Prescription for safety: First-of-its kind fentanyl program launches in B.C.

A community services organization in Vancouver has launched a first-of-its-kind prescription program designed to draw fentanyl users away from potentially dangerous street supply. On April 7, PHS Community Services—a non-profit organization that offers housing and addiction treatment programs—handed a prescription to the first patient in its paid fentanyl prescription program. Through this “enhanced access” program, patients get prescriptions for powdered fentanyl with dosages based on a thorough intake and assessment process. These prescriptions are filled by a pharmacist and paid for by the patient, according to a CBC News report. "The common feedback we had from patients was that they would prefer fentanyl, that we needed to match what they were buying from the drug dealer in order to get them away from that street supply,” Dr. Christy Sutherland, medical director for PHS Community Services told CBC News. “So we worked as a team to create a new fentanyl option for our patients and community.” Read: Canadian jurisdictions looking to decriminalize small amounts of drugs to curb overdose deaths As British Columbia continues to grapple with the opioid crisis—which sees an average of six people each day dying of illicit drug poisoning—drug dealers are increasingly cutting fentanyl with toxic substances such as benzodiazepines and carfentanil. This puts users of fentanyl, which has become the street drug of choice, at higher risk of drug poisoning or overdose. "When we think about organized crime cooking fentanyl in these clandestine labs and trying to dose it out into dime bags, there's no way that they could make a consistent dose from unit to unit,” said Dr. Sutherland. “And so people don't know how much they're taking at a time.” With the new program, patients no longer need to get their fentanyl supply from criminal sources. Read: Street drug potentially 20 times stronger than fentanyl pops up in Sask. "This is a legal prescription—it’s labelled with your name and the contents of the prescription in a prescription vial,” said Dr. Sutherland. “They also have a receipt for the purchase of the prescription and have an active prescription on file at the clinic.” The program could also eliminate or reduce the need to administer fentanyl alternatives such as Dilaudid, which some patients don’t find helpful, she said. "They get their own unique prescription that is exactly the dose they need," said Dr. Sutherland. "Think about the agony of opioid-use disorder, of always being in withdrawal, always having uncertainty . . .. To know that you're not going to wake up at St. Paul's Hospital post-overdose, having had your belongings stolen from you or having been assaulted along the way." Leslie McBain, co-founder of Moms Stop the Harm—a network of Canadian families affected by substance abuse—described the new program as “fantastic” and potentially life-saving. Read: Half of Ontario opioid deaths interacted with healthcare system the month before: study "It's well thought out. It is legal. It is regulated,” she said. “There's pharmacists and medical people involved and in a setting that is low barrier and non-stigmatizing.” There had been some concerns that participants in the program could turn around and sell the prescribed fentanyl. But McBain said that is unlikely. "When a person gets what they need in a safe setting, there's no sort of impetus to go out and sell it," she said. "Why would a person ... sell it to go get something else that's dangerous and possibly fatal?" Dr. Sutherland said the program gives patients “dignity and respect . . . and that’s how I want to treat my patients.” As the program continues to roll out, PHS Community Services will be gathering data to evaluate effectiveness and inform potential expansion to other parts of the province. Read: Study finds prescribing opioids can be effective in helping people stop using IV drugs

Prescription for safety: First-of-its kind fentanyl program launches in B.C.

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