Pubdate: Sat, 15 Aug 2015
Source: Globe and Mail (Canada)
Copyright: 2015 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Sunny Dhillon
Page: A7

OVERDOSES PROMPT CALLS FOR 'ANTIDOTE'

A recent spike in fentanyl-related deaths highlights need for wider
access to naloxone to reverse drug's effects

Hugh Lampkin was working late when he heard a knock at the door.
"There's a guy down," the stranger said. "He's overdosed, and he's
blue."

Mr. Lampkin, president of the Vancouver Area Network of Drug Users,
grabbed a nearby supply of naloxone - a medication that can reverse
the effects of overdose - and raced down the block to the scene.

The man who had overdosed did not have a pulse, or heartbeat, and
wasn't breathing. Mr. Lampkin gave him a naloxone injection and began
CPR. A minute and a half later, he gave a second injection. Less than
two minutes after that, Mr. Lampkin said, the man's pulse and
heartbeat returned and he took a massive breath.

"It was like when you see it in the movies," he recalled.

The use of the drug fentanyl - an opioid up to 100 times more potent
than morphine that's increasingly being cut into other drugs such as
heroin, oxycodone, or crystal methamphetamine due to its low cost -
has made headlines across the country, following a long list of tragic
deaths from coast to coast.

The Canadian Community Epidemiology Network on Drug Use this week
issued a bulletin that said fentanyl-related deaths had spiked in the
country's four largest provinces. In Vancouver, fentanyl was suspected
in at least 16 overdoses last Sunday alone, including six within one
hour.

Health Canada has said it's "deeply concerned." Though some arrests
have been made by various police departments, a Calgary officer this
week acknowledged that they "will not be able to arrest their way out
of this problem."

Public awareness campaigns have been launched, but the calls for
increased prevention and law enforcement have been joined in some
quarters by calls for increased treatment - namely, wider availability
of naloxone, the medication sometimes referred to as the overdose
"antidote" that's only available through prescription and only for
people at severe risk of overdose.

Health Canada announced three weeks ago it would review naloxone's
prescription status. However, it cautioned the process could take 18
months.

Several cities and provinces have gone so far as to develop naloxone
programs and take home kits on their own. Edmonton was the first, in
2005. Toronto launched its program in 2011, with the rest of Ontario
and B.C. following suit in 2012. The Alberta government earlier this
year announced it, too, would roll out a provincial program.

Dr. Jane Buxton, harm-reduction lead at the B.C. Centre for Disease
Control, which operates the B.C. naloxone program, said more than
4,000 people have been trained on how to respond to an overdose and
2,700 kits - which include two sealed vials of naloxone - have been
dispensed. Naloxone cannot be abused and has no effect in the absence
of opioids. She said more than 260 overdoses have been reversed,
though the actual total is likely higher.

Dr. Buxton said program staff has been especially busy this week,
given the heightened attention around fentanyl. She said the program
has recently been handing out 500 kits a month but more than 500 were
requested this week alone, along with training courses.

The current program does have some limitations, she said, such as the
fact the kits can be dispensed only to people prescribed to use
opioids. "[The naloxone] is not getting out to everybody who could be
using it," Dr. Buxton said in an interview.

Mr. Lampkin said his organization is planning a naloxone training
course for the next week or so. He said he'd like to make it a monthly
occurrence.

"My personal preference is the weekend before welfare [cheques are
issued]," he said in an interview. "Thursday, Friday, Saturday, those
are usually the days with the highest overdoses."

- - with a report from Andrea Woo

THE NUMBERS

1,019 Number of deaths in Canada between 2009 and 2014 in which
post-mortem toxicological screening detected the presence of fentanyl,
according to the Canadian Community Epidemiology Network on DrugUse.

655 Number of deaths in Canada between 2009 and 2014 in which fentanyl
was a cause or contributing cause.

120 Number of fentanyl-detected deaths in Alberta in 2014, up from 6
in 2011.

90 Number of fentanyl-detected deaths in B.C. in 2014, up from 13 in
2012.

21 Number of fentanyl-detected deaths in Quebec in 2013, up from seven
in 2009.

111 Number of deaths in Ontario in which fentanyl was directly
implicated in 2013, up from 63 in 2009. (Data on fentanyl-detected
deaths was not available.)

$40-$60 The price a fake oxycodone tablet containing fentanyl can sell
from in B.C.'s Lower Mainland, according to Sergeant Lindsey Houghton,
spokesperson for the Combined Forces Special Enforcement Unit - B.C.
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