Canadian Vending Machine To Dispense Hydromorphone ^NEW^
Canadian Vending Machine To Dispense Hydromorphone - https://urluss.com/2t7whQ
A Canadian pilot project is testing an opioid vending machine that dispenses safe doses of hydromorphone to individuals with opioid use disorder to determine whether it can reduce overdose deaths from illicit use of fentanyl and heroin.
Similar to an ATM, the MySafe machine weighs 800 lb and is bolted to the floor. It only dispenses individually prescribed, appropriately dosed hydromorphone tablets to users who have been registered and screened. Participants can use the machine up to four times per day.
"I do believe if you allow people to stabilize their drug routine a little bit more by having a secure and safe place where they can get their drugs, then there will be much more time for connection," said Tyndall. "The idea of having a machine dispense the drugs gives people some control and autonomy."
"We have made it so hard to get people into treatment. Opioid agonist treatments are so harshly regulated that it's really difficult for the people who need them to get these drugs. I'd be in favor of vending machines dispensing buprenorphine," he said.
Right now, the vending machine is more a proof of concept than anything else. Thirteen patients are currently enrolled and a total of 48 can be served by the machine on any given day. To participate, they must first be medically examined and have their urine tested once a week to measure any outside drug use. They also must have a recent history of overdose and unsuccessful prior attempts at treatment. But participants do not have to attend counseling, swear off all other substances or show up every day at a particular time.
In a bold move outlined in a recent Washington Post piece, public officials in British Columbia (BC) are taking a contrarian approach: use carefully regulated and secure vending machines to dispense prescription hydromorphone pills to addicts with chronic opioid use disorder, with the added benefit of shielding them from the deadly scourge of fentanyl-laced drugs currently circulating on the streets. The BC Center for Disease Control (BCCDC) plans to implement this plan in Spring of 2018.
The vending machine concept could be the solution to many of these issues. The pilot project works this way: addicts could obtain 2-3 hydromorphone pills up to 3 times a day from the vending machine. The cost savings are immense, based on projections outlined in the article. The cost per patient is estimated at $3.00 a day (Canadian), as opposed to $25,000.00 Canadian dollars annually at the formal clinics.
Of course, hydromorphone vending machines raised concerns. Law enforcement worried that the machines could be tampered with, and the hydromorphone stolen. Other people worry this medication could be sold on the black market. But the machines are supposedly difficult to break, more like ATMs than typical vending machines, and the small amounts dispensed each day per person are thought to make it less likely to sell these pills.
In Canada, harm reduction ideas do not cause the pearl-clutching outrage we tend to have in the U.S. Can you imagine a proposal in some state legislature for a vending machine to dispense hydromorphone? It probably would not be given a hearing.
Currently, the vending machine is more a proof of concept than anything else. Thirteen people are currently enrolled and a total of 48 can be served by the machine on any given day. To participate, patients must be medically cleared & examined, as well as have their urine tested once a week to measure any potential outside drug use. They also must have a recent history of overdose and unsuccessful prior attempts at treatment. But participants do not have to attend counseling, swear off all other substances or show up every day at a particular.
With little legal or political appetite for such a program in the United States, Dispension Industries is piloting its first ever Narcan kiosk in Philadelphia. CEO Corey Yantha said this kiosk was the first of its kind in the country, though cities like New York have recently announced plans to follow suit. Las Vegas and the state of Kentucky have experimented with Narcan vending machines, but both of those programs require people to register for the program first.
The Oakland County Jail has installed a naloxone vending machine for people who are leaving jail. Drug users who leave incarceration are especially vulnerable to overdose. Abstaining from heroin/fentanyl for a period of time, say during a jail sentence, reduces a user's tolerance for the drugs. Often, people who have been abstinent restart their habit using the same amount of drugs they used before they stopped. Doing so is overwhelming and causes overdose and, often, death. With the vending machine, anyone leaving jail has access to Narcan.
In this April 12, 2017, photo, Trac-B Exchange program manager Chelsi Cheatom demonstrates how to use a needle vending machine at the Southern Nevada Health District in Las Vegas. Several communities are trying harm-reduction techniques like needle exchanges, opioid vending machines and even safe injection sites in the face of the opioid epidemic.
Besides providing a better-sourced form of opioids and perhaps preventing crime related to getting drugs, the vending machine might provide a bridge to replacement therapies, Kious said. Controlled access may increase the likelihood users will switch to something like Suboxone, or enter a 12-step program or try therapy.
Dispension Industries Inc. says its machines, which look like an ATM and weigh 360 kilograms, can dispense drugs such as hydromorphone to people addicted to opioids by scanning their palm. (Dispension Industries Inc.)
"A person can access the machine by simply scanning their palm and the machine will know that this person gets this dose (amount) and it will dispense their medication within 15 seconds," Yantha said in a recent interview.
The machines look like ATMs, weigh about 360 kilograms and are called MySafe Verified Identity Dispenser. They are tamper-proof and provide a safe way for addicts to get clean opioids such as hydromorphone instead of off the street.
Making a safe opioid available in vending machines may be the next harm reduction tool to fight the deadly overdose epidemic, says the executive medical director of the B.C. Centre for Disease Control.
Dr. Mark Tyndall said he envisions a regulated system where drug users would be assessed, registered and issued a card to use in vending machines to obtain hydromorphone, a painkiller commonly marketed under the brand name Dilaudid.
Funding to expand access to hydromorphone would first be used to distribute pills through supportive housing units that also dispense methadone and suboxone as well as through a nurse at supervised injection sites before they are sold through vending machines, Tyndall said.
High-dose injectable hydromorphone is currently provided to chronic substance users at a Vancouver clinic called Crosstown, the only such facility that also dispenses diacetylmorphine, or medical-grade heroin to patients who have repeatedly failed to kick an addiction to illicit drugs after multiple drug substitution programs.
Karen Ward, a longtime substance user and former board member of the Vancouver Area Network of Drug Users, said she supports drug dispensing from a vending machine for people who are at highest risk for overdose and may not have a family doctor or housing. 2b1af7f3a8