People are seen in an alleyway in Vancouver’s Downtown Eastside, Wednesday, Feb. 6, 2019. British Columbia’s chief coroner is to release statistics for illicit drug overdose deaths in 2018 on Thursday. THE CANADIAN PRESS/Jonathan Hayward

Drug-dispensing machine model should be expanded to fight overdoses: B.C. doctor

Doctor behind MySafe wants to see the program grow

Don Durban holds his palm up to a screen on a tall steel box akin to a vending machine crossed with an ATM that displays his first name and an identification number seconds before dispensing what he calls a life-saving plastic package.

Durban, 66, takes out two small hydromorphone pills and leaves a storefront with the heroin substitute he gets there four times a day as part of a program aimed at tackling an overdose crisis that has killed an estimated 5,000 people in British Columbia since 2016.

“I don’t have to smoke fentanyl. It’s saving lives and I’m here to save mine,” Durban said.

The machine, called MySafe, is bolted to the floor in a building next to an overdose prevention site in Vancouver’s Downtown Eastside.

Dr. Mark Tyndall came up with the idea for the machine. He stocks it with hydromorphone delivered by a pharmacy for drug users whose urine has been tested for the presence of fentanyl.

READ MORE: Behind the scenes of the MySafe dispensing machine

Tyndall, who has spent 20 years working in harm reduction and is a professor of medicine at the University of British Columbia’s school of population and public health, said a biometric scanner in the machine identifies patients who are dispensed particular dosages of the pain-management opioid sold under the brand name Dilaudid.

Eight patients are using MySafe and three more were added this week. The machine can be programmed to provide the drug for 48 people, Tyndall said, adding most of his patients have been swallowing the hydromorphone, which is sometimes crushed and cooked before being injected intravenously like heroin.

His vision would see MySafe machines installed in overdose-ravaged communities across Canada, but in Vancouver, the epicentre of the opioid crisis, only one other doctor has come on board to prescribe hydromorphone from the machine.

Resistance from physicians so far is possibly because other “medicalized” models — where patients use methadone or inject a medical grade of heroin under supervision — have become the norm, even though his program is cheaper to run and does not require supervision, Tyndall said.

“This is a harm reduction thing where I don’t want to see people continue to buy fentanyl and die.”

Concerns about diversion of hydromorphone dispensed from MySafe are negligible because patients in the program are monitored and anyone they may be passing the drug on to could be saved from the illegal drug supply known to contain fentanyl, Tyndall said.

“This is the same arguments against harm reduction altogether, that we’re just enabling people and what is the motivation to them to stop using drugs if we’re just giving them drugs? What I’ve seen people go through to get illegal drugs, it’s crazy.”

Tyndall said patients who use MySafe can use drugs alone, the way most people do, without fearing their addiction could kill them.

Health Canada said in a statement it is aware of the project, noting the dispensing of medication falls under provincial regulations.

British Columbia’s Ministry of Mental Health and Addictions said it will await the results of the independent project involving MySafe.

“The ministry is focused on our own work to scale up access to medically supervised prescription alternatives to toxic street drugs as part, just one part, of establishing a full continuum of care and delivering an urgent, comprehensive response to this crisis, including prevention, enforcement, harm reduction and treatment and recovery,” it said in a statement.

The MySafe machine is located on the same street as two of North America’s first supervised approaches to harm reduction. Insite allows drug users to inject their own substances, while Crosstown provides between 100 and 120 people with medical grade heroin they inject several times daily.

Dr. Scott MacDonald, who runs Crosstown, said the clinic based on a European model provides support from health-care staff including nurses, a pharmacist and social workers.

MacDonald said it has spawned nine smaller programs in Canada, six of them in B.C., and the rest in Edmonton, Calgary and Ottawa, for patients who have failed at multiple attempts to treat their addiction.

“While there’s been a small scale-up, what’s blocking expansion at this time is just a willingness to fund it and pay for the nursing staff,” he said.

Efforts to combat overdoses in the Vancouver area include the distribution of take-home fentanyl test strips, distributed by the regional health authority starting this month, so drug users can see if their urine contains the opioid before taking illicit substances.

Camille Bains, The Canadian Press

Like us on Facebook and follow us on Twitter.

opioids

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Port Hardy Mounties help First Nation chief build smokehouse

‘We have great maya’xala for all the community members, in each of the communities…’

Emaciated grizzly found dead on central B.C. coast as low salmon count sparks concern

Grizzly was found on Gwa’sala-‘Nakwaxda’xw territory in Smith Inlet, 60K north of Port Hardy

Access to remote Side Bay beach up in the bureaucratic air

Roads to the pristine north west coast Vancouver Island beach at risk of being deactivated

Mount Cain planning a modified winter season for north Island ski and snowboarders

Skiing is a COVID-friendly activity, but shared public spaces require adjustment

Remote B.C. tourism lodge staffed for coastal clean up instead of wilderness tours

The Great Bear Rainforest is home to exotic wildlife — and international trash

QUIZ: A celebration of apples

September is the start of the apple harvest

B.C. migrant, undocumented workers rally for permanent residency program

Rally is part of the Amnesty for Undocumented Workers Campaign led by the Migrant Workers Centre

Preparations underway for pandemic election in Saskatchewan and maybe B.C.

Administrators in B.C. and around the country are also looking to expand voting by mail during the pandemic

Nearly 20 per cent of COVID-19 infections among health-care workers by late July

WHO acknowledged the possibility that COVID-19 might be spread in the air under certain conditions

Ferry riders say lower fares are what’s most needed to improve service

Provincial government announces findings of public engagement process

Supreme Court Justice Ruth Bader Ginsburg dies at 87

The court’s second female justice, died Friday at her home in Washington

Comox Valley protesters send message over old-growth logging

Event in downtown Courtenay was part of wider event on Friday

Application deadline for fish harvester benefits program extended

Those financially impacted by the pandemic have until Oct. 5 to apply

VIDEO: B.C. to launch mouth-rinse COVID-19 test for kids

Test involves swishing and gargling saline in mouth and no deep-nasal swab

Most Read