CHARBONNEAU – Forget hydromorphone, give them fentanyl

CANADA’S SAFER SUPPLY program is a good idea but the drug they hand out isn’t what users want. On the positive side, it does provide users with a safer alternative to the toxic, illegal drugs that they buy on the street.

“Safer supply services can help prevent overdoses, save lives, and connect people who use drugs to other health and social services,” says the Government of Canada website.

There are nine safer supply sites in B.C., all of them on the Lower Mainland and Vancouver Island.

Safer supply is controversial because drugs are given to addicts who are not in a recovery program. Why feed addiction?

Well, the option to giving addicts safe drugs is often death. Canada is in the midst of an opioid crisis that has killed over 35,000 people since 2016. So why not give them safer drugs?

Despite being a good idea, the safer supply problem has created unintended consequences: the drug that’s given out, hydromorphone, doesn’t satisfy the users’ need to get high the way fentanyl does.

“Fentanyl is a stupendously powerful synthetic opioid that leaves users with a formidable drug tolerance,” says reporter Adam Zivo.

“Those who use fentanyl generally don’t find that other, comparatively weaker, opioids give them a satisfying high (National Post, May 9, 1023).”

In Zivo’s investigative report, he found that a significant portion of the safer supply drugs end up being sold on the street.

Hydromorphone is being sold at rock-bottom prices. Proceeds of the sale are going to purchase often-deadly fentanyl.

The flood of hydromorphone on the street has reduced the price of a tablet to a fraction of what it once was.

According to a doctor in Vancouver, an 8-mg tablet of hydromorphone was $8 before safer supply. Then it dropped to $4 after Vancouver launched hydromorphone vending machines in 2020. The price dropped to between 25 and 33 cents per tablet after the safer supply program was expanded.

But why would drug users sell their hydromorphone to buy riskier street fentanyl?

“According to the addiction physicians I interviewed, although the typical 8-milligram tablet of hydromorphone given to addicts is four times the dose generally used in hospital settings, its effect relative to fentanyl is like holding a candle to the sun,” says Zivo.

The abundance of cheap hydromorphone has seen a rise of young people requesting help with dependence on hydromorphone. Because the tablets are so cheap, users often pop a handful which can be deadly.

Youth generally understand the risks of using fentanyl and therefore stay away from it. However, because hydromorphone is prescribed by a doctor and marketed as “safe,” young people underestimate its dangers and are more likely to try it.

Then, in an attempt to get a more intense high, some users are crushing hydromorphone tablets for intravenous injection, potentially leading to excruciating and disfiguring infections that have paralyzed some patients.

Dr. Sharon Koivu, an addiction physician with the London Health Sciences Centre, has noticed an increase in serious infections relating to intravenous drug use. Speaking with her patients, she learned that many of them were buying cheap hydromorphone, then crushing and injecting it.

The solution to the safer supply problem of hydromorphone is obvious: give addicts safe doses of fentanyl so they don’t die from the toxic stuff sold on the street.

David Charbonneau is a retired TRU electronics instructor who hosts a blog at http://www.eyeviewkamloops.wordpress.com.