Drug checking and harm reduction: It could save lives

Dr Ian Hodgson, CNS Correspondent
At the 25th Harm Reduction International Conference (#HR17)  held in Montreal earlier this week, over 1000 people gathered to address one of the great public health challenges of our time: the lack of adequate support for people who use drugs, and an increasingly hostile and economically austere environment that denies basic services to a vulnerable population. Delegates at the conference include activists, researchers, community workers, and people who use drugs.

According to the Global State of Harm Reduction Report, released in 2016 by Harm Reduction International, there has been a rapid increase in drug-related deaths since 2000, suggesting an epidemic of overdoses within the drug using community.

There has been a 327% increase in drug-related overdose deaths in Canada since 2008, a 137% increase in the US since 2000, and a 64% increase in the UK since 2014. 

According to the Canadian Minster of Health, Jane Philpott, speaking during the conference’s opening ceremony, “In Canada there were approximately 500 overdose deaths last year in Alberta [and] more than 900 in British Columbia. Fentanyl has contributed to deaths in every region of the country.”

Fentanyl, a synthetic opioid, is similar to morphine but much more potent, and street drugs containing illicitly manufactured Fentanyl are partly responsible for the overdose crisis, and contamination by Fentanyl is not confined to Canada. In the US, the widespread distribution of Fentanyl is now becoming the new norm, with a spiraling number of deaths associated with contaminated street heroine. According to Dan Ciccarone, Professor of Family and Community Medicine at the University of California San Francisco (UCSF), authorities, "are not treating the overdose issue as a true public health outbreak."
Rick Lines
Photo credit: HRI

Results from a study released at the beginning of the conference suggest that a system for checking the quality of street drugs can prevent accidental overdose. Reporting from Vancouver, the researchers undertook 1009 drug checks at a long-running Supervision Injection Centre. They found that Fentanyl had contaminated some 80% of heroine, 80% of Crystal Meth, and 40% of cocaine being used onsite. According to Rick Lines, Executive Director of Harm Reduction International, “Street drugs are costing lives, and this research confirms what we’ve long known - that supervised injection sites and drug checking can prevent unnecessary deaths.”

Effective harm reduction must adopt a public health approach and address all threats facing people who use drugs. “Drug checking is harm reduction, that could change lives,” according to Dr Mark Lyshshyn, Medical Health Office at Vancouver Coastal Health and lead researcher of the study.

Rapid escalation of overdose-related deaths is clearly a public health crisis. It requires a robust response, much like during the 1990s AIDS epidemic when the provision of condoms and sterile syringe programmes had a significant impact on HIV incidence. But harm reduction is much more than responding to physical threats, and it’s hoped that this conference creates a powerful collective response to kickbacks against effective harm reduction currently being proposed in countries such the US and Philippines.

Dr Ian Hodgson, CNS (Citizen News Service)
19 May 2017

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