Could vending machines help solve B.C.'s opioid overdose crisis?

A leading public health official suggests opioid vending machines could help solve British Columbia's drug overdose epidemic.

Dr. Mark Tyndall, the executive medical director of theBC Centre for Disease Control, said it's one way to get safe drugsinto the hands of substance users who are dying in unprecedented numbers because the street drug supply has turned toxic.

"We really can't tackle the overdose problem by trying to reduce the availability of prescription drugs," Tyndall told On the Island host Gregor Craigie.

"There aremany ways that we can do this. Probably the most extreme would be a vending machine," he said.

Tyndall suggested that vending machines could dispense eight-milligram Dilaudid pills, (a brand name for the opioid medication hydromorphone).

The pills are cheap, at a cost of 32 cents each. Atypical user would crush, dissolve and inject the drug three times a day.

Access to the pills would becontrolled through assessment of drug dependency and with limits on the number of pills dispensed each day.

While Tyndallacknowledged the public might not be ready for drug vending machines, he said distribution of clean drugscould start on a smaller scale.

For example, he said,Dilaudidcould be distributedin pill form at asupportive housing facility that manages other medications,or at supervised consumption sites.

A step in that direction is a Health Canada-approved proposal to pilot models of oral hydromorphone distribution in Vancouver and Victoria.

The numbers of participants and launch date have not been established, and consultations are in progress about when and how to allow take-home drugs and other details.

Provincial guidelines for opioidaddiction treatment recognize that not all users can tolerate or benefit from recommendedreplacement therapies withSuboxone or methadone.

In October, the B.C. Minister of Addictions and Mental Health, Judy Darcy,asked health authorities to scale up access to injectable hydromorphonefor long-term substanceusers. Supervised hydromorphoneinjections arecurrently available to a small number of long-time drug usersatVancouver's Crosstown Clinic.

Tyndall said the space, cost and staffing requirements mean the Crosstownmodel would not be able to reach the numbers ofpeople who need it,even in the most optimisticscale-up scenario.