The City of Vancouver is now home to a groundbreaking experiment in the fight against opioid overdoses.
It’s an initiative called the MySafe Project, which launched the world’s first biometric opioid vending machine in Vancouver’s Downtown Eastside as part of a pilot project in December 2019.
More than 5,000 people have died of drug overdoses since B.C. declared a public health emergency in 2016, and calls for access to a safe drug supply have mounted from political leaders and health experts in recent years.
MySafe works like this: registered opioid users, who have been evaluated on their drug use, health status and social situation, are prescribed a heroin-alternative called hydromorphone which they receive on a pre-determined schedule.
The machine, an 800-pound secure dispenser similar to an ATM, is located near the Overdose Prevention Site on East Hastings Street. It uses a biometric scanner that reads the vein pattern on the palm of a user’s hand to verify their identity.
“You just put your hand up to the machine, it welcomes you and dispenses a drug in a little box in the bottom and you take them and leave,” said Dr. Mark Tyndall, MySafe project lead and professor at UBC’s School of Population and Public Health, in a video announcing the project.
“There’s two points to a safe supply,” he said.
“One is the obvious thing that in one hand you have deadly fentanyl and the other hand you have a pharmaceutical drug with a known dosage, the person who takes the known dosage will not overdose.”
Tyndall argues that using the machines can allow drug users to “break the cycle … and the hustle they go through” to get drugs, allowing them to focus on stabilizing their lives.
The idea is not new. While he was still with the BC Centre for Disease Control, Tyndall raised the concept at a forum on the overdose crisis in 2018.
In September, he announced plans to move ahead with the Toronto-built machines.
The eight-milligram hydromorphone pills cost about 35 cents each, said Tyndall at the time. They are typically crushed and injected by people who previously used OxyContin when the drug was more widely available.
The drug is also available through several Vancouver clinics running pilot projects on controlled access to opioids for people with addiction.
But Tyndall argues limiting supply to a clinical setting, with strict rules and regulations, is less effective than providing them to people to use on their own terms.
“I believe if we do allow people to stabilize their routine a little bit more by having a secure, safe place where they can get their drugs and cut into the activities they have to do to get their drugs there will be a lot more time for connection,” said Tyndall in the video.
B.C.’s Ministry of Mental Health and Addictions said it is not involved in the project, which is being run independently by Tyndall in his capacity with UBC.
“As with any independent research project, we will await the results,” said the ministry in a statement.
“The Ministry is focused on our own work to scale up access to medically-supervised prescription alternatives to toxic street drugs as just one part of establishing a full continuum of care and delivering an urgent, comprehensive response to this crisis – including prevention, enforcement, harm reduction and treatment and recovery.”
The initiative has earned the support of Vancouver police, as a way of cutting down on overdose deaths.
“These machines dispense a known substance which has a known strength and are not contaminated,” said Const. Tania Visintin in an email.
“These machines are a locked safe which people are able to access their prescriptions.”
But the idea of take-home opioids has sparked concerns among some experts.
In an interview with CKNW’s The Jill Bennett Show at the time Tyndall initially floated the vending machines, B.C. addictions specialist Dr. Launette Rieb said the approach carries its own dangers.
“Also, this doesn’t purify the stimulant use supply, which is also tainted with fentanyl. And to hand out stimulants is also a very unproven tactic. So is giving take-home doses to inject.”
Rieb also said while harm reduction is important, the approach fails to address what she calls the underlying cause of overdose deaths: addiction.
She pointed to the Portuguese model of decriminalization, in which users are not arrested for possession but are instead given long-term free drug treatment, housing and subsidized job placements.
For the meantime, the MySafe Project is limited to five users.
MySafe says participants will be regular users who have displayed a history of overdose and who have fentanyl detected in their urine. They will also have regular follow-ups with healthcare workers.