The opioid battle
Jordan Ryan | Monday, February 26, 2018
Not a day goes by without seeing something in the news regarding the opioid crisis. On average, we lose 176 Americans a day to drug overdoses. Unfortunately, we have yet to unlock an effective solution capable of producing successful results. State and local governments have reacted to this crisis by, at least in part, playing the all too common blame game. Hundreds of cities, counties and states have sued opioid manufacturers and distributors. The lawsuits contend that governmental units have incurred billions of dollars in costs addressing the problem created by the drug companies’ misleading marketing of opioids as relatively safe and rarely addictive alternative pain medications. While these suits may have merit and could well compensate the public entities for costs incurred, they do little to help those struggling with opioid addictions.
This problem is evident not only in the United States, but also in our neighbor to the north, Canada. In the first half of 2017, about 1,460 people died as a result of an opioid-related, a figure that Canada’s public health agency estimates will surpass 4,000 once data is reported for the balance of the year. Most of these deaths are concentrated in British Columbia, one third to be exact. As part of the battle to address this epidemic, the Province has initiated a new program: vending machines filled with drugs. The British Columbia Center for Disease Control just recently announced that it plans to install three vending machines this spring that will dispense hydromorphone pills, a powerful prescription opioid, to people with a high risk of overdose. Experts believe this drug could reduce dependencies on contaminated street drugs cut with lethal substances such as fentanyl. The pilot program is being funded with a grant from Health Canada, the national Canadian agency responsible for public health.
Though seemingly counterintuitive, public officials are very optimistic about this program’s potential success. The province has experience with supervised access to drugs. Currently, they sponsor eight supervised sites, where addicts inject illegal drugs under the supervision of nurses who can intervene in case of an overdose. While these programs have been effective, officials say their models carry heavy costs, are difficult to scale and limited in their accessibility, particularly in rural communities.
Under the pilot vending machine project, drug users would be able to get two to three hydromorphone pills three times a day. The cost per patient would be roughly only 3 Canadian dollars per day. The machines are relatively inexpensive, making it easy to expand the program quickly. Additionally, the security of the machines is an obvious concern. The manufacturers of the pill dispensing devices claim that by the use of real time monitors and biometric identification to access the machines, there will be little risk of theft and fraud.
Surprisingly, vending machines have played a role in coping with drug abuse for some time now. Health officials in the United States have experimented with the use of drug addiction related vending machines. Last April, the Southern Nevada Health District and a local organization Trac-B Exchange, launched a vending machine program which provided clean needles, sharps disposal boxes and other necessary supplies to encourage users to throw away used needles in order to prevent the spreading of diseases. Three vending machines were placed throughout the Las Vegas area, mostly in readily accessible community centers. These vending machines have been so successful that an additional five more were installed in October 2017.
In what seems to be a never-ending battle, our struggle with this opioid epidemic may take more aggressive and creative efforts. From past experience, what we do know is that the solution to the problem will take a multi-front approach. Part of the battle has to attack the root cause of the crisis, those who unfortunately find themselves addicted to these dangerous drugs. Our healthcare officials need to keep open minds and remain perceptive to out-of-the-box solutions to this incredibly complex problem. Perhaps the experience of our northern neighbor Canada may serve as a model for at least part of a solution which could save thousands of lives in our own country.
The views expressed in this column are those of the author and not necessarily those of The Observer.