The deadly effects of fentanyl are back in focus, following a string of eight deaths in Victoria attributed to drug overdoses.
It’s a sign of how bad things have become that warnings from police and health officials about the powerful narcotic have become almost routine.
In the first of a three-part mini series on addiction, we look at how the drug is taking hold on the street.
Marshall Smith works with Cedars at Cobble Hill, a Vancouver Island treatment and recovery centre, and says addiction is something that can happen to anyone.
He should know – he’s been through it himself. Smith was cheif of staff to a BC Cabinet minister and helped oversee Vancouver’s olympic bid before drug addiction took him to the streets and back.
“As this disease progresses, unfortunately you are in a position where you lose control over your ability to stop consuming these drugs. My career got int he way of my drug use, and one of them had to go. And unfortunately, it was going to be my career.”
Fentanyl: Symptom of a broken system
We’ve come to know fentanyl partly because of a series of high profile overdoses, like the North Vancouver couple who died after taking pills laced with the drug.
But Smith says its presence on the street is the last link in a bigger chain that needs to be broken before we can solve the problem.
The drug itself is a high-potency opiate that has legitimate medical uses like treating cancer pain. The problem, Smith says, is that it’s in demand because of a growing opiate addiction epidemic.
“We have an opiate crisis [that’s] being fueled by the health care system itself. We have physicians in the British Columbia that are not checking the PharmaNet system before prescribing opiates, people are doctor shopping. They’re handing it out like candy.”
Smith says that as people get hooked on painkillers, then organized crime steps in – either stealing drugs like Fentanyl from pharmancies, or manufacturing synthetic copies. It then gets pressed into pills and sold on the street.
“The chain is, people go onto opiate painkillers prescribed by their doctors. Often, those are not prescribed or supervised properly. They become dependent on it, at some point they’re no longer able to get those pills from their doctor, they turn to the streets to supplement that use, and that’s when they run into trouble.”
Tackling the problem
He’s signed on to a report called Together, we can do this making 13 recommendations to the provincial government, many of them now under consideration. And he says the College of Doctors and Physicians has also responded to the report with a comittment to tackle unsafe prescribing and to get more doctors onto the PharmaNet system.
But he says solving the problem involves a shift in perception away from looking at addiction as a street problem, or something that happens to people on the edges of society.
“The vast majority of addiction in our communities is coursing it’s way through suburban neighbourhoods, high schools, kitchen tables, board room tables.”
Smith says that means getting to addicts early, before they end up on the street, and ending the myth that addicts need to hit rock bottom or “want to change.”
He says it will take work from all three levels of government, and comprehensive and innovative recovery strategies like Delta’s Little House Society, which brings addicts into care in the community and makes recovery attractive.