MySafe is a national program providing prescribed hydromorphone tablets (dilaudid) to eligible participants as an alternative to the poisoned street supply of drugs. Their prescription is stored in a highly secure storage locker, that can be accessed once per day using a biometric palm scan. It was done as an ethical response to over 11,000 people who have died due to toxic street drugs.
The MySafe program operates 3 machines in Vancouver (1 downtown and 2 in the Downtown Eastside) and currently serves about 90 people. We also have a fourth machine in Victoria serving about 30.
Participants consent to having their prescriptions accessed through this secure dispensing storage machine, equivalent to an individualized storage locker. Selected participants will undergo a full medical and social assessment which includes current drug use patterns and their risk of overdose. They will be assigned a lane in a machine and have their palm scanned for a biometric hand profile that will allow them access. Dilaudid tablets per day are dispensed in a regulated schedule.
We have seen some dramatic changes in their lives. It creates a much-needed stability in the client so that they can get their life back and, in many cases, has lead to reduction with some in full recovery.
We carefully screen and select participants and do regular follow-up interviews and urine tests and always find dilaudid in the samples. On two occasions we have not, we spoke with the participant to assess whether continuing with the program was right for them.
We cannot say 100% that there has never been diversion to another person as this is the very nature of the unregulated drug market. From what we have observed, any diversion is to a friend or partner who is drug sick.
Prescription diversion goes way beyond the scope of MySafe. With prescriptions and street drugs, the origin of the current supply is highly variable and unregulated. Unless the person received it from the doctor or pharmacy, the current death rate shows that anything can end up in the poisoned supply. This has increased the need to get all drugs tested that come from anywhere other than those legitimate sources.
We estimate that MySafe provides less than 5% of all the legal prescriptions of dilaudid in Vancouver.
The other 95% of safe supply programs and prescribers in the community dispense thousands of dilaudid pills everyday – mainly through pharmacy pick-ups and deliveries.
Much like any pharmacy pick up or in house delivery of safe supply, we cannot 100% guarantee what MySafe participants do. Regular check-ins have never indicated any cases reported to any staff or peers or clients of youth diversion.
We want young people to thrive and live long happy safe lives and have opportunities. We need to ask ourselves the bigger picture here and acknowledge why and what youth are doing to not die from the toxic drug supply. It is becoming clearer that young people need support and safer access too. MySafe is not a program intended for youth, and we must all work together to improve education to youth about drugs and addiction.