Supporters say a pandemic was needed to make progress in promoting safe care for people with drug problems, and there is no guarantee that progress will continue.
On March 26, the state government introduced new clinical guidelines after the federal government announced a number of exceptions to the regulated substances law. The changes would allow physicians, nurses, and pharmacists to prescribe safe drug delivery to people dealing with substance use disorders to support social distance in the face of two public health emergencies.
Corey Ranger, a downtown street nurse, says safe care is the best step forward in these circumstances. Ranger works with Victoria's homeless population and cannot say that he has seen an increase in overdoses – until now. With borders closing and people isolating themselves, illegal drug supply is becoming scarce and Ranger says that this makes the local situation volatile.
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“Drugs are cut with other drugs. There are many benzos contained in opiates, and naloxone does not act on benzos, so it causes different types of overdoses, ”he says, adding that the lack of availability alters people's tolerance to medications, which also result can overdose.
An open letter to Prime Minister John Horgan, along with a number of ministers, calls for the decriminalization of drugs as the next step in containing the COVID-19 pandemic and the overdose crisis.
Leslie McBain, co-founder of Moms Stop the Harm – one of the 17 organizations that signed the letter and 22 people, from mayors to pharmacists to scientists – says there are still questions about what safe care should look like but calls this a "big window into the future".
"[The government’s] has been forced to respond and they cannot scratch it back," says McBain. "It's not like COVID-19 is leaving us and we are all returning to a normal feeling that they will say we can no longer have secure care because we have no COVID-19 – they are not going to to do. "
According to Judy Darcy, Minister of Mental Health and Addiction, this is not necessarily the case.
"The federal government says these guidelines will expire in late September 2020 and I don't have a crystal ball," says Darcy.
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According to the new guidelines for safe care, people who do not have a doctor can contact a fast-access addiction clinic or The Harbor Safe Consumption Site for a prescription. Ranger explains that while people get a prescription for 23 to 30 days of safe care, it doesn't mean you can take medication worth 23 days home with you.
"Part of the prescription says you have to take your medication for a day or two," says Ranger. "The advisory tools ask us to find pharmacies that can deliver, and there are some that do."
An increase in overdose deaths was reported in Vancouver from March 23 to 29, and Ranger believes this is only a matter of time on site.
"I can say on the island in Victoria that we usually lag behind trends for a week so that this can happen to us," he says.
McBain is concerned about the same thing, saying that she does not believe that secure care will be introduced quickly enough.
"This is a victory for those who have been committed to secure care for years, and it is important, but will it stop what might be the perfect storm for the homeless and marginalized? I don’t think it’s going to be rolled out quickly enough not to see what’s coming with COVID infections and to prevent withdrawal from a dwindling supply of street drugs, ”she says. “Prices are rising and the supply is falling. People are getting desperate, it's really scary. "
She says that the stigma of drug use is spreading the progress that needs to be made, and points out that alcohol and marijuana retailers are seen as essential services.
"Liquor stores are an essential service because people are addicted to alcohol … People are addicted to drugs and why they don't have secure supplies, but people who are addicted to alcohol have safe supplies," says McBain.
Social services providers agree that secure care is a big step forward, but believe that a pandemic should not have been needed to get there.
“It is great that we have this foundation, but there is certainly still a lot to be done to achieve this and that work needs to be done with a sense of urgency because we are many of the things we do . We are currently planning and we are planning for things that are already happening, ”says Ranger.
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Addiction Treatment Addiction TreatmentCoronavirusMental Health and Addictions Minister Judy Darcy
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