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含羞草研究社橫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 含羞草研究社渆nabled addiction,含羞草研究社� calling the machines 含羞草研究社渁ppalling and irresponsible,含羞草研究社� 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含羞草研究社� criticism, on Aug. 27 Premier David Eby asked for the Ministry of Mental Health and Addictions to review Health Authority programs where 含羞草研究社渉arm reduction services are distributed without involving the direct contact between a service provider or peer support worker with somebody struggling with addiction,含羞草研究社� the Premier含羞草研究社檚 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.
含羞草研究社淚t含羞草研究社檚 very concerning that these interventions, these machines, are being closed for review,含羞草研究社� 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.
含羞草研究社淭hey should clearly stay open while a review takes place. There含羞草研究社檚 no clear argument for these machines being harmful.含羞草研究社�
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含羞草研究社檚 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 含羞草研究社渋mmense amount of stigma and discrimination in society at large and within health-care settings,含羞草研究社� Kerr said.
含羞草研究社淏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,含羞草研究社� he said.
BC Green Party Leader Sonia Furstenau told The Tyee in an emailed statement her party is 含羞草研究社渄eeply concerned含羞草研究社� about the removal of 含羞草研究社渁n evidence-based solution to fill a service gap,含羞草研究社� such as for people who needed to access harm reduction supplies outside of a hospital or medical clinic含羞草研究社檚 operating hours.
含羞草研究社淲hen these kiosks were launched, the province committed to monitoring their use,含羞草研究社� Furstenau said. 含羞草研究社淚f they含羞草研究社檝e been removed, we want to see data justifying the decision and details on any consultations with those impacted 含羞草研究社� people who use drugs, drug policy advocates and frontline workers.含羞草研究社�
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含羞草研究社檚 questions and instead provided an emailed statement that said it is working to 含羞草研究社渋ncrease both the access to these supplies and connection with health care workers and peers含羞草研究社� 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含羞草研究社檚 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 含羞草研究社渄ue to challenges with the location related to constrained space and fire alarm activity.含羞草研究社�
In-person interactions 含羞草研究社減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,含羞草研究社� 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.
含羞草研究社淪aving lives is important, and that含羞草研究社檚 what harm reduction does. For those who say, `I don含羞草研究社檛 support harm reduction, I support treatment,含羞草研究社� the answer is that dead people don含羞草研究社檛 seek treatment,含羞草研究社� Haden said.
In addition, limiting access to naloxone during an overdose crisis that is killing more than six British Columbians per day is 含羞草研究社渞eckless,含羞草研究社� Kerr said.
含羞草研究社淲e know that, even with the widespread distribution efforts we have now, some people still have difficulty accessing naloxone when they need it,含羞草研究社� Kerr said. 含羞草研究社淲e should be doing absolutely everything we can to ensure access.含羞草研究社�
Naloxone kits are available for free in many pharmacies and health care facilities across B.C. If you don含羞草研究社檛 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 含羞草研究社渘avigate these complex issues based on the evidence.含羞草研究社�
含羞草研究社淭hat含羞草研究社檚 not what含羞草研究社檚 happening here,含羞草研究社� he added. 含羞草研究社淲hat含羞草研究社檚 happening here is it含羞草研究社檚 becoming a political tool, and that含羞草研究社檚 unfortunate.含羞草研究社�
The Office of the Premier told The Tyee 含羞草研究社渢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.含羞草研究社�
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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