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Offer drug testing at safe consumption sites, Alberta opioid commission recommends

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Alberta’s supervised consumption sites should be permitted to offer drug testing to help users learn what dangers might be lurking in their illicit narcotics, the province’s opioid commission recommended Friday.

While questions persist about the effectiveness of fentanyl-sensing strips and other testing devices, providing insight to users on what they plan to inject or ingest will undoubtedly save lives, commission leaders said.

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“Anytime you can give people a bit more understanding than absolutely none about what’s in their drugs, I think that’s a positive,” Elaine Hyshka, co-chair of the Minister’s Opioid Emergency Response Commission, told a news conference downtown.

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Six supervised consumption sites have been approved for Alberta. Facilities in Calgary and Lethbridge have already opened, while four sites in Edmonton are expected to open within weeks.

The province’s latest report on the opioid crisis showed at least 562 Albertans died last year due to a fentanyl-related overdose. 

The report also showed fentanyl is increasingly showing up in combination with other types of drugs, including methamphetamine and heroin. In many cases, users are unaware their drugs may contain lethal amounts of the illicit opioid. 

Hyshka said fentanyl test strips have been used in both Ontario and British Columbia, including at Vancouver-based Insite, the country’s first supervised consumption facility.

In its first year of piloting the strips, 80 per cent of the drugs tested at Insite were found to contain fentanyl.

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Insite clients who received a positive result were 10 times more likely to reduce their dose. And those who cut down their intake were 25 per cent more likely to avoid an overdose, the facility reported.

A file image of a fentanyl test strip being used at Insite, a Vancouver-based supervised drug consumption site. (Supplied by Vancouver Coastal Health)
A file image of a fentanyl test strip being used at Insite, a Vancouver-based supervised drug consumption site. (Supplied by Vancouver Coastal Health) Edmonton

Dr. Mark Lysyshyn, medical health officer at Vancouver Coastal Health, acknowledged the strips are not entirely failsafe. There have been some cases of false negatives, and questions remain about how effective they are at detecting fentanyl analogs such as carfentanil.

More recently, the Vancouver health authority has been piloting a $50,000 infra-red spectrometer. Lysyshyn said the device is good at detecting a range of substances including heroin, cocaine and crystal meth.

However, it is less effective at detecting substances in very small quantities such as fentanyl.

“So we use it in combination with the test strips, and then we can give somebody a pretty complete picture of what’s in the drug mixture they are about to take,” Lysyshyn said.

He said the hope is to eventually have the strips available in the community, so drug users can use them at home.

“The more we can open it up to people who aren’t going to come to supervised injection sites, the more it can potentially have a benefit.”

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It’s unclear when testing tools might be introduced to Alberta, though Hyshka said she hopes it’s as soon as possible. 

The commission unveiled 14 new recommendations Friday, all of which were accepted by Alberta Health.

Included was a proposal for the government to develop a process for setting up overdose prevention sites.

Such sites are similar to supervised consumption sites in that they provide medical care for drug users, but they tend to be more temporary and do not offer the same wraparound services.

The province’s first overdose prevention site opened Friday on Kainai First Nation in southern Alberta, which declared a state of emergency after a spike in overdoses. The site is operating out of an Atco trailer eight hours each day.

Hyshka said such sites could also be used at summer festivals or other events where widespread drug use is expected.

Other recommendations include:

• Ease restrictions for prescribing methadone and medical heroin, which are used as treatments for opioid use disorder.

• Organize a national conference in Edmonton in October to discuss drug policy and harm reduction.

• Approve a mobile supervised consumption site in Calgary.

• Open supervised consumption services in Medicine Hat, Red Deer and Grande Prairie.

• Develop guidelines around protective clothing and safety practices for workers who may come into contact with fentanyl.

• Expedite consumer protection legislation, to ensure people seeking mental health and addiction services receive proper care.  

kgerein@postmedia.com

twitter.com/keithgerein

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