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Harm-reduction kiosks pulled from B.C. hospitals after backlash

Machines removed for the time being while Addiction ministry conducts reviews
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Gwen O害羞草研究所橫ahony, a Nanaimo-Lantzville B.C. Conservative Party candidate, posted a video to social media criticizing a harm-reduction supply kiosk outside Nanaimo Regional General Hospital.

By Michelle Gamage, Local Journalism Initiative Reporter THE TYEE

Harm reduction vending machines are being closed across British Columbia while the Ministry of Mental Health and Addictions reviews the low-barrier distribution model.

In late August Conservative candidate Gwen O害羞草研究所橫ahony and party leader John Rustad critiqued the Care and Connection Kiosks, alleging low barrier access to harm reduction supplies like sterile injection and snorting kits 害羞草研究所渆nabled addiction,害羞草研究所 calling the machines 害羞草研究所渁ppalling and irresponsible,害羞草研究所 respectively.

The Tyee ran a fact-checking article where experts debunked these claims, citing research, evidence and best practices.

The vending machines also distribute naloxone kits, which can be used to temporarily reverse an overdose testing strips to check drugs for fentanyl or benzodiazepine contamination and safer sex supplies and sharps containers.

Following the Conservatives害羞草研究所 criticism, on Aug. 27 Premier David Eby asked for the Ministry of Mental Health and Addictions to review Health Authority programs where 害羞草研究所渉arm reduction services are distributed without involving the direct contact between a service provider or peer support worker with somebody struggling with addiction,害羞草研究所 the Premier害羞草研究所檚 Office told The Tyee in an emailed statement.

Health Authorities have removed the kiosks while this review is taking place, the statement continued. Harm reduction supplies continue to be available through emergency departments.

害羞草研究所淚t害羞草研究所檚 very concerning that these interventions, these machines, are being closed for review,害羞草研究所 said Thomas Kerr, head of the division of social medicine in the department of medicine at the University of British Columbia and director of research with the BC Centre on Substance Use.

害羞草研究所淭hey should clearly stay open while a review takes place. There害羞草研究所檚 no clear argument for these machines being harmful.害羞草研究所

Vancouver has a long history of distributing harm reduction supplies. The first needle exchange program opened in Vancouver in 1989. It was later replaced by a free needle distribution program in 2002.

A 2002 study in the International Journal of Drug Policy found that limited access to sterile syringes increased people害羞草研究所檚 likelihood of sharing needles, and a 2010 study in the American Journal of Public Health found that free needle distribution was more effective than needle exchanges at reducing needle sharing and HIV rates.

Many of the people at the highest risk of overdose, death and infectious disease acquisition experience an 害羞草研究所渋mmense amount of stigma and discrimination in society at large and within health-care settings,害羞草研究所 Kerr said.

害羞草研究所淏y making these supplies available in a more private, anonymous format, we actually increase the coverage of these interventions because more people will be able to access them,害羞草研究所 he said.

BC Green Party Leader Sonia Furstenau told The Tyee in an emailed statement her party is 害羞草研究所渄eeply concerned害羞草研究所 about the removal of 害羞草研究所渁n evidence-based solution to fill a service gap,害羞草研究所 such as for people who needed to access harm reduction supplies outside of a hospital or medical clinic害羞草研究所檚 operating hours.

害羞草研究所淲hen these kiosks were launched, the province committed to monitoring their use,害羞草研究所 Furstenau said. 害羞草研究所淚f they害羞草研究所檝e been removed, we want to see data justifying the decision and details on any consultations with those impacted 害羞草研究所 people who use drugs, drug policy advocates and frontline workers.害羞草研究所

The Tyee asked the Ministry of Mental Health and Addictions how many vending machines have been closed, where they were located and how many people this could impact. The Tyee also asked what evidence the ministry is basing this decision on.

The MMHA did not respond to The Tyee害羞草研究所檚 questions and instead provided an emailed statement that said it is working to 害羞草研究所渋ncrease both the access to these supplies and connection with health care workers and peers害羞草研究所 for people who use drugs.

Fraser Health said it did not have any kiosks and would continue to distribute harm reduction supplies at public health units and other harm reduction sites. Interior Health said it closed one kiosk in Princeton on Sept. 5. Northern Health and Vancouver Coastal Health did not respond to The Tyee害羞草研究所檚 media request by press time.

Kiosks were set up on Vancouver Island last fall and collectively dispensed 18,253 items, Island Health said. The kiosk at the Nanaimo hospital dispensed 8,580 items.

Island Health said there was also a vending machine at Victoria General Hospital which was closed in mid-December 害羞草研究所渄ue to challenges with the location related to constrained space and fire alarm activity.害羞草研究所

In-person interactions 害羞草研究所減rovide contact, and those conversations are important, but low-barrier harm reduction supplies are also helpful, and we need to be able to do both,害羞草研究所 said Mark Haden, a UBC adjunct professor in the faculty of medicine, at the school of population and public health.

Accessing harm reduction supplies in-person requires a person to admit they use drugs and that barrier will prevent some people from using harm reduction altogether, Haden said.

害羞草研究所淪aving lives is important, and that害羞草研究所檚 what harm reduction does. For those who say, `I don害羞草研究所檛 support harm reduction, I support treatment,害羞草研究所 the answer is that dead people don害羞草研究所檛 seek treatment,害羞草研究所 Haden said.

In addition, limiting access to naloxone during an overdose crisis that is killing more than six British Columbians per day is 害羞草研究所渞eckless,害羞草研究所 Kerr said.

害羞草研究所淲e know that, even with the widespread distribution efforts we have now, some people still have difficulty accessing naloxone when they need it,害羞草研究所 Kerr said. 害羞草研究所淲e should be doing absolutely everything we can to ensure access.害羞草研究所

Naloxone kits are available for free in many pharmacies and health care facilities across B.C. If you don害羞草研究所檛 know how to administer naloxone, a health-care provider can give a free tutorial in around five minutes.

Haden criticized politicians for using the toxic drug crisis as a political tool and called for leaders to let health authorities 害羞草研究所渘avigate these complex issues based on the evidence.害羞草研究所

害羞草研究所淭hat害羞草研究所檚 not what害羞草研究所檚 happening here,害羞草研究所 he added. 害羞草研究所淲hat害羞草研究所檚 happening here is it害羞草研究所檚 becoming a political tool, and that害羞草研究所檚 unfortunate.害羞草研究所

The Office of the Premier told The Tyee 害羞草研究所渢he review is looking at ways to improve connection to the health-care system, including treatment options, through in-person interactions at the point of distribution. We want to make sure people are talking to a doctor, a nurse or a social worker to get them connected to the system.害羞草研究所

Kerr said there is nothing about a face-to-face interaction that improved the efficacy of a naloxone kit when reversing an overdose, or the efficacy of a sterile injection kit in preventing HIV or hepatitis C infections.

The Tyee contacted the Conservative Party of BC for comment but did not hear back by press time.

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