Vancouver doctor doubles down on opioid pills vending machine idea
Dr. Mark Tyndall, head of the B.C. Centre for Disease Control, says it would be an important tool in the fight to prevent overdose deaths.
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As Vancouver records the city’s highest-ever number of overdose deaths, the head of B.C.’s Centre for Disease Control says he wants to move ahead on a controversial but innovative idea he feels is vital in the fight to save lives.
Dr. Mark Tyndall first proposed a vending machine back in December as a way to distribute prescription opioids to people with serious addictions who haven’t responded to other treatments.
“I tried to pull this argument back because the media really liked that story and it caught people’s attention. I probably did about 15 or 20 interviews over the next three days,” Tyndall told Vancouver city council during an update on the opioid overdose crisis on Jan. 16.
“After about 20 interviews I totally convinced myself that the best way to distribute these things would be through vending machines, or ATM-type machines.”
After the first burst of news stories, Tyndall was contacted by a cannabis distribution company who told him they had such a machine available, pushing the vending machine idea further to reality.
Council heard Wednesday that 335 people in Vancouver died of overdoses in 2017, the highest number ever. The illegal drug supply is now completely tainted with powerful synthetic opioids like fentanyl, meaning that drug users risk overdose every time they use.
Tyndall told council that providing clean drugs to some drug users is now necessary to prevent more deaths. Crosstown Clinic provides injectable hydromorphone to about 150 people, but it’s been difficult to import what’s sometimes referred to as medical-grade heroine, and patients must inject at the clinic under supervision several times a day.
By contrast, oral hydromorphone pills (like the brand name Dilaudid) are cheap and easy to obtain and can be prescribed by any physician.
Tyndall believes an ATM or “vending machine” would be the most efficient way to secure the pills from theft, and distribute them in the right amounts to the right people through biometrics such as a fingerprint scan.
Dr. Patricia Daly, medical health officer with Vancouver Coastal Health, told council the health authority is interested in trying out the idea, but a pilot project would be evaluated “rigourously” and Tyndall would have to speak with the College of Physicians and Surgeons of B.C.
The college adopted new guidelines in 2016 meant to tackle the problem, widespread across North America, of over-prescription of opioids.
“If I started to take 50 people and prescribe these things every day, I would definitely get called on what am I doing?” Tyndall acknowledged of the current guidelines around prescribing.
Tyndall asked Vancouver city council to support the idea as he tries to get the pilot program up and running. Under a current $1.5 million grant, 200 patients could participate — and the “vending machine” could be delivered in one month’s time.
“The support of the city would go a long way towards supporting the ministry and health Canada and other places that need to get behind this.”
With files from Wanyee Li and David P. Ball