Drug users tell B.C. health minister: Show some 'political bravery' and prescribe safer heroin
Minister Terry Lake has said he needs more evidence and public support for prescription heroin, but advocates and researchers say there's no time to lose.
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British Columbia's health minister, who is not running for reelection in May, must show some "political bravery" and immediately begin prescribing regulated heroin to hard-to-treat opioid users, addictions advocates said Monday.
Karen Ward, with the Vancouver Area Network of Drug Users (VANDU), issued the demand a day before Tuesday's national day of action on the opioid crisis, which claimed 914 B.C. lives last year — and continued in January with 116 deaths.
Ward said that even just tripling the current 140 graduates of a landmark Vancouver prescription heroin study, SALOME, who are allowed to receive the drug would save many lives.
"It would take some political bravery to do it," she said. "… But surely this is the bravery that's required."
Metro requested an interview with health minister Terry Lake on Monday morning, but he was unavailable. But last month Lake told The Canadian Press he might support expanding prescription heroin, "but we need the evidence first."
"People tell me, 'Yes, you should just do it,'" he said, "but you have to be careful of any potential unintended consequences."
He later told the Province newspaper: "I know a lot of people are passionate about it, but I also know there are people with strong reservations about (prescription heroin) … What I don’t want to do is take two steps backwards because you get a negative backlash."
Ward countered that she found Lake's stance "a little disingenuous."
"This is a politician who wields a great deal of power to change minds on issues like this … in his words, to bring people along and see the sense of programs like this," she said. "Personally, I think there is broad public support, when they hear how it works and the testimony of people with lived experience, they say, 'Geez, why aren't we doing this?'"
In an earlier interview with Metro, SALOME's lead researcher Dr. Eugenia Oviedo-Joekes said many more opiate users would benefit if there were political will and funding.
Those are the patients for whom "first-line treatments" using opioid replacements such as methadone and suboxone, haven't worked, she explained. But prescriptions are currently only permitted for the original cohort, and only after the former Conservative government lost a court battle to shutter the program in 2013.
"Prescription heroin plays a small but important role," Oviedo-Joekes told Metro in a Feb. 1 phone interview. "There are 300 people on the street right now who would qualify.
"If they’re not doing well with methadone or suboxone, what are we supposed to do — let them continue injecting poison in the street?"
A spokeswoman for the health ministry sent an emailed statement in lieu of an interview with Lake, stating that "first-line treatments such as suboxone and methadone … work well for the majority of patients," but that for others "more work needs to be done to gain a better understanding of how the evidence the supporting use of injectable diacetylmorphine and hydromorphone for the treatment of opioid use disorder can be practically applied and implemented in B.C."
For Dr. Oviedo-Joekes, the evidence the therapy works for hard-to-treat patients is already in, but the consequences of delaying further are fatal.
"People have this idea they can tell people how to live their lives," she told Metro. "Trying to have control over this is killing people."
Advocates will rally at noon Tuesday at Oppenheimer Park for drug policy reforms as part of a National Day of Action on the Overdose Crisis.