Pubdate: Sat, 02 Jul 2016
Source: Vancouver Sun (CN BC)
Copyright: 2016 Postmedia Network Inc.
Contact:  http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477
Author: Jordan Westfall
Page: B4

FEDERAL RESPONSE MAY WORSEN OVERDOSE CRISIS

Monitoring could boost street markets, says Jordan Westfall.

Federal Health Minister Jane Philpott unveiled new details of Canada's
national drug strategy at the Charting New Futures in Drug Policy
conference last Friday in Toronto. Health Canada pledged $40 million
to create a national prescription drug monitoring program (PDMP) that
will increase surveillance on physicians and patients alike. The
program is purported to reduce rates of problematic opioid use.

However, PDMPs can have the unintended consequence of transitioning
prescription opioid patients to illicit street drugs. Their
$40-million pledge could mean that rates of overdose deaths for
persons who use drugs in some regions of Canada (particularly in B.C.)
might actually increase. How? With increased surveillance of
prescribing practices will come increased pressure for physicians to
stop prescribing opioids to their patients. Patients are cut off, and
as a result, seek opioids in an unpredictable street market where
fentanyl, a drug 100 times more powerful than heroin, is needlessly
killing people every day.

Street markets are saturated with fentanyl these days. In B.C., it's
responsible for a 75 per cent increase in overdose deaths that led the
provincial government to declare a public health emergency. In
Alberta, fentanyl overdose deaths have soared 4,500 per cent since
2011.

But Health Canada doesn't measure the impact of their PDMP policy on
rates of overdose death.

Health Canada uses a narrow, exclusionary measurement of successful
policy (reduced consumption of prescription opioids). It doesn't even
consider overdose death as an unintended consequence, despite research
indicating that this has occurred in other jurisdictions.

Decision making of this sort occurs frequently, and exposes systemic
issues in our nation's drug policy.

It contributes to the overdose epidemic that is devastating thousands
of Canadian families.

The health outcomes of people impacted in the most acute way are
excluded from the very definition of policy success. Heath Canada must
measure how their new policies will reduce overdose deaths; reduce
stigma and marginalization; and how it will impact the health outcomes
of people who use drugs. Otherwise, we've already been written off.
Now for a hopeful prayer. In an absolute reverse image of the evidence
for Health Canada's PDMP program, research showing that supervised
consumption facilities reduce overdose deaths is near unanimous (ergo,
reductions in overdose deaths are actually measured).

Unfortunately, the government's Respect for Communities Act makes
legally opening a supervised injection site in Canada exceedingly
difficult. The Health Minister held steadfast that Health Canada would
not repeal the Respect for Communities Act, despite the barrier it
presents to reducing overdose deaths.

Instead, Philpott has given her promise that the agency will work with
applicants through the section 56 exemption process required to open a
supervised consumption site in Canada. How's that for a leap of faith?
There is a public health emergency in Canada. We need an emergency
response. Our lives will not wait.

We need to include current and former drug users as the primary
stakeholders when policy is written. Otherwise, more death will be a
result. How?

For proof, consider the impact on Ontario's overdose death rate after
the OxyContin reformulation in 2012. OxyContin was replaced by a
tamper-resistant version called OxyNEO, in hopes of reducing diversion
of the drug to illicit marketplaces. However, in the absence of
OxyContin, former patients transitioned to more harmful substances
like fentanyl and heroin. The next year, Ontario experienced its worst
year in provincial history for overdose deaths.

People who use drugs know better than any other stakeholder how
damaging it can be when the government gets it wrong.

We pay for their mistakes with our lives.

Jordan Westfall (Jordan Westfall is president of the Canadian 
Association of People Who Use Drugs.
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MAP posted-by: Matt