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Comment: Feeding addicts what they crave is no solution

The suggestion that expanding access to hydromorphone by making it available without prescription will do nothing to reduce toxic fentanyl overdoses.
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A man injects hydromorphone at the Providence Health Care Crosstown Clinic in the Downtown Eastside of Vancouver in 2016. Darryl Dyck, The Canadian Press

A commentary by a retired anaesthesiologist.

The B.C. Coroners Service has produced another report showing that toxic drugs are killing people. This is not news — the numbers are increasing yearly despite measures to destigmatize recreational drug use and provide a safe supply.

The three-year pilot program which last year provided free clean hydromorphone (Dilaudid) to addicts hasn’t changed the numbers.

As part of the rebranding of recreational drug use as a health issue rather than a criminal one, the amount of drugs allowed for “personal use” has been pegged at 2.5 grams.

This is absurd; 2.5 grams of cocaine is sufficient for a couple of “highs” but 2.5 grams of fentanyl will put 50 people into respiratory arrest, especially now when the drug is cut with benzodiazepines.

Drug pushers must love this because they can legally get away with carrying small amounts of fentanyl. The effect of these policies is to increase the drug supply.

The “safe” hydromorphone is not a drug of choice for addicts who have been on fentanyl because it doesn’t produce the same “high” and information that it is traded quickly for cash is freely available.

The cost of a hydromorphone tablet on the street is apparently $2 and is easily affordable and available to school children.

So in practice, safe supply alters the drug availability dynamic and attracts non-users and experimenters. The suggestion that expanding access to hydromorphone by making it available without prescription will do nothing to reduce toxic fentanyl overdoses.

The coroner only tracks deaths and not naloxone treated overdoses or usage, and hydromorphone only accounts for three per cent of the total deaths as opposed to fentanyl, which is responsible for around 80 per cent.

Even addicts who can have their drugs analyzed for free to determine safety will still use the tainted drugs because it’s a “high” they are craving.

We must reduce the availability of toxic fentanyl.

But what do kids who get addicted to safe hydromorphone move on to next? Likely cocaine and then fentanyl. The system is a mess and heavily influenced by liberal policies rather than data and facts.

The only practical route to getting clean is through a substitution program with methadone or Suboxone.

If there’s any hope of rescuing our youth it is through rehab programs and incarceration because feeding addicts what they crave is no solution.

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