In a public-health crisis, the first priority should be to keep people from dying. And on that basis, a proposal to use vending machines to distribute safe drugs to people with opioid addictions deserves support and funding.
Dr. Mark Tyndall of B.C.’s Centre for Disease Control proposed the idea at a South Island Community Overdose Response Network symposium in Victoria this month.
It’s a bold approach. We have experimented with programs that provide users with opioids, but those have been in a clinical setting, with participants carefully vetted and supervised. Those requirements have also meant the programs have been slow to launch, costly and limited in the number of people who can be reached.
Tyndall argues that providing hydromorphone, known under the brand name Dilaudid, through vending machines at places such as supervised-consumption sites, will save lives by allowing people to avoid the risk of illicit drugs that include fentanyl. The cost is negligible, about 32 cents a pill.
“Right now, we’re asking people to go to an alley to buy drugs that are likely poisoned,” he said. “What I’m proposing is not nearly as crazy. We need to blanket the province with an opportunity to get safer drugs.”
There are risks, but they are small. Some people might be encouraged to use more drugs if they are freely available. Some might resell the drugs they get — though that should mean the buyers would at least get less risky drugs.
And, as well as saving lives, the approach could free some users from the scramble to raise money for drugs and reduce property crimes.
The idea will trouble some people.
But they should be much more troubled by the fact that more than 1,200 British Columbians died due to illicit-drug overdoses in the first 11 months of 2017, compared with 922 for all of 2016 and 510 in 2015. The increase comes despite the provincial government’s declaration of a health emergency early in 2016.
The numbers tell us that what are we doing is not working. Overdoses are already claiming four times more lives than car crashes, and the toll continues to rise.
The priority should be on keeping people alive while we work on longer-term solutions.
There have been moderate successes. Supervised-consumption sites have emerged in some communities, and they have worked — not one person died in a site in the province this year. But there are still too few, and the federal government’s process was so slow that some people opened illegal sites in frustration.
There are few easy solutions to end the crisis, which is ravaging communities across North America. Co-ordinated action on a wide range of responses, from curbs on the illegal fentanyl market to greater access to prescribed drugs, is needed.
But in the meantime, we can keep people alive with basic, simple measures such as the proposal to provide safe drugs through vending machines.