In response to the opioid crisis, Canada embarked a few years ago on a safer supply program in which doctors prescribe pharmaceutical opioids to addicts to keep them from using contaminated street drugs. If this approach works well for some patients, others will outright resell the pills, obtained at public expense, to buy drugs on the street that put them at risk, discovered The duty.
The ease with which Dilaudid can be found on the streets hastened the fall of a young opium addict, now in remission.
“If it hadn’t been so easy to find, I wouldn’t have — I don’t mean never — I think I wouldn’t have developed an addiction so quickly to such a strong dose,” confides Kim, a brilliant and eloquent young girl, who requested anonymity so that her testimony would not harm her future.
Kim had everything of the model little girl: she went to an excellent school with an international profile and lived in a beautiful suburban house with her parents. At age 13, she developed a fascination with drugs. “For me, it was like a catalog, I wanted to try them all. » She had not finished high school when she was already in a detoxification center.
She remained sober for a little over two years and returned to school. But at the end of CEGEP: relapse. This time it is the crystal meth (crystal methamphetamine) who was calling him. By injection. It lasted a year and a half. “It really didn’t cost much, it was really accessible. It was the biggest addiction I had ever had… Before opioids. »
Therapy, sobriety, going back to college, working. Kim thought she was out of her problems for good. But she became close to a colleague who was addicted to opioids. When she told him she had very intense menstrual pain, he suggested she take Dilaudid. “He told me that two milligrams was nothing at all and that I could take it just when I needed it. At one point I said: let’s go. »
With this friend, she had to go around the city to find 2 mg tablets, because generally, it is 8 mg tablets that are sold on the streets. This is what is generally prescribed under the safer supply program and what some are reselling, as revealed The duty Friday.
The first time she took a pill, she was so sick that she took Naloxone, a drug given to those who overdose on opioids. “I said to myself: never again. »
The next month, she still went back for Dilaudid, but she was convinced she had control. “I didn’t have a prescription, but I really took them literally. And it helped: it didn’t completely take away the pain, but I didn’t need to take time off when I had my period. I was able to be functional. »
Addiction
As the 2 mg tablets were difficult to find, she fell back on 8 mg, which she methodically cut. “I was becoming desensitized to it. In my head, I told myself that I had eights, but I was cutting them into quarters. And then, it was for my period. I was very good at bragging about the idea. »
But insidiously, the drugs were taking control. “It struck me how quickly tolerance increased. And when I got into the injection, it got worse and worse. »
At the same time, she bought heroin on the dark web to avoid fentanyl, which is hidden everywhere in street drugs. But it still took some effort, and eventually, she ended up resorting to street heroin.
Daily allowance
Even in the middle of a pandemic, with the curfew, Kim never had difficulty finding Dilaudid near Place Émilie-Gamelin, in Montreal. Especially in the morning, when pharmacies open. “From the quantity they had, I thought at first they were dealers, but most of them didn’t, they were people who had prescriptions, she says. It’s happened many times that people [vendaient le Dilaudid] still in the pharmacy jar, with their name written on it. »
Some could raise the equivalent of a hundred dollars a day thanks to the safer supply, she explains. “For most people, it became like a guaranteed income. Their bottle of Dilaudid was their allotment for the day. »
Over time, one of the dealers became his friend. “Every morning he sold the 12 Dilaudids he had for $60, so $5 each. Normally it was $10. But he didn’t care, because he got them for free. It freaked me out, I didn’t understand. But, in fact, it was because he was using something else: crack, crystal meth. He was a polydrug addict. »
Often, he still found himself wanting, because the amount of heroin he got in exchange for his Dilaudid wasn’t enough to get him through the day, Kim said. “If he had taken his 12 Dilaudid, he would not have had a buzz that intense, but it would have been better than a high dose of heroin or fentanyl. It’s like it’s not worth it; It wasn’t a good calculation, but it was definitely his preference. »
She met several people who sold their Dilaudid for fentanyl. “I didn’t understand that either. But if you ever dare to sell your Dilaudid for fentanyl, you’re done! You just increased your tolerance to the point that Dilaudid won’t hurt you anymore. high, then you sell it for fentanyl, it’s a vicious circle. It increases your tolerance so quickly. After that, you can’t go back. »
Remission
Seeing everyone else doing it, she too wanted to get a prescription for free Dilaudid. He was prescribed suboxone, a treatment to help him stop using, with 10 Dilaudid per day in an effort to initiate withdrawal. She took Dilaudid, without ever touching suboxone. “I said I was taking it, but it wasn’t working. »
But Kim wanted out. Her doctor changed her prescription to Kadian, a slow-acting opioid that patients must take in front of the pharmacist. A situation that exasperated him. “It freaked me out to see how much I was being watched: the pharmacist opened Kadian’s pills in a jar to make sure I swallowed them for real. While we give 15-20 Dilaudid [à d’autres] like that without supervision. »
For about a year, Kim has been receiving monthly long-acting buprenorphine injections. [Sublocade] which completely cuts off the effect of opioids. “It worked really well for me, and that’s what made me able to stop,” she confides. Because yes, during a moment of weakness, it’s so easy to find. I had impulses and, every time, I found something. But when I injected myself [la drogue], it didn’t do anything because of the Sublocade. I was a little angry at first, but that’s what allowed me to break those impulses. »
Kim knows she remains fragile, but she envisions a future far from opioids and injections. And above all, far from a fatal overdose.