Andrew Bethune
Published: Apr 16, 2020 at 2:30 p.m.Updated: Apr 17, 2020 at 9:54 a.m.FacebookTwitterMore4
Corey Yantha remembers when COVID-19 hit Nova Scotia vividly: “My calendar here says ‘mayor visit,’ which was on the 11th [of March], and then on Friday the 13th, my note says, ‘world cancelled,’” he says by phone.
Yantha, president of Dartmouth-based Dispension Industries, was meeting with the mayor of Halifax to discuss expanding MySafe, Dispension’s opioid-dispensing ATM collaboration, which was employed in Vancouver in late 2019 to prevent opioid overdoses. Less than 24 hours after Yantha’s meeting with Mike Savage, the mayor put himself into voluntary isolation after a brush with the virus. Closures and lockdowns soon followed across Nova Scotia.
Less than a month later, all non-essential businesses are closed. Nova Scotians have been told to stay home and only go out for important errands. The global pandemic is affecting different groups in different ways. People with children struggle to work from home while parenting full-time. Students attempt to write exams on the internet. People who use illegal drugs are finding the supply drying up.
Dr. Mark Tyndall, the physician driving the MySafe program, said in a phone interview that everybody’s on “pins and needles” in the lower east side of Vancouver, the epicentre of Canada’s enduring opioid crisis. COVID-19 hasn’t spread through the community. If – or when – it does, says Tyndall, “The potential for transmission is very high…this would be a very serious situation for people living in shelters and marginally housed.”
The opioid epidemic, declared a public health emergency in Vancouver four years ago, is made worse by the COVID-19 pandemic. It’s a crisis on top of a crisis. The usual harm-reduction approach, a designated location where drugs can be taken with oversight by first aid-trained staff, is problematic. Such sites constitute a public gathering place and have closed. People are injecting in alleys again. The illegal drug supply is getting more expensive and less predictable. Overdose deaths still happen often.
Safer option
MySafe, Dispension Industries’ opioid-dispensing ATM, debuted in Vancouver in December as part of Tyndall’s plan to replace risky street drugs with safe, pharmaceutical-grade opioids and reduce the staggering rate of overdoses.
About a dozen patients use the machine. All report an improved quality of life and less involvement in the dangerous street activities that used to pay for their habit.
The next step is to expand the program.
“We’re fighting two battles. The whole concept of giving people using illegal drugs safer drugs still takes some time to sink in, both amongst the general public but also among physicians and addiction doctors who have been doing just the opposite for so many years,” Tyndall says.
“Then there’s the technology part, getting people to understand how technology can work in our favour.”
In Nova Scotia, people who use drugs face a complicated situation. The province’s only overdose prevention site closed mid-March. Other addiction services are operating with reduced hours or via telehealth.
“Before COVID was a really big thing, I said, ‘this is a really good time to leverage cities and communities to implement these machines,’” says Matt Bonn, program co-ordinator for the Canadian Association of People who Use Drugs (CAPUD).
Bonn says harm reduction is the way of the future, and the pandemic shows that a technology-based approach like MySafe is safest for all involved. However, public funding is not available for harm reduction. On top of that, Bonn says it’s hard to find a doctor willing to prescribe a drug to a person who is addicted to it.
“You can’t have the machine without the prescriber,” he says, echoing Dr. Tyndall.
CAPUD has expressed its support for the MySafe machines and would like to see one in Halifax.
Next steps
The machine is a promising solution to both public health crises. It is an eight-foot-tall, 800-pound ATM that scans the veins in a user’s hand to identify them. It is a secure way to provide safe, clean drugs to users. With COVID-19 risk, there is one new advantage to list for the machine: it greatly reduces the chance of infection spread. There is no face-to-face interaction. No pharmacist is needed. There is minimal need to even touch the machine. And the drugs dispensed are sanitary. There’s no telling how many unwashed hands have touched a baggie of heroin.
This month, the MySafe pilot project will expand as a quick response to the COVID-19 pandemic. Five new machines will be set up at different locations in Vancouver, Victoria and London at the end of April, and functional in May. Research is underway at Dalhousie to apply an antiviral coating to the few surfaces on the machine touched by users’ hands.
Addiction is a disease that was already a crisis. The global pandemic has made many things worse, but people like Bonn, Tyndall, and the Dispension crew continue to reduce whatever harms they can.
Harm reduction services are still available by phone:
- Mainline Needle Exchange (902) 423-9991
- Direction 180 (902) 420-0566
- Out of the Cold (902) 902-219-4690
- Open Door Clinic (902) 818-2442
- Mobile Outreach Street Health: (902) 429-5290
- CAPUD: (902) 406-0092