On Pragmatism and the Overdose Crisis - in support of prescription heroin

Imagine for a moment: you visit your family doctor because you have been feeling unwell. The doctor assesses you and says that you have dangerously high blood sugar or high blood pressure, or heart disease. The doctor says, "there are drugs for that, but unfortunately , it is not legal for me to prescribe them to you and that you will need to find what you need on the street." Just imagine…

A larger more pragmatic view must be taken on the opioid overdose crisis. We need to begin to shift our focus from one of more law enforcement, more border security, more statistics, more research, onto the immediate overdose crisis, and place it on what will work today. As the documentary, ‘Unstoppable’ on fentanyl, recently pointed out, the ‘chemists’ will continue to pump out unregulated, even more toxic versions of fentanyl, which has the effect of killing more people and further addicting the ones that don’t die. And there is a ridiculous amount of money for all involved in the supply side.

We will never catch all illicit fentanyl, or have enough beds, or catch in the safety net all those people who are addicted. Besides, what is going to take the place of heroin in their lives? Will they get jobs, housing, medical and mental health treatment, counselling? No they will not. Not in the present system.

So we need to be pragmatic and realistic. Our resources need to be going into assessment and dispensing safe, regulated, cheap or even subsidized opioids in safe venues. This will put the black marketers out of business by eliminating or drastically reducing their market. They will surely find some other nefarious work.

Let us accept that a segment of the population needs to ease its pain through drug use. Let us accept that this is not a moral failing, and let us treat it like the health issue that it is. If the medical community is allowed to treat drug dependent people with the medicine they need, i.e. opioids, they won’t die, they are healthier, they will not have to resort to crime to fund their needs. Their families will be safer. The whole community is healthier. The billions of dollars saved in law enforcement, border services, incarceration, and emergency healthcare can easily fund the recovery and social services we need. .

Let’s get real in ending the overdose crisis. Let’s try what will surely work. That would be a gift.

Leslie McBain