Friday, February 2, 2018

British Columbia: Opioid in vending machines, an idea that may be a valuable tool

Posted by Canadiana for Borderland Beat   republished from The Canadian Press

Making a safe opioid available in vending machines may be the next harm reduction tool to fight the
deadly overdose epidemic, says the executive medical director of the B.C. Centre for Disease Control.

Dr. Mark Tyndall said he envisions a regulated system where drug users would be assessed, registered and issued a card to use in vending machines to obtain hydromorphone, a painkiller commonly marketed under the brand name Dilaudid.

“I’m hoping that it’s kind of like supervised injection sites,” he said of the program that could begin as early as next March. “At first it sounded a bit off the wall and now it’s pretty well accepted.”

Funding to expand access to hydromorphone would first be used to distribute pills through supportive housing units that also dispense methadone and suboxone as well as through a nurse at supervised injection sites before they are sold through vending machines, Tyndall said.
“People could pick these drugs up at supervised injection sites but there’s no reason you couldn’t use vending machine technology to do that. So people would show up, have their card, click it in and get a couple of pills.”

Hydromorphone pills dissolve well in water and Tyndall said he expects most people will grind them up and inject them.

A small part of the funding will come from a three year, $1 million Health Canada grant that includes patients in Alberta, Tyndall said, adding the machines could also be placed in other areas where drug use is prevalent, as well as near health clinics in remote communities.

“We don’t have really anything to offer people who are dying around the province in smaller communities, where sometimes they don’t even have a doctor who can prescribe methadone and certainly will never have a supervised injection site,” Tyndall said.

“You’d have to ensure there’s some security system because we don’t want people kicking these things in and stealing all the pills, and we don’t want situations where people are taking out big quantities and selling them on the street.”

Tyndall said while theft is a major concern of any opioid distribution system, anyone buying stolen hydromorphone pills would at least be getting safe drugs instead of those that could be laced with the powerful opioid fentanyl, which has been linked to hundreds of deaths across Canada.

Safeguards would also include supplying two or three pills, up to three times a day, to prevent users from being targeted by criminals, Tyndall said.

“We’ve done some focus groups and most people feel they’d be quite happy with two Dilaudids, eight milligrams, three times a day,” he said.

However, people who are assessed as doing well could eventually obtain a two- or three-day supply of pills, much like take-home methadone, Tyndall added.

High-dose injectable hydromorphone is currently provided to chronic substance users at a Vancouver clinic called Crosstown, the only such facility that also dispenses diacetylmorphine, or medical-grade heroin to patients who have repeatedly failed to kick an addiction to illicit drugs after multiple drug substitution programs.

“This is not an addiction medicine response,” Tyndall said, adding new approaches need to have an impact on the overdose epidemic. “We need to make this is pubic health thing, much like vaccine programs.”

The B.C. Coroners Service has reported that 1,208 people fatally overdosed in British Columbia between January and October this year. It said fentanyl was detected in 999 of the confirmed and suspected deaths so far in 2017, an increase of 136 per cent from the same period last year.

Ontario’s Health Ministry said the province has about half a dozen remote locations where prescription drugs are available through dispensing machines. Patients consult in real time with an off-site pharmacist using two-way video monitor in the machine.

Allan Malek, chief pharmacy officer of the Ontario Pharmacists Association, said Tyndall has floated an innovative idea during a national overdose crisis but it would have to be adequately monitored.


“In terms of what’s happening in B.C. and other parts of the country, these are discussions that have to be had. People are dying. Something has to be done.”

34 comments:

  1. If I say "let them die!" people would consider me a vile and callous person. Yet when crack cocaine devastated black and Latino communities in the US, the criminal justice system showed no mercy. So I'm fresh out of sympathy for opioid users and don't care if they die.

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    1. I don't understand your correlation. So because the US criminal justice system failed that means you've lost sympathy for people meeting an untimely death? I think your priorities may be a bit misplaced, perhaps instead you should take up your quarrels with the justice system rather than people who have made bad choices or had bad choices thrust upon them.

      Then again, I guess projected apathy -is- the latest trend in North America right now.

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    2. This isn’t about the black and latino US justice system. First of all wrong country. It’s about Canadian or specifically Vancouver addicts and reducing harm to themselves and harm to others through crime. Just cause ur mad at an issue in the US, don’t take it out in us.

