First ever paid prescription fentanyl program launched in Vancouver

A first-of-its-kind program makes fentanyl powder available by prescription for a fee in Vancouver.

Dr. Christy Sutherland, Medical Director for PHS Healththe organization that runs the program said the aim was to meet drug users where they are, rather than administering alternatives like Dilaudid that patients might not find helpful.

“Common feedback we had from patients was that they would prefer fentanyl, that we needed to match what they were buying from the drug dealer to get them away from that street supply. So we worked as a team to create a new fentanyl an option for our patients and our community,” she said, speaking on CBC On the coast.

The opioid crisis continues to wreak havoc in British Columbia, with an average of six people dying every day from illicit drug poisoning.

Fentanyl is now the street drug of choice, but it’s increasingly being cut with all sorts of toxicants, including benzodiazepines and carfentanil, a much more potent fentanyl analogue.

“When you think about organized crime cooking fentanyl in these clandestine labs and trying to dose it into dime bags, there’s no way they can do a consistent dose from unit to unit. And so people don’t know how much they’re taking at a time,” Sutherland said.

Moms Stop the Harm rolls down Hastings Street in Vancouver to mark the fifth anniversary of the overdose crisis in British Columbia in April 2021. (Ben Nelms/CBC)

How the program works

The PHS “enhanced access” program begins with a robust intake regimen, Sutherland said, including a nurse who works with the patient to determine the correct dosage and prescription.

The patient then takes that prescription to a pharmacy, pays for the fentanyl like any other medication, takes it home, and uses it on their own schedule.

The idea is that a safe and consistent supply eliminates the need to interact with the criminal underworld of drugs, which helps stabilize the patient’s life.

“They get their own unique prescription that’s exactly the dose they need,” Sutherland said. “Think of the agony of opioid use disorder, of still being in withdrawal, of still having uncertainty…Knowing that you’re not going to wake up in St. . Paul after overdosing, having your stuff stolen or being mugged along the way.”

Leslie McBain, co-founder of Moms Stop the Harm, said the program would save lives.

“It’s well thought out. It’s legal. It’s regulated. There are pharmacists and medical staff involved and in a low-barrier, non-stigmatizing setting. I think it’s fantastic,” he said. she declared.

McBain said fears that patients would resell their prescription fentanyl are unfounded.

“When a person gets what they need in a safe setting, there’s no kind of impulse to go out and sell it,” she said. “Why would a person sell it to get something else that is dangerous and possibly deadly?”

Legal requirement

Sutherland said another good thing about the program is that possession of prescription fentanyl is not illegal.

“This is a legal prescription. It is labeled with your name and the contents of the prescription in a prescription bottle. They also have a receipt for the purchase of the prescription and have an active prescription on file at the clinic,” she said.

The enhanced access program started Thursday with just one client. Sutherland said data is being collected to gauge the effectiveness of the program and thinks the model could be expanded quickly to other locations in British Columbia.

“For this person who started yesterday, the dignity and respect you get from filling a prescription, paying for it and bringing it home is a lot. And that’s how I want to treat my patients. “, she said.