Preventing ODs: Coalition decries ‘systemic barriers’
With just enough methadone to last the trip home to Montreal, Melodie was in a panic that she’d missed her flight. She was in Paris, and her supply of prescription methadone, a medicine that helps lower cravings and withdrawal symptoms caused by opiate use, was about to run out. Without it, she worried about a relapse, going into the street in desperation, and doing something dangerous for a fix.
But an online search brought her to a Parisian mobile health clinic. And they welcomed her. They gave her the methadone that she needed to stay sober. There was no bureaucracy, no delay, and no prescription signed by someone in authority — just instant help.
That’s what Quebec needs now, more resources — and more money — invested in public health techniques that have proven their worth, Melodie, who heads L’Injecteur, a magazine by and for people who use drugs, said Tuesday.
With deaths soaring from illicit drugs contaminated with fentanyl, a coalition of community groups, crisis workers, activists and drug users called on the Quebec Health Department and the City of Montreal to improve health prevention services for a population at risk of dying of overdoses.
Why not invest immediately in harm-reduction methods that are known to work? demanded Jean François Mary.
“Are (political and health) authorities waiting for a magic number of dead — an acceptable quota?” said the director of a provincial association for the promotion of drug users’ health, the Association québécoise pour la promotion de la santé des personnes utilisatrices de drogues (AQPSUD). “Let’s not repeat the same mistakes made in Vancouver,” where more than 1,100 people have died this year alone because of fentanyl-related intoxication.
Mary, whose group is a member of the Montreal Harm Reduction Coalition, lashed out Tuesday against what he called systemic barriers to health, hours after the provincial ambulance service, Urgences-Santé, reported a sharp uptick in deadly overdose cases this autumn.
According to the most recent data, 60 people died of overdoses between Aug. 18 and Oct. 16 in Montreal. Most of the deaths, 41 cases, occurred in the downtown Centre Sud area.
Nearly 60,000 people died of fentanyl-related drug overdoses in the U.S. last year, while Canada had more than 2,800 cases.
Whether it’s called an escalating public health crisis, or a looming crisis, it’s all just semantics, Mary said. “For us, it’s people we know. I can put faces to this crisis,” he said. “We are seeing people dying. We have the means to act as a society — and it’s unacceptable that we’re not.
“The first solution is naloxone — and we don’t understand why that isn’t already in place,” Mary said of the powerful antidote currently available in four Montreal pharmacies. Provincial health officials announced in mid-September that Quebecers would be able to obtain naloxone free of charge in all pharmacies. First responders, including police, will be also able to carry the kits and administer the antidote.
But community groups and crisis intervention workers immediately responded by calling for wide distribution at safe injection sites as well as organizations that work with users. More than 75 per cent of Montreal’s drug users get their paraphernalia at safe injection sites and needle exchanges. That’s where the naloxone should be, workers said.
When a community’s water supply is contaminated, officials move in with clean bottled water, Mary said. “But when we have contaminated drugs, we let people die and we do nothing,” he said, even though pharmacies are filled with clean opioids.
The coalition is calling for better drug treatments for users; extended hours for safe injections sites, up to 24 hours a day; funding for methadone substitution programs, which currently have wait lists, and testing kits so drug users can be sure what they are taking really is safe.