A pair of articles from the London Free Press has highlighted a disturbing 400% increase in heart valve infections since 2009 amongst intravenous Hydromorph Contin users in London, Ontario.
The London Free Press articles stem from the story of Lisa Faye, 31, an intravenous drug user in London, Ontario. In February of 2016, Lisa was admitted to the Adult Medicine ward of Victoria Hospital (London Health Sciences Centre) for a heart valve infection.
"Lisa was struggling to breathe, her aunt said. Her fever had spiked to 39.8 C. Staff had inserted a tube to get antibiotics to her heart and warned she might need transfusions. An infection had attacked her blood too, causing sepsis, which can cause death" - London Free Press
As an opiate addict, Lisa was also suffering from withdrawal during her hospital stay. This creates a very tough situation for the patient. Facing the pain of withdrawal, and stuck in the hospital for the treatment of a serious ailment; yet the need to 'fix' and get relief is still very much there. Faye opted to briefly leave the hospital in order to retrieve the supplies necessary for injection, and upon her return, she got her fix using medication she had been hoarding. Albeit not without staff catching her, and kicking her out for doing so. She was given a cab voucher and told to leave.
This situation probably isn't surprising to any current or former intravenous drug user. Addiction is a very powerful thing, especially opiate addiction. Being forced to go without, or without enough, is a difficult thing to accurately describe to someone who has never experienced the true power and pull of opiates. It's truly as though someone is withholding a substance necessary for life; you feel your fix that badly.
This whole situation raises a lot of questions and problems. If staff were aware Faye was an opiate addict, were they simply not bothering to help keep her comfortable enough to be able to remain in hospital for the duration of her care and treatment? If they weren't aware, and catching her injecting hoarded medication was how they found out, their reaction of handing her a cab voucher and booting her out the door absolutely blows my mind. Here is a woman in clear need of immediate medical attention not only for her life-threatening physical illnesses, but also addiction and previous traumas; yet the first reaction by a staff of medically trained professionals is to send this poor woman to the streets to die. That is simply wrong, and people should be outraged.
Luckily Faye had someone close, her Aunt Lorraine, to help advocate for her in this dire situation. "Lorraine phoned the hospital and demanded to speak to someone who could help. A social worker named Patricia phoned back, then contacted Dr. Andrea Sereda of the Intercommunity Health Centre and London police Sgt. Lorna Bruce, who leads a program to better protect prostitutes from the risks of walking the street. Sereda and Bruce drove to Lisa’s apartment and found her in such bad condition, they took her immediately to University Hospital." According to the London Free Press article, she is receiving care in hospital, and has been told it could be the end of March before she would be ready to be discharged.
The role stigma plays here is huge. I'm sure that Faye was well aware of the stigma surrounding her use and lifestyle. I don't doubt she's encountered that stigma before when dealing with healthcare workers and in general. Luckily, in this case there was someone there to help advocate on behalf of the addict. However, in many cases, there isn't someone available to advocate. What then? Had that been the case in Faye's situation, she may not have survived. She should be commended for having the strength to share her story publicly, and bringing awareness to the many barriers and stigmas intravenous drug users face.
Interestingly, Faye is far from the only addict and Hydromorph Contin user in London who has experienced a heart valve infection. According to Doctor Sharon Louise Koivu, "the number of addicts she’s seen in London with an infected heart valve has grown by about 400 per cent" since 2009. The culprit? Koivu believes that it's the prescription drug Hydromorph Contin, a popular choice amongst intravenous opioid users here in London, Ontario. But what is it about this particular drug that is leading to such life-threatening infections amongst users?
First of all, Hydromorph Contin's popularity surged in early 2012 when the government of Ontario banned the sale of the drug OxyContin. Oxy was hugely popular, and relatively safe compared to other options. Unlike OxyContin, that can be completely crushed and dissolved, Hydromorph Contin cannot. This is precisely what Koivu believes to be the problem.
I searched all over for images that could help illustrate the problem with Hydromorph Contin, and I came up nearly empty. Since I'm no longer using, it's not quite as easy as it used to be for me to simply snap a few photos of the pills and the injection preparation process. However, I was lucky enough to get some help from the wonderful 'Harm Reductionist Extraordinaire Nat', A.K.A. @thesyc66; who snapped some great photos for me to help give you guys a visual. Thanks so much, Nat!
Below, are two photos of various different strengths of Hydromorph Contin Capsules.
In order to use intravenously, the small beads located inside the capsule are removed and poured into a cooker.
They are then crushed, mixed with water and injected. Below is the residue left behind in the cooker after injecting.
The problem is, these little capsules do not crush and dissolve completely, leaving behind residue and particles that pass through a basic filter, into a syringe, and then into the users blood stream upon injection. It is these particles that Koivu "believes damages blood vessels and causes infections in the valve that connects the upper and lower chambers on the right side of the heart."
In order to help investigate the tie between Hydromorph Contin and the 400% increase in heart vale infections, Koivu applied to Health Canada for research funds, but has yet to receive any.
Regardless of what drugs you ban (prescription or illicit), addiction is still going to exist. By removing safer options, addicts are forced to move to replacement drugs that often cause far more harm. Since OxyContin was banned in Ontario, opiate addiction hasn't showed any sign of slowing down. Other drugs have simply moved in to take its place. Now, we see Hydromorph Contin, both pharmaceutical and illicit Fentanyl, Heroin and even Crystal Methamphetamine. Banning the use of safer, prescription drugs is not the solution here.
Unfortunately, addiction is still seen as some sort of moral failure on the part of the addict, and as something that needs to be punished. In the case of Faye, that punishment came in the form of revoking life-saving care and treatment. This is an absolutely inexcusable way of dealing with those struggling with addiction, and it needs to change immediately. Until we begin to provide users with safe options, humane treatment, and respect, those struggling with addiction will continue to suffer from unnecessary harm, stigma, and barriers to much needed care and treatment.
By K. Lanktree
- Freelance Writer -
- Blog Mistress -
- Former IV Drug User -
- Methadone Patient -
- Lover of all things Harm Reduction -
Help keep 'Studio L' online by donating to help offset the costs! Thanks💋