A large group of drug users living in cities and towns across B.C. has put forward a plan its members maintain could significantly reduce overdose deaths.
“The B.C./Yukon Association of Drug War Survivors (BCYADWS) requests the provincial government immediately enact a new Ministerial Order to facilitate the rapid implementation of heroin buyer clubs in British Columbia,” reads a media release issued over the Labour Day long weekend (August 30).
“Drug user groups from B.C. are recognized innovators and leaders in implementing harm reduction innovations,” it continues. “This is the time for the Province to act so we can act.”
The call is largely in reference to a detailed report that was published by the B.C. Centre on Substance Use (BCCSU) last February.
Titled “Heroin Compassion Clubs,” the document describes “A cooperative model to reduce opioid overdose deaths and disrupt organized crime’s role in fentanyl, money laundering and housing unaffordability.”
It outlines how people who use drugs could form cooperatives or ‘co-ops’. Membership would require a visit with a doctor who would evaluate each individual’s addiction to opioids. Then members could pool resources and negotiate to bulk-purchase opioids from regulated suppliers. They could obtain diacetylmorphine (prescription heroin) and hydromorphone (a similar opioid sold under the brand name Dilaudid) from regulated suppliers and use those drugs as relatively safe alternatives to unknown substances found on the street.
“By aggregating their purchase orders and relevant resources, members are able to take advantage of volume discounts, price protection, shared storage and distribution facilities and costs, and other economies of scale to reduce their overall purchasing costs,” the BCCSU document reads.
The plan was inspired by the buyers clubs of the 1980s that emerged in response to the HIV/AIDS epidemic. Patients with HIV/AIDS organized into groups to improve their bargaining positions and purchasing power in order to make expensive drugs more affordable. They also procured and distributed experimental drugs for HIV/AIDS that had yet to receive government approval and sold generic and pirated versions of patented drugs that were prohibitively expensive. (The film Dallas Buyers Club shared one version of these groups with a large audience upon its release in 2013.)
The BCYADWS call for the establishment of heroin buyers clubs argues members could put their plan into action without breaking the law via a provincial ministerial order.
“This action is within the context of the public health emergency declared in April 2016, and follows the successful Ministerial Order in December 2016 that facilitated the immediate implementation of overdose prevention sites,” it reads.
In December 2016, then B.C. health minister Terry Lake signed a ministerial order that allowed for non-profit groups and health-care providers in B.C. to establish locations where people could bring drugs to inject them under the supervision of staff trained in overdose response.
That ministerial order was part of a number of harm-reduction measures that the B.C. Centre for Disease Control credits with saving more than 3,000 lives over a 20-month period analyzed.
“It is inexcusable for the Province to have the power to sign this Ministerial Order and not follow through knowing the evidence and the devastating loss in our province and beyond,” Hawkfeather Peterson, a BCYADWS board member, said quoted in the group’s release.
There were 538 illicit-drug overdose deaths during the first six months of 2019, according to the B.C. Coroners Service. That puts the province on track for 1,076 deaths by the end of the year, a number that would be significantly fewer than the 1,535 deaths that B.C. experienced in 2018. But 1,076 is still unfathomably higher than the annual average of 204 deaths that B.C. experienced from 2001 to 2010.
Last year, the dangerous synthetic-opioids fentanyl or carfentanil were associated with more than 85 percent of overdose deaths.
BCYADWS’s plan to reduce overdose deaths by allowing the bulk-purchase of pharmaceutical opioids might sound radical, but it has the support of many of B.C.’s top politicians and health-care providers.
Ahead of International Overdose Awareness Day (August 31), Vancouver mayor Kennedy Stewart said he wants higher levels of government to help make available a “safe supply,” another term for pharmaceutical opioids that are offered as an alternative to street drugs that are often adulterated with fentanyl and other dangerous substances.
“We are living and breathing trauma every day as we watch our family, friends, and neighbours die preventable deaths across every Vancouver neighbourhood,” Stewart said quoted in a media release. “We call on health professionals, all levels of governments, and the public to join us in advocating for a safe supply of drugs, to protect and prevent further loss of our loved ones.”
Top health officials in B.C. such as Dr. Patricia Daly, chief medical health officer for Vancouver Coastal Health, and Dr. Bonnie Henry, provincial health officer of B.C., have also both repeatedly expressed support for such a plan. They also want the provincial government to effectively decriminalize the personal possession of hard drugs like cocaine and heroin in order to reduce stigma and encourage people to seek treatment.
“There is widespread global recognition that the failed ‘war on drugs’ and the resulting criminalization and stigmatization of people who use drugs has not reduced drug use but instead has increased health harms,” reads an April 2019 report Henry authored. “The societal stigma associated with drug use leads many to use drugs alone and hidden, increasing their risk of dying.”