As Fentanyl Crisis Hits Canada, Buprenorphine Out Of Reach

By Zachary Siegel 01/29/16

Amid the opiate crisis, medications must be widely available.


There has been a ten-fold spike in fentanyl-related overdoses in British Columbia, according to BC Coroner’s service. Heroin is often being cut with fentanyl, which in recent years has contributed to an increase in mortality.

Many like to blame and vilify pharmaceutical companies for contributing to the opioid epidemic, however studies show that people who are legitimately prescribed painkillers rarely abuse them. And the fentanyl that’s being found at overdose scenes has not been diverted from the pharmaceutical industry. Rather, what’s being found is called non-pharmaceutical fentanyl (NPF), and it’s being manufactured in clandestine laboratories.

A 21-year-old woman in British Columbia, Izzy, overdosed on fentanyl and was found dead on Hastings, a street for the destitute on Vancouver’s Downtown Eastside, reported CBC News. Sadly, just meters away from where Izzy overdosed was a building that contained naloxone, a drug that could have potentially reversed her overdose.

Izzy’s mother blames the needlessly complicated and bureaucratized medical system that made buprenorphine out of reach for her daughter. “Daily witnessed ingestion” is required by the College of Physicians and Surgeons for the first two months of buprenorphine dosing. This means Izzy was required to physically go to a pharmacy to prove that she had taken her medication that was prescribed to her.

Bailey, Izzy’s mother, said that was unrealistic and because of that policy her daughter was not able to remain on the drug that could have satiated her craving, preventing the fateful day she went out to buy heroin and was given fentanyl instead.

Some doctors think that, like methadone, Suboxone needs to be administered in a clinical setting. Others, such as Dr. Seonaid Nolan, disagree. "Suboxone has better safety profile than methadone, and there really is no need to regulate it and [regulate it] more than a doctor prescribing insulin to a diabetic," he said.

In America, Suboxone does not need to be taken in a clinical setting, but is still expensive and hard for many to get, as doctors are limited in the number of patients they can have on buprenorphine at once. Some people travel hundreds of miles to see a doctor who is able to prescribe it.

But like in British Columbia, the number of fentanyl overdoses has skyrocketed in America. Drugs like naloxone and medications like buprenorphine must be widely available to stem the stunning number of opiate-related deaths.

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.