London

5 ways this doctor says prescribing opioids to drugs users can help

There's a movement in this country to offer drug users hospital-grade opioids and London's Dr. Andrea Sereda is leading the charge. She's been prescribing opioids to some of her patients at the Intercommunity Health Clinic for nearly four years.

Dr. Andrea Sereda prescribes hospital-grade opioids to high-risk drug users in London

Dr. Andrea Sereda of London Intercommunity Health Centre runs the country's first Safer Supply program. (Rebecca Zandbergen/CBC News)

There's a movement in Canada to offer drug users hospital-grade opioids and London's Dr. Andrea Sereda is leading that charge. She's been prescribing opioids to some of her patients at the Intercommunity Health Clinic for nearly four years.

Right now, Health Canada is currently wading through funding applications from organizations hoping to offer similar programs across the country. 

Dr. Andrea Sereda joined London Morning to talk about her Safer Supply program.

What is a safe supply?

Our street supply in London and across the country is mostly Fentanyl right now. But it's cut with many other things. Many samples are full of caffeine, GHB, ketamine, anti-depressants. It's really a toxic kitchen soup and it's making people sick in lots of ways. 

The idea around safer supply is offering people a clean drug supply of known potency and known dose so that they can avoid many of the harms that are caused by the toxic street supply right now.

What form are people getting these prescribed opioids?

The model that we're offering in London is a daily dispensed take-home prescription of pills that the patients then use in their home, on the street or wherever they're laying their head that night.

Is it safe to take it alone?

It's certainly safer than the street supply. But we always advocate that our patients use around other people are use at our supervised consumption site because that gives them another degree of safety.

How do you decide which patient you will prescribe opioids to?

It basically boils down to, do we think they're going to die imminently. It can be death due to overdose, death due to recurrent infections related to injection drug use. It can be death due to street life.

Advocates say a safe supply of drugs is needed to combat the thousands of deaths from the opioid crisis. (Spencer Platt/Getty Images)

How many patients do you have on the safer supply program?

113.

What does success mean on a program like this?

We look at lots of measures.

  1. We know we're decreasing homelessness.
  2. We know we're decreasing the number of people in the program who inject drugs. A substantial proportion switch to oral use. 
  3. We're looking at their health outcomes. Whether they're managing their HIV, their Hepatitis C, their other chronic medical conditions. All of that is getting better.
  4. We know for women who are involved in the survival sex trade, a lot of them are able to make safer choices around their involvement in that type of work.
  5. We know we're decreasing petty crimes.

Why is harm reduction the right way?

Harm reduction saves lives. So we've seen that with the initial needle exchange programs in Vancouver 20 years ago. We've seen that with the push for supervised consumption sites. All of these faced the same opposition at the beginning and all of them have solid evidence behind them to save lives. We know that this harm reduction intervention is also saving lives. 

There's a movement in Canada to offer drug users hospital-grade opioids. London's Dr. Andrea Sereda is leading that charge and has been prescribing opioids to some of her patients at the Intercommunity Health Clinic for nearly four years. 8:22

About the Author

Rebecca Zandbergen

Host, London Morning

Rebecca Zandbergen is from Ottawa and has worked for CBC Radio across the country for more than 15 years, including stops in Iqaluit, Halifax, Windsor and Kelowna.