Pubdate: Thu, 01 Sep 2016
Source: Metro (Vancouver, CN BC)
Copyright: 2016 Metro Canada
Contact:  http://www.metronews.ca/vancouver
Details: http://www.mapinc.org/media/3775
Author: Rosemary Westwood
Page: 10

LESSONS FROM THE FRONTLINES OF THE FENTANYL CRISIS

In harm-reduction circles they say every overdose is preventable. By
that standard, B.C. is failing dramatically.

Speak to those at the front lines of the unprecedented drug overdoses
hitting Vancouver and, if they've been around long enough, the 1990s
will come up.

It was a decade of headline-grabbing OD deaths, peaking in 1998 when
417 people in B.C. died from illicit-drug overdoses.

But 2016 is shaping up to be far, far worse.

Already, at least 371 people have died in the province, a two-a-day
rate that could translate into 800 deaths by year's end. The
provincial health officer declared an emergency in April.

The highest-profile culprit is fentanyl, a viciously toxic synthetic
opioid detected in 60 per cent of OD deaths this year and 86 per cent
of drugs at Insite, Vancouver's safe-injection site. It's spreading
across the country at an alarming pace.

"2015 was the first year the number, the rate, was above 1998," noted
Dr. Jane Buxton, an epidemiologist and head of harm reduction for the
B.C. Centre for Disease Control.

"I'm either so angry or so heartbroken," Ann Livingston, a long-time
activist with the Vancouver Area Network of Drug Users (VANDU), told
me. "I think, Oh my God. We went through this is in the '90s, and we
lobbied like hell, and we got Insite, so there was some sense of
moving forward. And now there seems to be even less action."

It's a sentiment that might surprise anyone aware of the growing
headlines on opioid overdoses across this country over the last two
years, from Alberta's 270 fentanyl-related deaths in 2015, to a recent
national investigation by the Globe and Mail, to this week's statement
from Ontario police chiefs and community safety groups calling 2016 a
record-breaking year for overdose alerts and warning that fentanyl is
a "ticking time bomb."

In response, both B.C. and Alberta have struck overdose task forces,
and Manitoba has a fentanyl-awareness task force. The federal
government has made naloxone - a lifesaving anti-overdose drug -
available without prescription nationally.

The move is part of Health Canada's "Action on Opioid Misuse" plan,
and yesterday, to mark International Overdose Day, the ministry
announced it was "moving forward" with a plan to restrict six
chemicals used to make fentanyl, citing RCMP reports of "an increase
in domestic production" of the drug, which is also made in China and
shipped into Canada.

But all this is not enough for Livingston. It's common parlance in
harm-reduction circles that every overdose is preventable. By that
standard, she says, B.C. is failing dramatically.

In her eyes, the explosion of fentanyl and related deaths is a symptom
of ineffective drug, homelessness and policing policies. She cites
insufficient or ineffective recovery programs; a clamp-down on opioid
prescribing that drives those with addictions to street drugs; and
lower welfare support for the homeless, which she argues leads greater
numbers of drug users into jails, and thus raises their risk of
post-release overdose.

And she blames the dearth of legal, publicly accessible safe-injection
sites like Vancouver's Insite, still the only such facility in North
America - a legacy of the Harper government, which fought the site all
the way to a loss at the Supreme Court, and then legislated onerous
rules that have curtailed efforts to duplicate Insite, and its
undisputed public-health success, elsewhere.

Judging by the Liberal government's messaging, that could change. A
year ago, on a campaign stop in Vancouver, Justin Trudeau told a
crowd, "I certainly want to see more safe-injection sites opened
around the country." In March, his health minister, Jane Philpott,
told the CBC, "Sites like Insite in Vancouver and others like them
have the possibility to save countless lives."

But possibility and reality are miles apart. And possibility is where
many proposed sites - in Victoria, in Toronto, and five more in
Vancouver - remain. While Canadians continue to die at alarming rates,
the Liberal government has given no indication that undoing the
Conservative legislation is a priority.

It is hard to view that as anything other than heel-dragging.

"You know what will speed this up, I think?" Livingston told
me.

"Parents of kids who've died need to sue, right away. I tell ya, I
would. Because it's part of this awful stigma. If you're a drug
addict, you're supposed to be so ashamed of yourself that your life
doesn't matter."

B.C. is already calling the fentanyl crisis what it is - a
public-health emergency -and Ottawa needs to follow suit. Why should
death by overdose entail any less federal action than death by
poisoned water, for instance?

"We shouldn't have to wait," Livingston said, "while they fiddle and
faddle and argue, or whatever the hell they're doing, while our kids
die."
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