Pubdate: Fri, 01 Jan 2016
Source: Globe and Mail (Canada)
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Andrea Woo
Page: A1

PROPORTION OF B.C. OVERDOSE DEATHS LINKED TO FENTANYL SURGES

Fentanyl was detected in more than a third of British Columbians who
died after overdosing on illicit drugs in the past year, as the deadly
opioid believed responsible for at least a dozen deaths in the past
few weeks alone becomes a grimly entrenched scourge in Western Canada.

Dozens of overdoses suspected to have been caused by fentanyl have
been reported throughout B.C. since Dec. 19, including four in
Vancouver and eight in Greater Victoria that were fatal. Deaths linked
to fentanyl have also increased in other provinces, notably Alberta,
where the drug was connected to more than 200 deaths in the past year.

The fatal overdoses are part of a larger issue: Preliminary numbers
from the BC Coroners Service show that, of all illicit drug overdose
deaths in B.C., fentanyl is being detected in a growing percentage
every year. In 2012, the synthetic opioid was detected in less than 5
per cent, compared with 15 per cent in 2013 and 25 per cent in 2014.
>From January to Aug. 31 of 2015, fentanyl was detected in 35 per cent
of all illicit drug overdose deaths in B.C.

However, Barb McLintock, spokeswoman for the service, cautioned
against framing these as "fentanyl deaths."

"Even if we did end the year with fentanyl detected in one-third of
the overdose deaths, that is still two-thirds in which it is not
present, and the other illicit drugs are the cause of fatal
overdoses," she said, referring to drugs such as heroin, cocaine and
amphetamines.

"We do not want drug users thinking that if they can just avoid
fentanyl they are not at risk, as that is very much not the case."
Statistics from the agency indicate the overall number of people dying
of overdoses in B.C. has not significantly changed in recent years.
There were 331 overdose deaths in 2013, of which fentanyl was detected
in 49, and 356 deaths in 2014, including 90 in which fentanyl was
detected. For 2015, the agency's statistics go only to Aug. 31, a
period in which the province had recorded 257 overdose deaths, 91 of
which had fentanyl detected.

Fentanyl, a narcotic that is often mixed into other drugs and ingested
unknowingly, has become so common that warnings have popped up in the
bathrooms of Vancouver bars and nightclubs, and as guerrilla street
art around downtown Vancouver.

Fentanyl is a powerful synthetic opioid, anywhere from 50 to 100 times
more potent than morphine, that was developed to treat severe, chronic
pain. However, a North American crackdown on prescription opioids such
as oxycodone has coincided with an increase in the illicit consumption
of fentanyl, which is inexpensive and easy to manufacture.

Access to naloxone, an antidote for overdoses, is expected to ease the
coming year.

Medical professionals and other harm-reduction advocates want
naloxone, which can reverse the effects of an opioid overdose within
minutes, to be easier to get. It is currently available only by
prescription, and only opioid users who are at risk of overdosing can
get it - even though a friend or partner of the user would likely be
the one to administer it.

Health Canada announced this summer that it would review the drug's
prescription-only status, and this week said a decision is expected in
early 2016.

"Should Health Canada's review propose to make naloxone available
without a prescription, provinces, territories, public health
authorities and manufacturers of the drug would need to take
additional steps to make it accessible for safe use," the federal
department said in an e-mail.

In Alberta, fentanyl was linked to more than 200 fatal overdoses in
2015, prompting calls for the province to clear any hurdles that
prohibit first-responders from administering naloxone.

U.S. states such as Kentucky and Ohio announced this year that
pharmacists there would be able to dispense naloxone without a
prescription; New York City announced three weeks ago that it would
follow suit.

Meanwhile, Nanaimo Regional General Hospital announced this month that
its emergency department is now the third in B.C. to offer take-home
naloxone kits to patients seen for opioid-related medical emergencies.
St. Paul's Hospital in Vancouver and Royal Inland Hospital in Kamloops
also distribute the drug to patients identified as a possible risk of
opioid overdose.

B.C.'s pilot take-home naloxone program, now in its third year, has
also been credited with reversing hundreds of overdoses.

As of November, about 5,000 people have been trained to administer
naloxone, 4,000 kits have been provided and more than 325 overdoses
are reported to have been treated under the initiative, said Jane
Buxton, head of the B.C. Centre for Disease Control's harm reduction
office.
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