A study recently featured in the Canadian Medical Association Journal (CMAJ) said that given the urgency of the opioid epidemic and the number of people dying from drug overdoses, Canada needs new and different ways to get people with addictions to back away from taking chances with deadly dangerous street drugs.
That was part of the conclusion to a study published Monday in CMAJ that outlined the MySafe program in Vancouver where prescribed amounts of hydromorphone tablets are provided from biometric dispensing machines to people with addictions.
The study was authored by Geoff Bardwell, Andrew Ivsins, Manal Mansoor, Seonaid Nolan and Thomas Kerr; researchers and scientists associated with School of Public Health Sciences, University of Waterloo; and the British Columbia Centre on Substance Use, Department of Medicine, University of British Columbia, and St. Paul’s Hospital, Vancouver.
Sudbury Deaths Rise
The urgency of the crisis continues to be seen in Sudbury. The most recent figures provided by the Community Drug Strategy (April 2023) in Sudbury shows that 130 residents of the Sudbury and Manitoulin districts died from an opioid-related overdose in 2022.
This compares with 102 opioid-related overdoses deaths in the same area in 2021, and 106 overdose deaths related to opioids in 2020.
The CMAJ study gathered data from 46 participants (32 men, 14 women) who took part in the Vancouver MySafe program for at least one month, by accessing controlled amounts of hydromorphone from one of three dispensing sites in Vancouver. The idea of the program is to provide drug users with enough drug products to stave off the negative effects of withdrawal or to at least help the user try to manage withdrawal.
The idea is to dissuade the drug user from seeking a drug solution on the street. Users had reported using unknown amounts of heroin, fentanyl, crystal methamphetamine, crack cocaine, benzodiazepines, cocaine, cannabis, alcohol and other opioids prior to the study.
The biometric feature meant that users only had to apply their palm print in order for the machines to dispense the pharmaceutical-strength drug.
The users described a series of positive and negative features of the program.
One result was that several users said having regular access to the hydromorphone tablets reduced their spending on illicit drugs. For some users this meant being able to spend more money on food and clothes, as opposed to spending all or most of their money on street drugs. The authors said this reduced the need for criminalized or stigmatized forms of income generation (e.g., sex work, panhandling, robbery or theft, drug selling) to procure drugs.
Other users reported that the tablets did not seem to be strong enough as they had acquired a personal tolerance that did not fully negate the unwanted effects of withdrawal. In some cases, these users went back to the street to seek out stronger doses.
Other users reported they liked the 24/7 access to the dispensing machine because it did not tie them down to a schedule such as at a pharmacy or a supervised consumption site.
Also, most users reported that while they still used street drugs alongside the hydromorphone tablets, the tablet dispensing machine meant they had reduced their consumption of street drugs.
"Responses varied, with some participants reporting substantial reductions in use of illicit drugs and others suggesting they had been spending less money on drugs. Among these participants, having regular access to hydromorphone tablets allowed them to substitute illicit drugs with a prescribed alternative," the study said.
The conclusion of the study noted that "traditional treatments" have not been enough to address the opioid crisis in Canada.
"Given the urgency of the overdose epidemic, novel interventions must be implemented and evaluated to address risk of overdose and death. Continued reliance on traditional treatments (e.g., opioid agonist therapy, abstinence-based programs) is insufficient to address the overdose crisis. Our study shows one such intervention that can be used as a low-barrier model for the delivery of safer supply programs in settings contending with high rates of overdose death," said the study.
The full text of the CMAJ study can be found online here.
Len Gillis covers health care issues along with mining news for Sudbury.com.