Drug Supply and Ending Harmful Drug Use

The most commonly used street drugs in London, Ontario are not actually street drugs, they are prescription opiates. This includes such things as Oxycontin, Oxycodone, Percocet, Dilaudid, Fentanyl, etc. These substances originate from prescriptions at hospitals, walk-ins, or family doctors, or are diverted from pharmacies, or stolen from hospital supplies. Some individuals divert their entire prescription, some use part and divert the rest. Opiate addiction is powerful as there is a strong physical effect and change in neuro-chemicals that make the need to use more substance inevitable, and the ability to stop more difficult.

In Ontario, Bill 101 is a well intentioned attempt to reduce the harm in communities of prescription opiate use. The bill is focused on more ‘responsible’ prescribing of narcotics for physicians, requiring disclosure of information around monitored substances. Having received Royal Assent in November of 2010, the bill has begun to have the intended effect of reducing the prescribing of opiates. Subsequently, availability on the street has gone down, and price per unit has gone up.

At the same time as Bill 101 has been rolling out, in the U.S. they have started reconstituting opiates with antagonists so that if they are crushed or dissolved, the effect is negated. This has led to a large decrease in the supply coming from the 11 hospitals in Metro Detroit, that land first in Windsor.

What is the outcome?  Unfortunately, the outcome is not a reduction in narcotic addiction.  Making substances more difficult to access does not constitute a treatment for addiction.  Rather, what we are seeing is a resurgence of heroin use in Ontario, with Windsor leading the way.  We will likely actually see an increase in harm in our communities, as the heroin trade comes with all sorts of unpleasant components that do not exist when an individual experiencing addiction is simply obtaining substances through a prescription, theirs or someone else’s.

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8 thoughts on “Drug Supply and Ending Harmful Drug Use

  1. Curious: what’s the street value of Oxycontin in London? In Vancouver, I believe that it is the street drug with the highest price (last I heard, it was going for something like $22-25 a pop).

    It’s also interesting that these drugs are still given out at walk-ins in London. Most walk-in clinics in Vancouver — especially any in or near downtown — have a strict policy against prescribing them.

  2. Dan, it depends on how many milligrams the pill is, the Oxy 80mg’s can go for $60, and rising.

    There are at least 3 walk-in clinics that are functioning effectively as family doc offices with booked appointments and follow-up appointments. These are more open to addressing pain control in the context of addiction. Others still give out less popular prescription drugs that are used recreationally, which I won’t name here so no one gets the idea to start crushing their anti-depressant, but I’m sure you know the variety that is out there.

  3. You are on to an interesting thread Abe. Passing 101, designed to curb or reduce the amount of prescription opiates on the street, as it reads today is short sighted if not calamitous.

    Forcing the pharma opiates out will indeed open the door for drugs that organized crime will gladly supply and corner subsequently corner the market on. Crystal, Heroin, Crack etc.

    Right now the drugs flooding our streets can be traced back to the manufacturer. Manufacturers making billions of dollars on the sale and supply of said drugs. Perhaps it would be more prudent to think a little more about 101 with this in mind. I have spent many years up close and personal with addiction and 99.9% of the time some sort of trauma, mental health issue or past abuse is in the mix. The true cost of healing the folks struggling with opiate addiction isn’t calculated by detox alone. A long line of services must go hand and hand with detox programs. Now the immediate question that comes to my mind is ‘where are we going to get the money’? Purdue – Billions. Novartis – Billions. Abbott – Billions.

    It is about time that we start demanding these companies fund the services needed to clean this mess up. I don’t mean donating money to University Pharma research and programs. I mean funding shelters. Funding mental health treatment services. Trauma recovery. Job re-training. The list goes on.

    Forcing the pharma opiates out will also dry up the access to the funding really needed to effect some change.

    Sadly London is content to develop policy minus any input from the folks who know best. The addicts themselves. There is no communication and it is painfully apparent. London still thinks it has an Oxy problem. We both know there are other drug out there like Hydros and Ritalin that are far more popular. Oxy is considered expensive and lacking ‘legs’ by comparison.

    Anyhow, great thoughts and keep up the good fight.
    J

  4. I have not heard anything about heroin use in Windsor, how greatly is it increasing and in what areas? I am surprised by that fact.

  5. Good question Jordan. My source in Windsor, who runs a recovery home for women, said that heroin overdoses in Windsor outpaced prescription narcotic overdoses for the first time in over 20 years.

  6. Wow, I had no idea the heroin problem was here in Windsor. Mostly I hear of people taking fentanyl, which is scary enough. It seems that a lot of the people selling oxy have been pinched and fentanyl is filling the void. Not to mention a lot of methadone users have been using fentanyl because it is the only thing that breaks through. It’s quite worrying to think that with the crackdown on pain killers we’re opening ourselves up to a completely new, and worse problem.

  7. Thanks Jordan. Fentanyl is a scary, scary thing. It is safer in that these are known doses unlike heroin, but scary in that it is very powerful. People who are used to opiates often overdose because they don’t know the quantity, and underestimate the strength. We had 2 Fentanyl deaths in London last year.

  8. Pingback: A Perfect Storm | Abe Oudshoorn's Blog

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