Canada - Drug users to get access to hydromorphone tablets in Vancouver facility

[S.J.B.]

First in Canada drug program to launch in Vancouver's Downtown Eastside
Mike Howell
Vancouver Courier
December 20th, 2018

A program believed to be the first of its kind in Canada will launch in early January in the Downtown Eastside and allow 50 drug users to access a prescription painkiller tablet and inject it while in a monitored facility.

Coco Culbertson, senior manager of programs for the PHS Community Services Society, said participants will be given hydromorphone tablets -- a pain management opioid to reduce cravings for heroin -- that they will be allowed to crush and inject inside one of the society's overdose prevention sites.

"Continuing to have people live in this prison of overdose-reverse-repeat is not good enough," said Culbertson, after speaking to city council Thursday on the need for more treatment options to reduce the number of drug deaths in Vancouver. "So we feel we are tasked with doing something better for our community."

Added Culbertson: "If we're successful, I think it's a game-changer."

The site is located inside the Molson Bank building at 166 East Hastings, a location seen as ground zero for the ongoing overdose death crisis that has claimed more than 300 lives in Vancouver this year for the second consecutive year.

Read the full story here.

 

[S.J.B.]

Hydromorphone pills are so inexpensive that there is no reason every supervised injection site in the country shouldn't give them out. If they would just set up dispensaries where adults could buy them at-cost (plus a bit extra to pay for the storefront and employees) the fentanyl problem would vanish very quickly without the government having to spend a cent. I just hope they are handing out micron filters with the pills.

 

[Burnt Offerings]

Hydromorphone has always seemed like a strange choice for an opioid replacement therapy drug..it's a short-acting one, isn't it?

They should just provide Duramorph ampules for addicts in a harm reduction program like the one described above. I wonder why injection-ready morphine isn't a more popular option...it can't be good to inject a tablet...

 

[S.J.B.]

Hydromorphone has always seemed like a strange choice for an opioid replacement therapy drug..it's a short-acting one, isn't it?

That's it's reputation, but the seminal SALOME study showed that long-term heroin addicts cannot distinguish it from pure heroin, and when given the choice of having up to three injections a day, study participants had, on average, 2.5 injections per day in the hydromorphone group and 2.6 injections per day in the heroin group. Perhaps there is an adulterant in street heroin that makes it last longer, or maybe the doses just tend to be higher on average than in the hydromorphone pills people are used to, but the evidence seems clear: at equipotent dosages, the duration and effects of pure heroin and pure hydromorphone are essentially equivalent.

I wonder why injection-ready morphine isn't a more popular option...it can't be good to inject a tablet...

Injectable solutions are a much better option; however, they are way more expensive.

 

[Transcendence]

Why use pills and not injectable hydromorphone used in hospitals? I assume nobody getting this for replacement therapy is going to be taking this orally.

 

[S.J.B.]

Why use pills and not injectable hydromorphone used in hospitals? I assume nobody getting this for replacement therapy is going to be taking this orally.

The pills are drastically cheaper.

 

[LucidSDreamr]

While legit pain patients are being denied opioids. Society is absolutley retarded when it comes to drugs.

 

[Transcendence]

The pills are drastically cheaper.

I'm not sure they're going to turn out to be cheaper for the health care system when factoring the additional financial burden of treating talcosis.

 

[S.J.B.]

I'm not sure they're going to turn out to be cheaper for the health care system when factoring the additional financial burden of treating talcosis.

Agreed. However, these organizations have to work with what they have available. The number-one goal right now is to keep people from dying fentanyl-related poisoning deaths and hydromorphone tablets will suffice for that purpose. If they are smart enough to provide proper micron wheel filters, which are not terribly expensive, then the negative effects of providing pills over injectable solutions should be minimized.