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    3. Just do you know, a large proportion of addicts in Vancouver’s downtown east side are First Nations unfortunately

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    4. @11:32 Okay, wishing death upon them may have overly harsh. I retract that. But they should be subject to the same draconian drug laws that snared Blacks and Latinos. Or safe injection sites should include safe inhalation as well. If opioidists can spike legally then crack/meth smokers should be allowed to puff legally.

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    5. @rstevenpage is just upset because Hillary did not win the election. Can you say huge chip on his shoulder. Let’s not even get started with black crime in America. Can you justify that????????

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    6. His skin color is irrelevant. The American justice system does screw over minorities. You have to have $ for a good defense attorney. Otherwise you get railroaded. Lady justice is nothing more than a high priced whore that sells herself out to the highest bidder. The affluenza kid is proof of this. Along with many other cases. And justice for all? No. Hell fuck no! When you in jail there is no justice. There’s JUST US. - Sol Prendido

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    7. The unfortunate poor. - Sol Prendido

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    8. They have inject/smoke site in van

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    9. How can you even compare OPIATE ADDICTS trying to kill their pain to crack heads? TotaTot didiffere drugs And yes Crack cocaine users are the LOWEST in the drug user chain. All thiefs and die way too fast.

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  2. With all due respect, I don’t see any correlation to cartels or border related crime. Yes, the cartels are responsible for a lot of the drugs in North America, but certainly not all of them and especially in Canada. In fact, a lot of the drugs pouring into Canada come from the ports via almost every continent in the world.

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    1. I live in B.C. and can attest to the fact that while you make a good point, a significant amount of the drugs in the southern end of the province do in fact come from Mexico and Colombia.

      We have both the Norteños and MS-13 operating here. As well, various full patch members of local Hells Angel chapters and other gangs like the so-called 'United Nations' have been known to take trips to Mexico in order to consolidate relations with criminal groups operating there.

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    2. American imperialism is responsible for all the cocaine in AMERICA. I love the way most Americans love to point the fingers and pick on OTHER PEOPLE AND COUNTRYS , meanwhile US bankers, POLITICIANS, even the PRESIDENT Are robbing us blind with healthcare, BULLSH*T Lies, and BS laws. ITS SIMPLE, GRINGOS STOP DOING DRUGS, and the death and violence will decrease. Think about it, all these deaths and violence going on, just to appease your insatiable appetite for drugs.. so keep blaming the Mexicans and build your wall....hahahahab

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    3. I just went to Vancouver BC in december enterned thru washington. The mexican border crossings made that one look like a walk in the park, yet from the long line to get into canada i noticed i was the only hispanic close enough to tell at least and most people spent maybe 30 seconds talking to the border agent. When it cane to our car, we got asked questions for 10 minutes, they verified the hotel i said i was staying had a reservation, checked the car thoroughly. The cartel threat is very real there dude and it woukd be very easy for anyone of white skin color to smuggle anything into canada.

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  3. Didn't read the article . Just some of it . Dumbest damned thing they come up with yet . Man throwing all regulations out the window . Fuck ! the 5 year olds will be od'ing
    There are some dumb fucks out there !

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  4. God damned idiots . Continue trying to pamper the fucking dope heads . Step up the fight like it is ! either clean up on your own or get locked up . A solution ? There is no solution ! Life can be hell for a drug addict and that's why a lot of them clean up . Many fall by the wayside and that's just how it is . I'm glad I didn't have a bunch of bleeding heard stupid fucks around me when I was using . Would have never gotten clean . If the dope fiend is pampered and catered to , what is the incentive to get clean ? You put a goddamned dope vending machine in my area , bad thing will happen to it .

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    1. This is not new. Similar programs are being adopted here in the US. Philadelphia will be the fist city run program to have an on-site clinic to assist and assure injections are safely administered by supervised nurses.
      A controversial topic for many.

      May want to adopt a drunk driving lane for those impaired drivers in the future too!


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  5. Ingenious idea. At least the pills would not be laced. Thanks for sharing!

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  6. Stupid idea. Free clinics are much more safe. Why would you want people grinding up a pill and injecting it instead of swallowing it? This Tyndall guy sounds like a a total moron. This coming from someone who has been in treatment for opiates.

