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The medical approach to illegal drugs

Lorraine Graves   Mar-14-2018

Richmond medical health office Dr. Meena Dawar, spoke at a recent forum.

Photo by Chung Chow

December of 2017 saw 11 cases of meningitis and one death in B.C.

Public health, schools, and families all mobilized to make sure the sick were treated promptly. Prompt harm reduction prevented more deaths. Many people were immunized. Those exposed got antibiotics.



Saving lives, keeping people safe, was the only priority. No one was asked how they got the meningitis infection—had they kissed someone? Or perhaps shared a bottle of pop, or worse. It didn’t matter when lives were at stake.

There’s an epidemic ravaging our community. Richmond’s public health officer Dr. Meena Dawar calls it “quite shocking.” The main cause of death for young men used to be accidents and suicide. Now, it’s unintentional drug overdoses.

Dawar says last year 24 Richmodites died from overdoses.

“We have an astounding increase and that’s what’s troubling. It’s roughly one overdose death every other week in Richmond. The overdose deaths are the tip of the iceberg.”

She says opioids can stop someone’s breathing so that, even if they are revived, the young person is left brain damaged or brain dead.

Overdoses kill and damage habitual drug users and recreational drug users alike.

“Essentially, people cannot be sure what they are using. I think there’s a real problem out there because people are using illicit drugs to manage their pain and their trauma. If we are going to save them in the long run so they can heal, we do need to offer them a safe supply of drugs.”

But doesn’t it just encourage people to become and stay addicts?

“Absolutely not,” Dawar answers emphatically. “It does not encourage people to become drug addicts. They need a different dose and perhaps injection therapy. We need to expand injection opioid therapy.”

The general consensus amongst health professionals, school councilors and a host of community members gathered at a recent forum at the main Richmond Public Library was that harm reduction is the way to keep our young people alive. It does not condone the behaviour anymore than vaccinating against meningitis encourages or condones the behaviours that transmit it. Harm reduction does keep people alive and healthier until they can address why they use drugs.

“Compare this to being in a pub or tavern watching sports, consuming your drug (alcohol), a waitress will bring you a black coffee, call you a cab home--that’s harm reduction,” says Guy Felicella, a former injection drug user profiled previously in The Sentinel.

Just as a drunk driver may take innocent people with him, leaving many lives destroyed in the process, so too a drug death. And, it’s not always the families you’d suspect.

Paramedic James Fang describes how this opiate overdose crisis affects him personally.

“There was a 17-year-old male found at home in bed in a really affluent neighbourhood. He was not breathing. We treated him. He came to.”

Yet when Fang told the parents he needed to use Naloxone to temporarily reverse the effects of an opioid: “They got angry with us saying, ‘How dare you suggest my son used drugs!’”

On a normal shift Fang sees up to seven overdoses.

“The worst part is seeing the families--the pain, the anguish and there is nothing I can do to help.”

Naloxone kits and training are provided free through many Richmond pharmacies. So far, 14,000 kits have been used to save lives.

“People don’t want to be using,” says Dawar. ”They are using because of this chronic illness and they want to meet that need.” She encourages people to treat drug use as a medical matter.

“I would rather have somebody on opioid assistive therapy. It’s about keeping the people alive long enough, so they can heal.”

According to Dawar, people are dying of embarrassment. They are afraid someone will find out they use illicit drugs:.

“We’re losing young men. It speaks to the stigma of drug use—88 percent of those deaths were inside a residence.

“What’s important is that there were no deaths at supervised injection sites.”

Dawar says, “If people could be encouraged to take home that message—Don’t use alone. Have someone with you who is not using.”

The majority of all illegal drugs now have Fentanyl in them.

The Richmond forum, which Dawar lauded for. “Bringing the dialogue right into the open,” concluded with a list of actions: Access to safe injection sites, being able to talk to your kids, and refusing to let stigma dictate what we do and don’t do.

Parents tell children not to share straws, to prevent the spread of infections like meningitis. When they get sick, medical treatment is all we care about.

Dawar says, because of “the magnitude of this problem we need to make this a health issue not a moral one.”

“How many more people have to die before we look at this as a disease?”

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