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

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

Johnathan Lee Robichaud pleaded guilty to eight charges including sex-related offences against children and accessing, possessing and making or publishing child pornography. (Courtesy of Saanich Police)
Sentencing date moved for Saanich nanny guilty of child porn charges

Johnathon Lee Robichaud pleaded guilty to eight sex offences against children

(Google Maps)
Sophisticated glass-removal crime returns to downtown Victoria

Several businesses on Fort Street targeted overnight, say police

Eligible non-profit organizations and charities apply for support through North Saanich’s COVID-19 relief until Feb. 12.(Black Press Media file photo)
North Saanich lays out criteria for grants to non-profits

Eligible applicants can apply for an unlimited amount to help ease effects of COVID-19

(Black Press Media file photo)
Saanich repeals, reschedules two public hearings for consideration of new information

Move to hold public hearings for second time ‘very rare,’ mayor says

Health Minister Adrian Dix and provincial health officer Dr. Bonnie Henry head for the press theatre at the B.C. legislature for an update on COVID-19, Jan. 7, 2021. (B.C. government)
B.C.’s COVID-19 spread steady with 509 new cases Friday

Hospitalized and critical care cases decline, nine deaths

Seasonal influenza vaccine is administered starting each fall in B.C. and around the world. (Langley Advance Times)
After 30,000 tests, influenza virually nowhere to be found in B.C.

COVID-19 precautions have eliminated seasonal infection

Chief public health officer Dr. Theresa Tam provides an update on the COVID-19 pandemic in Ottawa on Friday, Jan. 8, 2021. THE CANADIAN PRESS/Sean Kilpatrick
Canada’s top doctor says to avoid non-essential travel as B.C. explores legal options

Premier John Horgan says he is seeking legal advice on whether it can limit interprovincial travel

Lilly and Poppy, two cats owned by Kalmar Cat Hotel ownder Donna Goodenough, both have cerebellAr hypoplasia, a genetic neurological condition that affects their ability to control their muscles and bones. Photo by Alistair Taylor – Campbell River Mirror
VIDEO: Wobbly Cats a riot of flailing legs and paws but bundles of love and joy to their owner

Woman urges others to not fear adopting cats with disabilities

Martin Luther King Jr. addresses the crowd during the march on Washington, D.C., in August of 1963. Courtesy photo
Government reinforces importance of anti-racism act on Black Shirt Day

B.C. Ministers say education “a powerful tool” in the fight for equity and equality

A northern resident killer whale shows injuries sustained by a collision with a vessel in B.C. waters. (Photo supplied by Ocean Wise Conservation Association)
Coast Guard ramps up protections for B.C. whales

First-ever Marine Mammal Desk will enhance cetacean reporting and enforcement

Dr. Shannon Waters, the medical health officer for the Cowichan Valley Region, is reminding people to stay the course with COVID-19 measures. (File photo)
‘Stay the course’ with COVID measures, Island Health reminds

Limit social activity, wash hands, wear a mask, and isolate if you feel sick

Jobs Minister Ravi Kahlon shared a handwritten note his son received on Jan. 13, 2021. (Ravi Kahlon/Twitter)
Proud dad moment: B.C. minister’s son, 10, receives handwritten note for act of kindness

North Delta MLA took to Twitter to share a letter his son received from a new kid at school

Cowichan Tribes members line up at a drive-up clinic on Wednesday, Jan. 13 to receive the first doses of the COVID-19 vaccine in the region. (Kevin Rothbauer/Citizen)
BCAFN condems racism against Cowichan Tribes after COVID-19 outbreak

“Any one of us could do everything right and still catch the virus”: Regional Chief Terry Teegee.

Most Read