London News & Search
The deadly painkiller fentanyl, thrust under a spotlight by a rare warning by three health agenices and city police, isn’t the only dangerous street drug raising eyebrows in London.
Heroin is also showing up, in levelsthose who work with addicts say they haven’t seen before.
One agency blames the spike on the province tightening the prescription drugs it covers under a program for people on social assistance and seniors, which has driven some users to heroin instead.
“I’ve never known it (heroin) here. Now it is,” said Karen Burton, needle and syringe program coordinator at Regional HIV/AIDS Connection in London, whose work includes a drug needle-exchange program. “Heroin is here and I don’t see it disappearing anytime soon.”
Frontline workers at the agency, which say they’re now seeing four or five heroin users a day, up from two to three people a month last year.
“There’s a large amount of heroin now in London and that’s a new situation as of January because of some changes in the way they (the province) fund drugs,” said Blair Henry, harm-reduction case manager at Regional HIV/AIDS Connection.
The province in January removed certain high-strength prescription painkillers from coverage under its Ontario Drug Benefit program amid the opioid drug crisis that’s swept the country in recent years, causing many overdose deaths.
Burton said the move has resulted in fewer high-dose opioid pills diverted to London streets, driving up the cost of the handful that remain. She said the government’s move, designed to stem prescription opioid abuse, has paradoxically driven people to illegal drugs instead.
“(High-dose prescription narcotics) are going to become more difficult to find and if they can get heroin on the street without looking so hard, then they’re going to get heroin,” said Burton.
A frightening prospect for Burton and Henry, who know heroin is sometimes laced with fentanyl, a hyper-potent opioid blamed for a growing number of deaths in Canada. Police in Sarnia suspect cocaine laced with fentanyl was responsible for a death last week, one of three oversdoes reported within hours.
Two other people were taken to hospital.
Henry said organized crime is likely bringing heroin to London, seeing an opening in the market now that high-dose narcotic pills are in short supply.
Addictions and Mental Health Ontario and the Canadian Mental Health Association were concerned Ontario’s move would have unintended consequences and outlined that position in a joint statement in February.
“Our organizations are concerned that reducing the availability of high strength opioids will not curb the opioid epidemic overall,” they said. “A well intentioned policy can lead to an increase in opioid related harm and further use of risky street drugs.”
At Addiction Services of Thames Valley, Dr. Ken Lee, who heads a clinic for recovering drug addicts, said he’s already seeing heroin in urine samples from some recovering drug users he sees.
“I think it’s hit the streets in London in the past month or so. Prior to this we have not seen any heroin positives in our urine testing,” he said. “All I am seeing is the tip of the iceberg.”
Ontario’s move to cut high-dose narcotic pills from its drug benefits has its defenders.
“These high-dose products normalize a very abnormal and, frankly, dangerous behaviour,” said Dr. David Juurlink, head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre in Toronto.
“It will help doctors not mismanage chronic pain as we’ve been doing.”
The province, spending $224.8 million this year on community addictions services, said de-listing high-dose opioids will stop many from hitting the streets.
“This supports appropriate access to opioids and encourages appropriate prescribing while limiting opportunities for the inappropriate use, abuse, and diversion of high-strength, long-acting opioids,” said Laura Gallant, a spokesperson for Health Minister Eric Hoskins.
Juurlink said smaller-dose opioid drugs are still covered by the Ontario Drug Benefit program. And for users who want to seek treatment, addiction and recovery resources are available too.
While Juurlink agrees not paying for the extra-strength drugs could force users to try other ones, he said limiting the use of high-dose prescription opioids is an important and long overdue step.
“In theory you do make it more likely that someone will turn to something that is more dangerous, but that doesn’t mean that it wasn’t the right thing to do in the first place,” he said.
WHAT OTHERS SAID
“We do think those prescribing guideline changes, in the long term, they’ll be very beneficial in terms of getting, hopefully, less people addicted through the medical system. In the short term, you’re going to see less pharmaceutical-grade drug on the street and that potentially could mean that other things — whether it’s heroin or fentanyl or other illicit drugs — (are) taking over that part of the market.”
— Dr. Chris Mackie, medical officer of health for Middlesex-London Health Unit
“The problem is not the opioids, the problem is that we have an increasing mental health crisis here . . . We’re going to end up with a new problem, or perhaps a worsening of an existing problem, which is undertreated chronic pain or the stigmatization of people with legitimate pain problems who actually benefit from these opioids.”
— David Walton, assistant professor, Western University school of physical therapy
London News & Search