Vancouver May Soon Open Five Supervised Injection Facilities to Combat Fentanyl Crisis

In May, The Fix reported that clandestinely manufactured fentanyl has virtually replaced heroin in the drug markets on Vancouver’s Downtown Eastside, which, due to the drug's potency, has led to a steep climb in the number of fatal overdoses. 

This deadly trend was confirmed by a new report from the British Columbia Coroner Service that found 308 illicit drug overdose deaths occurred from January through May of this year, compared with 176 deaths in the same period last year. In 2012, fentanyl was involved in only 5% of drug-related deaths in British Columbia—Canada's westernmost province—but the potent synthetic opioid was involved in 56% of the deaths in the first four months of 2016, according to the coroner's report.

The overdose crisis “is really our Ebola,” Dr. Mark Tyndall, executive medical director of the BC Centre for Disease Control, told CBC News last week, while discussing the startling report. 

Such a morbid picture has experts calling for two specific public health solutions: 1) wide distribution of naloxone, the antidote to opioid overdose, and 2) creating more supervised injection facilities (SIFs). 

And soon, Vancouver could see the opening of five new supervised injection sites. With regard to SIFs, Canada's Health Minister Terry Lake told CBC that, "We have seen the evidence. We know that we can reduce overdose deaths. We can reduce other related harms, reduce hospitalizations and connect people to services once they're ready to accept that help." Indeed, data suggest SIFs substantially reduce drug-related harms—mortality in particular. No one has ever died from an overdose inside a SIF. 

Health officials have yet to release the locations of the pending facilities until they are approved by Health Canada, but they are likely to be located inside existing facilities already serving the drug-using community. 

These five facilities would join the two already existing facilities in Vancouver. Both facilities have Health Canada permits, which are required so that medical staff can monitor illicit drug use at the site. But Health Minister Lake is asking Canada’s government to reconsider laws that restrict supervised injection facilities so more can open to combat the fentanyl problem. 

While these new facilities are yet to be approved, the death toll is rising, which is why Health Canada removed the need to have a prescription to obtain naloxone in March, around the time BC’s public health officer declared a state of emergency due to all the overdoses. 

So far, over 8,000 kits containing naloxone have been distributed by the BC Centre for Disease Control. Now available at over 100 establishments across the province, 1,200 kits have already been used to reverse overdoses, according to Dr. Tyndall. 

Health Minister Lake said "you can't flip a switch" and watch the problem go away, acknowledging that it will take time for the new services to take effect.

Meanwhile, the United States is experiencing its own rising prevalence of non-medical fentanyl, which has infiltrated heroin markets. Solving our own opioid crisis may require some friendly tips from our Northerly neighbors.