Pubdate: Thu, 25 Jan 2018
Source: Vancouver Sun (CN BC)
Copyright: 2018 Postmedia Network Inc.
Contact:  http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477
Author: Randy Shore
Page: A8

OPIOID RESPONSE HAS MOMENTUM, OUTGOING B.C. HEALTH OFFICER SAYS

Provincial health officer Dr. Perry Kendall will call it a career next
week, confident that the tools are finally in place to tackle the
opioid overdose crisis that has ravaged this province for more than
three years.

Kendall has been among the chief architects of B.C.'s response to the
deadly wave of powerful synthetic opioids that have largely replaced
heroin in the illicit drug supply.

Deputy provincial health officer Dr. Bonnie Henry will replace Kendall
when he officially retires on Jan. 31. Henry will become the first
woman to serve as B.C.'s provincial health officer.

Health policy has evolved dramatically on Kendall's watch. He notes
the creation of a permanent scientifically evaluated supervised
injection site on the Downtown Eastside, a province-wide network of
temporary injection and drug testing sites, and the distribution of
life-saving naloxone kits to any citizen in a position to witness an
overdose.

He has convincingly advocated for programs that provide addicts with
clean pharmaceutical opioids, following in the footsteps of successful
programs in Switzerland, Germany and Denmark. And it just might be
working. "We are not seeing anything like the number of overdoses in
public places that we used to, so the overdose prevention sites and
naloxone kits that are out there are having an impact," Kendall said
in an interview.

Fentanyl-related overdoses trended sharply upward through 2015, 2016
and between January and August of 2017, averaging more than 100 deaths
a month.

September and October saw the first notable dip in deaths, with 64 and
74 deaths attributed to fentanyl, respectively. In 2017, 83 per cent
of all overdoses were attributed to fentanyl contamination.

"Whether that indicates what we've been hoping to see - that is a
decline in overdose deaths related to fentanyl - we won't know until
the (next coroner's report) comes out," he said. "We've thought that
before and been wrong."

While Kendall has announced his retirement twice before - most
recently about two years ago - this time he will walk away with the
wheels of progress turning at full steam and real momentum provided by
the creation of a provincial ministry for mental health and addictions.

"As I got closer to the (second) date I realized that I wasn't ready
to go, that there was more to do as provincial health officer," he
said. "I was leaving a little too early."

The opioid overdose crisis was just ramping up, with an unprecedented
number of people dying, although no one knew just how bad things would
get. The typical rate of overdose deaths jumped from roughly 200 a
year to 500, 1,000, and finally an estimated 1,200 in 2017.

"I wanted to make sure that we were working through (the opioid
crisis) and then we were heading into an election cycle and I wanted
to be able to give some counsel if there was a transition to a new
government," he said.

Harm reduction and addictions resources are being established
throughout the province - fuelled by tens of millions of federal and
provincial dollars marshalled by his handling of the crisis.

Kendall declared a public health emergency in April 2016 in response
to a startling increase in opioid overdose deaths attributed to
synthetic opioids, specifically fentanyl and the even more deadly
carfentanil.

The timing of his response gives him a pang of regret.

"In hindsight, if I was to do it again, I would (have done) it a year
earlier," Kendall said. "The reason I didn't declare the emergency in
2015 is that we hadn't yet seen that horrendous kick up that came with
the arrival of carfentanil. I worried that by declaring it early while
it was less of an emergency, it would not get the kind of attention
and resources to it."

Drug injection sites across the province in response to the emergency
have managed thousands of overdoses, including 8,000 in their first 15
months of operation. There have been no deaths to date.

"I think had we been able to roll out responses like overdose
prevention sites a year earlier, we would have saved more lives and we
would have more resources in place than we currently do," he said.

While Kendall has been the face of the government response to the
opioid crisis, he also leaves a powerful legacy in First Nations
health delivery and evidence-based public health policy.

Kendall, who turns 75 on Feb. 2, helped create Canada's only First
Nations Health Authority, a province-wide body dedicated to providing
health, addiction and prevention services to First Nations people.

"I'm really proud of the health policy work I did, which was embraced
by Indigenous people," he said. "I think that work helped (former
premier) Gordon Campbell when the government sought to change its
relationship with First Nations people and in creating the First
Nations Health Authority."

Kendall arrived in Vancouver in 1974 to run the city's Pine Free
Clinic fresh off his experience at Toronto's Hassle Free Clinic. He
leaves as the province's top medical official, a post he has excelled
in for 18 years.

After a few weeks in Mexico, Kendall will hang out his shingle as a
consultant in public health delivery and drug policy and see who
knocks at his door. Arrive early, there is bound to be a lineup.
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MAP posted-by: Matt