McDONALD: Time to get serious about harm reduction during fentanyl crisis

OPINION

Great news!

The B.C. Coroner says only three people died of overdose in Kelowna in September about half the rate of 7.5 overdose deaths a month the city has been recording since the beginning of the year.

While obviously not such great news for their friends and family, anything running counter to the torrent of bad news coming from the opioid overdose crisis is a welcome relief.

Don’t get me wrong, the announcement today by the new Ministry of Mental Health and Addiction of a pilot study for a drug testing machine and expanded use of fentanyl test strips is also good news, but I think it stops far short of where we should be 18 months into this provincial emergency.

One of the problems is all the harm reduction measures undertaken so far involve the user having to reveal themselves by attending a public safe consumption site, walking into one of the street social service agencies or asking for help in an emergency room.

This is where liability for the government and the stigma around drug use collide — they will get sued if someone still overdoses using one of their test strips alone at home.

You’re never gonna get the middle class junkie to come into a pharmacy or the safe consumption site to check their dope, not so long as the chance of exposure could end their career or destroy their personal relationships.

Family doctors and walk-in clinics are not a good option as most physicians are not trained in addiction medicine and are more likely to try to weed out someone with an opioid addiction than welcome them as a new patient.

Anonymity can be offered but not fully guaranteed and the threat of pubic exposure as some kind of druggie is still the kiss of death in our society.

Both the Interior Health Authority and the new Ministry of Mental Health and Addictions have stressed the need to end the stigma around drug addiction and those who seek treatment for it.

We’re not going to be able to end stigma in time to deal with the deluge of overdose deaths so I think it's time to end any liability through a Good Samaritan law and start sending out anonymously a full-on harm reduction kit to anyone who contacts the health authority through a secure service.

No one is going to notice another package being delivered to someone’s door and it might just save a life.

Inside should be a naloxone kit clean syringes, a pipe for smoking or a personal inhaling straw for snorting.

Along with it, give out as many cheap strip tests as possible with the focus on fentanyl but consideration given to other drugs such as cocaine and crystal meth.

Of course, this is still a teachable and reachable moment so a full package of educational material should accompany the kit containing non-judgemental information about how to get into care.

But it should also provide detailed instructions about how best to inject, smoke or snort the various street drugs, education on the signs of overdose and how to self-administer naloxone if they think they are overdosing.

How far should we take this? The provincial government is already experimenting with providing injectable hydromorphone so why not include some in the kit. If it ends up on the street, so be it, at least it’s not contaminated with fentanyl.

As for the test strips, distribute them in a mass mail out, put them in magazines like shampoo samples, give them out at conventions in swag bags and put them on the end of swizzle sticks in the nightclubs. Make them ubiquitous like napkins or toothpicks.

If every has one, there’s no shame in having them and maybe they will actually get used.

Oh I can hear the arguments right now against sending out a party pack for junkies but try to put this into perspective.

If 63 cyclists had been knocked down and killed in the last nine months, we would be talking about nothing else. Could you imagine all the ghost bikes they would have to put out?

If 63 workers had so far this year managed to die in Kelowna in workplace accidents, WorkSafe B.C. would pretty much close the place down and would have inspectors running all over the place.

Well at least 63 people from all walks of life have died in this town so far this year, part of larger tragedy playing out across the province.

If you want to call trying save some from similar fate a party, then it’s time to get this party started.

— John McDonald is a long-time reporter, editor and photographer from the Central Okanagan with a strong curiosity about local affairs. You can reach him at jmcdonald@infonews.ca.