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Kamloops outreach organization eyes next steps in fentanyl crisis

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Image Credit: THE CANADIAN PRESS/Darryl Dyck

KAMLOOPS - As B.C. heads into another year of the fentanyl crisis, the leader of ASK Wellness is looking for long term solutions to opioid addictions.

ASK Wellness executive director Bob Hughes has watched the crisis grow throughout 2016 as people using the organization's services have overdosed and died, many due to the increased use of fentanyl in street level drugs. While he sees services like overdose prevention and safe consumption sites as helping save lives, he’s concerned people will see this as a solution.

“The last thing I want to do is just go, ‘here you can keep consuming your drugs,’ and us to be so consumed by the immediate crisis that we’re not looking [further],” he says. “The problem is we’re all focusing in right now on the tyranny of the urgent which is saving their lives, without looking and going ‘how do we figure ways out to get these people on a maintenance program.

"If they’re addicted already, let's call it what it is and provide them a multitude of options other than what they’re currently doing which is looking for street level opiates.”

While safe consumption sites are a short term tool to keep people alive, the Kamloops outreach organization for vulnerable people doesn’t see it as a solution to the crisis, just a band aid while people continue to risk their lives buying low quality drugs from street dealers.

“I think we want to move very, very slowly and the overdose prevention service is a step in the right direction,” he says. “But it needs to be commiserate upon a significant development in access to treatment and notions of treatment are different than I think a lot of the public sees.”

With treatment programs in place, he expects users who chose to seek help would be able to find stable housing, have better relationships with friends and family, find work and improve their overall health. Currently there's a gap though, in how developed treatment programs are. That's where Hughes wants to see growth.

“Who’s talking to that person about access to suboxone," he says. "Who’s working on a policy level to be able to get people prescription heroin or dilaudid that actually gets people stable and back into the community.”

Suboxone is a new development in drug abuse treatment in B.C., which helps people addicted to opioids move off of them. It also contains naloxone, which can reverse an overdose, so that a person is unable to get high again while regularly using suboxone.

While methadone can be used, Hughes says prescription heroin or dilaudid, a version of morphine, would be better choices. If people were prescribed heroin, Hughes says it would allow individuals who were addicted to find their fix in a different way, meaning they’re safe from street level drugs laced with fentanyl and aren’t funding their drug habit through crime.

Evidence that prescription heroin works already exists he says, with the North American Opiate Medication Initiative showing positive results. Hughes says some heroin addicts don’t want to move off of the drug, but can still be given an opportunity to live a fulsome life.

“The research points to this being very effective on health care costs,” he says. “People have learned to manage their alcohol. Lots of people drink every single day; and they manage to drink a certain amount every single day and still show up to work the next day and have a life.”

He isn't suggesting legalizing heroin for public use, but relaxing the regulations and government controlled distribution would mean people who are chronically addicted to opioids would have a safe and stable source and could move forward with their lives.

"It's logistically challenging and it requires some political will to move that dial, but here we've had the province move as close to supervised consumption services that you could possibly get without calling it that," he says.

Meanwhile suboxone has been in use in Ontario for years as a way to move off of opiates.

“The first person that we can get on suboxone we’ll say ‘You know what, we’ll get you a better apartment away from the chaos that’s here and help you to get well and get a job,’” he says.

While some of the treatment actions may seem counter-intuitive to the public, he says it’s important to get people off of the street level drugs, where people are playing ‘Russian roulette’ to get a high.

“I understand the public’s concern around ‘are we not just giving in to the whims of addictions when we do safe consumption?’ and I say it’s gotta be a means to an end,” Hughes says. “We want to get them well and hold them accountable for the fact that you keep on doing your drugs and overdosing is having an impact on our staff.

"At the end of the day we have to figure out some strategy for these folks other than simply rescuing them from killing themselves," he says. "We start with that now, but lets look at the long term plans."


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