Calgarypuck Forums - The Unofficial Calgary Flames Fan Community - View Single Post - BC to become first province with prescribed safe supply

Street Pharmacist · 07-17-2021, 01:49 PM

This needs to be done right, because some of these half measures are making things potentially worse. One clear factor in exacerbating the epidemic is cost. When people got more money from CERB, overdoses went up. BC did a "soft launch" of safer supply and some physicians would prescribe opiates to patients so they would not have to buy illicit opiates off the street of unknown purity and concentration. The way I see it, we have two distinct drivers if the current overdose epidemic:

1) Increased numbers of people suffering from Opioid Use Disorder. The causes of this are many and there's lots of research into this. It's due to increased access on the street and lower costs, increase mental health struggles, more addictive medications, changes in prescribing habits of opioids, and many more. This is the toughest nut to crack as none of these are easy to fix with policy.

2) An increasingly tainted supply that is now using much more potent opiates than before and dosing becomes trickier. Heroine potency didn't change all that much, but the newer synthetic opioids are 1000's of times more potent and trickier to standardize leading to many more overdoses, and we're seeing stimulants and other chemicals finding their way into the supply.

Safer supply only addresses number 2, and while there's no evidence, some are worried it may make number 1) worse by flooding the streets with cheap opiates

https://www.cbc.ca/news/canada/briti...oice-1.6078921

I still support Safe Supply as a concept, but we need other stronger options than simple opioids that Dr's currently use. For example, I had a patient with a daily dispensed prescription for hydromorphone tablets and dextroamphetamine tablets. In regular discussions with this patient, she told me it significantly decreased her need for other substances she would have otherwise purchased. But she's seeing some patients sell their safer supply because they need stronger stuff than what they can get from their Dr. So in order to get the fentanyl they crave, they sell their tablets of whatever the Dr gave them. That has the potential to make cost lower and accessibility of those opiates even higher leading potentially to a worsening of 1). There's a CBC article about this exact phenomenon https://www.cbc.ca/news/canada/briti...oice-1.6078921

07-17-2021, 01:49 PM	#83
Street Pharmacist Franchise Player Join Date: Nov 2006 Location: Salmon with Arms Exp:	This needs to be done right, because some of these half measures are making things potentially worse. One clear factor in exacerbating the epidemic is cost. When people got more money from CERB, overdoses went up. BC did a "soft launch" of safer supply and some physicians would prescribe opiates to patients so they would not have to buy illicit opiates off the street of unknown purity and concentration. The way I see it, we have two distinct drivers if the current overdose epidemic: 1) Increased numbers of people suffering from Opioid Use Disorder. The causes of this are many and there's lots of research into this. It's due to increased access on the street and lower costs, increase mental health struggles, more addictive medications, changes in prescribing habits of opioids, and many more. This is the toughest nut to crack as none of these are easy to fix with policy. 2) An increasingly tainted supply that is now using much more potent opiates than before and dosing becomes trickier. Heroine potency didn't change all that much, but the newer synthetic opioids are 1000's of times more potent and trickier to standardize leading to many more overdoses, and we're seeing stimulants and other chemicals finding their way into the supply. Safer supply only addresses number 2, and while there's no evidence, some are worried it may make number 1) worse by flooding the streets with cheap opiates https://www.cbc.ca/news/canada/briti...oice-1.6078921 I still support Safe Supply as a concept, but we need other stronger options than simple opioids that Dr's currently use. For example, I had a patient with a daily dispensed prescription for hydromorphone tablets and dextroamphetamine tablets. In regular discussions with this patient, she told me it significantly decreased her need for other substances she would have otherwise purchased. But she's seeing some patients sell their safer supply because they need stronger stuff than what they can get from their Dr. So in order to get the fentanyl they crave, they sell their tablets of whatever the Dr gave them. That has the potential to make cost lower and accessibility of those opiates even higher leading potentially to a worsening of 1). There's a CBC article about this exact phenomenon https://www.cbc.ca/news/canada/briti...oice-1.6078921