Pubdate: Wed, 13 Jul 2016
Source: Kingston Whig-Standard (CN ON)
Copyright: 2016 Sun Media
Author: Victoria Gibson
Page: A1


"We're talking about hundreds of deaths," Justine McIsaac lamented.

For the past year, McIsaac has been on the front lines of Canada's
opiate crisis, as an outreach worker for the Street Health Centre. The
hundreds of lives lost, she explained, go beyond the city's
boundaries, extending not just across the province but across the country.

Last week, an announcement was made by Federal Health Minister Jane
Philpott regarding the opiate crisis. Philpott signed an interim order
to temporarily allow naloxone - a critical overdose-reversing drug -
to be imported and sold in spray form across Canada.

McIsaac is hopeful that the order makes a difference in Kingston,
where the issue has hit hard.

"We've always been known to be kind of an amphetamine, methamphetamine
town," she said. However, over the past few years, she said, the
clinic has seen prescription opiate use blow up on the city's streets.

Three years ago, when the Oxycontin was taken off the Ontario Drug
Benefit Program, there was a shift towards usage of crystal
methamphetamine. All of a sudden, she said, the past year saw an
overwhelming spike in the use of heroin, fentanyl patches and

"Which has increased a serious amount of overdoses in our community,"
she said.

In September, the clinic launched its naloxone program, "and I swear
to God, it couldn't have come at a better time," she explained. Lethal
cocktails of drugs, such as heroin cut with fentanyl, were appearing
on Kingston's streets. Overdose kits were needed at an alarming rate.

"From the last week of January to March, we had our kit used, I think,
15 times on the street, which reversed all of these overdoses that
could have been deaths," she said. Over the past week alone, two kits
were administered within the city.

"To really shine a light on it, I trained an individual, and not even
45 minutes later she used her kit on her boyfriend, who was overdosing
on fentanyl."

However, many users shied away from the antidote kits because of the
injection element. Prior to Wednesday, the only way to legally
administer naloxone was via intermuscular needle.

McIsaac explained that the inter-nasal spray is, in a sense, more
user-friendly. As well, she pointed out its potential to reduce
syringe-related injury and incidents on the streets. However, other
hurdles remain for the antidote program, particularly through its
funding model. The program in Kingston is funded through the Hepatitis
C Secretariat, and requires that only those with a known history of
using opiates can receive kits.

"It makes it hard, you know? If somebody's parent comes in and says,
'my child is using opiates, I'm scared that they're going to
overdose,' I don't have the means to train them," she admitted.

In that circumstance, she said that she would do whatever she could,
encouraging the parent to come in with their child so the child could
be trained and the parent could learn by proxy what to do in case of
an overdose.

However, the prescription still needed to be written in the child's
name. McIsaac brightened when speaking to possible changes coming
"down the pipeline" with regards to that restriction.

On March 22, Health Canada removed naloxone from its Prescription Drug
List, and, as of June 24, the drug was made available in pharmacies
across Ontario, without a prescription and at no cost to "eligible

The provincial change came after a ruling by the National Association
of Pharmacy Regulatory Authorities, which reclassified naloxone as a
Schedule II drug in emergency overdose situations outside of a hospital.

With this change, family members or concerned friends will be able to
obtain the kit, and proper training on how to use it, through their
local pharmacy. As well, McIsaac hopes the nasal spray option "opens
the door" for potential first responder or police use of the drug.

According to Const. Steve Koopman and Sgt. Greg Sands of the Kingston
Police, while their officers don't currently supply or administer
naloxone - they're awaiting ministry guidelines and approval -
Kingston Police routinely supports such initiatives that have the
potential to save lives.

"Especially if the process and its administration is made simpler,"
Koopman wrote in an email.

Following Wednesday's order, the drug will be temporarily imported
from the United States. According to McIsaac, it's a big step for a
"super-sensitive matter."

"Unfortunately, society struggles with understanding addiction and
mental health," she said. "It's almost like there's a cost on people's

No matter what anyone's life situation is, she said, their lives

"No matter what. We, as a community, need to take responsibility and
take care of our own."
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