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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.

"I'm hoping that it's kind of like supervised injection sites," he said of the program that could begin as early as next March. "At first it sounded a bit off the wall and now it's pretty well accepted."

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.

"People could pick these drugs up at supervised injection sites but there's no reason you couldn't use vending machine technology to do that. So people would show up, have their card, click it in and get a couple of pills."

Hydromorphone pills dissolve well in water and Tyndall said he expects most people will grind them up and inject them.

A small part of the funding will come from a three year, $1 million Health Canada grant that includes patients in Alberta, Tyndall said, adding the machines could also be placed in other areas where drug use is prevalent, as well as near health clinics in remote communities.

"We don't have really anything to offer people who are dying around the province in smaller communities, where sometimes they don't even have a doctor who can prescribe methadone and certainly will never have a supervised injection site," Tyndall said.

"You'd have to ensure there's some security system because we don't want people kicking these things in and stealing all the pills, and we don't want situations where people are taking out big quantities and selling them on the street."

Tyndall said while theft is a major concern of any opioid distribution system, anyone buying stolen hydromorphone pills would at least be getting safe drugs instead of those that could be laced with the powerful opioid fentanyl, which has been linked to hundreds of deaths across Canada.

Safeguards would also include supplying two or three pills, up to three times a day, to prevent users from being targeted by criminals, Tyndall said.