One Doctor’s Answer to Drug Deaths: Opioid Vending Machines

Across North America, tainted opioids are killing people who use drugs. Vancouver’s Mark Tyndall says we should start dispensing safer pills using high-tech machines.

It’s a winter afternoon in Vancouver, and Mark Tyndall is taking me on a tour of all the places people can go if they want to use drugs and be pretty sure they won’t die.

Blue tarps and shabby tents with people sleeping in them line our route in the Downtown Eastside, where the wail of an ambulance siren is always around the corner. We see handwritten signs taped up in the back alleys, warning “Danger: Green Heroin. Use ¼ usual dose.”

From the outset, Insite was as much a public health intervention as it was a scientific experiment. The Canadian government granted the nonprofit a temporary exemption from the country’s Controlled Drugs and Substances Act, while researchers studied the program’s effects. Tyndall, who was working at the British Columbia Centre for Excellence in HIV/AIDS at the time, was one of the lead investigators on the project.

In the earliest days, he and his co-investigators were wary of overwhelming Insite’s participants with lengthy surveys and probing questions. So they started off small, assigning research assistants to simply sit across the street and count the number of people walking in the door. Gradually, though, their research expanded. And the results were profoundly counterintuitive or at least inconsistent with conventional wisdom.

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During the Canada Post strike announced September 25, 2025, the following measures will be undertaken to minimize service disruption to BC-CfE clients and providers.

  • The BC-CfE Laboratory has transitioned to private courier for delivery of outgoing reports and documents. Results required urgently can be faxed upon request. (Lab Contact Information: Phone 604-806-8775; FAX 604-806-9463)
  • The BC-CfE Drug Treatment Program (DTP) will fax outgoing forms and documents to the provider’s office. (DTP Contact Information: Phone 604-806-8515; FAX 604-806-9044)
  • St. Paul’s Hospital Ambulatory Pharmacy has transitioned to private courier for delivery of medications. We recommend requesting medication at least 2 weeks in advance in case of delivery delays, particularly to rural/remote parts of BC. (Contact Information: Phone 1-800-547-3622; FAX 604-806-8675)

During the Canada Post strike, we recommend that documents be faxed or couriered to our sites, versus utilization of regular mail service

The BC-CfE Laboratory is streamlining reporting processes for certain tests in order to simplify distribution and record-keeping, and to ensure completeness of results. Beginning September 2, 2025, results for the ‘Resistance Analysis of HIV-1 Protease and Reverse Transcriptase’ (Protease-RT) and ‘HIV-1 Integrase Resistance Genotype’ tests will be combined into a single ‘HIV-1 Resistance Genotype Report’.
For more details and example reports, please click on the button below