CBC Investigates

'A major barrier': Make drugs that prevent fentanyl deaths free, families and experts say

Families and experts say drugs that prevent fentanyl deaths should be free if governments are serious about preventing fentanyl deaths.

$12 a day to control cravings and $50 for overdose antidote kit too high, Richmond, B.C., mom says

'I'm terrified,' says Jennifer Molto, who worries her son will die of a fentanyl overdose. (Natalie Clancy/CBC)

Jennifer Molto hates the sound of a ringing phone.

"Every morning, I wake up and I think, 'Is today the day?'"

The Richmond, B.C., woman lives in constant fear the next call will be to tell her that her 23-year-old son is dead.

He's addicted to fentanyl, a powerful opioid that has killed hundreds of Canadians in the past two years and triggered a public health crisis in B.C.

A drug called Suboxone has proven effective in suppressing fentanyl cravings, but Molto's son can't afford a prescription.

It costs $12 a day, but since he had a good-paying job last year, he doesn't qualify for provincially funded prescriptions because he's not on social assistance.

When his addiction spiralled, he lost his job and his pharmacy let him run a tab, which grew quickly and became a source of shame.

"It got to the point that he owed over $300 to the pharmacy, $12 a day, and he was too embarrassed to go back, so he just stopped," Molto said.

It was easier to spend $20 on a hit of illicit fentanyl.

"He got a fix from somebody instead," she said.

'Scared all the time'

"It's like Russian roulette. You don't know if this is going to be the bad dose ... I'm scared all the time," said Molto, who suffers from renal failure and is unable to work.

"I don't have $50,000, $25,000. I'm on a disability. I can't pay for rehab."

Paramedics and firefighters work to revive an overdose patient with repeated doses of naloxone, the antidote to opioids such as fentanyl. (Frederic Gagnon/CBC)

She says if the provincial and federal governments were serious about reducing fentanyl overdose deaths they would make Suboxone and methadone free for anyone who needs them.

"They absolutely shouldn't have to pay for it ... We need to get help for addicts before they die, because one hit can kill somebody," she said.

"[Premier] Christy Clark just doesn't get it. If my son dies, his blood is on her hands ... she's not putting it a priority and it needs to be top priority."

Molto says she borrowed thousands of dollars from family and friends this week and got her son, who doesn't want his name published, into a rehab centre.

Premier says she will fix it

When CBC News took Molto's suggestion to the premier, she agreed to consider it.

"If there's a group of people there who aren't on social assistance or haven't demonstrated that they can't pay for it but aren't getting it as a result, we should fix that," Clark said.
'We should fix that,' B.C. Premier Christy Clark says of the fact some fentanyl addicts can't afford a prescription for Suboxone to control their cravings. (Denis Dossman/CBC )

"The Health Ministry is thinking about that now."

Clark says most patients are covered through the province's PharmaCare program. 

But Dr. Keith Ahamad, who treats addicts at St. Paul's Hospital in Vancouver, says the lack of Suboxone and methadone coverage for those not on social assistance is a big problem for many of his patients.

"$400 a month for four or five months before the medication is covered ... is a major barrier," he said.

B.C. health officer Dr. Perry Kendall, who declared the public health emergency and co-chairs the provincial task force Clark appointed to try to reduce overdose deaths, says in his opinion, "obviously cost should not be a barrier to any kind of treatment." 

Only users get naloxone free

Molto and many others with loved ones who suffer from addiction carry naloxone, the potentially life-saving antidote to fentanyl, with them at all times.

Naloxone kits are now available without prescription, but each one costs $50 — if you can find a pharmacy that has them. Kits are only free for drug users.

Bernie Pauly, an associate professor who studies addiction at the University of Victoria, says family members of addicts should get kits for free "because if someone is overdosing, it could well be the family member who is going to be there."

Naloxone kits like this are now sold without a prescription at pharmacies. (Harold Dupuis/CBC )

"They can take the training and should be able to have access to kits as well," said Pauly, adding several agencies teach how and when to administer the shot.

In a statement to CBC News, Health Canada says provinces are responsible for ​deciding which drugs are covered.

"Health Canada is deeply concerned about the growing number of opioid-related overdoses and deaths," which is why the department removed the need for a prescription for naloxone last spring and recently approved the nasal version, which is widely available but costs more.

Toxicology lab backed up

The latest figures on overdose deaths from B.C.'s coroner service are expected this week, but Chief Coroner Lisa Lapointe says the toxicology lab is backed up, which isn't a good sign.

Still, she's hopeful that recent measures taken in B.C., including easing restrictions on Suboxone, will start to pay off.
Lisa Lapointe, B.C.'s chief coroner, says there would be far more deaths if naloxone wasn't being used widely. (Tristan Le Rudulier/CBC)

"The availability of Suboxone will make a significant difference I believe, plus the availability of naloxone," she said.

"We know for a fact that hundreds of antidotes, naloxone, are being used weekly and we know we'd see far more deaths, but for those interventions."


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With files from Manjula Dufresne