VANCOUVER—An opioid tablet distribution program starting Jan. 8 in Vancouver’s Downtown Eastside will be the first of its kind in the world, and the doctor behind the idea hopes it will save and change lives.

“You’ll see someone stabilize over a matter of a few days, because you have eliminated that need to engage in the illicit drug market, eliminated their need to do sex work, eliminated their need to do crimes to get money,” said Dr. Christy Sutherland, the medical director for Portland Hotel Society (PHS).

Since 2016, street drugs such as heroin have been routinely tainted with the powerful synthetic opioids fentanyl and carfentanil. Every time someone uses drugs bought on the street, they’re risking overdose and death: In 2017, more than 1,400 people in B.C. died of an overdose. So far this year, 1,143 people have died.

As the death toll has risen, so has the political will to expand programs to give pharmaceutical-grade, non-tainted opioids to people who are experiencing addiction. The B.C. government now has a framework for this kind of treatment.

This week, Vancouver City Council voted to approve a series of measures on the overdose crisis, including work to identify a storefront space in the Downtown Eastside where the BC Centre for Disease Control could operate a “low barrier” hydromorphone distribution project.

That project is still in the planning stage, according to the BCCDC.

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Sutherland has been running an injectable hydromorphone program for around 300 people over the past two years. She said it’s similar to a program first developed as a clinical trial by Crosstown Clinic, which still treats around 130 patients who participated in those trials. Patients in the injectable hydromorphone program inject twice a day under medical supervision, Sutherland said.

But offering lower-dose Dilaudid tablets will increase the flexibility of the program, as patients will be able to take one or multiple doses if needed. PHS’ overdose-prevention site near Main and Hastings is open until 11 p.m., so patients can drop by when it’s convenient for them. All drugs are administered under the supervision of a nurse.

The Ministry of Mental Health and Addictions has approved the project, and PHS will be sharing data with Vancouver Coastal Health. The BC Centre on Substance Use will study the outcomes for people in the program over the next five years.

Sutherland said the tablet program gives her one more option to offer to people who may not have found success with other opioid treatments, like methadone or suboxone.

“I have patients who are on methadone … and they just can’t eliminate those few times a week that they’re using illicit fentanyl, and the ongoing risk of death is high,” she said.

Sutherland said the assumption that abstinence is the only real path to recovery from drug addiction is out of date and dangerous.

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“We know for opioids that rapid detox, sweating it out, actually increases death because you lose your tolerance and then have relapse,” she said.

“I really have compassion for my patients. I want them not to die, I want them to not get HIV. I want them to have housing and be able to achieve their goals like spending time with friends.”

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