Pubdate: Tue, 01 Mar 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: Justin Giovannetti
Page: A3

FENTANYL ANTIDOTE NOT ON ALBERTA RESERVES

While naloxone kits are available in pharmacies and walk-in clinics 
across the province, only four are in First Nations communities

The Alberta government's primary response to a surge in deaths from 
the drug fentanyl last year has been to make free antidote kits 
available across the province, however doctors warn that many 
aboriginal communities are still struggling to access the potentially 
life-saving kits.

With 272 overdose deaths from fentanyl in Alberta last year, double 
the previous year's total, the size of the province's program for the 
distribution of an antidote known as naloxone has expanded rapidly 
over the past three months. Alberta Health has more than doubled its 
purchase of the kits to 7,000 and has made them freely available in 
pharmacies since Feb. 17.

While the antidote is now available in more than 300 pharmacies and 
walk-in clinics across Alberta, only four kits are located on 
reserves, according to data from the provincial government. Health 
Canada, which helps provide care on reserves, confirmed with The 
Globe and Mail that no nurses employed by the federal government are 
currently certified to prescribe or administer naloxone.

"Health Canada nursing services have been focused on education and 
awareness and harm-reduction activities as needed. There are no 
Health Canada nurses currently certified but the department is 
working closely with communities to assess needs," wrote Sylwia 
Krzyszton, a spokeswoman for Health Canada.

By comparison, 1,600 emergency medical technicians working for the 
province of Alberta were trained to administer naloxone by early January.

The Blood Tribe declared a state of emergency in March, 2015, as 
deaths from fentanyl soared in the community. Health Canada responded 
by sending naloxone kits to the First Nation and provided $200,000 in 
emergency funding.

"They were really slow initially to help," Dr. Esther Tailfeathers, a 
physician based out of the Blood Tribe, said of Health Canada's 
response to the emerging fentanyl crisis in 2015. "And we haven't had 
much since they first responded. It's mostly been Alberta Health with 
the naloxone kits."

According to Dr. Tailfeathers, while Health Canada could do more in 
her community, the sense of urgency with which the federal government 
first responded to the Blood Tribe should be replicated across the 
province. Health Canada, which serves 75,000 on-reserve First Nations 
members in Alberta, is currently working with 17 of the province's 45 
First Nations to develop a plan to combat fentanyl.

"It might be time-consuming and costly, but Health Canada should take 
Blood Tribe as an example for what they should do," she said.

Alberta Health Minister Sarah Hoffman says she sent letters to all of 
Alberta's chiefs this summer, seeking their input and giving them 
information on how to access kits for their reserves if needed. 
According to her, the fentanyl crisis is still growing in her 
province and Health Canada has been a good partner.

"Their heart is in the right place," she said of Health Canada's 
approach so far. "I know that there is a history of jurisdictional 
challenges; I'm not interested in talking about who has what 
responsibilities. "We need to help people now." Fentanyl was 
developed to treat extreme pain, and is 100 times more potent than 
morphine in its legal form. However, a dose as small as two grains of 
sand can be lethal. Many of the pills seized on the streets of 
Alberta's largest cities over the past year were manufactured by 
organized crime and were found to contain far more than the lethal dose.

Fentanyl is fast-acting and can create a sense of euphoria, but can 
also cause users to experience breathing problems and die within 15 
minutes of consuming the drug. Naloxone is an antidote that can 
reverse the symptoms of a fentanyl overdose within minutes, but it 
must be administered quickly.

While a user still needs to seek medical attention, the antidote can 
buy them time to reach a health centre. Naloxone is currently 
available only by prescription; however, Health Canada has been asked 
to change that designation.
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MAP posted-by: Jay Bergstrom