Pubdate: Sun, 20 Sep 2015
Source: Toronto Sun (CN ON)
Copyright: 2015 Canoe Limited Partnership
Author: Shawn Jeffords
Page: 10


City report calls for greater access to life-saving drug naloxone

Paramedic Dominic Wong says he remembers nearly every call where he's
administered naloxone.

The often dramatic effect of the opioid overdose antidote stands

Like a call from East York a few years ago.

He and his partner arrived at the home to find a man passed out in a
second-floor bedroom. His family had no idea what happened and called
911 in a panic.

"His respiration was slow and pretty shallow," Wong said. "Eventually,
he wouldn't have been able to get enough oxygen to the rest of the
body. It was pretty critical that way."

Wong says paramedics ran through a mental checklist to try to figure
out what went wrong. They scanned the surroundings, quickly talked
with family, searched for any clue that might lead them to the cause
and a possible treatment.

Then the family told him the man had a drug problem at one point, but
he'd received treatment.

He was clean. It couldn't be that, they told him.

But Wong pulled out naloxone and prepared it in IV form to deliver it
into the man's system as fast as possible.

"He woke up before we even got him downstairs," Wong said. "He started
talking to us, asking what happened? What's going on?"

Wong, who's been a Toronto paramedic since 1991, says the overdose
antidote is a valuable part of a paramedic's toolkit, but stresses a
patient must also go to hospital for treatment.

"I remember some of these cases because there are happy endings and
positive results," he said.

A staff report coming to the city's board of health next week
highlights the success of paramedics' use of naloxone. But it also
reveals drug overdoses are up in the city, with a 41% increase in
overdose deaths between 2004 and 2013.

The report sounds the alarm about the number of those deaths caused by
opioids such as fentanyl.

It calls on both the provincial and federal government to change laws
to allow greater access to naloxone, which is currently only available
through prescription. It also asks governments to introduce Good
Samaritan legislation to protect people who witness overdoses and call
911 from prosecution.

Toronto paramedics have been using naloxone to save lives for years,
but the report also discusses the success of so-called peerto-peer

According to public health statistics, since the start of the
Preventing Overdose in Toronto program at the city's needle exchange,
The Works, in 2011, 2,000 naloxone kits have been distributed and
they've prevented 300 overdoses.

"It involves taking something that until then was only available
through EMS or at emerg and giving that medication like an EpiPen to
someone to use if someone is overdosing," The Works manager Shaun
Hopkins said. "We're giving people something very concrete that is

Hearing stories from people who have experienced the near-death
traumas first-hand convinced Hopkins the program works.

"At so m e po i n t it becomes a program, I have to do the proposal,
write it up the right way," she said. "You almost become a little
inured to the impact. Then the first time someone comes in and tells
that story, it blew me away. I wasn't expecting it."

Susan Shepherd, manager of the Toronto Drug Strategy Secretariat for
public health, says the 206 overdose deaths recorded in 2013 was the
highest number since they began tracking the data in the 1980s.

"75% of these deaths are accidental," she said. "They're largely
preventable. There's action that can be taken that can save lives."

Increased access to naloxone is one part of addressing the problem,
she said.

"Right now the access is fairly limited in terms of how you can get
naloxone. If you're a parent and you're concerned about a son or
daughter who may be using drugs and is at risk of overdose, you
couldn't get naloxone."

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Health Canada eyeing drug's benefits

Toronto Public Health will ask for increased access to opioid
antioverdose medicine this week, and there are signs both the province
and federal government could be on board.

In July, Health Canada announced it will begin an 18-month study of
naloxone, which is currently only available through a

The idea would be to treat naloxone like EpiPens and insulin, the
department suggested in a press release.

"In the event Health Canada's initial assessment finds that the
benefits of expanding access appear to outweigh potential risks, the
next step would be a public consultation," the release says.

Meanwhile, in a statement to the Toronto Sun, Ontario Health Minister
Dr. Eric Hoskins said the government has created several programs to
combat addiction and overdoses, including the Narcotics Monitoring
System, the Ontario Pain Medication Review, and harm reductions
programs that distribute naloxone to people at risk.

"Over the last decade, funding for community mental health and
addictions services has grown from $567.5 million to more than $1
billion annually," he said. "As a result, the number of new clients
receiving community addiction treatment services has increased 83.5%
since 2007-08."
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