British Columbia Doctors Disrupt ‘Safe Supply’ of Non-Prescription Heroin

Doctors are asking the Department of Health to fund heroin treatment for 200 British Columbians at an average cost of $ 25 per day.

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Two British Columbia doctors who have started a business to provide clean heroin to people at risk of drug overdose have received their first shipment.

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But they have a problem: to distribute it, they need the support of the province. And the province will only say that the idea is under consideration.

Fair Price Pharma Inc. founders Martin Schechter and Perry Kendall, a former BC provincial health worker, said 15 kilograms of diacetylmorphine they purchased from an approved European supplier arrived in Canada in November. He sits in his steel drums.

Doctors are asking the Department of Health to fund heroin treatment for 200 British Columbians at an average cost of $ 25 per day. If they get the commitment from the province, the two men say they will invest $ 1 million of investor money in a facility to turn the powder into inhalable doses.

“We have more purchase orders ready, we just need the green light,” said Schechter, founding director of the University of British Columbia’s School of Population and Public Health. “This first batch contains thousands of doses. This will last us until our next expedition.

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Fair Price Pharma hired a federally licensed dealer to import the heroin. This concessionaire received approval from Health Canada in September. The contract includes a nondisclosure agreement that prohibits doctors from disclosing the cost of the drug.

“Because the drug can be stored at room temperature, our doses can be shipped province-wide and we could support programs on Vancouver Island, in the northern, interior and Fraser health regions as well. than Vancouver Coastal Health, ”said Schechter.

Patients could access Fair Price Pharma’s supply as early as February through doctors at health clinics, overdose prevention sites or through peers at a compassion club – if the province s ‘engage.

The Vancouver Coastal Health Authority is interested in distributing the drug, but says the amount it can dispense is limited.

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“It’s because there are only a small number of doctors in Vancouver ready to prescribe,” said Dr. Patricia Daly, chief medical officer of Vancouver Coastal Health. “Each physician is limited in the number of patients he can prescribe as this requires monitoring their consumption.”

British Columbia’s model of requiring a doctor’s orders “is not a barrier low enough to prescribe the tens of thousands of people at risk of overdose,” Daly said. She urges the province to fund more community safe supply programs.

A man injects street drugs in an alley in Vancouver’s Downtown Eastside in April 2020. Photo by JESSE HIVER /REUTERS

Sarah Blyth is director of the Overdose Prevention Society of Vancouver, which operates three supervised injection sites in the Downtown Eastside. She hopes to be able to avoid further overdoses not only with clean needles and naloxone, but also with an uncontaminated supply of pharmaceutical heroin.

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Street drugs are often intersected with very dangerous drugs such as fentanyl, carfentanil and benzodiazepines, Schecter said. Overdoses of contaminated drugs were responsible for 1,782 deaths in late October in British Columbia.

“Tomorrow is when we are ready to distribute a secure supply,” Blyth said. “We have the knowledge and the confidence of the community, we just need an uncontaminated supply of medicines. “

Compassion clubs were offered by advocates in Downtown Eastside this year, with the idea of ​​having peer-led groups selling pharmaceutical grade drugs, including heroin, to adult users without a prescription. However, they require a federal exemption from drug laws.

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Canada approved heroin-assisted treatment for addicts who have failed to respond to traditional drug-assisted therapies, such as methadone, in 2016, and 160 patients in British Columbia are prescribed an injectable form of heroin by doctors at specialty clinics in Surrey and Vancouver.

Schechter, the principal investigator of the first trial of heroin assisted treatment in North America conducted in Vancouver and Montreal in 2005-2008, found that the use of heroin to treat relapsing users was more cost effective than methadone maintenance.

“People who use illicit drugs have told us that they spend between $ 40 and $ 100 a day on poison,” he said.

If doctors get enough backing to invest in a processing plant in British Columbia, the company’s goal is to ramp up production to add slow-release capsules and powdered heroin prescriptions.

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“For years the province has said the problem with prescribing more heroin is that there is no national supply and the drug is expensive to acquire. Now that we have it, I think they are running out of excuses, ”Schechter said.

“So many more British Columbians are in desperate need of a secure supply than the few who currently receive it.”

In an emailed statement, the British Columbia Ministry of Mental Health and Addictions said British Columbians already have access to pharmaceutical alternatives to street drugs, starting with priority opioids, including fentanyl patches and hydromorphone pills, both of which require a prescription from a doctor.

“We will continue to explore the possibility of expanding the range of pharmaceutical alternatives available through the policy as we move forward, including diacetylmorphine… our government continues to work with the College of Pharmacists of BC, the College of Physicians and Surgeons, health authorities and other partners to address issues related to safer prescribed supplies.

[email protected]tmedia.com

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