Officials not doing enough to stem drug abuse.

By Susan Lazaruk and Stanley Tromp. The Province (Vancouver, BC), 27 Feb 2014


A B.C. drug expert says hospitals and their pharmacies are not doing enough to help stem an "explosion" of prescription drug abuse.

The claim by Simon Fraser University Prof. Benedikt Fischer, an expert on prescription opioid abuse, is supported by documents obtained by The Province under freedom of information legislation.

The documents show Vancouver area hospitals:

Couldn't account for narcotics. Provided access to automated drug dispensers to ex-employees.

Stored drugs with high street value in a wooden cupboard that could be easily pried open.

"(Prescription drug) overdose deaths really skyrocketed in the last 10 years," Fischer said.

Canada hasn't been as aggressive as the U.S. in trying to control the illegal resale of legal drugs, said Fischer. "We've been asleep at the wheel," he said.

The supply of prescription narcotics comes from "diversion" of drugs to the black market at a number of points - manufacturing, warehousing, hospitals and "double doctoring" prescription drug fraud - as well as from families and friends.

The November 2013 internal audit of narcotics and controlled drugs at two Vancouver Coastal Health hospitals revealed numerous examples of lax record-keeping, storage and disposal of drugs.

Among the audit's "high-risk" findings were shortcomings in the way narcotics given to patients were recorded, how narcotics were handled and controlled in operating rooms, how access to automated drug dispensers was managed and how narcotics designated for destruction were controlled.

The audit documented nine other "moderate risk" findings, including inconsistent inventory counts at hospital pharmacies, improper physical safeguards of the drugs and inadequate record-keeping and reporting of losses.

"Vancouver Coastal Health staff have a critical role in ensuring narcotics are not misused or diverted," the audit noted.

"There is a risk that people within the health care system (patients or health care staff ) abuse narcotics due to addictions, or divert narcotics for personal profit," the audit said. It noted research that showed addiction rates among nurses of 10 to 20 per cent.

It also emphasized the importance of reminding staff that, by law, losses must be reported to Health Canada within 10 days.

Fraser Health spokeswoman Tasleem Juma said there were just 18 reported narcotics losses among the 18 million prescription filled out at nearly two dozen hospitals from Powell River to Abbotsford from 2010 to 2013.

Meanwhile, narcotics handling procedures at Vancouver-area hospitals have been standardized and improved under a new "robust policy" implemented last year, Michele

Babich, executive director of Lower Mainland Pharmacy Services, said in an emailed statement.

Fischer speculated that hospitals prefer to deal with thefts internally. He said that "in theory" anyone caught stealing drugs in large quantities will face trafficking charges, but added: "I suspect that few of these cases make it to the criminal stage."

Fraser Health's Juma said: "If an internal investigation determines the loss of a narcotic is due to theft, the RCMP are immediately notified."

Juma said thefts in hospitals have led to discipline or charges, but released no details.

RCMP spokesman Sgt. Rob Vermeulen didn't respond to a request for an interview.



Prescription drugs abound on Vancouver streets.

By Susan Lazaruk, The Province (Vancouver, BC), 27 Feb 2014

Finding pharmaceuticals for sale is just as easy as walking down to the open-air drug markets on Vancouver's Downtown Eastside, according to one addict.

"Everything from Extra Strength Tylenol to methadone, every Oxy you can find, every benzo, like Valium, Rivotril, Dilaudid, Dexedrine," said Laura Shaver, who's on a methadone maintenance program for heroin addiction.

"If I wanted to buy drugs, I would go down to the Carnegie corner or to the 100-block of (East) Hastings or the 300-block of Hastings and say, 'Who's got Oxys?'" she said.

She quickly rattled off the going rates - $5 for 4 mg of Delaudid, $10 for 8 mg of Delaudid, $6 for 10 mg of Oxy-Contin, $20 for 80 mg of OxyContin.

Shaver, who's also president of the B.C. Association of People on Methadone, said it used to be easier to score illegal drugs such as heroin, cocaine and crystal meth on the streets, but legal prescription drug over the past year have become just as plentiful.

Meanwhile, police have done the math and know that the resale of prescription drug can turn big profits, through "drug trafficking, both by organized criminals and individuals taking advantage of lucrative street markets," said RCMP Cpl. Heather Dickinson of Ontario's drug squad in a power-point presentation obtained by The Province.

In it, Dickinson noted a $4, 80 mg OxyContin pill would fetch $80 on the street and $400 on northern reserves, meaning a 100-pill bottle could bring in up to $40,000.

She called prescription drug abuse "extremely complex" because "mere possession is not enough to prosecute."

Dickinson noted it's responsible for overdose deaths, home invasions and break-ins, pharmacy robberies, assaults, impaired driving and fraud in the health care system.

The Canadian Association of Chiefs of Police endorses a national prescription drug misuse strategy, she said.