Canada: 'They're quicker than we are': Inside the fight against the opioid crisis - PressFrom - Canada
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Canada 'They're quicker than we are': Inside the fight against the opioid crisis

16:51  11 october  2018
16:51  11 october  2018 Source:   cbc.ca

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" They ' re quicker to finding a way around things. The exporters of this product out of China, they ' re pretty quick on their feet. In May 2017, Alberta set up the Opioid Emergency Response Commission. Made up of experts from diverse backgrounds including parents and frontline workers

They call it the opioid crisis : a rapid uptick in the use of both prescription and non-prescription opioid drugs across Canada and the United States. The phenomenon began in the 1990s but has peaked in recent years with increased restrictions on prescribed opiates and the appearance of fentanyl

They call it the opioid crisis: a rapid uptick in the use of both prescription and non-prescription opioid drugs across Canada and the United States.

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The phenomenon began in the 1990s but has peaked in recent years with increased restrictions on prescribed opiates and the appearance of fentanyl, a powerful synthetic painkiller that's become the street drug of choice for many.

Highly addictive, cheap to buy, and lucrative to those who sell it, fentanyl has been responsible for thousands of deaths across the country.

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Continuing the Fight against America’s Opioid Crisis . Jun 13, 2018 | COMMUNICATIONS •. For years, House Republicans have been leading the These are many times stronger than heroin and far cheaper, so drug dealers often use them to lace or replace heroin. They call it the opioid crisis : a

The Opioid Crisis . More than 300,000 Americans have died from overdoses involving opioids since 2000. On October 26, 2017, President Trump announced that his Administration was declaring the opioid crisis a national Public Health Emergency under federal law, effective immediately.

The death toll is staggering. Since January 2016, more than 8,000 Canadians have died of an accidental opioid overdose, according to the Public Health Agency of Canada, and most of those deaths are from fentanyl.

  • This is the third instalment in a four-part series in conjunction with the Calgary Eyeopener about how the fentanyl crisis is affecting people in the city

In Alberta, fentanyl deaths continue to rise. Alberta Health reports that in 2016, 348 people died of accidental fentanyl poisoning. In 2017, that number had grown to 569 people, and in just the first half of 2018, 330 people had died of accidental fentanyl poisoning — around two people per day in this province alone.

Fentanyl "is a more potent formulation than what years before was out there," said pharmacist Amy Rego, owner of Beacon Pharmacy in the Sheldon Chumir Health Centre.

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They call it the opioid crisis : a rapid uptick in the use of both prescription and non-prescription opioid drugs across Canada and the United States.

The centre is also home to the city's only supervised consumption site.

Fentanyl is a deadly opioid that has killed thousands of Canadians.© CBC Fentanyl is a deadly opioid that has killed thousands of Canadians.

Fentanyl doesn't discriminate

Fentanyl doesn't discriminate, she said; her clients who receive opioid maintenance medication range in age from 14 to their 70s.

"[The drug is] a hundred times more potent than morphine. So that in itself — we're talking a granule. You don't need much. The second thing is the affinity for the drug to the receptors in your brain. It's a very high affinity. So it attaches, and the euphora. They've made it such that it's highly addictive that way," Rego said.

That highly addictive quality of fentanyl has caused an "epidemic," according to Calgary police Staff Sgt. Kyle Grant, who works in the Strategic Enforcement Unit.

"It's very cheap for the manufacturers to bring in and produce, and highly profitable for them to sell. It's thousands per cent profit, versus what they put out to get it, and when you're making that much money, I don't think it's ever really going away."

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Why are more Americans than ever dying from drug overdoses? Deaths from drug overdoses in the US reached staggering new heights in 2017, according to newly published figures. In areas hard-hit by the opioid epidemic, few Americans surveyed felt drugs ‘posed a crisis in their own communities’.

Almost 100 people are dying every day across America from opioid overdoses – more than car crashes and shootings combined. “ We ’ re trying to develop a drug that locally turns down pain signals in order to prevent them from ever being transmitted to the brain,” Pavlik said.

Amy Rego is the owner of Beacon Pharmacy in the Sheldon Chumir Health Centre.© David Bell/CBC Amy Rego is the owner of Beacon Pharmacy in the Sheldon Chumir Health Centre.

Calgary police and the RCMP say most of the drug comes into North America via China, though some is coming up through Mexico, with a small amount being made here in labs in Canada.

China is attempting to regulate exports, but with thousands of fentanyl analogues or recipes, banning export of particular analogues is akin to banning house designs instead of banning bricks.

"The illegal supply side of this problem, they're quicker than we are," said MP Karen McCrimmon, parliamentary secretary for Public Safety Minister Ralph Goodale.

"They're quicker to finding a way around things. The exporters of this product out of China, they're pretty quick on their feet. Sometimes we're playing catch up."

Crackdown on pill presses, imports

The federal government has taken some action to tackle the opioid crisis in Canada.

In May 2017, it passed Bill C-37 to tighten control of pill presses, which are being used in the drug trade to press raw fentanyl powder into pill form, often after being diluted with a cutting agent such as caffeine powder or baking soda.

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Combating the Opioid Crisis . 1987 Partnership for a Drug-Free America Anti -Narcotics Campaign. For law enforcement, the fight against narcotics continues. In 2016, nearly 30 years later, more than 20,000 Americans were killed by fentanyl and fentanyl analogues, and that number continues to rise

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The federal government also gave Canada Border Services agents the power to open international mail under 30 grams,to check for drugs being imported.

Fentanyl comes in small amounts and is easy to mail.

Over a one-year period between 2017 and 2018, border agents seized 14 kilograms of fentanyl, enough for potentially 15,000 fatal doses, McCrimmon said.

