s going to have to thread the needle.

Many of the attendees here are part of the “recovery community”—their journeys involve getting clean largely via the 12 steps. The path involves fierce personal reckoning and surrender to a higher power until the demon slowly loosens its grip and you get your life back, though with eternal vigilance and abstinence as part of the deal.

Wood approached the medical-health field in a gradually tightening circle. In an undergrad geography degree at UBC, he did a term project that involved mapping the spread of HIV, which nudged him to pursue medical geography—a subfield that looks at airborne and vector-borne illness. He applied for a summer job at the BC Centre for Excellence in HIV/AIDS, where he quickly distinguished himself as a protégé of Dr. Julio Montaner. Hired as a junior research assistant, the young Wood churned out a provocative paper so quickly that Montaner read about it in the newspaper he opened on a flight later that same summer. After Wood knocked off a PhD in epidemiology in 2003, he began publishing at a furious rate. He and Montaner would go on to co-author dozens of influential papers, including two humdingers—one published in The Lancet that helped shape the conversation around AIDS treatment in Africa and another on anti-viral drug strategy, published in The British Medical Journal, that was dubbed Science magazine’s 2011 scientific breakthrough of the year.

In 2005, Wood and his colleague Thomas Kerr—an epidemiologist and now co-director of the BCCSU—found themselves almost single-handedly trying to save InSite, Canada’s first supervised drug-injection site, from a court challenge by the Harper government, which vehemently viewed drug use as a criminal matter. The battle went all the way to the Supreme Court, with Wood and Kerr arguing evidence should trump morality when it came to reducing the risk of disease transmission and overdose.

In the end, their efforts ensured one of the world’s most high-profile experiments in harm reduction, one that has since become a global model in public health, was spared the knife.

In the mid-aughts, Wood interrupted his progress in HIV/AIDS research to go to med school, thinking he would have more impact as a physician. He blitzed through the University of Calgary’s compressed curriculum, putting himself in the comically intense position of being a professor at UBC while a med student in Calgary. He completed his MD in two years and nine months.

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