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    1. MaybeMbrcbeca hydromophonehh is meant to be shot and not orally .

      Oral absorptabs is less than 30% you waste more than half a pill. IV is well over 99%

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  7. Wow.just fuckn wow.i do not agree with this and i have no problem with methadone clinics.i do not agree with "giving"people 6 8mg dilaudids everyday to shoot up.or medical grade heroin to shoot up.they need to pay even if its only 10$ a day they should pay something.and never should shooting up be justified and encouraged

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  8. Canada is just as hooked as the U,S on heroin. There have been a few Canadians capos that got killed in Mexico, one in Sinaloa to be exact. Canada has problems with drugs, a few years ago there was a mayor that was hooked on crack and got fired. Don't remember his name but he even admit to it. Unlike Clinton who didn't inhale lol

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    1. That would be our now deceased mayor of Toronto Rob Ford. Drugs can be found almost anywhere in Canada. Unless there are brilliant statistics for drug addicts getting clean and living productive lives it is a waste of human and fiscal resources to bring them back to life more than 2 times. Let the vermin OD.

      _Canadian girl

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    2. Mayor Rob Ford

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  9. I feel that then users will still get their drugs off of the street and now they will be getting these pills on top of whatever else they will be getting. They will probably sell these pills because they prefer the heroin or only use them if their hustle isn't working for them and will only use them if they have no other choice. Suboxone clinics seem to work because they watch you take them and when you have taken Suboxone, you can get high off opiates until the pill/strip has worn off.

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    1. Thing is suboxone like methadone messes up your metabolism and deteriorates your eyesights.
      Plus suboxone acute withdrwals canc cause psychotic episodes

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  10. This is Brave New world in the making! Scary stuff going on in our world now a days.... this is honestly mote shocking and worrying than all the cartel news posted! -some 20 yr old

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  11. They should put opana in there instead of dilaudid

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  12. You could say Canada is very progressive similar to Nordic countries even the jail time is a lot less than the U.S. for similar crimes.There is pros and cons to both.Whether a person though leans to the left or right I think the point is harm reduction.These people will otherwise likely die or rip off a lot of innocent people but on the other hand I agree with some of you here that are ex-addicts and you would know when you say what is the point of cleaning up,no incentive there.Life of an addict is supposed to be hard til you get sick and tired of being sick and tired and hit bottom and that's when you will make the change.They must have to turn people away big time every day,free drugs,wow.

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  13. I worked for decades in the Downtown Eastside/Main & Hastings streets area which is the bulls eye of addiction country. We eventually got the company to let us have guards on our trucks when we would have to go into a building. Everything would get stolen from the trucks, including two-stage ladders. These are desperate people. It's not just injection drugs. People are puffing all kinds of shit. I worked with a guy that management tried to save, but he ended up dead in a skid road hotel down there. He was German, and he had the false shame that he was personally responsible for WWII because of his race. No one ever talks about that form of racism. It killed him. As for letting the dopers die or killed off, there is another alternative. This doctor has an office down there in the heart of the beast, and he does his best to treat them. https://drgabormate.com/ He was experimenting with ayahuasca https://en.wikipedia.org/wiki/Ayahuasca
    his clients, which has had a very high degree of success, but the government stopped him. I've been in the skid row bars drinking with these people, talking especially the indigenous native people. After you hear them tell their stories, you have tremendous sympathy for them. Entire families wiped out from dope or booze. They went from their rez to the (I forget the nick name...Downtown Rez?). You have to imagine that you, white men and women, have been invaded, your land stolen, and you were put on a patch of land called the reservation. You lost the war and all around you are the invaders. How do you now live? You think that's not possible to be in that kind of situation? There's a reason for all the ruins around the world, and it ain't just climate change that caused it.

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  14. K 1 -8 IN Vending machines , seen it all know ! I beat the US never do that !

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  15. Is this an early April fools joke?

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  16. I am for total legalization of all drugs, it's our bodies and if we feel like putting something into it fine. Now, although I'm for total legalization I also believe if you decided to ingest something and then you go out and harm another person while on said substance you need to book thrown at you. As far as all those people dying from different types of overdoses it can all be explained by Evolution, the strong move forward and the weak fall by to the side.

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