The RCMP also has 130 sniffer dog teams specially trained to detect fentanyl, she added, and border services is investing in more technology to detect the drug upon arrival to Canada.

Grant said that police in Calgary are doing what they can. Border agents alert local police when a package containing fentanyl is destined for a particular city and police then follow up with the addressee.

'Overwhelming'

"We're on top of it as much as we can be," he said. "The subject itself is overwhelming. But there's never a shortage of work."

When investigators make fentanyl drug seizures, they're "potentially saving lives. They're saving lives they don't even know about."

He added that "any seizure is a success. Because as we know and see, it only takes a portion of a pill to kill somebody, right?"

Women in Calgary's Beltline smoke fentanyl through pen tubes.© Elizabeth Withey/CBC Women in Calgary's Beltline smoke fentanyl through pen tubes.

Katherine Pederson knows all too well how deadly the drug is.

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The overdose crisis is driven by illicit use of drugs – not those given on prescription for patients in need, says neuroscientist and author Marc Lewis.

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Her daughter Angelina (Lina) developed a drug problem in her early teens; Pederson and her husband Matthew Faulds tried everything to help.

In 2017 when she was 16, Lina took a fentanyl pill at a Calgary Stampede party and died.

"Lina touched every single public service and a private centre and still we lost her. So there's something wrong with that. Like, how do you think a parent feels when they've done everything they can?"

Lina was among 12 case studies reviewed in a June 2018 report on youth opioid use issued by the Office of the Child and Youth Advocate of Alberta.

Katherine Pederson and Matthew Faulds lost their daughter Angelina to fentanyl in 2017.© CBC Katherine Pederson and Matthew Faulds lost their daughter Angelina to fentanyl in 2017.

The report highlights that youth are particularly vulnerable to the opioid crisis and require special strategies to respond to their substance use. In Alberta in 2017, 71 youth between the ages of 15 and 24 died from fentanyl, and 35 more youth died in the first half of 2018.

In May 2017, Alberta set up the Opioid Emergency Response Commission. Made up of experts from diverse backgrounds including parents and frontline workers, the commission makes recommendations on how the provincial government can combat the opioid crisis.

This summer the commission made 32 recommendations, all of which are being implemented by government.

Dr. Elaine Hyshka, co-chair of the commission, said the crisis can be resolved but it's going to take some unconventional strategies.

"No one would say that increasing rates of overdose deaths is success by any measure," Hyshka said, but added that the government's quick response to the commission's recommendations is a sign of hope.

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That is why effective today my administration is officially declaring the opioid crisis a national public health We will be bringing some very major lawsuits against people and against companies that are We are going to be working with all of them . We are taking the fight directly to the criminals in

"We've seen a significant amount of progress in terms of building our system capacity to respond to the crisis in a relatively short period of time."

[Pharmaceutical companies] were certainly the kindling that set the stage, but fentanyl was the match. - Dr. Elaine Hyshka

But until accidental overdose numbers begin to significantly decline, she said, "there is more work to do."

McCrimmon agrees the problem isn't unsolvable — but that international cooperation with China is needed to stop the flow of the drug across international borders.

Lawsuits may be coming to help pay for the toll fentanyl is taking on the healthcare system.

In early October, the British Columbia government tabled the Opioid Damages and Health Care Costs Recovery Act — legislation to fast-track a class-action lawsuit against players in the opioid industry, including drug manufacturers, drugstore chains, distributors and wholesalers.

Hyshka supports any efforts to garner more resources for the opioid response, but said the "issue goes deeper."

Safer alternatives

"[Pharmaceutical companies] were certainly the kindling that set the stage, but fentanyl was the match," she said.

"At the end of the day we have to get people off the illegal market. We have to get people who are struggling — even if they're going to use — onto safer alternatives."

Hyshka said Alberta is keenly watching how B.C. is handling the crisis; some of the plans, she said, are "promising."

That province is considering implementing a low-threshold hydromorphone program, she explained, which would help get people off illicit fentanyl.

"If we're willing to think outside the box and recognize that what we've been doing traditionally has not been effective, then we can get on top of it but it's going to require significant willingness to move into uncharted territory," she said.

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Many Calgary drug users are taking advantage of Safeworks, the city's supervised consumption site where clients who use illicit substances can receive clean needles and be monitored to prevent overdoses.

Many of Beacon Pharmacy's clients access treatment services in the Chumir and use Rego's pharmacy to "dose," receiving daily opioid maintenance medications such as methadone or Suboxone — putting Rego's pharmacy at the epicentre of the epicentre.

Angelina (Lina) Pederson was 16 when she died after taking fentanyl at a Calgary Stampede party.© Supplied Angelina (Lina) Pederson was 16 when she died after taking fentanyl at a Calgary Stampede party.

The Calgary Zone continues to have the highest rate of fentanyl deaths in Alberta (20.1 per 100,000 person years, according to Alberta Health's Opioid Response Surveillance Report from Aug. 31, 2018, compared with the provincial average of 15.1).

The work at Beacon Pharmacy isn't for everyone.They've gone through numerous staff.

While it's not what she'd envisioned when she and Rich opened the pharmacy a decade ago in 2008, Rego finds the work rewarding, especially when she fosters solid relationships with opioid users in treatment who've been mistreated or demeaned at other pharmacies.

Of her work she said, "It's great the way it is. I wouldn't have it any other way."

Some clients at Beacon Pharmacy receive daily opioid maintenance medications like Suboxone.© Sally Pitt/CBC News Some clients at Beacon Pharmacy receive daily opioid maintenance medications like Suboxone.

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