Vancouver Coastal Health is looking to expand supervised injection as a standard nursing service, with an eye to potentially offering it at all nine of its hospitals as it confronts an increase in overdoses from fentanyl and other drugs.
Mark Lysyshyn, a medical health officer with the agency, discussed the goal of expanded injection sites during a public lecture Wednesday that focused on how to prevent overdose deaths due to fentanyl in the local drug supply. The powerful synthetic opioid analgesic, which is being cut into other drugs for its high potency, has been detected in a growing number of illicit overdose deaths, with many users ingesting it unknowingly.
Dr. Lysyshyn told the auditorium of mostly hospital staff and clinicians that the health authority is looking for a way to apply for one Section 56 exemption from federal drug laws that would allow the health authority to offer the service at multiple sites, as injection drug use is not solely a Downtown Eastside problem.
“Even where I work on the North Shore, at the Central Community Health Centre, we have clients pick up harm-reduction supplies, immediately go into the bathroom, overdose, and sometimes they’re not found until the next person goes into the bathroom,” Dr. Lysyshyn said. “It would seem to make sense to have a room available there where a nurse could supervise that injection and rescue that person if they overdose.”
The fact that the Dr. Peter Centre in Vancouver’s West End received an exemption last month illustrates a new willingness by Health Canada to approve supervised injection service as part of an integrated model, Dr. Lysyshyn said.
Supporters of supervised injection sites have characterized the Respect For Communities Act, introduced by the Harper government, as a deliberate effort to make it nearly impossible to open a new injection site. Under the act, prospective operators must meet a laundry list of requirements, including extensive consultation with community partners; letters of approval from government, police and health professionals; and statistics and other information on crime and public nuisance in the area.
To apply for each Vancouver Coastal Health (VCH) site individually would require substantially more time and effort.
But Eric Morrissette, a spokesman for Health Canada, confirmed it is possible to operate multiple supervised injection sites under one Section 56 exemption.
“Each application for an exemption is different and is reviewed by Health Canada on its own merit,” he said in an email.
Other initiatives aimed at preventing overdose deaths include a project in development that would allow users to report overdoses in real time online.
“It’ll be a fluid survey that will ask questions to a drug user, or a friend, about the circumstances around an overdose: where it occurred, what they took, if they can upload pictures,” Dr. Lysyshyn said. “We’re going to see if we can use that information to then provide real-time information back to the community.”
VCH has also launched messaging campaigns that teach drug users how to recognize the signs of an overdose and emphasize the need to call 911 immediately.
“That seems like an obvious thing, but people involved in illicit drugs are [reluctant] to have police show up at their door,” Dr. Lysyshyn said. “We’re trying to assure people that if police show up at their door when someone’s having an overdose, no one’s going to be arrested. They’re going to take you to the hospital.”
Fentanyl was detected in 5 per cent of illicit drug overdose deaths in 2012. This climbed to 15 per cent in 2013, 25 per cent in 2014 and 30 per cent last year.Report Typo/Error