Pubdate: Sat, 20 May 2017
Source: Edmonton Journal (CN AB)
Copyright: 2017 The Edmonton Journal
Author: Catherine Griwkowsky
Page: A3


Provinces chief medical officer calls for heightened efforts amid
deepening crisis

Alberta's top doctor is calling for expanded efforts to combat a high
number of opioid deaths as health officials released a new report on
fentanyl overdoses Friday.

"We need to continue our efforts to decrease the number of overdoses
that we're seeing due to fentanyl and other opioids," said Dr. Karen
Grimsrud, the province's chief medical officer of health, following
the release of Alberta Health's Opioids and Substances of Misuse
report on Friday.

"Our first quarter of this year is approximately the same as what we
saw last quarter," she said in an interview. "We may be seeing a
levelling off, but we really can't say at this point for sure. But the
numbers, regardless, are high still."

The numbers may seem about the same, with 119 deaths in the fourth
quarter of last year compared to 113 people who died of a fentanyl
overdose in the first quarter of 2017. But that number is about a 61
per cent increase from 70 deaths in the first quarter of 2016.

"There's not one simple answer to it - it's not one simple population
to it, either," Grimsrud said. "We know we have in the inner city
vulnerable, chronically addicted, sometimes homeless people. Fentanyl
is now more easily accessible and there's the issue of overdosing
easily because of its toxicity.

"We also have outside the downtown core, in Edmonton and Calgary,
we're seeing a large number of deaths due to fentanyl. They may not
have addiction problems and it may be more recreational use. We're
trying to do a more indepth look at all of our deaths to try to
understand that piece better."

Alberta Liberal Party Leader Dr. David Swann, a physician, renewed his
plea to declare a state of emergency in the province and to bring back
the position of chief addictions and mental health officer.

"I am also troubled by the manner in which this report was made
available. As was the case with the interim report, I find it highly
disrespectful to concerned Albertans to release such important
information without formal commentary from the minister on a Friday
afternoon, and, in this case, just ahead of a long weekend," Swann
said in an emailed statement on Friday.

"It hints at an NDP government that is more concerned about biding its
time, protecting its political skin, and avoiding accountability for a
crisis that it clearly does not have a handle on despite its best efforts."

The rate of emergency department visits due to fentanyl and opioid
overdoses has been increasing by an average of six per cent per
quarter to 2016 from 2014, up 23 per cent from the first quarter.

Of fentanyl overdose deaths, 80 per cent are males, with the largest
group being otherwise-healthy 30 to 34-year-olds. In non-fentanyl
opioid deaths, the proportion of women is higher than the percentage
of female fentanyl deaths. There is also a broader age range.

"Someone who may be an opioid death, they may have a more complex
medical history, chronic pain or other chronic illnesses," Grimsrud
said, adding the medical examiner may take longer to confirm the cause
of death.

Carfentanil deaths are included in statistics of fentanyl deaths. In
the first quarter, there were 21 carfentanil overdose deaths.

For the first time, the office is reporting multi-drug

"We just want to get a complete picture to make sure we understand
what is happening," she said.

Grimsrud said the report does not include the numbers of


"A big piece we will need to continue our efforts on is the opioid
replacement therapy, making that available to people who are
interested in coming off drugs if they have an addiction issue," she

Pharmacists are a potential point of intervention, given that about
half of people who died of an overdose interacted with pharmacists in
the 30 days before their death. At that point, pharmacists can talk
about naloxone kits, for example.

But there are positive signs in the report.

More people are accessing naloxone kits and opioid replacement
therapies, including methadone and suboxone.

"That is encouraging," Grimsrud said. "That means more people
receiving treatment for their dependency on opioids."

The fact that take-home naloxone kits are available free of charge is
a good step, but they should be available in more places, she said.

The changed legislation to allow first responders to administer
naloxone is positive, but it should also be more widely available, she
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