Pubdate: Tue, 13 Feb 2018
Source: Recorder & Times, The (CN ON)
Copyright: 2018 Recorder and Times
Contact: http://www.recorder.ca/letters
Website: http://www.recorder.ca/
Details: http://www.mapinc.org/media/2216
Author: Wayne Lowrie
Page: A1

LOCALS FACE DRUG DILEMMA

Municipal governments across Leeds and Grenville have been grappling
with the question of whether or not their volunteer firefighters
should carry naloxone kits to treat patients who overdose on opioids.

And they have been coming up with different answers.

In the Township of Leeds and the Thousand Islands, for example, the
council has voted to supply the lifesaving antidote to its
firefighters and have them trained in its use.

Likewise in the Town of Gananoque where both its firefighters and
police officers have access to the kits and know how to use them.
Mayor Erika Demchuk said her town's police and fire departments have
carried the kits for months, both for their own protection and that of
the public.

But Edwardsburgh/Cardinal has adopted the opposite stance. Its council
decided to reject the carrying of the kits on the advice of its fire
chief.

Similarly, the volunteer firefighters of Elizabethtown-Kitley have
decided they don't want to administer naloxone and they have sent that
recommendation to township council.

The last two municipalities are bucking a trend to see the drug more
available in Ontario. The province now distributes the drug kits free
to fire departments that agree to participate in the Ontario Naloxone
Program. In fact, naloxone is now offered free to the public at many
drug stores, both local school boards have the kits in schools and the
City of Kingston recently decided to put naloxone in its public
buildings alongside the defibrillators.

Chris Lloyd, chief of the counties' paramedic service, said the
provincial health ministry and the fire marshal's office have been
pressuring all first responders, including volunteer fire departments,
to carry the kits and be trained in how to administer naloxone.

Lloyd said his department supports the idea that volunteer first
responders carry naloxone, adding that EMS will work with any
volunteer fire services that want to enter the program.

All counties ambulances carry naloxone and its paramedics are trained
in its use, Lloyd said. But in rural Leeds and Grenville, volunteer
firefighters are often first on the scene at medical calls. Their
ability to administer the drug could enhance the chances of saving a
life, he said.

First responders often don't know whether or not an unconscious
patient has been using opioids because callers don't want to say for
fear of getting police involved, he said. But Lloyd said naloxone
poses no danger to people who are unconscious for other reasons. The
drug merely helps overdosed patients to breathe, he said.

He added much of the training is to teach first responders how to deal
with patients once they become conscious. Overdosed patients sometimes
will wake up angry that the first responders have ruined their
pleasant high and become violent, he said. Or they will become sick
and vomit.

Lloyd said that first responders without naloxone know to continue
ventilation and CPR until EMS arrives with the drug.

Rideau Lakes Mayor Ron Holman, who chairs the Rural Ontario Municipal
Association, said the naloxone debate is not unique to Leeds and
Grenville. Municipalities across Ontario have struggled with the same
issues and come up with different answers, Holman said.

Some volunteer firefighters say they signed up to protect their
neighbours from fires, not to respond to medical calls and drug
overdoses, he said. Other municipalities give the kits to protect
their first responders from accidental exposure to opioids, not to
administer to the public.

He urged municipal councils to look at liability issues before
deciding on naloxone. For example, could a municipality be liable if
it decided not to carry the kits and a resident died? Or what if they
carry kits for their own use but fail to save the life of an
unconscious person? Or what if a first responder mistakenly
administers the wrong drug, resulting in death?

Holman said the municipalities should look at all of these questions
before deciding on whether to join the naloxone program or not.

Lloyd said the United Counties of Leeds and Grenville so far have
dodged the opioid overdose epidemic that has swept the country.

In Ontario from May to July 2017, there were 336 opioid-related
deaths, which represents a 68-percent increase over the some period in
2016, he said.

There were no deaths in Leeds and Grenville during the same period,
Lloyd said. Local paramedics did respond to 14 drug overdose calls and
they administered naloxone nine times. In five of those cases,
firefighters were on the scene as well, he said.

Five of the calls were for Brockville while the others were scattered
among Edwardsburgh/ Cardinal, Augusta, Prescott, Merrickville and
Athens, said Lloyd.
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MAP posted-by: Matt