Adrienne Tanner is a Vancouver commentator who writes about civic affairs
Mark Tyndall stood before Vancouver City Council at a recent meeting to proselytize for his latest harm-reduction scheme: vending machines to dispense opioids to drug users.
"I really wish we could get 50 of these things going in the next year," said Dr. Tyndall, executive medical health director of the BC Centre for Disease Control. "We could supply clean drugs to thousands of people and our overdose numbers would plummet." He plans to start with a pilot project in Vancouver.
Remarkably, Vancouver's city council, which is so divided its members can't agree on a bike lane, barely flinched – even though this plan goes far beyond current supervised drug-distribution programs conducted primarily in clinical settings.
Mayor Gregor Robertson and almost every councillor thanked Dr. Tyndall and Dr. Patricia Daly, Vancouver Coastal Health's chief medical health officer, for their efforts to reduce the number of overdose deaths. Even Non-Partisan Association (NPA) councillor Hector Bremner, who questioned the logic of a program that would profit the corporate purveyors of addictive opioids, said after the meeting he would support a pilot project.
"I am open to any idea if it will save a life."
Dr. Tyndall's plan may sound reckless if you don't know that these are nothing like candy machines that can be rocked and kicked into submission.
Manufactured by the medical-marijuana industry, each one is made from 750 pounds of military-grade steel and programmed to dispense prescribed quantities of pills only to registered users, using biometric identification. The advantage of circumventing a clinical setting is that many drug users are too ashamed or find it inconvenient to present at clinics or pharmacies for clean drugs. Instead they shop on the street, where deadly fentanyl contamination is rampant.
The cross-party acceptance of Dr. Tyndall's vending-machine experiment by our civic politicians indicates both how serious the overdose crisis has become, and how far the harm-reduction dial has moved over the past two decades.
In 2017, more than 1,400 people died of illicit drug overdoses in British Columbia, most of them fentanyl-related. It was the most catastrophic year ever, despite myriad harm-reduction efforts, which include legal and extralegal supervised drug-use sites, widespread naloxone-kit distribution and a smattering of supervised hydromorphone (opioid) distribution programs.
Are opioid vending machines another step on the slippery slope to the complete decriminalization of drugs? Maybe, and that would be supported by Dr. Tyndall, many city councillors and Vancouverites who are weary of the crime, disease and misery associated with the illegal street drug trade.
And if the new program defies a whole bunch of provincial and federal regulations, Dr. Tyndall is the first to admit and defend that too.
"We don't have time to get everyone agreeing on it. If we went through the federal process for the overdose-prevention units, we wouldn't have any."
Perhaps because Vancouver is a port city with a long history of drug problems, it has always been more willing than other Canadian municipalities to flout the law and lead the country in harm-reduction measures.
As Dr. Tyndall spoke, many councillors nodded in agreement. Tim Stevenson called him brave. Green councillor Adriane Carr proclaimed addiction should be treated as a medical condition and supplying safe drugs is the way to go. NPA councillor Melissa De Genova said she was disappointed when the NAOMI trial, which dispensed free heroin to users, ended.
What a sea change since 2002, when the NPA dumped Mayor Philip Owen because he supported Insite, Vancouver's first supervised drug-use site.
Today, councillors still squabble over harm-reduction budgets and which of the four pillars championed by Mr. Owen – prevention, treatment, enforcement or harm reduction – deserves the most resources. But no one questions harm reduction itself.
It is a rare person in Vancouver who hasn't stumbled upon a paramedic crew crouched over a limp body and watched anxiously, hoping this is not another bump in the dismal statistics. And most of us now know someone touched by the overdose death of a family member or friend.
Vancouver City Council, despite all its flaws and factions, seems to have figured out that the opioid crisis is no place to play politics.