Wednesday, June 18, 2014

Health News

Hillbilly Heroin

9-1-1 callers that face arrest in overdose cases among changes needed says CDPC

Released by CDPC, Burnaby


pioid-related overdose is one of the leading causes of accidental death in Canada — in Ontario alone, close to 550 people died this way in 2011.

“The worst part,” insists Donald MacPherson, Executive Director of the Canadian Drug Policy Coalition (CDPC), “is that these deaths are entirely preventable. Overdose prevention programs already exist across Canada. All that’s needed is legislative and regulatory changes to scale them up.”

That’s the thrust of the CDPC’s latest policy brief, developed in consultation with frontline overdose prevention workers across Canada.

The full brief “Opioid overdose prevention & response in Canada” can be downloaded here.

The brief’s public launch – Apathy and Overdose: A free public forum on accidental drug overdose – will be held on Wednesday, June 18 in Toronto at College Street United Church.

View full details of the event here.

In addition to MacPherson, speakers include Dan Bigg of the Chicago Recovery Alliance, and a panel of people that includes a parent, a former paramedic, a youth worker and a person who has illicit drug use experience – all of whom have witnessed or experienced an accidental overdose.

The event is co-sponsored by the Canadian Harm Reduction Network (CHRN), Patients Canada, John Howard Society Toronto, Jac’s Voice, The Canadian HIV/AIDS Legal Network and Canadian Students for Sensible Drug Policy.

As CHRN Director Walter Cavalieri notes: “Unless it’s a celebrity death, overdose gets little notice, but it affects us all; we need to acknowledge this epidemic, and do something to prevent these unnecessary losses.”

Summary of Opioid overdose prevention & response in Canada

The brief itself proposes a comprehensive approach to overdose prevention and response that includes five key components:

1. Make the safe and effective medication to reverse opioid overdose (naloxone) more readily available and cost effective by including it in provincial drug plans and making it available over-the-counter.

2. Scale up community-based and other overdose programs that include education and training on how to prevent and respond to overdose. Include peers, family, and first responders in these programs.

3. Reduce the barriers to calling 911 during a drug overdose event by implementing national 911 Good Samaritan legislation (i.e. legislation that would protect people from being arrested and charged with drug possession if they call for help during an emergency).

4. Implement appropriate guidelines for opioid prescription that do not limit access to needed pain medication or result in further discrimination against people who use drugs.

5. Increase the timely collection, analysis, and dissemination of data on drug overdose events.

One of the most pragmatic and effective interventions to prevent overdose injury and death is the “take-away naloxone program.” Based on 180 similar initiatives in the US, the program involves distributing overdose response kits – take-home-naloxone (THN) kits – to people who have been trained to prevent, recognize and respond to an overdose. Naloxone is a 40-year old medication that when administered during an opiate overdose reverses the effects of the drug. It has no narcotic effect and people cannot become dependent on this drug.

Streetworks in Edmonton pioneered this initiative in Canada and similar programs have spread throughout Canada. For example, in British Columbia a THN program operates in 35 sites, from large urban hubs such as Vancouver and Surrey, to smaller rural centres such as Cranbrook, Campbell River and Fort St. John. Nearly 1000 people have been trained including staff and volunteers at health and social service agencies, as well as friends and family members of people who use drugs. Over 600 kits have been dispensed to clients who use opioids and various resource materials are being developed to assist community partners to increase the reach of the program. Since its origins in 2012, 55 overdoses have been reversed.

Editor's Note: For information on what to do if you find yourself addicted to opioids, visit


Wednesday, June 18, 2014

A solution to the epidemic of fatal overdoses: an antidote administered by peer helpers

Training peer helpers, outreach workers and family members and friends to administer naloxone, a simple-to-use medication used as an antidote for overdoses of opioids, will make it possible to arrest the escalation of severe poisonings and fatal overdoses among drug users in Montreal.

With the support of scientific data and experience gained in similar projects in Vancouver and Toronto, as well as in the United States, the Centre de recherche et d'aide pour narcomanes (Cran), an addiction research and assistance centre, and Méta d'Âme, an association of users and peer helpers, have launched a project known as PRO-FAN (prevention and reduction of overdoses - training on, and access to, naloxone). This pilot project aims to train third parties to come to the assistance of regular or occasional users of opioids who fall victim to an overdose. Known by the brand name NARCAN®, naloxone is an antidote that is used in emergency rooms to reverse the effects of an overdose, in particular respiratory distress and heart failure.

According to Dr. Marie-Ève Goyer, a physician at Cran, it is urgent that we train people who are close to users at risk; these people include peer helpers, family members and the police. At this point in time, even ambulance attendants are not allowed to administer this drug. It is also with some exasperation that Guy Pierre Lévesque, Director General of Méta d'Âme, stresses the need to act quickly to save lives and prevent further victims from succumbing to an overdose.

The Ministère de la Santé et des Services sociaux has stated that it has asked the Institut national de santé publique du Québec to develop recommendations, by September, regarding the administration of naloxone by peer helpers, an approach that is advocated by the PRO-FAN project, as well as other possible avenues for expanding access to naloxone.

Cran and Méta d'Âme are urging the government to act quickly to put a legal framework in place for the PRO-FAN project, provide funding for the project and make it sustainable. The project committee, consisting of Cran, Méta d'Âme and the Douglas Institute Research Centre, will meet on Thursday, June 19. The public health department of the Agence de la santé et des services sociaux de Montréal will also attend this first meeting.

By way of background on these efforts, here are the latest statistics from the public health department: since May there have been 28 cases of severe poisoning and 15 fatal overdoses—a tally never seen before in such a short period of time in Montreal. The substances that were often involved in the past were illegal opioids. The opioid class includes heroin, morphine, prescription opioids such as hydromorphone (Dilaudid®), oxycodone (OxyContin® or OxyNeo®), and fentanyl, an opioid 40 times more potent than heroin. Fentanyl is often found as an ingredient in synthetic drugs manufactured by clandestine laboratories.

"The administration of naloxone by third parties is not a panacea, but it is clearly an effective solution. It is part of a desire to expand the pharmacopeia in Quebec, which includes substitution treatments using methadone or buprenorphine, but which should also include medical prescriptions for injectable opioids and supervised injection services. These treatments and services are highly productive and cost-effective, and far cheaper than the costs associated with hospital care, legal proceedings and the fight against crime. Furthermore, they serve as a gateway to the healthcare system and encourage social reintegration," points out Dr. Goyer.



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