Pubdate: Mon, 11 Jul 2016
Source: Hamilton Spectator (CN ON)
Copyright: 2016 The Hamilton Spectator
Contact:  http://www.thespec.com/
Details: http://www.mapinc.org/media/181
Author: Molly Hayes
Page: A1

OPIOID ANTIDOTE NOW EASIER TO ACCESS

Ontario makes overdose-blocking naloxone available at pharmacies for
users and their families

For the first time in Ontario, family and friends of opioid users will
be able to pick up naloxone kits for free from pharmacies.

In the midst of what they're calling an opioid crisis, local
addictions experts are thrilled with recent undertakings by the
province to make a life-saving opioid antidote more accessible to
those at risk of overdose.

Previously available only by prescription and through public health
unit programs, kits with injectable naloxone - which blocks the
effects of opioids to reverse the effects of an overdose - will now be
available free at Ontario pharmacies, and will also be offered to
anyone being discharged from a provincial corrections facility -
including the Barton Street Jail.

It's a "logical and evidence-based" step, Dr. Fiona Kouyoumdjian, a
part-time physician at the Barton Street Jail, says. "It just makes
sense."

As a public health physician at St. Michael's Hospital and McMaster
University, Kouyoumdjian was involved in two recent studies that
highlighted the heightened risk of overdose post-incarceration. In the
two weeks after someone is released from jail, they are 56 times more
likely than the general population to overdose. And in the year that
follows, they are between 12 and 14 times more likely to overdose.

With decreased access to drugs in jail, tolerance is lowered. The risk
is that former inmates go back to using the same amount they used to
use before incarceration, and their bodies won't be able to handle
it.

The distribution of naloxone kits to those getting out of jail is a
move that addictions experts - including the Municipal Drug Strategy
Coordinators' Network of Ontario (MDSCNO) and the Association of Local
Public Health Agencies - have long been calling for.

"I guarantee lives will be saved," Michael Parkinson, a member of the
MDSCNO, says of the increased access.

In Scotland, for example, a similar national naloxone program, which
provides discharged inmates with a kit, has cut its fatality rate by
almost 50 per cent in just a few years.

It's unclear exactly how the program will actually be rolled out in
Ontario, between the Ministry of Health and Long-Term Care and the
Ministry of Community Safety and Correctional Services.

Hamilton's public health unit says they are awaiting word from the
health ministry on the parameters of the program, such as eligibility
and funding details. But out the gate, spokesperson Clorinda Pagliari
says, they are "pleased" with the announcement.

Clare Graham, press secretary to David Orazietti, Minister of
Community Safety and Correctional Services, expressed full support for
the program.

"We recognize that those admitted to the correctional system with
complex, social, medical, and behavioural needs require our support,"
she said.

"Doctors and other medical professionals will also continue to work
with inmates while in custody to provide withdrawal counselling and
access to drug replacement therapies, such as methadone and suboxone,
to reduce overdoses among discharged inmates."

Kouyoumdjian stresses the importance of consulting inmates and those
with lived addictions experience as part of the implementation
process, and hopes that this will lead to more engagement
opportunities to prevent overdoses behind bars.

Pharmacists are similarly hopeful about increasing dialogue with
clients, now that naloxone kits are available for free without
prescription.

Pharmacist Kathleen Leach, at Sutherland's Pharmacy on James Street
South in Hamilton, says she has already had inquiries from clients who
are actively using opioids, and she welcomes the opportunity to have
conversations about the kits with other clients down the road.

"Certainly if I saw somebody on large doses of narcotics, or who were
routinely taking them, then I might have a conversation with them
about keeping a kit in the home," Leach says.

She has signed up for the mandatory training through the Ontario
Pharmacists Association, and expects she will be ready to dispense
kits in a week or so.

Pharmacies will be reimbursed $70 for the kits, the dispensing and the
training.

One hurdle, Leach says, is that pharmacists have to source the kit
components themselves, and some mechanical parts may be difficult to
track down. She expects some pieces will be available for purchase
only in bulk - in quantities far larger than she'll need.

But she acknowledges there is a certain level of "public service" in
carrying the kits.

She also expressed concern that the reimbursement process requires
pharmacists to track the names of those who receive kits, which she
says could be a barrier to some people because of the stigma
surrounding opioid use.

But for the first time, you don't have to be a user yourself to get a
kit. Friends and family of those at risk of overdose are also able to
walk in and pick one up. Leach says this is crucial. The MDSCNO's
Parkinson agrees. "An opioid (overdose) victim cannot save
themselves," he says.
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MAP posted-by: Matt