Prince George Citizen October 3, 2018 by Prince George Citizen

Wednesday, October 3, 2018 | Your community newspaper since 1916

Treatment options needed to curb overdoses, critic says Jeremy HAINSWORTH Citizen news service

CITIZEN PHOTO BY JAMES DOYLE

Used needles sit in an alleyway between Quebec Street and Dominion Street on Tuesday morning.

Needle return rate better than 90 per cent, health officer says Mark NIELSEN Citizen staff mnielsen@pgcitizen.ca Contrary to the impression left with city council, the vast majority of needles Northern Health’s harm reduction clinic gives out are returned, according to public health officer Dr. Andrew Gray. As part of a presentation Sept. 17 on the deployment of two-person bylaw compliance teams to the downtown, city council was told they picked up enough needles to fill three 19-litre (five-gallon) pails over August. That drew some strong comments from Coun. Brian Skakun, who questioned whether the clinic can even be considered a needle exchange anymore. “It’s just absolutely appalling and in my opinion, Northern Health has completely failed us,” Skakun said. But Gray said that despite appearances, more than 90 per cent are either recovered from clients on a voluntary basis when they exchange them for fresh ones at the clinic at Third Avenue and George Street or discarded in special containers distributed around the city.

Unfortunately, a small proportion does end up discarded on the street and of course that’s where the public concern arises. — Dr. Andrew Gray, public health officer “Unfortunately, a small proportion does end up discarded on the street and of course that’s where the public concern arises,” he said. Gray acknowledged the number the team found is more than people would like to see but also noted they patrol areas where most of the public tend not to go such as alleyways. All the needles the team picked up were found on the street and in camps in the downtown and none from the sharps containers placed around the area, city

spokesperson Mike Kellett confirmed on Tuesday. Gray dismissed requiring clients to exchange needles on a one-for-one basis as unrealistic because it will force users to share needles and increase the risk of getting infections and spreading viruses like HIV. Gray also said they don’t pose the danger many people think they do. He said the chances of being stuck by a needle are low and the viruses found on one are likely dead by the time it’s been found. “There’s actually never been a case of anyone contracting HIV from a discarded needle that’s been sitting around, versus a fresh needle that’s just been used and has visible blood on it,” he said. That said, a discarded needle should still be handled with care. Ideally, said Gray, they should be picked up with tongs or gloves and put into a rigid container – a plastic bottle or pop can will do. And he said children should be discouraged from picking up any needle that happens to have been found in a playground or park.

Illicit drug deaths surpass last year’s total Mark NIELSEN Citizen staff The number of deaths in the city from overdoses on illicit drugs is continuing to climb. There were 29 such deaths as of the end of August, seven more than were recorded for all of 2017, according to an update from the B.C. Coroners Service. “Things have gotten much worse in Prince George,” said Northern Health public health officer Dr. Andrew Gray. He said an unpredictable drug supply appears to be a culprit. “A lot of people know they’re getting fentanyl now but the dose is so unpredictable,” Gray said. “That’s what really drives the overdose risk.” A form of opioid, the drug is considered 100 times more potent than heroin and has been the source of a surge in

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overdose deaths large enough for authorities to call it a health care crisis in the province. Northern Health’s strategy for preventing deaths includes distribution of takehome kits of naloxone which counters the effects of fentanyl. They’re distributed out of the harm reduction clinic at Third and George, which can also test drugs for their contents and provide a place for addicts to use their drugs and be treated immediately should they suffer an overdose. More clients are getting access to suboxone and methadone to help wean them off opioids. And with some funding from the provincial government, Northern Health is in the process of establishing a community action team made up of representatives from a number of different

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organizations to try to come up with a shared strategy. A little empathy can also go a fair way, according to Gray. “One of the limiting factors for us to mounting a complete response to this is stigma and criminalization,” Gray said. “People are trying to cope with their pain and generally speaking, that’s why (they become addicted)... the pain that arises due to severe childhood trauma or to physical injury. “There is more and more discussion of these issues in our society as a result of this crisis, which is one good thing. “But having compassion and understanding the struggles that people are going through and why they make the choices they do is one of the most important things for us to really get to the bottom of this emergency.”

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The BC NDP government’s delays in providing a greater range of addiction recovery options in the face of the overdose crisis are putting lives at risk, the BC Liberal opposition critic for mental health and addictions said Tuesday. “We need more treatment and recovery options immediately,” Jane Thornthwaite said in an interview. “We clearly are not doing what needs to be done.” She told the Legislature on Monday that the NDP should work to end the opioid crisis by offering identified addicts residential treatment as is done in Portugal. “Continuing to pour money into harm reduction, including replacement therapies and drugtesting kits, helps save lives today but won’t end the cycle of addiction,” Thornthwaite told MLAs. She said in the interview those options are part of the solution but not the full spectrum of what’s needed. She suggested a need for more detox availability followed by other recovery options. “It could be 12-step, it could be not,” she said. “There’s a real inequality right now in our province about abstinence-based treatment.” Her suggestions contrast with those put forward to Union of BC Municipalities conference (UBCM) delegates last month by the NDP-appointed leader of overdose crisis response team. Dr. Patricia Daly angered members of B.C.’s abstinence-based addiction recovery community when she suggested opioid addicts use prescribed drug treatments for the rest of the lives. “(There’s) a need for lifelong treatment that will allow you to function,” said Daly, Vancouver Coastal Health’s chief medical health officer. Daly told UBCM delegates that pressure to remain abstinent and the stigmatization of relapse in 12-step recovery programs may not be as effective a long-term solution such as medication. Thornthwaite said the comments have resulted in B.C.’s recovery community using a #StopDaly hashtag on social media. In a Sept. 26 response to a request to identify which drug replacement therapies are approved for use, Anna Low, freedom of information co-ordinator for Vancouver Coastal Health, said Daly is not an expert in that area. “Dr. Daly does not make recommendations for drug treatments for opioid use disorder as this is not her area of expertise,” Low said in the emailed response. “In B.C., these are made by the B.C. Centre for Substance Use (BCCSU), and they communicate directly with physicians with their recommendations. Some are also endorsed by the provincial government.” Low noted the authority “does not approve drugs or medications for opioid use disorder – this is the jurisdiction of Ministry of Health, College of Pharmacists, and Lower Mainland Pharmacy.” The provincial Ministry of Health website said PharmaCare covers methadone, buprenorphine/naloxone (also known as Suboxone) and the slow-release morphine Kadian as treatments for opioid addiction. None of the manufacturers of those specific drugs listed in the ministry website are named in a lawsuit the government filed against opioid drug makers Aug. 29. NDP deputy caucus chair Rachna Singh agreed with Thornthwaite in the Legislature that residential care investments are needed to assist addicts in quitting drugs. However, she also stressed the need for harm reduction and overdose prevention sites such as Insite in Vancouver’s Downtown Eastside. There, medical staff supervises users as they inject. Singh, a former alcohol and drug counsellor, said the first priority is to keep people alive. “There’s no treatment for addiction if the patient is dead,” Singh said. “We should have all kinds of treatment models. If we don’t have the person seeking the treatment alive, there’s no point in creating all these kinds of services.”

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