Prescribed Dilaudids from safe supply used as currency for illicit drugs, London police say

Prescribed opioids intended to prevent people from consuming street drugs are being used as currency to buy toxic, illicit drugs, London police said on Monday. 

"Diverted safe supply is being resold into our community. It's being trafficked into other communities, and it is being used as currency in exchange for fentanyl, fuelling the drug trade. That is a big concern for us," said Chief Thai Truong. 

At a news conference, police shared that in the first six months of this year, they've seized more than 11,100 eight-milligram tablets of Dilaudids — a brand name of hydromorphone — prescribed to people with narcotic addictions as part of a safe opioid supply program, among other drugs. 

Truong said drug trafficking is happening at both organized and street levels, and because there is a high supply of Dilaudids in London, their value is much lower. The street value for one tablet is between $2 to $5 in London, but in other cities, the cost can range from $15 to $30, he added. 

"Other jurisdictions where supply is not as abundant, that's where the price of the Dilaudids are increasing," he said. "If you think about individuals who may not have an abundance of money to support their substance [use] disorder, they now have it in those pills."

The concern of prescribed Dilaudids being diverted onto the streets has prompted London's safe supply program, which is Canada's oldest, to work with police and the Middlesex-London Health Unit to review its current policies and improve it to prevent diversion. 

"Although we have confidence in our existing protocols, continuous improvement is the standard in all the work we do," said Scott Courtice, executive director of the London InterCommunity Health Centre, where the city's safe supply program operates from. 

"We don't want to see prescribed medication ending up in our community. And part of the reason why we want to engage people to look at our protocols with fresh eyes, can perhaps help discover opportunities for us to be doing things differently."

Proven diversion leads to removal from program

The program serves 280 people and requires patients to submit regular urine samples and toxicology tests. If the medication is not found to be in their system, that's an indication of diversion, Courtice said, adding that anyone proven to be diverting is removed from the program.

"Diverting medication is breaking trust with a clinician in a very significant way," he said. "Some of the other things we do is move from a take home to an observed dose at pharmacies, which reduces the potential for them to make it into the community."

When asked for specific numbers of how many people have been removed, Courtice said those numbers were not immediately available. He added that he has not seen the trend of diversion among patients at his clinic.

There are three other clinics, in addition to the health centre, which prescribe safe supply but Courtice is unsure of their protocols, he said. 

The opioid crisis is the most pressing public health issue in the community and diversion must be mitigated, but harm reduction tools like safe supply are essential to ensuring people don't die from toxic drug overdoses, said medical officer of health, Dr. Alex Summers. 

"Across Ontario and in British Columbia, where these programs are in place, the vast majority of deaths associated with opioids are related to illicit drugs. It's the unreliability of those products that inevitably leads to overdoses and these folks are getting further victimized by those running these types of drug trades," he said. 

50 charges laid in six months

Fifty people have been charged after London police seized approximately $789,000 worth of drugs and 30 guns, following a six-month long enforcement strategy. These include: 

• 11,132 Hydromorphone (Dilaudid) pills
• 2 kg of Fentanyl
• 3 kg of Methamphetamine
• 5 kg of Cocaine
• 296 grams of Crack Cocaine
• 1,875 Oxycodone pills
• 153 grams of Carfentanyl
• Conductive Energy Weapon (CEW)
• 30 firearms
• Approximately $79,877 in cash from suspected drug trafficking proceeds