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Are medical doctors to blame for the opioid overdose crisis?

Recent court case sheds light on the rise of fentanyl in Vancouver
fentanyl
Fentanyl drug uses are urged to be extra cautious following 12 suspected 12 overdoes in the neighbourhood of Columbia Street and Gore Avenue.

I finally got around to reading Provincial Court Judge Bonnie Craig’s reasons for sentencing Walter James McCormick last month to 13 years and 144 days in prison for his involvement in the drug trade, specifically the selling of the deadly synthetic narcotic, fentanyl.

While the 45-page judgment is interesting reading during times like these in Vancouver and across the province, with the judge pointing out McCormick’s “moral culpability” in selling fentanyl during a widely known crisis, there is more to this story than a 53-year-old dealer going to prison for a long time.

Dr. James Kennedy can attest to that.

He testified in the case as an expert on the effect of fentanyl on the human body. Under cross-examination by McCormick’s lawyer, Kennedy did us all a favour and provided a history that is helpful to understanding why 914 people died of an overdose in B.C. last year, with 60 per cent of the deaths between January and October linked to fentanyl.

The judge summed it up in four sentences.

“In cross-examination, Dr. Kennedy agreed that much of the blame for what has been described as the opioid epidemic can be attributed to the over-prescription of opioids as pain medication by medical doctors. In the 1990s, doctors were convinced by prescription drug companies that opioid painkillers were effective and rarely caused addiction.”

And the last two sentences…

“As the medical profession started to better understand the risks associated with opioid use, including its addictive qualities, doctors started to cut patients off their prescriptions. This led to people turning to the street to find their drugs, which in turn led to an increased demand for opioids on the street.”

The doctor’s insight was supported by the testimony of Sgt. Peter Sadler, a Vancouver police drug squad member, who told the court how fentanyl was added to, or used to replace, the more common street drugs heroin and oxycodone.

In 2012, a newer, safer form of oxycodone was manufactured. So dealers began using fentanyl in place of oxycodone and selling it as oxycontin. The purchasers did not know they were buying fentanyl.

Which brings us back to McCormick and the drug offences he committed in Vancouver in January and February of 2015, and in Richmond in May 2016.

In an undercover operation, police purchased 3,000 fentanyl pills from McCormick. When police searched his storage locker, they found a pile of drugs, including 27,000 fentanyl pills, four kilograms of cocaine, one kilogram of methamphetamine, 374 grams of MDMA, five grams of heroin, more than 22 kilograms of cannabis and a pill press.

The street value of the drugs was estimated at $2,034,132.

Police also seized $171,905 in cash, a .40 calibre pistol and .22 calibre rifle. McCormick made $100,000 bail and then got in trouble in Richmond in May 2016, with police seizing 1,049 fentanyl pills, two kilograms of cocaine, 18 kilograms of cannabis, 4,285 alprazolam pills, $4,736 in cash and seven cell phones.

Despite all that work by police, the judge pointed out “there was no evidence that his offences caused any overdose deaths, but they certainly introduced a high level of risk to the community.”

Craig also said this: “[McCormick] admitted at the sentencing hearing that, while he was on bail, there was regular coverage by local and national news outlets on overdose deaths in the community related to fentanyl. In some of these articles and broadcasts, Mr. McCormick was specifically named as an alleged fentanyl trafficker. Yet, in the face of this coverage, not only did he intentionally take on the risk of further offending, he did so knowing the deadly effect fentanyl was having in the community. His moral culpability when committing this offence is very high.”

That moral culpability, it can be argued, extends beyond McCormick.

Those medical doctors Kennedy talked about? Prescription drug companies? Finger-wagging politicians at all levels of government protecting their own turf?

Push, push, push.

mhowell@vancourier.com

@Howellings